Colorectal cancer screening, perceived discrimination, and low-income and trust in doctors: a survey of minority patients

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Bhattacharya Shelley B

2009-09-01

Full Text Available Abstract Background Completion of colorectal cancer (CRC screening testing is lower among low-income and minority groups than the population as a whole. Given the multiple cancer screening health disparities known to exist within the U.S., this study investigated the relationship between perceived discrimination, trust in most doctors, and completion of Fecal Occult Blood Testing (FOBT among a low-income, minority primary care population in an urban setting. Methods We recruited a convenience sample of adults over age 40 (n = 282 from a federally qualified community health center (70% African American. Participants completed a survey which included measures of trust in most doctors, perceived discrimination, demographics and report of cancer screening. Results Participants reported high levels of trust in most doctors, regardless of sex, race, education or income. High trust was associated with low perceived discrimination (p Conclusion Perceived discrimination was related to income, but not race, suggesting that discrimination is not unique to minorities, but common to those in poverty. Since trust in most doctors trended toward being related to age, FOBT screening could be negatively influenced by low trust and perceived discrimination in health care settings. A failure to address these issues in middle-aged, low income individuals could exacerbate future disparities in CRC screening.

Income, income inequality and youth smoking in low- and middle-income countries.

Science.gov (United States)

Li, David X; Guindon, G Emmanuel

2013-04-01

To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Health-related quality-of-life in low-income, uninsured men with prostate cancer.

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Krupski, Tracey L; Fink, Arlene; Kwan, Lorna; Maliski, Sally; Connor, Sarah E; Clerkin, Barbara; Litwin, Mark S

2005-05-01

The objective was to describe health-related quality-of-life (HRQOL) in low-income men with prostate cancer. Subjects were drawn from a statewide public assistance prostate cancer program. Telephone and mail surveys included the RAND 12-item Health Survey and UCLA Prostate Cancer Index Short Form and were compared with normative age-matched men without cancer from the general population reported on in the literature. Of 286 eligible men, 233 (81%) agreed to participate and completed the necessary items. The sample consisted of 51% Hispanics, 23% non-Hispanic whites, and 17% African Americans. The low-income men had worse scores in every domain of prostate-specific and general HRQOL than had the age-matched general population controls. The degree of disparity indicated substantial clinical differences in almost every domain of physical and emotional functioning between the sample group and the control group. Linear regression modeling determined that among the low-income men, Hispanic race, and income level were predictive of worse physical functioning, whereas only comorbidities predicted mental health. Low-income patients with prostate cancer appear to have quality-of-life profiles that are meaningfully worse than age-matched men from the general population without cancer reported on in the literature.

Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations

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K Michael Hambidge

2017-07-01

Full Text Available Abstract Background Maternal stature and body mass indices (BMI of non-pregnant women (NPW of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC. Methods Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m2 was calculated. Z-scores were determined using WHO reference data. Results A total of 7268 NPW participated in Equateur, DRC (n = 1741; Chimaltenango, Guatemala (n = 1695; North Karnataka, India (n = 1823; and Thatta, Sindh, Pakistan (n = 2009. Mean age was 23 y and mean parity 1.5. Median (P25-P75 height (cm ranged from 145.5 (142.2–148.9 in Guatemala to 156.0 (152.0–160.0 in DRC. Median weight (kg ranged from 44.7 (39.9–50.3 in India to 52.7 (46.9–59.8 in Guatemala. Median BMI ranged from 19.4 (17.6–21.9 in India to 24.9 (22.3–28.0 in Guatemala. Percent stunted (<−2SD height for age z-score ranged from 13.9% in DRC to 80.5% in Guatemala; % underweight (BMI <18.5 ranged from 1.2% in Guatemala to 37.1% in India; % overweight/obese (OW, BMI ≥25.0 ranged from 5.7% in DRC to 49.3% in Guatemala. For all sites, indicators for higher SES and higher age were associated with BMI. Lower SES women were underweight more frequently and higher SES women were OW more frequently at all sites. Younger women tended to be underweight, while older women tended to be OW. Conclusions Anthropometric data for NPW varied widely among low-income rural populations in four countries located on three different continents. Global comparisons of anthropometric measurements across sites using standard reference data serve to highlight major differences among populations of low-income rural NPW and assist in evaluating the rationale for and the design of optimal

A qualitative study of the aspirations and challenges of low-income mothers in feeding their preschool-aged children

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Herman Allison N

2012-11-01

Full Text Available Abstract Background The prevalence of obesity among preschool-aged children has increased, especially among those in low-income households. Two promising behavioral targets for preventing obesity include limiting children’s portion sizes and their intake of foods high in solid fats and/or added sugars, but these approaches have not been studied in low-income preschoolers in the home setting. The purpose of this study was to understand the contextual factors that might influence how low-income mothers felt about addressing these behavioral targets and mothers’ aspirations in feeding their children. Methods We recruited 32 English-speaking women in Philadelphia, Pennsylvania who were eligible for the Supplemental Nutrition Assistance Program and who were the biologic mothers of children 36 to 66 months of age. Each mother participated in 1 of 7 focus groups and completed a brief socio-demographic questionnaire. Focus group questions centered on eating occasions, foods and drinks consumed in the home, and portion sizes. Each focus group lasted 90 minutes and was digitally recorded and transcribed verbatim. Three authors independently identified key themes and supporting quotations. Themes were condensed and modified through discussion among all authors. Results Thirty-one mothers identified themselves as black, 15 had a high school education or less, and 22 lived with another adult. Six themes emerged, with three about aspirations mothers held in feeding their children and three about challenges to achieving these aspirations. Mothers’ aspirations were to: 1 prevent hyperactivity and tooth decay by limiting children’s sugar intake, 2 use feeding to teach their children life lessons about limit setting and structure, and 3 be responsive to children during mealtimes to guide decisions about portions. Especially around setting limits with sweets and snacks, mothers faced the challenges of: 1 being nagged by children’s food requests, 2 being

Tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years: data from 68 low-income and middle-income countries.

Science.gov (United States)

Xi, Bo; Liang, Yajun; Liu, Yunxia; Yan, Yinkun; Zhao, Min; Ma, Chuanwei; Bovet, Pascal

2016-11-01

Tobacco use is an important risk factor for non-communicable diseases worldwide. However, the global extent and prevalence of tobacco use in adolescents is poorly described. Using previously collected survey data, we aimed to assess tobacco use and second-hand smoke exposure in young adolescents aged 12-15 years in 68 low-income and middle-income countries. We used data from the Global School-based Student Health Survey (2006-13) and the China Global Tobacco Youth Survey (2013), which are school-based surveys of young adolescents aged 12-15 years that assess health behaviours using a standardised, anonymous, self-reported questionnaire. We calculated the prevalence of current tobacco use and exposure to second-hand smoke in young adolescents from 68 low-income and middle-income countries that collected these data in the surveys. We used a multilevel model to estimate the association between parental tobacco use, second-hand smoke, and adolescent tobacco use, adjusting for sex, age, school, school class, country's purchasing power parity, smoking initiation age, national prevalence of tobacco use among adults, year the WHO FCTC was ratified for each country, proxy of socioeconomic status, and survey year. The mean prevalence of current tobacco use was 13·6%, ranging from 2·8% in Tajikistan to 44·7% in Samoa. In most countries, the prevalence of tobacco use was higher for boys than girls, and higher for adolescents aged 14-15 years than for those aged 12-13 years. The overall prevalence of second-hand smoke exposure was 55·9%, ranging from 16·4% in Tajikistan to 85·4% in Indonesia. Parental tobacco use (as reported by the young adolescents), especially maternal use, was associated with tobacco use in young adolescents (odds ratio 2·06, 95% CI 1·93-2·19, for maternal and 1·29, 1·23-1·35 for paternal use). Second-hand smoke exposure was also a risk factor for young adolescents' tobacco use (2·56, 2·43-2·69). However, the prevalence of tobacco use was not

Narrowing the Early Mathematics Gap: A Play-Based Intervention to Promote Low-Income Preschoolers’ Number Skills

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Nicole R. Scalise

2018-01-01

Full Text Available Preschoolers from low-income households lag behind preschoolers from middle-income households on numerical skills that underlie later mathematics achievement. However, it is unknown whether these gaps exist on parallel measures of symbolic and non-symbolic numerical skills. Experiment 1 indicated preschoolers from low-income backgrounds were less accurate than peers from middle-income backgrounds on a measure of symbolic magnitude comparison, but they performed equivalently on a measure of non-symbolic magnitude comparison. This suggests activities linking non-symbolic and symbolic number representations may be used to support children’s numerical knowledge. Experiment 2 randomly assigned low-income preschoolers (Mean Age = 4.7 years to play either a numerical magnitude comparison or a numerical matching card game across four 15 min sessions over a 3-week period. The magnitude comparison card game led to significant improvements in participants’ symbolic magnitude comparison skills in an immediate posttest assessment. Following the intervention, low-income participants performed equivalently to an age- and gender-matched sample of middle-income preschoolers in symbolic magnitude comparison. These results suggest a brief intervention that combines non-symbolic and symbolic magnitude representations can support low-income preschoolers’ early numerical knowledge.

“YOU GET ANGRY INSIDE YOURSELF”: LOW-INCOME ADOLESCENT SOUTH AFRICAN GIRLS’ SUBJECTIVE EXPERIENCE OF DEPRESSION

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Meyer, Karin

2015-09-01

Full Text Available Informed by the feminist social constructionist approach this study aimed at exploring the subjective experiences of depression of low-income South African adolescent girls. Participants in this study (girls between the ages of 12 and 14 live in a semi-rural low-income coloured community in the Western Cape. Participants were familiar with the concept of depression, but it seemed that for them the central emotion associated with depression was anger, which often manifested in destructive behaviours. Furthermore, participants seemed to construct depression as a relational problem, suggesting that psychotherapy may be indicated as an important intervention strategy.

Maternal Characteristics Associated with Television Viewing Habits of Low-Income Preschool Children

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Conners, Nicola A.; Tripathi, Shanti P.; Clubb, Richard; Bradley, Robert H.

2007-01-01

Few studies have examined maternal characteristics associated with heavy or inappropriate television viewing on the part of their children. We investigated the relationship between children's television viewing habits and maternal depressive symptoms and parenting beliefs. The participants were 175 low income children (mean age = 62.1 months) and…

42 CFR 435.229 - Optional targeted low-income children.

Science.gov (United States)

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 in...

Role of expendable income and price in food choice by low income families.

Science.gov (United States)

Burns, Cate; Cook, Kay; Mavoa, Helen

2013-12-01

The public health literature suggests that the cheapness of energy-dense foods is driving the obesity epidemic. We examined food purchases in low-income families and its relationship to the price of food and availability of funds. In-depth interviews were conducted with 22 parents with children less than 15 years of age whose major source of income was a government pension. A photo taxonomy, where participants sorted 50 photos of commonly purchased foods, was used to explore food choice. The most common food groupings used by the participants were: basic, emergency, treat and comfort. The process of food purchase was described by participants as weighing up the attributes of a food in relation to price and money available. Shoppers nominated the basic unit of measurement as quantity per unit price and the heuristic for food choice when shopping as determining "value for money" in a process of triage relating to food purchase decisions. Participants stated satiation of hunger to be the most common "value" relative to price. Given that the foods nominated as filling tended to be carbohydrate-rich staples, we suggest that public health initiatives need to acknowledge this triage process and shape interventions to promote nutrition over satiation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific.

Science.gov (United States)

Petersen, Solveig; Swinburn, Boyd; Mavoa, Helen; Fotu, Kalesita; Tupoulahi-Fusimalohi, Caroline; Faeamani, Gavin; Moodie, Marjory

2014-01-01

Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children's perception of their health-related quality of life (HRQoL) and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries. To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region. A cross-sectional study from Tonga addressing all secondary schoolchildren (11-18 years old) on the outer island of Vava'u and in three districts of the main island of Tongatapu (2,164 participants). A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji). A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants). HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0. HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen's d 1.0) and a small difference between Tonga and the lower income country Fiji (Cohen's d 0.3). The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen's d 0.6). The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

Low health-related quality of life in school-aged children in Tonga, a lower-middle income country in the South Pacific

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Solveig Petersen

2014-08-01

Full Text Available Background: Ensuring a good life for all parts of the population, including children, is high on the public health agenda in most countries around the world. Information about children's perception of their health-related quality of life (HRQoL and its socio-demographic distribution is, however, limited and almost exclusively reliant on data from Western higher income countries. Objectives: To investigate HRQoL in schoolchildren in Tonga, a lower income South Pacific Island country, and to compare this to HRQoL of children in other countries, including Tongan children living in New Zealand, a high-income country in the same region. Design: A cross-sectional study from Tonga addressing all secondary schoolchildren (11–18 years old on the outer island of Vava'u and in three districts of the main island of Tongatapu (2,164 participants. A comparison group drawn from the literature comprised children in 18 higher income and one lower income country (Fiji. A specific New Zealand comparison group involved all children of Tongan descendent at six South Auckland secondary schools (830 participants. HRQoL was assessed by the self-report Pediatric Quality of Life Inventory 4.0. Results: HRQoL in Tonga was overall similar in girls and boys, but somewhat lower in children below 15 years of age. The children in Tonga experienced lower HRQoL than the children in all of the 19 comparison countries, with a large difference between children in Tonga and the higher income countries (Cohen's d 1.0 and a small difference between Tonga and the lower income country Fiji (Cohen's d 0.3. The children in Tonga also experienced lower HRQoL than Tongan children living in New Zealand (Cohen's d 0.6. Conclusion: The results reveal worrisome low HRQoL in children in Tonga and point towards a potential general pattern of low HRQoL in children living in lower income countries, or, alternatively, in the South Pacific Island countries.

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

Science.gov (United States)

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, environm...

Resource handbook for low-income residential retrofits

Energy Technology Data Exchange (ETDEWEB)

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.

Patient participation in free cataract surgery: a cross-sectional study of the low-income elderly in urban China.

Science.gov (United States)

Lin, Haotian; Lin, Duoru; Long, Erping; Jiang, Haofeng; Qu, Bo; Tang, Jinzhu; Lin, Yingfen; Chen, Jingjing; Wu, Xiaohang; Lin, Zhuoling; Li, Xiaoyan; Liu, Zhenzhen; Zhang, Bo; Chen, Hui; Tan, Xuhua; Luo, Lixia; Liu, Yizhi; Chen, Weirong

2016-04-15

To explore the characteristics of the low-income elderly who underwent free cataract surgery and to determine the degree of patient satisfaction with the free cataract surgery programme in urban China. A free cataract surgery management workflow was designed as a poverty relief project in Guangzhou. In this study, participants who underwent free cataract surgery between January and August 2014 received a telephone interview based on a structured questionnaire. Data were collected on patient demographics, resources, health conditions, reasons for undergoing the free surgery and overall evaluation of the free cataract surgery programme. Among the 833 participants, the mean surgical age was 76.85±7.46 years (95% CI 76.34 to 77.36), and the male to female ratio was 385:448. The majority (94.31%, 746/791) of patients resided in the main urban districts. Patients underwent surgery 61.08±60.15 months (95% CI 56.17 to 66.00) after becoming aware of the cataract, although 66.83% of them reported that their daily lives were influenced by cataracts. Only 21.5% of the respondents underwent physical examinations that included regular eye screening, and only 6.30% were highly educated patients. Financial problems were the primary reason cited by patients for participating in the free surgery programme. Those patients with a monthly family income of 1000-2999¥ (US$161-482) per capita constituted the largest patient population. The free clinics in the parks and the free cataract surgery were highly rated (9.46 and 9.11 of 10 points) by the beneficiaries. The telephone survey revealed a high level of patient satisfaction regarding the free cataract surgery programme. Most of the patients who participated in the programme resided in major urban districts and had poor health awareness and a low level of education. The information provided by this study is crucial for improving and expanding the management of free cataract surgery programmes. NCT02633865; Post

Household expenditure for dental care in low and middle income countries.

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Mohd Masood

Full Text Available This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries who participated in the WHO World Health Survey (WHS were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries.

Does a low-income urban population practise healthy dietary habits?

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Azizan, Nurul Ain; Thangiah, Nithiah; Su, Tin Tin; Majid, Hazreen Abdul

2018-03-01

The purpose of this study was to identify the unhealthy dietary habits and practices in a low-income community in an urban area and determine the associated factors. A cross-sectional survey was conducted in a low-income housing area in Kuala Lumpur, Malaysia. Data were collected using a questionnaire via face-to-face interviews by trained enumerators in order to obtain details on sociodemographic characteristics and dietary practices. Descriptive statistics showed that 86.7% of the respondents in the low-income community consumed fruit and vegetables less than five times per day, 11.7% consumed carbonated and sweetened drinks more than twice per day and about 25% consumed fast food more than four times per month. In total, 65.2% (n=945) did not have healthy dietary practices. Binary logistic regression showed that age, education and ethnicity were significant predictors of unhealthy dietary practices among the low-income community. Those in the 30-59 years age group had higher odds (odds ratio 1.65, p=0.04) of practising an unhealthy diet as compared with those older than 60 years of age. Unhealthy dietary practices were found to be common among the low-income group living in an urban area. Healthy lifestyle intervention should be highlighted so that it can be adopted in the low-income group.

Who is affected by neighbourhood income mix? gender, age, family, employment and income differences

NARCIS (Netherlands)

Galster, G.; Andersson, R.; Musterd, S.

2010-01-01

This paper analyses the degree to which the mixture of low-, middle- and high-income males in the neighbourhood affects the subsequent earnings of individuals, and aims to test explicitly the degree to which these impacts vary across gender, age, presence of children, employment status or income at

Suppressor Effects in Coping Research with African American Adolescents from Low-Income Communities

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Gaylord-Harden, Noni K.; Cunningham, Jamila A.; Holmbeck, Grayson N.; Grant, Kathryn E.

2010-01-01

Objective: The purpose of the current study was to demonstrate the replicable nature of statistical suppressor effects in coping research through 2 examples with African American adolescents from low-income communities. Method: Participants in the 1st example included 497 African American adolescents (mean age = 12.61 years, SD = 0.99; 57% female)…

42 CFR 436.229 - Optional targeted low-income children.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Optional targeted low-income children. 436.229... Options for Coverage as Categorically Needy Options for Coverage of Families and Children and Aged, Blind, and Disabled Individuals, Including Pregnant Women § 436.229 Optional targeted low-income children...

Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries

DEFF Research Database (Denmark)

Kozuki, Naoko; Katz, Joanne; Lee, Anne Cc

2015-01-01

BACKGROUND: Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. OBJECTIVES: The specific aims of this study were to estimate the association between...... short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. METHODS: We conducted an individual participant data meta-analysis with the use of data sets from 12...... population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each...

Cooking Matters for Adults Improves Food Resource Management Skills and Self-confidence Among Low-Income Participants.

Science.gov (United States)

Pooler, Jennifer A; Morgan, Ruth E; Wong, Karen; Wilkin, Margaret K; Blitstein, Jonathan L

Determine the impact of Cooking Matters for Adults (CM) on food resource management (FRM) skills and self-confidence 6 months after course completion. Quasi-experimental design with nonequivalent comparison group and 6-month follow-up. Cooking Matters for Adults programs in CA, CO, ME, MA, MI, and OR. Participants in CM attending classes in April to July, 2016 (n = 332); comparison group (n = 336). Cooking Matters for Adults educated low-income adults to shop for and prepare healthy meals economically using hands-on meal preparation, facilitated discussion, and an interactive grocery store tour. Classes met for 2 hours, once a week for 6 weeks. Food resource management practices; FRM self-confidence (ie, in shopping for and preparing healthy foods on a budget); worrying that food might run out. Pearson's chi-square test and t tests identified measures associated with outcomes of interest and between-group differences. Repeated-measures linear mixed models with fixed and random effects were used to examine differences in outcomes between participants in CM and nonequivalent comparison group and to estimate the treatment effect of the program at 3 and 6 months after course completion. Six months after course completion, CM participants demonstrated improvements in all outcome measures of interest: Use of FRM practices improved (P = .002) as did FRM confidence (P < .001). Participants also worried less that food would run out before they had money to buy more (P = .03). This study demonstrated a positive impact of including FRM skills and confidence building in a nutrition education program, the effects of which could be seen for 6 months after participation in the program. Equipping low-income families with FRM skills allowed them to access healthier foods even during times of hardship. Copyright © 2017 Society for Nutrition Education and Behavior. All rights reserved.

A Preliminary Study of Low-Income African American Fathers' Play Interactions with Their Preschool-Age Children.

Science.gov (United States)

Fagan, Jay

1996-01-01

Examined play interactions of 33 low-income African American fathers with their preschool-age children in relation to the fathers' psychological characteristics, love for the child's mother, employment status, education, and coresidence with the child. The fathers' self-esteem was the best predictor of play interactions. Coresidence with the child…

The Use of Refundable Tax Credits to Increase Low-Income Children's After-School Physical Activity Level.

Science.gov (United States)

Dunton, Genevieve; Ebin, Vicki J; Efrat, Merav W; Efrat, Rafael; Lane, Christianne J; Plunkett, Scott

2015-06-01

The current study investigates the extent to which a refundable tax credit could be used to increase low-income children's after-school physical activity levels. An experimental study was conducted evaluating the effectiveness of an intervention offering a simulated refundable tax credit to parents of elementary-school-age children (n = 130) for enrollment in after-school physical activity programs. A randomized controlled design was used, with data collected at baseline, immediately following the 4-month intervention (postintervention), and 6 weeks after the end of the intervention (follow-up). Evaluation measures included (1) enrollment rate, time spent, weekly participation frequency, duration of enrollment, and long-term enrollment patterns in after-school physical activity programs and (2) moderate to vigorous physical activity. The simulated tax credits did not significantly influence low-income children's rates of enrollment in after-school physical activity programs, frequency of participation, time spent in after-school physical activity programs, and overall moderate-to-vigorous intensity physical activity at postintervention or follow-up. The use of refundable tax credits as incentives to increase participation in after-school physical activity programs in low-income families may have limited effectiveness. Lawmakers might consider other methods of fiscal policy to promote physical activity such as direct payment to after-school physical activity program providers for enrolling and serving a low-income child in a qualified program, or improvements to programming and infrastructure.

Complexity of food preparation and food security status in low-income young women.

Science.gov (United States)

Engler-Stringer, Rachel; Stringer, Bernadette; Haines, Ted

2011-01-01

This study was conducted to explore whether preparing more complex meals was associated with higher food security status. This mixed-methods, community-based study involved the use of semistructured interviews to examine the cooking practices of a group of young, low-income women in Montreal. Fifty participants aged 18 to 35 were recruited at 10 locations in five low-income neighbourhoods. Food security status was the main outcome measure and the main exposure variable, "complex food preparation," combined the preparation of three specific food types (soups, sauces, and baked goods) using basic ingredients. Low-income women preparing a variety of meals using basic ingredients at least three times a week were more than twice as likely to be food secure as were women preparing more complex meals less frequently. Women who prepared more complex meals more frequently had higher food security. Whether this means that preparing more complex foods results in greater food security remains unclear, as this was an exploratory study.

Estimates of burden and consequences of infants born small for gestational age in low and middle income countries with INTERGROWTH-21^st standard

DEFF Research Database (Denmark)

Lee, Anne Cc; Kozuki, Naoko; Cousens, Simon

2017-01-01

Objectives  To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard. Design  Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14...... birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age......  CHERG birth cohorts from 14 population based sites in low and middle income countries. Main outcome measures In low and middle income countries in the year 2012, the number and proportion of infants born small for gestational age; number and proportion of neonatal deaths attributable to small...

Food insecurity is associated with cost-related medication non-adherence in community-dwelling, low-income older adults in Georgia.

Science.gov (United States)

Bengle, Rebecca; Sinnett, Stephanie; Johnson, Tommy; Johnson, Mary Ann; Brown, Arvine; Lee, Jung Sun

2010-04-01

Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.

Developmental Trends in Self-Regulation among Low-Income Toddlers

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Raikes, H. Abigail; Robinson, JoAnn L.; Bradley, Robert H.; Raikes, Helen H.; Ayoub, Catherine C.

2007-01-01

The attainment of self-regulatory skills during the toddler years is an understudied issue, especially among low-income children. The present study used growth modeling to examine the change over time and the final status in children's abilities to self-regulate, in a sample of 2,441 low-income children aged 14 to 36 months. Positive growth in…

Gender Differences in Emotion Expression in Low-Income Adolescents Under Stress.

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Panjwani, Naaila; Chaplin, Tara M; Sinha, Rajita; Mayes, Linda C

2016-06-01

Gender roles in mainstream U.S. culture suggest that girls express more happiness, sadness, anxiety, and shame/embarrassment than boys, while boys express more anger and externalizing emotions, such as contempt. However, gender roles and emotion expression may be different in low-income and ethnically diverse families, as children and parents are often faced with greater environmental stressors and may have different gender expectations. This study examined gender differences in emotion expression in low-income adolescents, an understudied population. One hundred and seventy nine adolescents (aged 14-17) participated in the Trier Social Stress Test (TSST). Trained coders rated adolescents' expressions of happiness, sadness, anxiety, shame/embarrassment, anger, and contempt during the TSST using a micro-analytic coding system. Analyses showed that, consistent with gender roles, girls expressed higher levels of happiness and shame than boys; however, contrary to traditional gender roles, girls showed higher levels of contempt than boys. Also, in contrast to cultural stereotypes, there were no differences in anger between boys and girls. Findings suggest gender-role inconsistent displays of externalizing emotions in low-income adolescents under acute stress, and may reflect different emotion socialization experiences in this group.

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

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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…

Adverse childhood experiences of low-income urban youth.

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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.

Mammography and Pap test screening among low-income foreign-born Hispanic women in the USA

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Fernandez Maria E.

1998-01-01

Full Text Available Little is known about the factors influencing screening among low-income Hispanic women particularly among recent immigrants. A sample of 148 low-income, low-literate, foreign-born Hispanic women residing in the Washington DC metropolitan area participated in the study. The mean age of the sample was 46.2 (SD = 11.5, 84% reported annual household incomes<=$15,000. All women were Spanish speakers and had low acculturation levels. Ninety six percent had reported having a Pap smear, but 24% were not in compliance with recommended screening (Pap test within the last 3 years. Among women 40 and older, 62% had received a mammogram, but only 33% were compliant with age appropriate recommended mammography screening guidelines. Women in this study had more misconceptions about cancer than Hispanics in other studies. Multivariate logistic models for correlates of Pap test and mammography screening behavior indicate that factors such as fear of the screening test, embarrassment, and lack of knowledge influenced screening behavior. In conclusion, women in this study had lower rates of mammography screening than non-Hispanic women and lower rates of compliance with recommended Mammography and Pap test screening guidelines.

[Differences in factors associated with health checkup participation between persons with differing income levels. A cross-sectional analysis using residential taxation as a measure of household income].

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Tsukishima, Eri; Takahashi, Kyoko; Yano, Koichi; Mori, Mitsuru

2012-11-01

Health insurers in Japan are required to provide health checkups specifically designed to detect signs of metabolic syndrome. Since National Health Insurance organizations have been increasing their numbers of low-income beneficiaries, this observational study was carried out to investigate the differences between persons with differing household income levels based on the factors associated with their participation in health checkups. The data source for this study was a database of scored answers in collected, unsigned questionnaires provided by the National Health Insurance of Sapporo City. The survey was conducted in 2009, approaching 3000 beneficiaries aged 40-74 years and sampling 4 groups divided by household income and participation in the 2008 health checkup. The survey included questions about demographics, awareness of the details of the health checkup, and knowledge of lifestyle-related diseases. Valid answers from 1656 respondents were analyzed using multiple logistic regression analysis. After analyzing the level of awareness of health checkup details among subjects and its association with checkup participation, knowledge of the locations where the checkups were held showed the highest adjusted odds ratios. Multivariate logistic regression analysis showed that the following factors were associated with participation in checkups in both lower- and higher-income groups: previous and regular participation in health checkups, willingness to attend the next checkup, and status of family or friends regarding checkup participation. In addition, that a substantial out-of-pocket cost for the checkup was not levied had a significant relationship with checkup attendance in lower-income beneficiaries, while personal obligation to undergo regular health checkups regardless of the busyness of their schedules was found to have a significant relationship in higher-income beneficiaries. In addition, logistic models that excluded factors of previous and future health

Motivators of and Barriers to Engaging in Physical Activity: Perspectives of Low-Income Culturally Diverse Adolescents and Adults.

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Bragg, Marie A; Tucker, Carolyn M; Kaye, Lily B; Desmond, Frederic

2009-01-01

Obesity rates are rising in the United States, especially among low-income and racial/ethnic minority individuals. Exploring motivators and barriers relative to engaging in physical activity is imperative. The purpose of this study was to identify motivators and barriers relative to engagement in physical activity as reported by culturally diverse low-income adolescents and adults. A total of 91 adolescent (11 to 15 years of age) and adult (18 years of age or older) participants who self-identified as African American, Hispanic, or non-Hispanic White engaged in age group-, race/ethnicity-, and gender-concordant focus groups. Qualitative data analysis indicated that the motivators and barriers most commonly identified among the adolescent and adult focus groups were: social influence; time and priorities; physical environment; fun and enjoyment; inherently physical activities; weight concerns; fatigue, physical discomfort and current fitness level; and immediate positive feelings. Findings were generally similar across age group, gender and race/ethnicity. Age group-specific, gender-specific and race/ethnicity-specific motivators and barriers were related to how commonly the motivators and barriers were identified among each group. Implications for increasing physical activity among low-income culturally diverse adolescents and adults are discussed.

Readability and Understanding of Informed Consent Among Participants With Low Incomes: A Preliminary Report.

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Ittenbach, Richard F; Senft, Elizabeth C; Huang, Guixia; Corsmo, Jeremy J; Sieber, Joan E

2015-12-01

With passage and implementation of the Affordable Health Care Act, more vulnerable segments of the U.S. population will now have access to regular health care and increased opportunities to participate in biomedical research. Yet, access to new groups brings with it new responsibilities for investigators, most importantly, reducing burdens for participants. Data collected through this small pilot study suggest several preliminary but potentially important findings when working with adults from low-income populations: First, while all participants read some parts of the consent forms (55%), only a minority reported reading the entire form (45%); second, 73% of participants reported understanding the study very well whereas only 27% reported understanding the study "a little"; third, there was a slight reported advantage of the simplified form over the regular form; however, this difference varied by section. Relatedly, other research has shown a high incidence of persons reading none of the consent form, but signing a statement that they have read and understood the study. Why does this occur? What are we teaching people when we request that they sign a consent form they have chosen not to read? What are the ethical and regulatory implications? Embedded ethics studies such as this one, although pilot and preliminary in nature, offer a number of advantages, such as stimulating additional scientific inquiry as well as challenging established institutional practices. © The Author(s) 2015.

Recycling attitudes and behavior among a clinic-based sample of low-income Hispanic women in southeast Texas.

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Pearson, Heidi C; Dawson, Lauren N; Radecki Breitkopf, Carmen

2012-01-01

We examined attitudes and behavior surrounding voluntary recycling in a population of low-income Hispanic women. Participants (N = 1,512) 18-55 years of age completed a self-report survey and responded to questions regarding household recycling behavior, recycling knowledge, recycling beliefs, potential barriers to recycling (transportation mode, time), acculturation, demographic characteristics (age, income, employment, marital status, education, number of children, birth country), and social desirability. Forty-six percent of participants (n = 810) indicated that they or someone else in their household recycled. In a logistic regression model controlling for social desirability, recycling behavior was related to increased age (Precycle (Precycling saves landfill space (Precycling takes too much time (Precycling knowledge and recycling behavior (Precycling behavior among Hispanic women and highlight the need for educational outreach and intervention strategies to increase recycling behavior within this understudied population.

Recycling Attitudes and Behavior among a Clinic-Based Sample of Low-Income Hispanic Women in Southeast Texas

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Pearson, Heidi C.; Dawson, Lauren N.; Radecki Breitkopf, Carmen

2012-01-01

We examined attitudes and behavior surrounding voluntary recycling in a population of low-income Hispanic women. Participants (N = 1,512) 18–55 years of age completed a self-report survey and responded to questions regarding household recycling behavior, recycling knowledge, recycling beliefs, potential barriers to recycling (transportation mode, time), acculturation, demographic characteristics (age, income, employment, marital status, education, number of children, birth country), and social desirability. Forty-six percent of participants (n = 810) indicated that they or someone else in their household recycled. In a logistic regression model controlling for social desirability, recycling behavior was related to increased age (Precycle (Precycling saves landfill space (Precycling takes too much time (Precycling knowledge and recycling behavior (Precycling behavior among Hispanic women and highlight the need for educational outreach and intervention strategies to increase recycling behavior within this understudied population. PMID:22493693

Centre-based day care for children younger than five years of age in high-income countries.

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van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

2014-09-23

A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

Diabetes Awareness of Low-Income Middle School Students Participating in the Help a Friend, Help Yourself Youth Diabetes Awareness Education Program

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Wroten, Kathryn; Reames, Elizabeth S.; Tuuri, Georgianna

2012-01-01

The study reported here investigated the effectiveness of the LSU AgCenter Help a Friend, Help Yourself youth diabetes education curriculum to increase knowledge and awareness of diabetes and its symptoms in low-income middle school students participating in the Boys and Girls Club after-school program. The curriculum includes four lessons with…

The influence of environmental and personal factors on participation of lower-limb prosthetic users in low-income countries: prosthetists' perspectives.

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Kam, Season; Kent, Mallory; Khodaverdian, Alin; Daiter, Liane; Njelesani, Janet; Cameron, Debra; Andrysek, Jan

2015-05-01

To examine the environmental and personal factors in low-income countries (LICs) that influence prosthetic rehabilitation of adults with lower-limb (LL) amputations and their ability to participate in daily activities. In this qualitative descriptive study, 11 prosthetists participated in semi-structured interviews by telephone or Skype. Qualitative thematic analysis was guided by the International Classification of Function. Facilitating continuity of care, consideration of physical environments and usage, prosthetic quality including durability and socket fit, and minimizing the visibility of disability, were found to be important factors affecting the provision of prosthetic services in LICs. Environmental and personal factors must be considered when providing prosthetic rehabilitation for adults with LL amputations in LICs in order to optimize participation in activities. Results from this study provide new insights about some of the factors that influence the ability of individuals with LL amputations to rehabilitate to a level where they are able to participate in meaningful activities within their communities. There are unique environmental and personal components that can influence activity and participation of lower-limb (LL) prosthetic users in low-income countries (LICs). These components are often overlooked in the design of prosthetic devices and provision of prosthetic services. Continuity of care, condition of the post-surgical residuum, outdoor environments of common occupations, aesthetics and durability of prostheses, and user comfort should all be considered when providing prosthetic rehabilitation to adults with LL amputations in LICs to promote activity and participation. Results of our study can inform the practice of prosthetists in LICs by highlighting their contributions in enabling participation for LL prosthetic users. Our results can also inform the design of durable and comfortable prostheses and the provision of more appropriate

Medicaid Coverage Expansions and Cigarette Smoking Cessation Among Low-income Adults.

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Koma, Jonathan W; Donohue, Julie M; Barry, Colleen L; Huskamp, Haiden A; Jarlenski, Marian

2017-12-01

Expanding Medicaid coverage to low-income adults may have increased smoking cessation through improved access to evidence-based treatments. Our study sought to determine if states' decisions to expand Medicaid increased recent smoking cessation. Using pooled cross-sectional data from the Behavioral Risk Factor Surveillance Survey for the years 2011-2015, we examined the association between state Medicaid coverage and the probability of recent smoking cessation among low-income adults without dependent children who were current or former smokers (n=36,083). We used difference-in-differences estimation to examine the effects of Medicaid coverage on smoking cessation, comparing low-income adult smokers in states with Medicaid coverage to comparable adults in states without Medicaid coverage, with ages 18-64 years to those ages 65 years and above. Analyses were conducted for the full sample and stratified by sex. Residence in a state with Medicaid coverage among low-income adult smokers ages 18-64 years was associated with an increase in recent smoking cessation of 2.1 percentage points (95% confidence interval, 0.25-3.9). In the comparison group of individuals ages 65 years and above, residence in a state with Medicaid coverage expansion was not associated with a change in recent smoking cessation (-0.1 percentage point, 95% confidence interval, -2.1 to 1.8). Similar increases in smoking cessation among those ages 18-64 years were estimated for females and males (1.9 and 2.2 percentage point, respectively). Findings are consistent with the hypothesis that Medicaid coverage expansions may have increased smoking cessation among low-income adults without dependent children via greater access to preventive health care services, including evidence-based smoking cessation services.

Income inequality and adolescent fertility in low-income countries.

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Castro, Ruben; Fajnzylber, Eduardo

2017-09-28

: The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999). Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.

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

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2012-10-25

...-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY... amend its low-income credit unions regulation by extending the time credit unions have to accept a low- income designation. Under the current rule, an FCU that has received notification from NCUA that it...

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

Science.gov (United States)

2013-01-18

...-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY... amending its low-income credit unions regulation by extending the time period in which a federal credit union (FCU) may accept a low-income designation. Under the current rule, an FCU that receives notice...

Pilot study of participant-collected nasal swabs for acute respiratory infections in a low-income, urban population

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Vargas CY

2016-01-01

Full Text Available Celibell Y Vargas,1 Liqun Wang,1 Yaritza Castellanos de Belliard,1 Maria Morban,1 Hilbania Diaz,1 Elaine L Larson,2,3 Philip LaRussa,1 Lisa Saiman,1,4 Melissa S Stockwell1,5,6 1Department of Pediatrics, 2School of Nursing, 3Department of Epidemiology, Mailman School of Public Health, Columbia University, 4Department of Infection Prevention and Control, NewYork-Presbyterian Hospital, 5Department of Population and Family Health, Mailman School of Public Health, Columbia University, 6NewYork-Presbyterian Hospital, New York, NY, USA Objective: To assess the feasibility and validity of unsupervised participant-collected nasal swabs to detect respiratory pathogens in a low-income, urban minority population. Methods: This project was conducted as part of an ongoing community-based surveillance study in New York City to identify viral etiologies of acute respiratory infection. In January 2014, following sample collection by trained research assistants, participants with acute respiratory infection from 30 households subsequently collected and returned a self-collected/parent-collected nasal swab via mail. Self/parental swabs corresponding with positive reverse transcription polymerase chain reaction primary research samples were analyzed. Results: Nearly all (96.8%, n=30/31 households agreed to participate; 100% reported returning the sample and 29 were received (median time: 8 days. Most (18; 62.1% of the primary research samples were positive. For eight influenza-positive research samples, seven (87.5% self-swabs were also positive. For ten other respiratory pathogen-positive research samples, eight (80.0% self-swabs were positive. Sensitivity of self-swabs for any respiratory pathogen was 83.3% and 87.5% for influenza, and specificity for both was 100%. There was no relationship between level of education and concordance of results between positive research samples and their matching participant swab. Conclusion: In this pilot study, self

Hong Kong men with low incomes have worse health-related quality of life as judged by SF-36 scores.

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Ko, G T C; Wai, H P S; Tsang, P C C; Chan, H C K

2006-10-01

To analyse the association between income and health-related quality of life using the Medical Outcome Study Short Form 36 (SF-36) Chinese version in Hong Kong Chinese working population. Cross-sectional observation study. A commercial company in Hong Kong. All clerical and administrative staff of a commercial company was invited to participate; 876 of the 1003 staff agreed. The subjects were categorised into three income groups according to monthly income in Hong Kong dollars (low, 10,000-25,000; high, >25,000). The mean age of the 288 men and 588 women was 34.9 (standard deviation, 7.9; median, 34.0; range, 18-71) years. SF-36 scores on health-related quality of life. The distribution of income was 30% in high-, 54.8% in middle-, and 15.2% in low-income groups. Women had similar SF-36 scores among different income groups. In men, for most variables there was a significant positive linear correlation between income and SF-36 scores. Low income is associated with a worse health-related quality of life in Hong Kong Chinese men.

Postpartum Health Information Seeking Using Mobile Phones: Experiences of Low-Income Mothers.

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Guerra-Reyes, Lucia; Christie, Vanessa M; Prabhakar, Annu; Harris, Asia L; Siek, Katie A

2016-11-01

Objectives To assess low-income mothers' perceptions of their postpartum information needs; describe their information seeking behavior; explore their use of mobile technology to address those needs; and to contribute to the sparse literature on postpartum health and wellness. Methods Exploratory community-based qualitative approach. Interviewees were recruited among clients of community partners and had children aged 48 months and under. A survey assessing demographics was used to identify low-income mothers. 10 low-income mothers were recruited from survey participants to complete in-depth interviews regarding postpartum information needs, information seeking, and technology use. Interviews were transcribed verbatim and coded by three researchers independently. Narratives were analyzed along predetermined (etic) and emergent (emic) categories. Results Establishing breastfeeding and solving breastfeeding problems were central postpartum concerns leading to information seeking. Interviewees reported almost exclusive use of mobile phones to access the Internet. Mobile applications were widely used during pregnancy, but were not valuable postpartum. Face-to-face information from medical professionals was found to be repetitive. Online information seeking was mediated by default mobile phone search engines, and occurred over short, fragmented time periods. College graduates reported searching for authoritative knowledge sources; non-graduates preferred forums. Conclusions for Practice Low-income postpartum women rely on their smartphones to find online infant care and self-care health information. Websites replace pregnancy-related mobile applications and complement face-to-face information. Changes in searching behavior and multitasking mean information must be easily accessible and readily understood. Knowledge of page-rank systems and use of current and emergent social media will allow health-related organizations to better engage with low-income mothers online and

Mitigating Barriers to Civic Engagement for Low-Income, Minority Youth Ages 13-18: Best Practices from Environmental Youth Conferences

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Haco Hoang

2013-12-01

Full Text Available Several studies indicate that there is a civic engagement gap for low-income, minority youth even though they reside in communities grappling with deteriorating social, environmental and economic conditions. Using the annual Environmental Youth Conference (EYC in Los Angeles as a case study, this article offers best practices for identifying: 1 factors that foster civic engagement among low-income, minority youth ages 13-18, and 2 strategies to mobilize the targeted youth populations on environmental issues. Los Angeles is a useful case study because it is a large and demographically diverse city facing extreme environmental challenges due to its significant agricutlural and industrial sectors.

Low and Middle Income Mothers' Regulation of Negative Emotion: Effects of Children's Temperament and Situational Emotional Responses

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Martini, Tanya S.; Root, Carol A.; Jenkins, Jennifer M.

2004-01-01

The present study investigated the effects of situational (child situational emotions) and dispositional (child temperament) child variables on mothers' regulation of their own hostile (anger) and nonhostile (sadness and anxiety) emotions. Participants included 94 low and middle income mothers and their children (41 girls; 53 boys) aged 3 to 6…

Income inequality and adolescent fertility in low-income countries

Directory of Open Access Journals (Sweden)

Ruben Castro

2017-09-01

Full Text Available Abstract: The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999. Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.

Pre-Hurricane Perceived Social Support Protects against Psychological Distress: A Longitudinal Analysis of Low-Income Mothers

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Lowe, Sarah R.; Chan, Christian S.; Rhodes, Jean E.

2010-01-01

Objective: In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method: Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8%) was African American; 10.4%…

76 FR 79650 - Proposed Information Collection; Comment Request; Survey of Income and Program Participation...

Science.gov (United States)

2011-12-22

...' participation in government programs as well as prior labor force patterns of household members. These... were interviewed. We estimate that each household contains 2.1 people, age 15 years or older, yielding... of Income and Program Participation (SIPP) Wave 13 of the 2008 Panel AGENCY: U.S. Census Bureau...

Longitudinal Effects of a Two-Generation Preschool Programme on Receptive Language Skill in Low-Income Canadian Children to Age 10 Years

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Mughal, Muhammad Kashif; Ginn, Carla S.; Perry, Robert L.; Benzies, Karen M.

2016-01-01

We explored longitudinal effects of a two-generation preschool programme on receptive language scores in children (n = 78) at age 10 years, living with low income. Scores at four time-points, programme intake, exit, age 7, and age 10 years were measured using the "Peabody picture vocabulary test" (3rd ed.). Effects of culture…

Utilization of internet technology by low-income adults: the role of health literacy, health numeracy, and computer assistance.

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Jensen, Jakob D; King, Andy J; Davis, LaShara A; Guntzviller, Lisa M

2010-09-01

To examine whether low-income adults' utilization of Internet technology is predicted or mediated by health literacy, health numeracy, and computer assistance. Low-income adults (N = 131) from the midwestern United States were surveyed about their technology access and use. Individuals with low health literacy skills were less likely to use Internet technology (e.g., email, search engines, and online health information seeking), and those with low health numeracy skills were less likely to have access to Internet technology (e.g., computers and cell phones). Consistent with past research, males, older participants, and those with less education were less likely to search for health information online. The relationship between age and online health information seeking was mediated by participant literacy. The present study suggests that significant advances in technology access and use could be sparked by developing technology interfaces that are accessible to individuals with limited literacy skills.

Effects of low income on infant health.

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Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

2003-06-10

Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not

Socioeconomic status and COPD among low- and middle-income countries.

Science.gov (United States)

Grigsby, Matthew; Siddharthan, Trishul; Chowdhury, Muhammad Ah; Siddiquee, Ali; Rubinstein, Adolfo; Sobrino, Edgardo; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Checkley, William

2016-01-01

Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low- and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.

Trends in state/territorial obesity prevalence by race/ethnicity among U.S. low-income, preschool-aged children.

Science.gov (United States)

Pan, L; Grummer-Strawn, L M; McGuire, L C; Park, S; Blanck, H M

2016-10-01

Understanding state/territorial trends in obesity by race/ethnicity helps focus resources on populations at risk. This study aimed to examine trends in obesity prevalence among low-income, preschool-aged children from 2008 through 2011 in U.S. states and territories by race/ethnicity. We used measured weight and height records of 11.1 million children aged 2-4 years who participated in federally funded health and nutrition programmes in 40 states, the District of Columbia and two U.S. territories. We used logistic regression to examine obesity prevalence trends, controlling for age and sex. From 2008 through 2011, the aggregated obesity prevalence declined among all racial/ethnic groups (decreased by 0.4-0.9%) except American Indians/Alaska Natives (AI/ANs); the largest decrease was among Asians/Pacific Islanders (A/PIs). Declines were significant among non-Hispanic whites in 14 states, non-Hispanic blacks in seven states/territories, Hispanics in 13 states, A/PIs in five states and AI/ANs in one state. Increases were significant among non-Hispanic whites in four states, non-Hispanic blacks in three states, Hispanics in two states and A/PIs in one state. The majority of the states/territories had no change in obesity prevalence. Our findings indicate slight reductions in obesity prevalence and variations in obesity trends, but disparities exist for some states and racial/ethnic groups. © 2015 World Obesity.

Socioeconomic inequalities in risk factors for non communicable diseases in low-income and middle-income countries: results from the World Health Survey.

Science.gov (United States)

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kunst, Anton; Harper, Sam; Guthold, Regina; Rekve, Dag; d'Espaignet, Edouard Tursan; Naidoo, Nirmala; Chatterji, Somnath

2012-10-28

Monitoring inequalities in non communicable disease risk factor prevalence can help to inform and target effective interventions. The prevalence of current daily smoking, low fruit and vegetable consumption, physical inactivity, and heavy episodic alcohol drinking were quantified and compared across wealth and education levels in low- and middle-income country groups. This study included self-reported data from 232,056 adult participants in 48 countries, derived from the 2002-2004 World Health Survey. Data were stratified by sex and low- or middle-income country status. The main outcome measurements were risk factor prevalence rates reported by wealth quintile and five levels of educational attainment. Socioeconomic inequalities were measured using the slope index of inequality, reflecting differences in prevalence rates, and the relative index of inequality, reflecting the prevalence ratio between the two extremes of wealth or education accounting for the entire distribution. Data were adjusted for confounding factors: sex, age, marital status, area of residence, and country of residence. Smoking and low fruit and vegetable consumption were significantly higher among lower socioeconomic groups. The highest wealth-related absolute inequality was seen in smoking among men of low- income country group (slope index of inequality 23.0 percentage points; 95% confidence interval 19.6, 26.4). The slope index of inequality for low fruit and vegetable consumption across the entire distribution of education was around 8 percentage points in both sexes and both country income groups. Physical inactivity was less prevalent in populations of low socioeconomic status, especially in low-income countries (relative index of inequality: (men) 0.46, 95% confidence interval 0.33, 0.64; (women) 0.52, 95% confidence interval 0.42, 0.65). Mixed patterns were found for heavy drinking. Disaggregated analysis of the prevalence of non-communicable disease risk factors demonstrated different

Family Resources as Protective Factors for Low-Income Youth Exposed to Community Violence.

Science.gov (United States)

Hardaway, Cecily R; Sterrett-Hong, Emma; Larkby, Cynthia A; Cornelius, Marie D

2016-07-01

Exposure to community violence is a risk factor for internalizing and externalizing problems; however, resources within the family can decrease the likelihood that adolescents will experience internalizing and externalizing problems as a result of such exposure. This study investigates the potential moderating effects of kinship support (i.e., emotional and tangible support from extended family) and parental involvement on the relation between exposure to community violence (i.e., witnessing violence and violent victimization) and socioemotional adjustment (i.e., internalizing and externalizing problems) in low-income adolescents. The sample included 312 (50 % female; 71 % African American and 29 % White) low-income youth who participated in a longitudinal investigation when adolescents were age 14 (M age = 14.49 years) and again when they were 16 (M age = 16.49 years). Exposure to community violence at age 14 was related to more internalizing and externalizing problems at age 16. High levels of kinship support and parental involvement appeared to function as protective factors, weakening the association between exposure to violence and externalizing problems. Contrary to prediction, none of the hypothesized protective factors moderated the association between exposure to violence and internalizing problems. The results from this study suggest that both kinship support and parental involvement help buffer adolescents from externalizing problems that are associated with exposure to community violence.

Examining mindfulness-based stress reduction: Perceptions from minority older adults residing in a low-income housing facility

Directory of Open Access Journals (Sweden)

Connolly Amy B

2011-05-01

Full Text Available Abstract Background Mindfulness-based stress reduction (MBSR programs are becoming increasingly common, but have not been studied in low income minority older populations. We sought to understand which parts of MBSR were most important to practicing MBSR members of this population, and to understand whether they apply their training to daily challenges. Methods We conducted three focus groups with 13 current members of an MBSR program. Participants were African American women over the age of 60 in a low-income housing residence. We tape recorded each session and subsequently used inductive content analysis to identify primary themes. Results and discussion Analysis of the focus group responses revealed three primary themes stress management, applying mindfulness, and the social support of the group meditation. The stressors they cited using MBSR with included growing older with physical pain, medical tests, financial strain, and having grandchildren with significant mental, physical, financial or legal hardships. We found that participants particularly used their MBSR training for coping with medical procedures, and managing both depression and anger. Conclusion A reflective stationary intervention delivered in-residence could be an ideal mechanism to decrease stress in low-income older adult's lives and improve their health.

The association between objective income and subjective financial need and depressive symptoms in South Koreans aged 60 and older.

Science.gov (United States)

Kim, Woorim; Kim, Tae Hyun; Lee, Tae-Hoon; Ju, Yeong Jun; Park, Eun-Cheol

2017-11-01

This study aimed to investigate the effect of the gap between objective income and subjective financial need on depressive symptoms in individuals aged 60 and older. Data from the 2011 and 2013 Korean Retirement and Income Study were used. A total of 4891 individuals aged 60 and older were included at baseline. The Generalized Estimating Equation model was used to examine the association between the gap in objective income and subjective financial need and the presence of depressive symptoms, which were measured using the Center for Epidemiological Studies Depression Scale. Compared to individuals in the middle objective income-middle subjective financial need group, individuals in the low-low category (odds ratio (OR): 1.30, 95% confidence interval (CI): 1.04-1.61) and the low-middle category (OR: 1.26, 95%CI: 1.09-1.45) showed a statistically significant higher likelihood of having depressive symptoms. In contrast, participants in the middle-low (OR: 0.74, 95%CI: 0.54-0.99), high-low (OR: 0.50, 95%CI: 0.34-0.73), high-middle (OR: 0.74, 95%CI: 0.63-0.87), and high-high categories (OR: 0.74, 95%CI: 0.55-0.99) were less likely to exhibit depressive symptoms. Additionally, the lower likelihood of depressive symptoms found in middle- and high-income groups with lower levels of subjective financial need was strong among individuals with chronic disease. Differences in the prevalence of depressive symptoms generally exist between individuals of the same income category depending on perceived income adequacy. Therefore, it is important to consider discrepancies in objective income and subjective financial need when assessing risk factors for depressive symptoms in older populations. © 2017 Japanese Psychogeriatric Society.

Adults and Children in Low-Income Households that Participate in Cost-Offset Community Supported Agriculture Have High Fruit and Vegetable Consumption.

Science.gov (United States)

Hanson, Karla L; Kolodinsky, Jane; Wang, Weiwei; Morgan, Emily H; Pitts, Stephanie B Jilcott; Ammerman, Alice S; Sitaker, Marilyn; Seguin, Rebecca A

2017-07-08

This paper examines fruit and vegetable intake (FVI) in low-income households that participated in a cost-offset (CO), or 50% subsidized, community-supported agriculture (CSA) program. CSA customers paid farms upfront for a share of the harvest, and received produce weekly throughout the growing season. A cohort of adults and children 2-12 y in a summer CO-CSA were surveyed online twice: August 2015 ( n = 41) and February 2016 ( n = 23). FVI was measured by the National Cancer Institute's (NCI) Fruit and Vegetable Screener (FVS) and an inventory of locally grown fruits and vegetables. FVI relative to United States (US) recommendations and averages, and across seasons, were tested with non-parametric tests and paired t -tests ( p < 0.05). Both adults and children in the CO-CSA had higher FVI than the US averages, and more often met recommendations for vegetables. Some summer fruits and vegetables were more often eaten when locally in-season. The CO-CSA model warrants further examination as an avenue for improving vegetable consumption among adults and children in low-income households. However, causality between CO-CSA participation and FVI cannot be inferred, as CO-CSA participants may be positive deviants with respect to FVI. A multi-state randomized controlled trial is currently underway to evaluate impacts of CO-CSAs on FVI and related outcomes.

Childhood asthma in low income countries

DEFF Research Database (Denmark)

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

2012-01-01

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...

Pre-hurricane perceived social support protects against psychological distress: A longitudinal analysis of low-income mothers

OpenAIRE

Lowe, SR; Chan, CS; Rhodes, JE

2010-01-01

Objective: In this study, we examined the influence of pre-disaster perceived social support on post-disaster psychological distress among survivors of Hurricane Katrina. Method: Participants (N = 386) were low-income mothers between 18 and 34 years of age at baseline (M = 26.4, SD = 4.43). The majority (84.8) was African American; 10.4 identified as Caucasian, 3.2 identified as Hispanic, and 1.8 identified as other. Participants were enrolled in an educational intervention study in 2004 and ...

Reimagining publics and (non)participation: Exploring exclusion from science communication through the experiences of low-income, minority ethnic groups.

Science.gov (United States)

Dawson, Emily

2018-01-01

This article explores science communication from the perspective of those most at risk of exclusion, drawing on ethnographic fieldwork. I conducted five focus groups and 32 interviews with participants from low-income, minority ethnic backgrounds. Using theories of social reproduction and social justice, I argue that participation in science communication is marked by structural inequalities (particularly ethnicity and class) in two ways. First, participants' involvement in science communication practices was narrow (limited to science media consumption). Second, their experiences of exclusion centred on cultural imperialism (misrepresentation and 'Othering') and powerlessness (being unable to participate or change the terms of their participation). I argue that social reproduction in science communication constructs a narrow public that reflects the shape, values and practices of dominant groups, at the expense of the marginalised. The article contributes to how we might reimagine science communication's publics by taking inclusion/exclusion and the effects of structural inequalities into account.

Age at immigration and the incomes of older immigrants, 1994-2010.

Science.gov (United States)

O'Neil, Kevin; Tienda, Marta

2015-03-01

Seniors comprise a growing proportion of new U.S. immigrants. We investigate whether late-age immigrants are disadvantaged in older age relative to those arriving earlier in life, based on income, reliance on public benefits, and access to public medical insurance. We test whether the 1996 welfare reform law altered the relationships between age at immigration and these outcomes. Immigrants aged 65 and older in the 1994-2010 Current Population Surveys were classified by age at immigration. Median and logistic regressions are used to estimate the association between age at immigration and several outcomes and to test whether these associations differ for arrivals before and after welfare reform. Late-age immigration is strongly associated with lower personal income, lower rates of Medicare and Social Security receipt, and higher participation in Supplemental Security Income (SSI) and Medicaid. Arrival after 1996 is associated with lower rates of SSI, Medicaid, and Medicare receipt. The association between late-age immigration and income is stronger for post-1996 arrivals relative to earlier arrivals, whereas that between late-age immigration and Medicaid is weaker, suggesting that the penalty conferred by late-age immigration grew after reform. Late-age immigrants face formidable economic disadvantages exacerbated by exclusion from public benefits, with implications for immigration, health care, and welfare policy. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Diurnal cortisol pattern, eating behaviors and overweight in low-income preschool-aged children.

Science.gov (United States)

Lumeng, Julie C; Miller, Alison; Peterson, Karen E; Kaciroti, Niko; Sturza, Julie; Rosenblum, Katherine; Vazquez, Delia M

2014-02-01

This study examined, among children, the associations among chaos in the home, diurnal cortisol patterns, eating behaviors and being overweight. Participants included 331 low-income children aged 3-4years. Mean salivary cortisol-intercept (representing morning peak, 60min since waking) and cortisol-slope (representing diurnal decline after peak) were calculated using mixed models from samples obtained across 3days. Parents reported chaos in the home by questionnaire and responded to the Children's Eating Behavior Questionnaire, generating subscales Food Responsiveness (FR), Emotional Overeating (EO), Enjoyment of Food (EF), and Satiety Responsiveness (SR). Body mass index was categorized as overweight vs. not. Path analysis evaluated associations among chaos, cortisol patterns, eating behaviors, and weight status. Children living in more chaotic homes had lower morning cortisol levels, consistent with "hypocortisolism" reported among individuals who have experienced significant allostatic load as a result of substantial early life chronic stress. Among girls, the hypocortisolism pattern predicted a higher likelihood of being overweight both directly and mediated through reduced Satiety Responsiveness; in boys, the association of the hypocortisolism pattern with being overweight was mediated entirely through Emotional Overeating. In summary, our results provide support for the conceptual model that psychosocial stress contributes to hypocortisolism, which contributes directly to a higher likelihood of being overweight in girls, and indirectly through reduced Satiety Responsiveness in girls and through increased Emotional Overeating in boys. Copyright © 2013 Elsevier Ltd. All rights reserved.

Video game genre preference, physical activity and screen-time in adolescent boys from low-income communities.

Science.gov (United States)

Thorne, Hayden T; Smith, Jordan J; Morgan, Philip J; Babic, Mark J; Lubans, David R

2014-12-01

The primary aim of this study was to examine the association between the types of video games played by adolescent boys and their participation in physical activity and recreational screen-time. Participants were 320 boys (mean age = 12.7, ±0.5 years) from 14 secondary schools located in low-income areas of New South Wales, Australia. Outcomes included height, weight, physical activity (accelerometers), total screen-time, and video game genre preference. Significant differences in both weekday and weekend screen-time were found between video game genre groups. In addition, significant differences in overall activity and moderate-to-vigorous physical activity were found between genre groups on weekdays. Between-group differences in physical activity on weekends were not statistically significant. This cross-sectional study has demonstrated that video game genre preference is associated with physical activity and screen-time in adolescent boys from low-income communities. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Assessment of Low-Income Adults' Access to Technology: Implications for Nutrition Education

Science.gov (United States)

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

2012-01-01

Objective: The main objective of this study was to investigate access and use of technologies such as the Internet among Indiana's low-income population. The secondary objective was to determine whether access and use of computers significantly differed by age, race, and/or education level. Methods: Data were collected from low-income adult…

Cross-national injury mortality differentials by income level: the possible role of age and ageing.

Science.gov (United States)

Moniruzzaman, S; Andersson, R

2008-11-01

To examine age- and cause-specific injury mortality differentials between low-income (LICs), middle-income (MICs) and high-income countries (HICs), and to discuss their implications in explaining changing injury mortality patterns with economic development against the background of general health transition theory. Cross-sectional study. The World Health Organization's mortality database was used as the source of injury mortality data. The grouping into LICs, MICs and HICs was based on data from World Development Indicator. Unintentional injury mortality (UIM) rates in children and adults are highest in LICs and MICs, respectively. UIM rates in the elderly population, however, increase with higher economic conditions and are highest in HICs. Based on these findings, it is hypothesized that ageing and injury interplay mutually with regard to health transition; declining rates in child UIM with economic development contributes to the ageing process, while increasing UIM among the elderly, in combination with ageing populations, boosts the absolute number of injury deaths in this segment.

Differences in perceptions and fast food eating behaviours between Indians living in high- and low-income neighbourhoods of Chandigarh, India.

Science.gov (United States)

Aloia, Christopher Robert; Gasevic, Danijela; Yusuf, Salim; Teo, Koon; Chockalingam, Arun; Patro, Binod Kumar; Kumar, Rajesh; Lear, Scott Alexander

2013-01-07

Increased density of fast food restaurants is associated with increased prevalence of obesity in developed countries. However, less is known about this relationship in developing countries undergoing rapid urbanization and how differences in neighbourhood income affect the patronage of fast food outlets. The purpose of the study is to explore the differences in fast food preferences, perceptions, and patronage between Indians living in high- and low-income neighbourhoods. This cross-sectional study recruited 204 men and women (35 to 65 years in age) from high- and low-income neighbourhoods who completed a questionnaire on fast food consumption. The questionnaire asked participants to define fast food and to provide reasons for and frequency of visits to fast food restaurants. The differences were analyzed using Chi square and t-tests for categorical and continuous variables, respectively. Participants from a high-income neighbourhood were more likely to perceive Western -style fast food as fast food, while people from the low-income neighbourhood were more likely to identify food sold by street vendors as fast food (p food from street vendors while less likely to dine out at both fast food and non-fast food restaurants (pfood restaurants than their low-income neighbourhood counterparts, there were no significant differences in the reasons for visiting fast food restaurants (convenience, price, social enjoyment, and quality of meals) between the two groups. Both groups preferred home cooked over restaurant meals, and they recognized that home cooked food was healthier. Overall, consumption of fast food was low. People from a high-income neighbourhood dined out more frequently and were more likely to perceive Western-style food as fast food compared to their counterparts from the low-income neighbourhood.

Age at Immigration and the Incomes of Older Immigrants, 1994–2010

Science.gov (United States)

Tienda, Marta

2015-01-01

Objectives. Seniors comprise a growing proportion of new U.S. immigrants. We investigate whether late-age immigrants are disadvantaged in older age relative to those arriving earlier in life, based on income, reliance on public benefits, and access to public medical insurance. We test whether the 1996 welfare reform law altered the relationships between age at immigration and these outcomes. Method. Immigrants aged 65 and older in the 1994–2010 Current Population Surveys were classified by age at immigration. Median and logistic regressions are used to estimate the association between age at immigration and several outcomes and to test whether these associations differ for arrivals before and after welfare reform. Results. Late-age immigration is strongly associated with lower personal income, lower rates of Medicare and Social Security receipt, and higher participation in Supplemental Security Income (SSI) and Medicaid. Arrival after 1996 is associated with lower rates of SSI, Medicaid, and Medicare receipt. The association between late-age immigration and income is stronger for post-1996 arrivals relative to earlier arrivals, whereas that between late-age immigration and Medicaid is weaker, suggesting that the penalty conferred by late-age immigration grew after reform. Discussion. Late-age immigrants face formidable economic disadvantages exacerbated by exclusion from public benefits, with implications for immigration, health care, and welfare policy. PMID:24942972

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

Science.gov (United States)

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

Low Income Consumer Utility Issues: A National Perspective; TOPICAL

International Nuclear Information System (INIS)

Eisenberg, J

2001-01-01

This report provides a survey of assistance programs that public utility commissions have approved in most states to assist the low-income customers of utilities within their states. Surveys find that there is no single model of low-income assistance; rather, each state has adopted a program that meets its particular circumstances. However, while the details of programs vary considerably, they all fall within four broad categories: (1) Affordability programs, which provide direct assistance in paying energy bills; (2) Consumer protections, such as collection practices and installment billing requirements, which make it easier to pay energy bills on time; (3) Education programs, which teach consumers about prudent energy use and counsel them about budgeting; and (4) Efficiency and weatherization programs, which make investments to help consumers control their energy bills by reducing their need for energy. Programs usually include more than one of these components. All programs also include outreach and evaluation components. This report describes these options, the advantages and disadvantages of each, and the economic and other benefits of utility assistance programs for low-income customers. Low-income programs help participants by lowering the fraction of their incomes devoted to energy bills (the energy burden) from a very high level. In the United States, the median household devotes only 3.8 percent of its income to electricity while a family depending on a minimum-wage earner must devote 12.1 percent to energy while facing housing cost increases all over the nation. Low-income families unable to keep up with these pressures find themselves forced to go without power at times, to move, or to forgo other necessities such as food or medicine in order to pay their electricity bills

Trends in overweight by educational level in 33 low- and middle-income countries: The role of parity, age at first birth and breastfeeding

NARCIS (Netherlands)

S.L. López Arana (Sandra Liliana); A. Burdorf (Alex); M. Avendano Pabon (Mauricio)

2013-01-01

textabstractThis study examined trends in overweight among women of reproductive age by educational level in 33 low- and middle-income countries, and estimated the contribution of parity, age at first birth and breastfeeding to these trends. We used repeated cross-sectional Demographic Health

Successful schools and risky behaviors among low-income adolescents.

Science.gov (United States)

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 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.

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

Science.gov (United States)

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.

Parenting perceptions of low-income mothers.

Science.gov (United States)

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.

Marital Status, Career and Income as Indicators of Life Satisfaction Among Middle-aged Career Women in Hulu Langat, Selangor, Malaysia

Directory of Open Access Journals (Sweden)

Siti Marziah Zakaria

2018-01-01

Full Text Available Life satisfaction is a subjective construct that varies according to gender, education level, age, income, marital status, and other demographic factors. Life satisfaction is an important issue among middle-aged women. They face various responsibilities, roles and expectation at this age. The objective of this article is to identify the differences in life satisfaction among middle-aged Malay women from different educational level, marital status, career and income. This study applied a survey technique, which is a set of questionnaire which consisted of socio-demographic scale and life satisfaction scale (based on Life Satisfaction Index - Short Form by Barrette and Murk, 2006. Simple random sampling and purposive sampling have been used to obtain the responses. A total of 410 middle-aged career women in Hulu Langat, Selangor have participated in this study. The finding showed that life satisfactions among middle-aged women are different depending on their marital status, career and income. This was based on the result of ANOVA. Single women and widower who are working in private sector and of low-income level reported to have the lowest life satisfaction. This finding may provide input to the planning of programs to enhance the well-being and life satisfaction among middle aged career women.

Occupational Engagement in Low-Income Latina Breast Cancer Survivors.

Science.gov (United States)

Sleight, Alix G

This qualitative study examined the experience of occupational engagement in low-income Latina breast cancer survivors and suggests the potential for occupational therapy practitioners to improve health outcomes in this vulnerable and underserved population. Semistructured interviews were conducted with 9 participants. Inductive analysis was used to code for themes and patterns related to occupational engagement and quality of life (QOL). Lack of occupational engagement negatively affected QOL, but participation in occupations such as religious activity and caregiving promoted well-being. Financial concerns and communication barriers decreased QOL. Breast cancer can have a negative impact on occupational engagement in low-income Latina breast cancer survivors; however, some occupations may increase QOL. Socioeconomic status and cultural values influence occupational engagement and QOL. Occupational therapy practitioners can improve health outcomes in this population through awareness of relevant sociocultural factors and attention to appropriate patient communication. Copyright © 2017 by the American Occupational Therapy Association, Inc.

Effect of Comprehensive School Physical Activity Programming on Cardiometabolic Health Markers in Children From Low-Income Schools.

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Burns, Ryan D; Brusseau, Timothy A; Hannon, James C

2017-09-01

The purpose of this study was to examine the effect of a 36-week Comprehensive School Physical Activity Program (CSPAP) on cardiometabolic health markers in children from low-income schools. Participants were 217 school-aged children (mean age = 10.1 ± 1.1 years; 114 girls, 103 boys) recruited from 5 low-income elementary schools. Cardiometabolic health markers were collected in a fasted state at 2 time-points, before commencement of the CSPAP for classroom and school level clustering and the modifying effects of grade level and sex, there were statistically significant improvements in HDL cholesterol (Δ = 3.6 mg/dL, 95% CI: 1.4 mg/dL to 5.8 mg/dL, P = .039), triglycerides (Δ = -14.1 mg/dL, 95% CI: -21.4 mg/dL to -6.8 mg/dL, P = .022), and mean arterial pressure (Δ = -4.3 mmHg, 95% CI: -8.5 mmHg to -0.1 mmHg, P = .041) following the 36-week CSPAP intervention. Sixth-grade children showed decreases in LDL cholesterol (Δ = -15.3 mg/dL, 95% CI: -30.5 mg/dL to -0.1 mg/dL, P = .033). Improvements in specific cardiometabolic health markers were found following a 36-week CSPAP in children from low-income schools.

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

Science.gov (United States)

Stotts Krall, Jodi; Lohse, Barbara

2009-03-01

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

Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993-2015).

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Roth, Daniel E; Krishna, Aditi; Leung, Michael; Shi, Joy; Bassani, Diego G; Barros, Aluisio J D

2017-12-01

The causes of early childhood linear growth faltering (known as stunting) in low-income and middle-income countries remain inadequately understood. We aimed to determine if the progressive postnatal decline in mean height-for-age Z score (HAZ) in low-income and middle-income countries is driven by relatively slow growth of certain high-risk children versus faltering of the entire population. Distributions of HAZ (based on WHO growth standards) were analysed in 3-month age intervals from 0 to 36 months of age in 179 Demographic and Health Surveys from 64 low-income and middle-income countries (1993-2015). Mean, standard deviation (SD), fifth percentiles, and 95th percentiles of the HAZ distribution were estimated for each age interval in each survey. Associations between mean HAZ and SD, fifth percentile, and 95th percentile were estimated using multilevel linear models. Stratified analyses were performed in consideration of potential modifiers (world region, national income, sample size, year, or mean HAZ in the 0-3 month age band). We also used Monte Carlo simulations to model the effects of subgroup versus whole-population faltering on the HAZ distribution. Declines in mean HAZ from birth to 3 years of age were accompanied by declines in both the fifth and 95th percentiles, leading to nearly symmetrical narrowing of the HAZ distributions. Thus, children with relatively low HAZ were not more likely to have faltered than taller same-age peers. Inferences were unchanged in surveys regardless of world region, national income, sample size, year, or mean HAZ in the 0-3 month age band. Simulations showed that the narrowing of the HAZ distribution as mean HAZ declined could not be explained by faltering limited to a growth-restricted subgroup of children. In low-income and middle-income countries, declines in mean HAZ with age are due to a downward shift in the entire HAZ distribution, revealing that children across the HAZ spectrum experience slower growth compared to

Performance pay improves engagement, progress, and satisfaction in computer-based job skills training of low-income adults.

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Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Silverman, Kenneth

2013-01-01

Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on typing and keypad programs for 7 months. Participants randomly assigned to Group A (n = 23) earned hourly and productivity pay on the typing program (productivity pay), but earned only equalized hourly pay on the keypad program (hourly pay). Group B (n = 19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance. © Society for the Experimental Analysis of Behavior.

75 FR 80364 - Sample Income Data To Meet the Low-Income Definition

Science.gov (United States)

2010-12-22

... 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union... (FCUs) that do not qualify for a low-income designation using the geo-coding software the NCUA has developed for that purpose to submit an analysis of a statistically valid sample of their member income data...

Family income and tooth decay in US children: does the association change with age?

Science.gov (United States)

Bernabé, E; Delgado-Angulo, E K; Murasko, J E; Marcenes, W

2012-01-01

This study explored whether the association of family income with tooth decay changes with age among children in the United States. A second objective was to explore the role of access to dental health care services in explaining the interrelationships between family income, child age and tooth decay. Data from 7,491 2- to 15-year-old children who participated in the 1999-2004 National and Health and Nutrition Examination Survey were analyzed. The association of family income with the prevalence of tooth decay in primary, permanent and primary or permanent teeth was first estimated in logistic regression models with all children, and then, separately in four age groups that reflect the development of the dentition (2-5, 6-8, 9-11 and 12-15 years, respectively). Findings showed that the income gradient in tooth decay attenuated significantly in 9- to 11-year-olds only to re-emerge in 12- to 15-year-olds. The age profile of the income gradient in tooth decay was not accounted for by a diverse set of family and child characteristics. This is the first study providing some evidence for age variations in the income gradient in tooth decay among children in the United States. Copyright © 2012 S. Karger AG, Basel.

Salivary alpha amylase diurnal pattern and stress response are associated with body mass index in low-income preschool-aged children.

Science.gov (United States)

Miller, Alison L; Sturza, Julie; Rosenblum, Katherine; Vazquez, Delia M; Kaciroti, Niko; Lumeng, Julie C

2015-03-01

Physiological stress responses are proposed as a pathway through which stress can "get under the skin" and lead to health problems, specifically obesity. We tested associations of salivary alpha amylase (sAA) diurnal patterns and stress responses with body mass index (BMI) in young, low-income children (51% male; 54% non-Hispanic white). Diurnal saliva samples were collected three times per day across three days for 269 children (M age 50.8 months, SD 6.3). Individual sAA intercept and slope values were calculated using random effect models to represent morning sAA levels and rate of sAA change across the day. A subset of children (n=195; M age 56.6 months, SD 6.9) participated in a lab-based behavioral stress protocol. Area under the curve increase (AUCI) across four timepoints was calculated to represent increase in sAA output during stress elicitation. Children were weighed and height measured and BMI z-score was calculated. Linear regression was used to evaluate associations of sAA intercept, sAA slope, and sAA AUCI with BMI z-score, controlling for child age, sex, and race/ethnicity; maternal weight status; and family income-to-needs ratio. Diurnal and stress-response sAA patterns were related to child adiposity: for each 1-standard deviation unit (SDU) decrease in morning sAA level, the child's BMI z-score increased by 0.11 (SE 0.05) SDU's (pstress elicitation, the child's BMI z-score increased by 0.14 (SE 0.06) SDU's (pstress responses and atypical diurnal patterns of sAA have been found following exposure to chronic life stressors such as poverty. Findings suggest that associations of stress, sAA, and elevated body mass index may develop very early in the lifespan. Copyright © 2014 Elsevier Ltd. All rights reserved.

How Low-Income Children Use the Internet at Home

Science.gov (United States)

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

2005-01-01

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

Type 1 Diabetes eHealth Psychoeducation: Youth Recruitment, Participation, and Satisfaction

Science.gov (United States)

Jaser, Sarah S; Faulkner, Melissa S; Murphy, Kathryn; Delamater, Alan; Grey, Margaret

2013-01-01

Background The Internet and other eHealth technologies offer a platform for improving the dissemination and accessibility of psychoeducational programs for youth with chronic illness. However, little is known about the recruitment process and yield of diverse samples in Internet research with youth who have a chronic illness. Objective The purpose of this study was to compare the demographic and clinical characteristics of youth with Type 1 diabetes on recruitment, participation, and satisfaction with 2 eHealth psychoeducational programs. Methods Youth with Type 1 diabetes from 4 sites in the United States were invited to participate (N=510) with 320 eligible youth consenting (mean age=12.3, SD 1.1; 55.3% female; 65.2% white; and mean A1C=8.3, SD 1.5). Data for this secondary analysis included demographic information (age, race/ethnicity, and income), depressive symptoms, and recruitment rates, including those who refused at point of contact (22.0%), passive refusers who consented but did not participate (15.3%), and those who enrolled (62.7%). Participation (80% lessons completed) and a satisfaction survey (ie, how helpful, enjoyable) were also analyzed. Chi-square or analysis of variance (ANOVA) analyses were used. Results There were significant differences in recruitment rates by income and race/ethnicity such that black, Hispanic, or mixed race/ethnicity and low-income youth were more likely to refuse passively compared to white and higher-income youth who were more likely to enroll (P<.001). Participation in program sessions was high, with 78.1% of youth completing at least 4 of 5 sessions. There were no significant differences in participation by program, age, gender, or race/ethnicity. Low-income youth were less likely to participate (P=.002). Satisfaction in both programs was also high (3.9 of 5). There were significant gender, race/ethnicity, and income differences, in that girls (P=.001), black, Hispanic, or mixed race/ethnicity youth (P=.02), and low-income

Comparison of motives underlying food choice and barriers to healthy eating among low medium income consumers in Uruguay

Directory of Open Access Journals (Sweden)

Gastón Ares

Full Text Available Abstract: Interventions aimed at changing dietary patterns should be designed based on the main motives underlying the food choices of specific target populations. The aim of the present study was to identify motives underlying food choice and barriers to healthy eating among consumers in two socioeconomic levels in Uruguay. Eleven focus groups were carried out with a total of 76 participants. Six of the groups involved low income participants and the others were conducted with middle income participants. Discussions were held around frequently consumed products, motives underlying food choices and barriers to healthy eating. Results confirmed the strong influence of income level on motives underlying food choice and barriers to the adoption of healthy eating. Low income participants described their choices as mainly driven by economic factors and satiety, whereas convenience was the main determinant of food selection for middle income participants. Implications for the design of public policies targeted at each group are discussed.

Comparison of motives underlying food choice and barriers to healthy eating among low medium income consumers in Uruguay.

Science.gov (United States)

Ares, Gastón; Machín, Leandro; Girona, Alejandra; Curutchet, María Rosa; Giménez, Ana

2017-05-18

Interventions aimed at changing dietary patterns should be designed based on the main motives underlying the food choices of specific target populations. The aim of the present study was to identify motives underlying food choice and barriers to healthy eating among consumers in two socioeconomic levels in Uruguay. Eleven focus groups were carried out with a total of 76 participants. Six of the groups involved low income participants and the others were conducted with middle income participants. Discussions were held around frequently consumed products, motives underlying food choices and barriers to healthy eating. Results confirmed the strong influence of income level on motives underlying food choice and barriers to the adoption of healthy eating. Low income participants described their choices as mainly driven by economic factors and satiety, whereas convenience was the main determinant of food selection for middle income participants. Implications for the design of public policies targeted at each group are discussed.

Perceptions of breastfeeding and planned return to work or school among low-income pregnant women in the USA.

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Rojjanasrirat, Wilaiporn; Sousa, Valmi D

2010-07-01

To describe the perceptions of breastfeeding in low-income pregnant women to understand their needs better as they plan to return to work or school. Maternal employment has a negative impact on breastfeeding duration. Yet there is insufficient research on challenges and facilitators regarding breastfeeding and employment issue among low-income women in the USA. Knowing the perceptions of breastfeeding among low-income pregnant women and their plan to return to work or school may have implications for nurses and midwives in providing quality care. Qualitative study using focus group interviews. The research setting consisted of three Women, Infants and Children clinics (WIC) in a midwestern city of the USA. Seventeen pregnant women (aged 19-35) participated in focus group interviews. Data were coded and analysed for themes and patterns using the QSR software - NVivo 6. Eleven participants were single. Ten women were primigravida, and seven were multipara. The following five themes were identified: (1) perceived benefits of breastfeeding; (2) general perceptions of breastfeeding; (3) maternal concerns; (4) having the right support; and (5) anticipated challenges of combining breastfeeding and work. Conclusions.  Low-income women anticipated substantial barriers for breastfeeding when they planned to combine breastfeeding and work or school. The results of this study have many implications for public health practice, research and policy. Educating employers and the public at large about the health and economic benefits derived from long-term breastfeeding could help promote breastfeeding awareness. Strategies supporting breastfeeding among low-income working women must be provided at multiple levels to help overcome the barriers they concern. Health care providers should help women gain confidence by minimising their uncertainties and fears about breastfeeding to prepare them to continue breastfeeding successfully after returning to work. © 2010 Blackwell

Longitudinal effects of group music instruction on literacy skills in low-income children.

Directory of Open Access Journals (Sweden)

Jessica Slater

Full Text Available Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

Longitudinal effects of group music instruction on literacy skills in low-income children.

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Slater, Jessica; Strait, Dana L; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

2014-01-01

Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6-9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development.

Longitudinal Effects of Group Music Instruction on Literacy Skills in Low-Income Children

Science.gov (United States)

Slater, Jessica; Strait, Dana L.; Skoe, Erika; O'Connell, Samantha; Thompson, Elaine; Kraus, Nina

2014-01-01

Children from low-socioeconomic backgrounds tend to fall progressively further behind their higher-income peers over the course of their academic careers. Music training has been associated with enhanced language and learning skills, suggesting that music programs could play a role in helping low-income children to stay on track academically. Using a controlled, longitudinal design, the impact of group music instruction on English reading ability was assessed in 42 low-income Spanish-English bilingual children aged 6–9 years in Los Angeles. After one year, children who received music training retained their age-normed level of reading performance while a matched control group's performance deteriorated, consistent with expected declines in this population. While the extent of change is modest, outcomes nonetheless provide evidence that music programs may have value in helping to counteract the negative effects of low-socioeconomic status on child literacy development. PMID:25409300

The impact of income inequality and national wealth on child and adolescent mortality in low and middle-income countries.

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Ward, Joseph L; Viner, Russell M

2017-05-11

Income inequality and national wealth are strong determinants for health, but few studies have systematically investigated their influence on mortality across the early life-course, particularly outside the high-income world. We performed cross-sectional regression analyses of the relationship between income inequality (national Gini coefficient) and national wealth (Gross Domestic Product (GDP) averaged over previous decade), and all-cause and grouped cause national mortality rate amongst infants, 1-4, 5-9, 10-14, 15-19 and 20-24 year olds in low and middle-income countries (LMIC) in 2012. Gini models were adjusted for GDP. Data were available for 103 (79%) countries. Gini was positively associated with increased all-cause and communicable disease mortality in both sexes across all age groups, after adjusting for national wealth. Gini was only positively associated with increased injury mortality amongst infants and 20-24 year olds, and increased non-communicable disease mortality amongst 20-24 year old females. The strength of these associations tended to increase during adolescence. Increasing GDP was negatively associated with all-cause, communicable and non-communicable disease mortality in males and females across all age groups. GDP was also associated with decreased injury mortality in all age groups except 15-19 year old females, and 15-24 year old males. GDP became a weaker predictor of mortality during adolescence. Policies to reduce income inequality, rather than prioritising economic growth at all costs, may be needed to improve adolescent mortality in low and middle-income countries, a key development priority.

Extension of the behavioral model of healthcare utilization with ethnically diverse, low-income women.

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Keenan, Lisa A; Marshall, Linda L; Eve, Susan

2002-01-01

Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. Community office. African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. Healthcare utilization, defined as physician visits and general healthcare visits. Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.

76 FR 36976 - Sample Income Data To Meet the Low-Income Definition

Science.gov (United States)

2011-06-24

... NATIONAL CREDIT UNION ADMINISTRATION 12 CFR Part 701 RIN 3133-AD76 Sample Income Data To Meet the Low-Income Definition AGENCY: National Credit Union Administration (NCUA). ACTION: Final rule. SUMMARY... low-income designation using the geo-coding software the agency has developed for that purpose to...

76 FR 24457 - Proposed Information Collection; Comment Request; Survey of Income and Program Participation...

Science.gov (United States)

2011-05-02

... around a central ``core'' of labor force and income questions that remain fixed throughout the life of... obtaining information on household members' participation in government programs as well as prior labor... contains 2.1 people, age 15 years or older, yielding approximately 94,500 person-level interviews in Wave 1...

The effects of eliminating supplemental security income drug addiction and alcoholism eligibility on the mental health of low-income substance abusers.

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Hogan, Sean R; Speiglman, Richard; Norris, Jean C

2010-09-01

On January 1, 1997, as the result of federal legislation, many low-income substance abusers lost income and healthcare benefits provided by the Supplemental Security Income (SSI) program. This study examined the effects of eliminating drug addiction and alcoholism (DAA) as qualifying impairments for SSI benefits on the mental health and mental health treatment utilization of former beneficiaries 3.5 years following the policy change. Study participants in four Northern California counties were categorized into three comparison groups based on their primary income source over the lifetime of the study. Findings indicated that overall the reported mental health status of former SSI DAA beneficiaries improved following the policy change; however, study participants who relied primarily on some other type of public assistance post-termination reported an increase in mental health treatment utilization.

HUD Low and Moderate Income Areas

Data.gov (United States)

Department of Housing and Urban Development — This dataset and map service provides information on the U.S. Housing and Urban Development's (HUD) low to moderate income areas. The term Low to Moderate Income,...

Experiential Cooking Programs for Low-Income Adults: Strategies for Success

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Franck, Karen; Vineyard, Michelle; Olson, Ann; Peterson, Ashley

2012-01-01

Experiential cooking classes for low-income adults can help improve healthy nutrition behaviors. However, nutrition educators and Extension professionals can face challenges in successful implementation of these programs such as difficulties recruiting and retaining participants. Drawing upon lessons learned from a cooking intervention with…

Empowering low-income black families of handicapped children.

Science.gov (United States)

Kalyanpur, M; Rao, S S

1991-10-01

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

Contraceptive use among low-income urban married women in India.

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Kumar, Manisha; Meena, Jyoti; Sharma, Sumedha; Poddar, Anju; Dhalliwal, Vikas; Modi-Satish Chander Modi, S C; Singh, Kamlesh

2011-02-01

The reports of a rise in contraceptive practices have not been matched by a similar decrease in population, so there is a need to look into the causes of this discrepancy. To obtain information from low-income urban married women regarding their contraceptive knowledge, practices, and utilization of the services. Percentage of low-income urban married women using contraception, different types of contraception used, influence of education on choice of contraception. All nonpregnant married women between the ages of 18 and 45 years, belonging to low-income groups were selected for study. Statistical analysis was done using EPI Info ver-5.0. Chi square test was used to test the significance of data. Contraceptive use among these women was 52%; the most common method was tubal ligation. Educated women used spacing methods more often than uneducated women. Women had adequate awareness regarding type of contraceptives available but had no idea about the timing of starting contraception after delivery and about emergency contraception. The low-income urban population is aware of the importance of limiting the family size and has family planning facilities yet has less contraceptive usage because of low level of education, increased rate of discontinuation, and lack of proper knowledge of the use of contraception. © 2010 International Society for Sexual Medicine.

Supporting and including children from low income families

OpenAIRE

Benoist, FD

2017-01-01

This chapter explores: • What we mean by low income and poverty and how poverty is defined • The families living on low income in the UK today and the impact of low income and poverty on children’s well-being, development and learning • Supporting children from low income families • The attainment gap between children from low income backgrounds and their peers • The pupil premium and how schools have used the extra funding to raise attainment • Key aspects of good practice and what schools c...

Life After Welfare Reform: Low-Income Single Parent Families, Pre- and Post-TANF.

Science.gov (United States)

Peterson, Janice; Song, Xue; Jones-DeWeever, Avis

This study used data from the first and last waves of the 1996 U.S. Census Bureau's Survey of Income and Program Participation to compare the characteristics and wellbeing of low-income, single parent families before and after passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), noting the characteristics and…

Posttraumatic stress disorder among low-income women exposed to perinatal intimate partner violence : Posttraumatic stress disorder among women exposed to partner violence.

Science.gov (United States)

Kastello, Jennifer C; Jacobsen, Kathryn H; Gaffney, Kathleen F; Kodadek, Marie P; Bullock, Linda C; Sharps, Phyllis W

2016-06-01

Women exposed to intimate partner violence (IPV) and other forms of lifetime trauma may be at risk for negative mental health outcomes including posttraumatic stress disorder (PTSD). The purpose of this study was to examine potential predictors of PTSD among low-income women exposed to perinatal IPV. This study analyzed baseline cross-sectional data from 239 low-income pregnant women in the USA who participated in a nurse home visitation intervention between 2006 and 2012 after reporting recent IPV. PTSD was assessed with the Davidson Trauma Scale (DTS) in which participants answer questions about the most disturbing traumatic event (MDTE) in their lifetime that affected them the week before the interview. In total, 40 % of the women were identified as having PTSD (DTS ≥40). PTSD prevalence significantly increased with age to nearly 80 % of women ages 30 and older (n = 23). Age was also the strongest predictor of PTSD (p violence were not significantly associated with PTSD status. Despite recent exposure to IPV, most participants identified other traumatic events as more disturbing than IPV-related trauma. Further, the risk for PTSD increased with age, suggesting that the cumulative effect of trauma, which may include IPV, increases the risk for PTSD over a lifetime. Implementing comprehensive screening for trauma during prenatal care may lead to the early identification and treatment of PTSD during pregnancy in a community setting.

Effect of national wealth on BMI: An analysis of 206,266 individuals in 70 low-, middle- and high-income countries.

Directory of Open Access Journals (Sweden)

Mohd Masood

Full Text Available This study explores the relationship between BMI and national-wealth and the cross-level interaction effect of national-wealth and individual household-wealth using multilevel analysis.Data from the World Health Survey conducted in 2002-2004, across 70 low-, middle- and high-income countries was used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as outcome variable. The potential determinants of individual-level BMI were participants' sex, age, marital-status, education, occupation, household-wealth and location(rural/urban at the individual-level. The country-level factors used were average national income (GNI-PPP and income inequality (Gini-index. A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries was fitted, treating BMI as a continuous outcome.The weighted mean BMI and standard-error of the 206,266 people from 70-countries was 23.90 (4.84. All the low-income countries were below the 25.0 mean BMI level and most of the high-income countries were above. All wealthier quintiles of household-wealth had higher scores in BMI than lowest quintile. Each USD10000 increase in GNI-PPP was associated with a 0.4 unit increase in BMI. The Gini-index was not associated with BMI. All these variables explained 28.1% of country-level, 4.9% of individual-level and 7.7% of total variance in BMI. The cross-level interaction effect between GNI-PPP and household-wealth was significant. BMI increased as the GNI-PPP increased in first four quintiles of household-wealth. However, the BMI of the wealthiest people decreased as the GNI-PPP increased.Both individual-level and country-level factors made an independent contribution to the BMI of the people. Household-wealth and national-income had significant interaction effects.

Financing the response to HIV in low-income and middle-income countries.

Science.gov (United States)

Izazola-Licea, José Antonio; Wiegelmann, Jan; Arán, Christian; Guthrie, Teresa; De Lay, Paul; Avila-Figueroa, Carlos

2009-12-01

To describe levels of national HIV spending and examine programmatic allocations according to the type of epidemic and country income. Cross-sectional analysis of HIV expenditures from 50 low-income and middle-income countries. Sources of information included country reports of domestic spending by programmatic activity and HIV services. These HIV spending categories were cross tabulated by source of financing, stratified by type of HIV epidemic and income level of the country and reported in international dollars (I$). Fifty low-income and middle-income countries spent US $ 2.6 billion (I$ 5.8 billion) on HIV in 2006; 87% of the funding among the 17 low-income countries came from international donors. Average per capita spending was I$ 2.1 and positively correlated with Gross National Income. Per capita spending was I$ 1.5 in 9 countries with low-level HIV epidemics, I$ 1.6 in 27 countries with concentrated HIV epidemics and I$ 9.5 in 14 countries with generalized HIV epidemics. On average, spending on care and treatment represented 50% of AIDS spending across all countries. The treatment-to-prevention spending ratio was 1.5:1, 3:1, and 2:1 in countries with low-level, concentrated and generalized epidemics, respectively. Spending on prevention represented 21% of total AIDS spending. However, expenditures addressing most-at-risk populations represented less than 1% in countries with generalized epidemics and 7% in those with low-level or concentrated epidemics. The most striking finding is the mismatch between the types of HIV epidemics and the allocation of resources. The current global economic recession will force countries to rethink national strategies, especially in low-income countries with high aid dependency. Mapping HIV expenditures provides crucial guidance for reallocation of resources and supports evidence-based decisions. Now more than ever, countries need to know and act on their epidemics and give priority to the most effective programmatic

Television viewing in low-income latino children: variation by ethnic subgroup and English proficiency.

Science.gov (United States)

Thompson, Darcy A; Matson, Pamela A; Ellen, Jonathan M

2013-02-01

Television viewing is associated with an increased risk for obesity in children. Latino children are at high risk for obesity and yet little is known about differences in television viewing habits within this population. The purpose of this study is to determine if hours of television viewed by young children with low-income Latina mothers differs by maternal ethnic subgroup and English language proficiency. This was a cross-sectional analysis of data from the Welfare, Children, & Families: A Three City Study. Participants were 422 low-income Latina mothers of Mexican and Puerto Rican descent with children ages 0-4 years old. The dependent variable was hours of daily television viewed by the child. The independent variable was maternal ethnic subgroup and English language proficiency. Analyses involved the use of multiple negative binomial regression models, which were adjusted for demographic variables. Multivariable regression analyses showed that compared to children with mothers of Mexican descent, children of mothers of Puerto Rican descent watch more daily television (child television viewing (IRR=1.29, 95% CI 1.04, 1.61). No relationship was found for children of Puerto Rican descent. Child television viewing varies in low-income Latino children by maternal ethnic subgroup and English language proficiency. Interventionists must consider the varying sociocultural contexts of Latino children and their influence on television viewing.

Television Viewing in Low-Income Latino Children: Variation by Ethnic Subgroup and English Proficiency

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Matson, Pamela A.; Ellen, Jonathan M.

2013-01-01

Abstract Background Television viewing is associated with an increased risk for obesity in children. Latino children are at high risk for obesity and yet little is known about differences in television viewing habits within this population. The purpose of this study is to determine if hours of television viewed by young children with low-income Latina mothers differs by maternal ethnic subgroup and English language proficiency. Methods This was a cross-sectional analysis of data from the Welfare, Children, & Families: A Three City Study. Participants were 422 low-income Latina mothers of Mexican and Puerto Rican descent with children ages 0–4 years old. The dependent variable was hours of daily television viewed by the child. The independent variable was maternal ethnic subgroup and English language proficiency. Analyses involved the use of multiple negative binomial regression models, which were adjusted for demographic variables. Results Multivariable regression analyses showed that compared to children with mothers of Mexican descent, children of mothers of Puerto Rican descent watch more daily television (television viewing (IRR=1.29, 95% CI 1.04, 1.61). No relationship was found for children of Puerto Rican descent. Conclusions Child television viewing varies in low-income Latino children by maternal ethnic subgroup and English language proficiency. Interventionists must consider the varying sociocultural contexts of Latino children and their influence on television viewing. PMID:23301653

Associations between family food behaviors, maternal depression, and child weight among low-income children

OpenAIRE

McCurdy, Karen; Gorman, Kathleen S.; Kisler, Tiffani; Metallinos-Katsaras, Metallinos-Katsaras

2014-01-01

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and ...

Empowerment in the process of health messaging for rural low-income mothers: an exploratory message design project.

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Aldoory, Linda; Braun, Bonnie; Maring, Elisabeth Fost; Duggal, Mili; Briones, Rowena Lynn

2015-01-01

Rural, low-income mothers face challenges to their health equal to or greater than those of low-income mothers from urban areas. This study put health message design into the hands of low-income rural mothers. The current study filled a research gap by analyzing a participatory process used to design health messages tailored to the everyday lives of rural low-income mothers. A total of forty-three mothers participated in nine focus groups, which were held from 2012 to 2013, in eight states. The mothers were from different racial and ethnic backgrounds. Participants discussed food security, physical activity, and oral health information. They created messages by considering several elements: visuals, length of message, voice/perspective, self-efficacy and personal control, emotional appeals, positive and negative reinforcements, and steps to health behavior change. This study was innovative in its focus on empowerment as a key process to health message design.

Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis.

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Siriwardhana, Dhammika D; Hardoon, Sarah; Rait, Greta; Weerasinghe, Manuj C; Walters, Kate R

2018-03-01

To systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs. Systematic review and meta-analysis. PROSPERO registration number is CRD42016036083. MEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017. Low-income and middle-income countries. Community-dwelling older adults aged ≥60 years. We screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I 2 =99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I 2 =97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years. The prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries. CRD42016036083. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

An Investigation of Participation in Weekly Music Workshops and Its Relationship to Academic Self-Concept and Self-Esteem of Middle School Students in Low-Income Communities

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Shin, Jihae

2011-01-01

The purpose of this study was to examine how I Am A Dreamer Musician Program (IDMP) affected academic self-concept and self-esteem of middle school students in low-income communities. During the seven weeks of the weekly music workshops, students participated in different musical activities including playing percussion instruments, singing,…

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis

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Ana Cristina Lindsay

2017-08-01

Full Text Available Latinos are the largest minority population group in the United States (U.S., and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15–44. Participants (n = 147 were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers′ Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish administered by bilingual interviewers. About one-third (34% of participants were classified as having obesity (BMI ≥ 30 kg/m2, 28.3% had elevated depressive symptoms (CES-D ≥ 16, and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR = 2.80, 95% confidence interval (CI: 1.24–6.33. Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02–1.09. Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in

Depressive Symptoms and Length of U.S. Residency Are Associated with Obesity among Low-Income Latina Mothers: A Cross-Sectional Analysis.

Science.gov (United States)

Lindsay, Ana Cristina; Greaney, Mary L; Wallington, Sherrie F; Wright, Julie A; Hunt, Anne T

2017-08-02

Latinos are the largest minority population group in the United States (U.S.), and low-income Latina women are at elevated risk of depression and obesity. Thus, the prevention of these two problems is a pressing public health concern in this population. Both depressive symptoms and obesity are modifiable factors that can be addressed by culturally relevant interventions. However, the association between depressive symptoms and obesity in Latina immigrant women is not well understood. Therefore, this cross-sectional study examined the association between depressive symptoms and obesity among Latina women of childbearing age (15-44). Participants ( n = 147) were low-income, predominantly immigrant Latina mothers enrolled in the Latina Mothers' Child Feeding Practices and Style Study. Women were eligible to participate if they self-identified as Latina; were enrolled in or eligible for the Special Supplemental Nutrition Program for Women, Infants and Children program; had a child between ages two and five years; and were living in the U.S. for at least one year, and residing in Rhode Island. Enrolled participants completed a survey in their language of preference (English or Spanish) administered by bilingual interviewers. About one-third (34%) of participants were classified as having obesity (BMI ≥ 30 kg/m²), 28.3% had elevated depressive symptoms (CES-D ≥ 16), and 70.1% were immigrants. Women with elevated depressive symptoms had increased odds of having obesity (odds ratio (OR) = 2.80, 95% confidence interval (CI): 1.24-6.33). Additionally, among immigrants, length of U.S. residency was associated with increased odds of obesity (OR = 1.05, 95% CI: 1.02-1.09). Findings underscore the need for screening and culturally relevant interventions designed to address both depressive symptoms and obesity among low-income Latina women of childbearing age. Furthermore, findings highlight the importance of taking into account the length of residency in the U.S. when

Assessing Technologies for Information-Seeking on Prostate Cancer Screening by Low-Income Men

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Susan W. McRoy

2014-11-01

Full Text Available Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older. Methods: The study comprised: 1 a survey assessing current use of the Internet, mobile phones and texting; 2 a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3 a formative field study in which subjects interacted with a health department nurse using text messages. Results: Survey results suggest the target population has greater access to, and familiarity with, cell phones and text messaging compared to the Internet and web-based searching. Participants were significantly more confident using a cell phone and preferred to get health information through text messaging. Participants in the controlled observational study accepted the text messaging system, with most indicating it answered their questions, was easy to use and was a favorable tool for information-seeking. The field study also demonstrated potential for automated question-answering and text messaging to help the target population access health information. Conclusions: A two-way text messaging system has great potential to promote health communication and health information distribution. Participant interest in this system was high and did not seem to be specific to prostate cancer screening, suggesting that information about other topics, such as high blood pressure screening, could be provided similarly. We believe more investigations should be focused on this area, especially on benefits for the low-income community.

Widening Income Inequalities: Higher Education's Role in Serving Low Income Students

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Dalton, Jon C.; Crosby, Pamela C.

2015-01-01

Many scholars argue that America is becoming a dangerously divided nation because of increasing inequality, especially in income distribution. This article examines the problem of widening income inequality with particular focus on the role that colleges and universities and their student affairs organizations play in serving low income students…

The persistent gap in health-care coverage between low- and high-income workers in Washington State: BRFSS, 2003-2007.

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Fan, Z Joyce; Anderson, Naomi J; Foley, Michael; Rauser, Eddy; Silverstein, Barbara A

2011-01-01

We examined the disparities in health-care coverage between low- and high-income workers in Washington State (WA) to provide support for possible policy decisions for uninsured workers. We examined data from the WA Behavioral Risk Factor Surveillance System 2003-2007 and compared workers aged 18-64 years of low income (annual household income income (annual household income ≥$35,000) on proportions and sources of health-care coverage. We conducted multivariable logistic regression analyses on factors that were associated with the uninsured. Of the 54,536 survey respondents who were working-age adults in WA, 13,922 (25.5%) were low-income workers. The proportions of uninsured were 38.2% for low-income workers and 6.3% for high-income workers. While employment-based health benefits remained a dominant source of health insurance coverage, they covered only 40.2% of low-income workers relative to 81.5% of high-income workers. Besides income, workers were more likely to be uninsured if they were younger; male; Hispanic; less educated; not married; current smokers; self-employed; or employed in agriculture/forestry/fisheries, construction, and retail. More low-income workers (28.7%) reported cost as an issue in paying for health services than did their high-income counterparts (6.7%). A persistent gap in health-care coverage exists between low- and high-income workers. The identified characteristics of these workers can be used to implement policies to expand health insurance coverage.

Knowledge, skills, and behavior improvements on peer educators and low-income Hispanic participants after a stage of change-based bilingual nutrition education program.

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Taylor, T; Serrano, E; Anderson, J; Kendall, P

2000-06-01

A nutrition education program, entitled La Cocina Saludable, was designed according to the Stage of Change Model and implemented in ten southern Colorado counties. The objectives were to improve the nutrition related knowledge, skills, and behaviors that lead to healthy lifestyles in a low-income Hispanic population. The content of the program included nutrition information designed to help mothers of preschool children provide for their children's nutritional needs. Previous studies suggest that low-income Hispanics often demonstrate low intakes of vitamins A and C, calcium, iron, and protein, and high rates of diabetes, obesity, and infections. Additionally, this population presents many obstacles for nutrition educators including limited resources, child care, transportation, time, language, culture, literacy, health beliefs, and, in some cases, the transient nature of the population. The program attempted to overcome these barriers by incorporating a flexible program format carried out by abuela (Hispanic grandmother) educators using the processes described in the Stage of Change Model. The program was evaluated using a knowledge, skills and behavior pre-test, post-test, and six-month follow-up survey on both the abuela educators as well as the actual class participants. Results of the peer education training sessions suggest that this type of training program can be effective in increasing the knowledge, skills, and behavior of peer educators as well as reduce need for retraining for educators who continuously teach classes. Additionally, the results suggest that this type of program can be effective in changing selected nutrition related knowledge, skills, and behaviors leading to healthy lifestyles for low-income Hispanic mothers of preschool children.

Job Satisfaction, Retirement Attitude and Intended Retirement Age: A Conditional Process Analysis across Workers’ Level of Household Income

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Davies, Eleanor M. M.; Van der Heijden, Beatrice I. J. M.; Flynn, Matt

2017-01-01

In the contemporary workplace, insight into retirement behaviors is of crucial importance. Previous empirical evidence has found mixed results regarding the relationship between work attitudes, such as job satisfaction, and retirement behaviors, suggesting that further scholarly examination incorporating moderating and mediating variables into retirement models is needed. Drawing on comparative models of attitude to retirement, we hypothesized a direct relationship between job satisfaction and intended retirement age for workers with a high household income and an indirect relationship between job satisfaction and intended retirement age, via retirement attitude, for workers with a low or mean household income. We collected data from a sample of 590 United Kingdom workers aged 50+. Using conditional process analysis, we found that the underlying mechanisms in our research model differ according to socio-economic status. We found no direct effect between job satisfaction and intended retirement age. However, an indirect effect was observed between job satisfaction and intended retirement age, via retirement attitude, for both low- and mean-household income individuals. Specifically, the relationship between job satisfaction and retirement attitude differed according to socio-economic group: for high-household income older workers, there was no relationship between job satisfaction and retirement attitude. However, for low- and mean-household income older workers, we observed a negative relationship between job satisfaction and retirement attitude. Otherwise stated, increases in job satisfaction for mean and low household income workers are likely to make the prospect of retirement less attractive. Therefore, we argue that utmost care must be taken around the conditions under which lower income employees will continue their work when getting older in order to protect their sustainable employability. PMID:28620329

Job Satisfaction, Retirement Attitude and Intended Retirement Age: A Conditional Process Analysis across Workers’ Level of Household Income

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Eleanor M. M. Davies

2017-05-01

Full Text Available In the contemporary workplace, insight into retirement behaviors is of crucial importance. Previous empirical evidence has found mixed results regarding the relationship between work attitudes, such as job satisfaction, and retirement behaviors, suggesting that further scholarly examination incorporating moderating and mediating variables into retirement models is needed. Drawing on comparative models of attitude to retirement, we hypothesized a direct relationship between job satisfaction and intended retirement age for workers with a high household income and an indirect relationship between job satisfaction and intended retirement age, via retirement attitude, for workers with a low or mean household income. We collected data from a sample of 590 United Kingdom workers aged 50+. Using conditional process analysis, we found that the underlying mechanisms in our research model differ according to socio-economic status. We found no direct effect between job satisfaction and intended retirement age. However, an indirect effect was observed between job satisfaction and intended retirement age, via retirement attitude, for both low- and mean-household income individuals. Specifically, the relationship between job satisfaction and retirement attitude differed according to socio-economic group: for high-household income older workers, there was no relationship between job satisfaction and retirement attitude. However, for low- and mean-household income older workers, we observed a negative relationship between job satisfaction and retirement attitude. Otherwise stated, increases in job satisfaction for mean and low household income workers are likely to make the prospect of retirement less attractive. Therefore, we argue that utmost care must be taken around the conditions under which lower income employees will continue their work when getting older in order to protect their sustainable employability.

Job Satisfaction, Retirement Attitude and Intended Retirement Age: A Conditional Process Analysis across Workers' Level of Household Income.

Science.gov (United States)

Davies, Eleanor M M; Van der Heijden, Beatrice I J M; Flynn, Matt

2017-01-01

In the contemporary workplace, insight into retirement behaviors is of crucial importance. Previous empirical evidence has found mixed results regarding the relationship between work attitudes, such as job satisfaction, and retirement behaviors, suggesting that further scholarly examination incorporating moderating and mediating variables into retirement models is needed. Drawing on comparative models of attitude to retirement, we hypothesized a direct relationship between job satisfaction and intended retirement age for workers with a high household income and an indirect relationship between job satisfaction and intended retirement age, via retirement attitude, for workers with a low or mean household income. We collected data from a sample of 590 United Kingdom workers aged 50+. Using conditional process analysis, we found that the underlying mechanisms in our research model differ according to socio-economic status. We found no direct effect between job satisfaction and intended retirement age. However, an indirect effect was observed between job satisfaction and intended retirement age, via retirement attitude, for both low- and mean-household income individuals. Specifically, the relationship between job satisfaction and retirement attitude differed according to socio-economic group: for high-household income older workers, there was no relationship between job satisfaction and retirement attitude. However, for low- and mean-household income older workers, we observed a negative relationship between job satisfaction and retirement attitude. Otherwise stated, increases in job satisfaction for mean and low household income workers are likely to make the prospect of retirement less attractive. Therefore, we argue that utmost care must be taken around the conditions under which lower income employees will continue their work when getting older in order to protect their sustainable employability.

Internet use among low-income persons recently diagnosed with HIV infection.

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Mayben, J K; Giordano, T P

2007-10-01

Patients are increasingly using the Internet to obtain health-related information, communicate with providers and access research. Use of the Internet to obtain health-related information by low-income patients recently diagnosed with HIV infection has not been examined. In 2005, we surveyed 126 low-income patients diagnosed with HIV infection within the last three years. Eighty-five percent of the patients wereInternet to access information about HIV, 52% had never used the Internet, 28% had never used it to obtain health-related information and only 18% had done so at least monthly for the last six months. Two-thirds of the population studied would need instruction on how to use the Internet. In multivariable regression, 2004 income > or =$15,000 predicted monthly Internet use to obtain health-related information. Older age, heterosexual intercourse as HIV risk factor and inadequate health literacy were independent predictors of needing instruction. The low-income population with HIV infection lags behind the general population in Internet access and may not benefit from Internet-dependent advances in health communication, including HIV-related interventions.

The views of low-income employees regarding mandated comprehensive employee benefits for the sake of health.

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Adikes, Katherin A; Hull, Sara C; Danis, Marion

2010-01-01

Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers.

The Views of Low-Income Employees Regarding Mandated Comprehensive Employee Benefits for the Sake of Health

Science.gov (United States)

Adikes, Katherin A.; Hull, Sara C.; Dams, Marion

2013-01-01

Socioeconomic factors stand in the way of good health for low-income populations. We suggest that employee benefits might serve as a means of improving the health of low-wage earners. We convened groups of low-income earners to design hypothetical employee benefit packages. Qualitative analysis of group discussions regarding state-mandated benefits indicated that participants were interested in a great variety of benefits, beyond health care, that address socioeconomic determinants of health. Long-term financial and educational investments were of particular value. These results may facilitate the design of employee benefits that promote the health of low-income workers. PMID:20391255

Social participation and healthy ageing: a neglected, significant protective factor for chronic non communicable conditions

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Joseph Jennifer

2011-10-01

Full Text Available Abstract Background Low and middle income countries are ageing at a much faster rate than richer countries, especially in Asia. This is happening at a time of globalisation, migration, urbanisation, and smaller families. Older people make significant contributions to their families and communities, but this is often undermined by chronic disease and preventable disability. Social participation can help to protect against morbidity and mortality. We argue that social participation deserves much greater attention as a protective factor, and that older people can play a useful role in the prevention and management of chronic conditions. We present, as an example, a low-cost, sustainable strategy that has increased social participation among elders in Sri Lanka. Discussion Current international policy initiatives to address the increasing prevalence of non-communicable chronic diseases are focused on cardiovascular disease, diabetes, respiratory disease and cancers, responsible for much premature mortality. Interventions to modify their shared risk factors of high salt and fat diets, inactivity, smoking and alcohol use are advocated. But older people also suffer chronic conditions that primarily affect quality of life, and have a wider range of risk factors. There is strong epidemiological and physiological evidence that social isolation, in particular, is as important a risk factor for chronic diseases as the 'lifestyle' risk factors, yet it is currently neglected. There are useful experiences of inexpensive and sustainable strategies to improve social participation among older people in low and lower middle income countries. Our experience with forming Elders' Clubs with retired tea estate workers in Sri Lanka suggests many benefits, including social support and participation, inter-generational contact, a collective voice, and facilitated access to health promotion activities, and to health care and social welfare services. Summary Policies to

Eye care utilization by older adults in low, middle, and high income countries

Directory of Open Access Journals (Sweden)

Vela Claudia

2012-04-01

Full Text Available Abstract Background The risk of visual impairment increases dramatically with age and therefore older adults should have their eyes examined at least every 1 to 2 years. Using a world-wide, population-based dataset, we sought to determine the frequency that older people had their eyes examined. We also examined factors associated with having a recent eye exam. Methods The World Health Surveys were conducted in 70 countries throughout the world in 2002-2003 using a random, multi-stage, stratified, cluster sampling design. Participants 60 years and older from 52 countries (n = 35,839 were asked "When was the last time you had your eyes examined by a medical professional?". The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank website. Prevalence estimates were adjusted to account for the complex sample design. Results Overall, only 18% (95% CI 17, 19 of older adults had an eye exam in the last year. The rate of an eye exam in the last year in low, lower middle, upper middle, and high income countries was 10%, 24%, 22%, and 37% respectively. Factors associated with having an eye exam in the last year included older age, female gender, more education, urban residence, greater wealth, worse self-reported health, having diabetes, and wearing glasses or contact lenses (p Conclusions Given that older adults often suffer from age-related but treatable conditions, they should be seen on a regular basis to prevent visual impairment and its disabling consequences.

Assessing the Digital Divide Among Low-Income Perinatal Women: Opportunities for Provision of Health Information and Counseling.

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Acquavita, Shauna P; Krummel, Debra A; Talks, Alexandra; Cobb, Alexandra; McClure, Erin

2018-04-30

Technology-based health interventions may provide a means to reach low-income perinatal women and improve outcomes for both mother and infant, yet little is known about technology access and interest among this population. This study explored interest, attitudes, and concerns regarding technology to deliver health information and interventions. Between May and October 2014, a cross-sectional study of 161 low-income pregnant and/or postpartum mothers (up to 1 year) was conducted, assessing attitudes and behaviors regarding the current use of devices and receptivity to interventions delivered through devices. Participants (ages 18-41) were pregnant or postpartum and able to read and comprehend English. Women were recruited from waiting areas at two urban clinics affiliated with the local health department in a Midwestern city in the United States. Surveys included 46 questions and were completed at the time of invitation. Descriptive statistics, independent sample t test, or chi-square for independence tests were completed using SPSS (version 23). Participants from this sample were mostly African American (60%) and had a mean age of 26 years. Most were postpartum (67%). The majority of the sample used mobile phones (most being smartphones), with less access and use of computers and tablets. A moderate level of interest in utilizing technology for health-related information and interventions was found, with concerns related to privacy and time.

Designing Low-Income Housing Using Local Architectural Concepts

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Trumansyahjaya, K.; Tatura, L. S.

2018-02-01

The provision of houses for low-income people who do not have a home worthy of being one of the major problems in the city of Gorontalo, because the community in establishing the house only pay attention to their wants and needs in creating a healthy environment, the beauty of the city and the planning of the home environment in accordance with the culture of the people of Gorontalo. In relation to the condition, the focus of this research is the design of housing based on local architecture as residential house so that it can be reached by a group of low income people with house and environment form determined based on family development, social and economic development of society and environment which take into account the local culture. Stages of this research includes five (5) stages, including the identification phase characteristics Gorontalo people of low income, the characteristics of the identification phase house inhabited by low-income people, the stage of identification preference low-income households, the phase formation house prototype and the environment, as well as the stage of formation model home for low-income people. Analysis of the model homes for low-income people using descriptive analysis, Hierarchical Cluster Analysis, and discrimination analysis to produce a prototype of the house and its surroundings. The prototype is then reanalyzed to obtain the model home for low-income people in the city of Gorontalo. The shape of a model home can be used as a reference for developers of housing intended for low-income people so that housing is provided to achieve the goals and the desired target group.

Social marketing nutrition education for low-income population.

Science.gov (United States)

Hagues, Rachel; Stotz, Sarah; Childers, Austin; Phua, Joe; Hibbs, Judy; Murray, Deborah; Lee, Jung Sun

2018-01-01

As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.

Interrelationship between food security status, home availability of variety of fruits and vegetables and their dietary intake among low-income pregnant women.

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Nunnery, Danielle L; Labban, Jeffrey D; Dharod, Jigna M

2018-03-01

To (i) determine differences in the availability of variety of fruits and vegetables (F&V) at home by food security status; and (ii) examine the inter-associations between food security status, availability of variety of F&V at home and frequency of F&V intake, among low-income pregnant women. Design/Setting Participants were interviewed to collect food security status, home availability of variety of F&V and frequency of F&V intake. Bivariate analyses, multivariate regression and exploratory mediation analyses were conducted using IBM SPSS Statistics version 23.0 and the PROCESS macro. Low-income pregnant women (n 198) were interviewed if they were ≥18 years of age, in the second trimester of pregnancy, and spoke English or Spanish. Low/very low food security was found among 43 % of participants. Compared with fully food-secure participants, very low food-secure participants reported a lower variety of fruits (P=0·028) and vegetables (P=0·058) available at home. Mediation analyses indicated that through home availability of variety of fresh F&V, food security status was associated with the daily intake of F&V (indirect effect (95 % CI): fresh fruits, -0·039 (-0·074, -0·013); fresh vegetables, -0·048 (-0·083, -0·023)). As food security worsened, the available variety of fresh F&V decreased, which was associated with lower intake. The study highlights the interlink between food security, home food environment and diet quality, and the importance of nutrition education intervention to promote a healthy home food environment and improved pregnancy outcomes among low-income women.

Prevalence study of compulsive buying in a sample with low individual monthly income.

Science.gov (United States)

Leite, Priscilla Lourenço; Silva, Adriana Cardoso

2015-01-01

Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Despite the small sample, the results of this study are important for understanding the problem in question.

Characteristics and Service Use of Medicaid Buy-In Participants with Higher Incomes: A Descriptive Analysis

OpenAIRE

Denise Hoffman; Kristin Andrews; Valerie Cheh

2013-01-01

This study examined the characteristics and service use of Medicaid Buy-In participants with higher incomes (above 250 percent of the federal poverty line), relative to participants with lower incomes. The study found higher-income participants were less likely to enroll in Medicare and more likely to be enrolled in third-party insurance. Service use for higher-income Buy-In participants concentrated on prescription drugs and durable medical equipment, and Medicaid expenditures for a selected...

HIV prevention and low-income Chilean women: machismo, marianismo and HIV misconceptions.

Science.gov (United States)

Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J

2008-04-01

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.

Preconception Health Behaviors of Low-Income Women.

Science.gov (United States)

Ayoola, Adejoke B; Sneller, Krista; Ebeye, Tega D; Dykstra, Megan Jongekrijg; Ellens, Victoria L; Lee, HaEun Grace; Zandee, Gail L

2016-01-01

Preconception behaviors have a significant impact on birth outcomes, particularly among low-income minority groups, and women with unplanned pregnancies. This study examined women's perceived health status and behaviors such as drinking, smoking, exercise, and use of multivitamins and folic acid. This was a descriptive study based on a convenience sample of women living in urban underserved neighborhoods. Univariate and bivariate analyses were conducted using STATA 13. The sample consisted of 123 women ages 18 to 51 years (mean = 30.57); 51.22% were Hispanic, 36.59% African American, and 12.2% Caucasian. Over 70% had a household income of less than $20,000, 57.72% had no health insurance in the last year, and 58.54% were not married. These women were below the Healthy People 2020 goals for drinking, smoking, and multivitamin use, especially those who were planning to get pregnant in the next 6 months or not sure of their pregnancy planning status. There were no significant differences on any of the preconception health behavior variables based on pregnancy intention. Nurses and healthcare providers should emphasize importance of practicing healthy behaviors during the preconception period among low-income ethnic minority women specifically those living in urban medically underserved areas who are unsure of their pregnancy planning status or are at risk of unintended pregnancy.

Lower education among low-income Brazilian adolescent females is associated with planned pregnancies

Directory of Open Access Journals (Sweden)

Faisal-Cury A

2017-01-01

Full Text Available Alexandre Faisal-Cury,1 Karen M Tabb,2 Guilherme Niciunovas,3 Carrie Cunningham,4 Paulo R Menezes,1 Hsiang Huang4,5 1Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; 2School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, USA; 3School of Medicine, Federal University of São Paulo, São Paulo, Brazil; 4Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA; 5Department of Psychiatry, Laboratory of Psychopathology and Psychiatric Therapeutics (LIM-23, Faculty of Medicine, University of São Paulo, São Paulo, Brazil Abstract: Adolescent pregnancy has social, economic, and educational consequences and is also linked to adverse perinatal outcomes. However, studies show a positive relationship between pregnancy and increased social status among low-income adolescents. This study aims to assess the association between planned pregnancy and years of schooling among low-income Brazilian adolescents. This is a secondary analysis of a cohort study conducted from May 2005 to March 2007 in public primary care clinics in São Paulo, Brazil. Participants (n=168 completed a detailed structured questionnaire. Logistic regression was used to examine the association between years of schooling and planned pregnancy. After adjusting for the covariates income, wealth score, crowding, age, marital status, and race, planned pregnancy was independently associated with lower years of education (odds ratio: 1.82; 95% confidence interval: 1.02–3.23. Although this finding may be related to these adolescents having less access to information and health services, another possible explanation is that they have a greater desire to have children during adolescence. Keywords: adolescent pregnancy, planned pregnancy, Brazil, low-income population, women

Effects of simplifying outreach materials for energy conservation programs that target low-income consumers

International Nuclear Information System (INIS)

Wong-Parodi, Gabrielle; Bruine de Bruin, Wändi; Canfield, Casey

2013-01-01

Critics have speculated that the limited success of energy conservation programs among low-income consumers may partly be due to recipients having insufficient literacy to understand the outreach materials. Indeed, we found outreach materials for low-income consumers to require relatively high levels of reading comprehension. We therefore improved the Flesch–Kincaid readability statistics for two outreach brochures, by using shorter words and shorter sentences to describe their content. We examined the effect of that simplification on low-income consumers′ responses. Participants from low-income communities in the greater Pittsburgh area, who varied in literacy, were randomly assigned to either original communications about energy conservation programs or our simplified versions. Our findings suggest that lowering readability statistics successfully simplified only the more straightforward brochure in our set of two, likely because its content lent itself better to simplification. Findings for this brochure showed that simplification improved understanding of its content among both low-literacy and high-literacy recipients, without adversely affecting their evaluation of the materials, or their intention to enroll in the advertised programs. We discuss strategies for improving communication materials that aim to reach out to low-income populations. - Highlights: • Brochures about energy programs for low-income consumers can be too hard to read. • We made brochures easier to read by using shorter words and shorter sentences. • Simplifying a straightforward brochure improved the understanding of all recipients. • However, simplifying a complex brochure had no effect on understanding. • We suggest strategies for improving outreach to low-income consumers

Gender Differences in Caregiver Emotion Socialization of Low-Income Toddlers

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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'…

Evaluation of DOE's Partnership in Low-Income Residential Retrofit (PILIRR) Program

Energy Technology Data Exchange (ETDEWEB)

Callaway, J.W.; Lee, A.D.

1989-05-01

In July 1986, the US Department of Energy (DOE) awarded competitive grants to five states to conduct pilot projects to establish partnerships and use resource leveraging to stimulate support for low-income residential energy retrofits. The projects were conducted under DOE's Partnerships in Low-Income Residential Retrofit (PILIRR) Program. These projects have been monitored and analyzed through a concurrent process evaluation conducted by the Pacific Northwest Laboratory (PNL). This study reports the findings of that evaluation. The overriding goal of the PILIRR Program was to determine whether the states could stimulate support for low-income residential energy improvements from non-federal sources. The goal for the process evaluation was to conduct an assessment of the processes used by the states and the extent to which they successfully established partnerships and leveraged resources. Five states were selected to participate in the program: Florida, Iowa, Kentucky, Oklahoma and Washington. Each state proposed a different approach to promote non-federal support for low-income residential weatherization. Three of the five states--Florida, Iowa, and Washington--established partnerships that led to retrofits during the monitoring period (October 1986--October 1988). Kentucky established its partnership during the monitoring period, but did not accomplish its retrofits until after monitoring was complete. Oklahoma completed development of its marketing program and had begun marketing efforts by the end of the monitoring period. 16 refs., 7 figs., 1 tab.

Social inequalities in adult oral health in 40 low- and middle-income countries.

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Bhandari, Bishal; Newton, Jonathon T; Bernabé, Eduardo

2016-10-01

This study evaluated social inequalities in adult oral health across several low- and middle-income countries. We used data from 40 countries that participated in the World Health Surveys. Participants' socio-economic position was assessed using the wealth index. Oral health was assessed using two perceived measures, namely total tooth loss and whether they had any problems with their mouth and/or teeth during the last 12 months (perceived needs). Absolute and relative wealth inequalities in oral health were measured using the slope index of inequality (SII) and the relative index of inequality (RII), respectively, after adjusting for participants' sex, age and education. There were wealth inequalities in total tooth loss and perceived needs in most countries. However, significant monotonic gradients were found in 21 countries for total tooth loss and in 18 countries for perceived needs. Two distinctive patterns of social inequality in oral health were found across countries using the RII and the SII. For total tooth loss, pro-rich inequality was found in 25 countries (significant RII/SII in eight countries) and pro-poor inequality was found in 15 (significant RII/SII in three countries). For perceived needs, pro-poor inequality was found in 26 countries (significant RII/SII in six countries) and pro-rich inequality was found in 14 (significant RII/SII in five countries). The well-documented social gradient in adult oral health favouring the rich was not present in all low- and middle-income countries. Pro-poor inequalities in total tooth loss, and particularly in perceived dental-treatment needs, were observed in some countries. © 2016 FDI World Dental Federation.

Content, participants and outcomes of three diabetes care programmes in three low and middle income countries.

NARCIS (Netherlands)

Olmen, J. van; Ku, G.M.; Darras, C.; Kalobu, J.C.; Bewa, E.; Pelt, M. van; Hen, H.; Acker, K. van; Eggermont, N.; Schellevis, F.; Kegels, G.

2015-01-01

Aims: To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines. Methods: Three programmes offering

Content, participants and outcomes of three diabetes care programmes in three low and middle income countries

NARCIS (Netherlands)

van Olmen, J.; Marie, K.G.; Christian, D.; Clovis, K.J.; Emery, B.; Maurits, V.P.; Heang, H.; Kristien, V.A.; Natalie, E.; Francois, S.; Guy, K.

2015-01-01

Aims To improve access and quality of diabetes care for people in low-income countries, it is important to understand which elements of diabetes care are effective. This paper analyses three diabetes care programmes in the DR Congo, Cambodia and the Philippines. Methods Three programmes offering

Infant feeding and school attainment in five cohorts from low- and middle-income countries.

Science.gov (United States)

Horta, Bernardo L; Bas, Abet; Bhargava, Santosh K; Fall, Caroline H D; Feranil, Alan; de Kadt, Julia; Martorell, Reynaldo; Richter, Linda M; Stein, Aryeh D; Victora, Cesar G

2013-01-01

Performance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association. Participants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa). The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3-12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa. Measures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

Infant feeding and school attainment in five cohorts from low- and middle-income countries.

Directory of Open Access Journals (Sweden)

Bernardo L Horta

Full Text Available Performance in intelligence tests tends to be higher among individuals breastfed as infants, but little is known about the association between breastfeeding and achieved schooling. We assessed the association of infant feeding with school achievement in five cohorts from low- and middle-income countries. Unlike high-income country settings where most previous studies come from, breastfeeding is not positively associated with socioeconomic position in our cohorts, thus reducing the likelihood of a spurious positive association.Participants included 10,082 young adults from five birth cohorts (Brazil, India, Guatemala, the Philippines, and South Africa. The exposures variables were whether the subject was ever breastfed, total duration of breastfeeding, and age at introduction of complementary foods. We adjusted the estimates for age at follow up, sex, maternal age, smoking during pregnancy, birthweight and socioeconomic position at birth. The key outcome was the highest grade achieved at school. In unadjusted analyses, the association between ever breastfeeding and schooling was positive in Brazil, inverse in the Philippines, and null in South Africa; in adjusted analyses, these associations were attenuated. In Brazil, schooling was highest among individuals breastfed for 3-12 months whereas in the Philippines duration of breastfeeding was inversely associated with schooling; and null associations were observed in South Africa and Guatemala. These associations were attenuated in adjusted models. Late introduction of solid foods was associated with lower schooling achievement in Brazil and South Africa.Measures of breastfeeding are not consistently related to schooling achievement in contemporary cohorts of young adults in lower and middle-income countries.

Prevalence of Cardiovascular Risk Factors in a Low Income Semi-Urban Community in the North-East Nigeria

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Rufus Adesoji Adedoyin

2012-08-01

Full Text Available AIM: Adoption of western lifestyles with alterations in diet and activity patterns has been implicated in the increasing risks for cardiovascular disease in low income countries. This study investigated the prevalence of prehypertension, hypertension, overweight and obesity as modifiable cardiovascular risk factors in a low income semi-urban community in the Northeast Nigeria. METHOD: 1004 adults who were 20 years and older were recruited through a multi-stage cluster sampling technique. Definition of prehypertension and hypertension were based on the World Health Organization (WHO /International Society of Hypertension guidelines while the WHO body mass index (BMI cut-points were used to define overweight and obesity. RESULTS: The mean age, BMI and blood pressure of the participants were 41.5 ± 13.5 years, 22.2±3.73Kg/m2 and 125/78mmHg respectively. The prevalence of prehypertension, hypertension, overweight and obesity were 40.3, 25.2, 15.4 and 3.8% respectively. The Odds Ratio (95% Confidence Interval for the hypertension among the obese persons compared with normal weight and overweight participants was 2.75 (1.25–6.04 and 1.62 (0.068–3.82 respectively. CONCLUSION: Prehypertension and hypertension sequentially were the most prevalent cardiovascular risk factors in the study population. The relative risk for hypertension among obese participants was about three times that of normal weight and about two times that of the overweight participants. [TAF Prev Med Bull 2012; 11(4.000: 463-470

Prevalence study of compulsive buying in a sample with low individual monthly income

Directory of Open Access Journals (Sweden)

Priscilla Lourenço Leite

2015-12-01

Full Text Available Introduction: Compulsive buying can be characterized as an almost irresistible impulse to acquire various items. This is a current issue and the prevalence rate in the global population is around 5 to 8%. Some surveys indicate that the problem is growing in young and low-income populations. Objectives: To evaluate the prevalence of compulsive buying among people with low personal monthly incomes and analyze relationships with socio-demographic data. Methods: The Compulsive Buying Scale was administered to screen for compulsive buying and the Hospital Anxiety and Depression Scale was used to assess anxiety and depression in a sample of 56 participants. Pearson coefficients were used to test for correlations. Results: The results indicated that 44.6% presented an average family income equal to or greater than 2.76 minimum wages. It is possible that compulsive buying is not linked to the purchasing power since it was found in a low-income population. Conclusion: Despite the small sample, the results of this study are important for understanding the problem in question.

Motives Underlying Food Choice for Children and Perception of Nutritional Information Among Low-Income Mothers in a Latin American Country.

Science.gov (United States)

Machín, Leandro; Giménez, Ana; Curutchet, María Rosa; Martínez, Joseline; Ares, Gastón

2016-01-01

The aim of the present study was to investigate the influence of nutritional information on how low-income mothers select food for their children. Five focus groups, each consisting of 5-10 participants, were conducted. Women, older than 18 years, mothers of young children who were beneficiaries of one of the national food stamps programs in Uruguay. Focus group discussions were held around motives underlying food choices for children and perception of labeling systems. Transcripts of the focus group discussions were analyzed using inductive coding. Forty-two women, aged between 18 and 40 years, participated in 5 focus groups. Results showed that low-income mothers do not consider nutritional information when selecting food their children. Traditional nutritional labeling was perceived as complex, difficult to find, and difficult to understand. Participants stressed that they relied on the nutrition claims included on labels for assessing the healthfulness of food products. Semi-directive and directive front-of-pack labels were positively evaluated in terms of ease of interpretation. Participants preferred the traffic light system over other alternatives. Results suggest the need to implement simplified nutritional labeling and to regulate the use of nutrition claims on products targeted at children. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Low-income Euro-American mothers' perceptions of health and self-care practices.

Science.gov (United States)

Mendias, Elnora P; Clark, Michele C; Guevara, Edilma B; Svrcek, Claire Y

2011-01-01

Health promotion activities may decrease preventable diseases and health system overuse. This study examined how low-income Euro-American mothers described their health/wellness, self-care practices (SCP), and SCP benefits, barriers, and interpersonal influences (norms, modeling, and social support) affecting their SCP. This descriptive qualitative study used a convenience sample of 10 low-income, English-speaking mothers, 25-43 years old, seeking women's/children's health services at a large urban Texas health clinic. Data were collected via face-to-face interviews, using a standardized semistructured interview guide; data were analyzed using Miles and Huberman's qualitative research methods. All participants primarily described themselves positively and as mothers and workers. Most viewed health and wellness as distinct but typically included physical and emotional well-being. Mothers valued health and SCP for personal and family reasons. All identified SCP benefits. Most identified SCP barriers. Women viewed themselves as vital to family function and well-being, learned SCP primarily from parents during childhood, and described limited support for SCP. The results provide a better understanding of participants' self-care decision making and are useful in designing appropriate clinical health promotions. Reducing health inequities in low-income women requires further study of the underlying causes and development of effective policies and measures to address them. © 2011 Wiley Periodicals, Inc.

Food purchasing selection among low-income, Spanish-speaking Latinos.

Science.gov (United States)

Cortés, Dharma E; Millán-Ferro, Andreina; Schneider, Karen; Vega, Rodolfo R; Caballero, A Enrique

2013-03-01

In the U.S., poverty has been linked to both obesity and disease burden. Latinos in the U.S. are disproportionately affected by poverty, and over the past 10 years, the percentage of overweight U.S. Latino youth has approximately doubled. Buying low-cost food that is calorie-dense and filling has been linked to obesity. Low-income individuals tend to favor energy-dense foods because of their low cost, and economic decisions made during food purchasing have physiologic repercussions. Diets based on energy-dense foods tend to be high in processed staples, such as refined grains, added sugars, and added fats. These diets have been linked to a higher risk of obesity, type 2 diabetes, and cardiovascular disease. This pilot study conducted ethnographic qualitative analyses combined with quantitative analyses to understand grocery shopping practices among 20 Spanish-speaking, low-income Latino families. The purpose was to analyze food selection practices in order to determine the effect of nutrition education on changes in shopping practices to later develop educational tools to promote selection of healthier food options. Participants received tailored, interactive, nutrition education during three to five home visits and a supermarket tour. Grocery store receipts for grocery purchases collected at baseline and at the end of the project were analyzed for each family to extract nutritional content of purchased foods. Nutritional content was measured with these factors in mind: quantity, calories, fats, carbohydrates, fiber, protein, and percentage of sugary beverages and processed food. Data were collected in 2010-2011 and analyzed in 2011-2012. After receiving between three and five home-based nutrition education sessions and a supermarket tour over a 6-month period, many families adopted instructions on buying budget-friendly, healthier alternative foods. Findings indicate that participating families decreased the total number of calories and calories per dollar

42 CFR 457.310 - Targeted low-income child.

Science.gov (United States)

2010-10-01

... family income at or below 200 percent of the Federal poverty line for a family of the size involved; (ii... 42 Public Health 4 2010-10-01 2010-10-01 false Targeted low-income child. 457.310 Section 457.310... Requirements: Eligibility, Screening, Applications, and Enrollment § 457.310 Targeted low-income child. (a...

Depression in Low-Income Elementary School Children in South Korea: Gender Differences

Science.gov (United States)

Lee, Gyungjoo; McCreary, Linda; Kim, Mi Ja; Park, Chang Gi; Jun, Won Hee; Yang, Soo

2013-01-01

This study examined depression in low-income elementary school children and identified gender differences in factors that influence depression from an ecological perspective. Participants were 262 first- to sixth-grade children recruited from six Korean community centers. Personal factors were anxiety and self-concept. Environmental factors…

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

Science.gov (United States)

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.

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

Science.gov (United States)

Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

2015-01-01

To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.

Social-cognitive predictors of low-income parents' restriction of screen time among preschool-aged children.

Science.gov (United States)

Lampard, Amy M; Jurkowski, Janine M; Davison, Kirsten K

2013-10-01

Parents' rules regarding child television, DVD, video game, and computer use (screen time) have been associated with lower screen use in children. This study aimed to identify modifiable correlates of this behavior by examining social-cognitive predictors of parents' restriction of child screen time. Low-income parents (N = 147) of preschool-aged children (2-6 years) completed self-administered questionnaires examining parent and child screen time, parent restriction of screen time, self-efficacy to restrict screen time, and beliefs about screen time. Structural equation modeling results indicated that greater self-efficacy to restrict screen time (β = .29, p = .016) and greater perceived importance of restricting child screen use (β = .55, p < .001) were associated with greater restriction of child screen use, after controlling for parent screen time. Family-based interventions that consider broader attitudinal factors around child screen time may be necessary to engage parents in restricting screen use.

The impact of diabetes prevention on labour force participation and income of older Australians: an economic study

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Passey Megan E

2012-01-01

Full Text Available Abstract Background Globally, diabetes is estimated to affect 246 million people and is increasing. In Australia diabetes has been made a national health priority. While the direct costs of treating diabetes are substantial, and rising, the indirect costs are considered greater. There is evidence that interventions to prevent diabetes are effective, and cost-effective, but the impact on labour force participation and income has not been assessed. In this study we quantify the potential impact of implementing a diabetes prevention program, using screening and either metformin or a lifestyle intervention on individual economic outcomes of pre-diabetic Australians aged 45-64. Methods The output of an epidemiological microsimulation model of the reduction in prevalence of diabetes from a lifestyle or metformin intervention, and another microsimulation model, Health&WealthMOD, of health and the associated impacts on labour force participation, personal income, savings, government revenue and expenditure were used to quantify the estimated outcomes of the two interventions. Results An additional 753 person years in the labour force would have been achieved from 1993 to 2003 for the male cohort aged 60-64 years in 2003, if a lifestyle intervention had been introduced in 1983; with 890 person years for the equivalent female group. The impact on labour force participation was lower for the metformin intervention, and increased with age for both interventions. The male cohort aged 60-64 years in 2003 would have earned an additional $30 million in income with the metformin intervention, and the equivalent female cohort would have earned an additional $25 million. If the lifestyle intervention was introduced, the same male and female cohorts would have earned an additional $34 million and $28 million respectively from 1993 to 2003. For the individuals involved, on average, males would have earned an additional $44,600 per year and females an additional $31

Coping with low incomes and cold homes

International Nuclear Information System (INIS)

Anderson, Will; White, Vicki; Finney, Andrea

2012-01-01

This paper presents findings from a study of low-income households in Great Britain which explored households’ strategies for coping both with limited financial resources in the winter months, when demand for domestic energy increases, and, in some cases, with cold homes. The study combined a national survey of 699 households with an income below 60 per cent of national median income with in-depth interviews with a subsample of 50 households. The primary strategy adopted by low-income households to cope with financial constraint was to reduce spending, including spending on essentials such as food and fuel, and thereby keep up with core financial commitments. While spending on food was usually reduced by cutting the range and quality of food purchased, spending on energy was usually reduced by cutting consumption. Sixty-three per cent of low-income households had cut their energy consumption in the previous winter and 47 per cent had experienced cold homes. Improvements to the thermal performance of homes reduced but did not eliminate the risk of going cold as any heating cost could be a burden to households on the lowest incomes. Householders’ attitudes were central to their coping strategies, with most expressing a determination to ‘get by’ come what may.

Evaluation of the Factor Structure of the Obstacles to Engagement Scale with Low-income African American Parents

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Deborah Winders Davis

2014-12-01

Full Text Available Objective: Parenting anticipatory guidance is one way to promote optimal child health and development and minimize disparities between children from lower socio-economic status families and their higher income peers. However, low rates of attendance at and completion of parenting programs has been demonstrated. Understanding barriers to participation has important implications. The Obstacles to Engagement Scale (OES has been used in some populations, but it has not been evaluated for use with low-income African American samples. The aim of the current study is to evaluate the factor structure of the OES with a sample of low-income, African American parents.Method: Parents or legal guardians with children aged 3-8 years completed a survey in the waiting room of a primary care pediatric academic practice in an urban location in the southern United States of America (N = 114. Almost 87% had < 12th grade education and 93% of the children received Medicaid services. The OES was one measure from a larger study and only participants with complete data on the OES were included in the exploratory factor analysis (EFA.Results: The EFA did not support the previous 4-factor solution (intervention demands, personal or family stressors or obstacles, relevance of or trust in intervention, and time and scheduling demands. Instead, a 3-factor statistical solution emerged, but not all items held together conceptually.Conclusions: The current study supports the necessity for evaluating study instruments for use with specific populations. Larger samples are needed to disentangle the effects of educational and poverty status from race and ethnicity and to develop and validate instruments that are appropriate for the study population.

Very Low Food Security in US Households Is Predicted by Complex Patterns of Health, Economics, and Service Participation.

Science.gov (United States)

Choi, Seul Ki; Fram, Maryah S; Frongillo, Edward A

2017-10-01

Background: Very low food security (VLFS) happens at the intersection of nuanced and complex patterns of risk characteristics across multiple domains. Little is known about the idiosyncratic situations that lead households to experience VLFS. Objective: We used classification and regression tree (CART) analysis, which can handle complex combinations of predictors, to identify patterns of characteristics that distinguish VLFS households in the United States from other households. Methods: Data came from 3 surveys, the 2011-2014 National Health Interview Survey (NHIS), the 2005-2012 NHANES, and the 2002-2012 Current Population Survey (CPS), with sample participants aged ≥18 y and households with income Survey participants were stratified into households with children, adult-only households, and older-adult households (NHIS, CPS) or individuals aged 18-64 y and individuals aged ≥65 y (NHANES). Household food security was measured with the use of the 10-item US Adult Food Security Scale. Variables from multiple domains, including sociodemographic characteristics, health, health care, and participation in social welfare and food assistance programs, were considered as predictors. The 3 data sources were analyzed separately with the use of CART analysis. Results: Household experiences of VLFS were associated with different predictors for different types of households and often occurred at the intersection of multiple characteristics spanning unmet medical needs, poor health, disability, limitation, depressive symptoms, low income, and food assistance program participation. These predictors built complex trees with various combinations in different types of households. Conclusions: This study showed that multiple characteristics across multiple domains distinguished VLFS households. Flexible and nonlinear methods focusing on a wide range of risk characteristics should be used to identify VLFS households and to inform policies and programs that can address VLFS

How a North Carolina program boosted preventive oral health services for low-income children.

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Rozier, R Gary; Stearns, Sally C; Pahel, Bhavna T; Quinonez, Rocio B; Park, Jeongyoung

2010-12-01

Dental caries (tooth decay), the most common chronic disease affecting young children, is exacerbated by limited access to preventive dental services for low-income children. To address this problem, North Carolina implemented a program to reimburse physicians for up to six preventive oral health visits for Medicaid-enrolled children younger than age three. Analysis of physician and dentist Medicaid claims from the period 2000-2006 shows that the program greatly increased preventive oral health services. By 2006 approximately 30 percent of well-child visits for children ages six months up to three years included these services. However, additional strategies are needed to ensure preventive oral health care for more low-income children.

Estimating the Impact of Low-Income Universal Service Programs

OpenAIRE

Daniel A. Ackerberg; David R. DeRemer; Michael H. Riordan; Gregory L. Rosston; Bradley S. Wimmer

2013-01-01

This policy study uses U.S. Census microdata to evaluate how subsidies for universal telephone service vary in their impact across low-income racial groups, gender, age, and home ownership. Our demand specification includes both the subsidized monthly price (Lifeline program) and the subsidized initial connection price (Linkup program) for local telephone service. Our quasi-maximum likelihood estimation controls for location differences and instruments for price endogeneity. The microdata all...

Simulation in Pre-departure Training for Residents Planning Clinical Work in a Low-Income Country

Directory of Open Access Journals (Sweden)

Kevin R. Schwartz

2015-12-01

Full Text Available Introduction: Increasingly, pediatric and emergency medicine (EM residents are pursuing clinical rotations in low-income countries. Optimal pre-departure preparation for such rotations has not yet been established. High-fidelity simulation represents a potentially effective modality for such preparation. This study was designed to assess whether a pre-departure high-fidelity medical simulation curriculum is effective in helping to prepare residents for clinical rotations in a low-income country. Methods: 43 pediatric and EM residents planning clinical rotations in Liberia, West Africa, participated in a simulation-based curriculum focused on severe pediatric malaria and malnutrition and were then assessed by survey at three time points: pre-simulation, post-simulation, and after returning from work abroad. Results: Prior to simulation, 1/43 (2% participants reported they were comfortable with the diagnosis and management of severe malnutrition; this increased to 30/42 (71% after simulation and 24/31 (77% after working abroad. Prior to simulation, 1/43 (2% of residents reported comfort with the diagnosis and management of severe malaria; this increased to 26/42 (62% after simulation and 28/31 (90% after working abroad; 36/42 (86% of residents agreed that a simulation-based global health curriculum is more useful than a didactic curriculum alone, and 41/42 (98% felt a simulator-based curriculum should be offered to all residents planning a clinical trip to a low-income country. Conclusion: High-fidelity simulation is effective in increasing residents’ self-rated comfort in management of pediatric malaria and malnutrition and a majority of participating residents feel it should be included as a component of pre-departure training for all residents rotating clinically to low-income countries.

Perceptions of New Zealand nutrition labels by Māori, Pacific and low-income shoppers.

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Signal, Louise; Lanumata, Tolotea; Robinson, Jo-Ani; Tavila, Aliitasi; Wilton, Jenny; Ni Mhurchu, Cliona

2008-07-01

In New Zealand the burden of nutrition-related disease is greatest among Māori, Pacific and low-income peoples. Nutrition labels have the potential to promote healthy food choices and eating behaviours. To date, there has been a noticeable lack of research among indigenous peoples, ethnic minorities and low-income populations regarding their perceptions, use and understanding of nutrition labels. Our aim was to evaluate perceptions of New Zealand nutrition labels by Māori, Pacific and low-income peoples and to explore improvements or alternatives to current labelling systems. Māori, Samoan and Tongan researchers recruited participants who were regular food shoppers. Six focus groups were conducted which involved 158 people in total: one Māori group, one Samoan, one Tongan, and three low-income groups. Māori, Pacific and low-income New Zealanders rarely use nutrition labels to assist them with their food purchases for a number of reasons, including lack of time to read labels, lack of understanding, shopping habits and relative absence of simple nutrition labels on the low-cost foods they purchase. Current New Zealand nutrition labels are not meeting the needs of those who need them most. Possible improvements include targeted social marketing and education campaigns, increasing the number of low-cost foods with voluntary nutrition labels, a reduction in the price of 'healthy' food, and consideration of an alternative mandatory nutrition labelling system that uses simple imagery like traffic lights.

Maternal concerns about children overeating among low-income children.

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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. Copyright © 2016. Published by Elsevier Ltd.

A Health Equity Problem for Low Income Children: Diet Flexibility Requires Physician Authorization.

Science.gov (United States)

Stookey, Jodi D

2015-09-01

USDA programs, such as the Child and Adult Care Food Program (CACFP), School Breakfast Program (SBP), and/or National School Lunch Program (NSLP), enable child care centers and schools to provide free and reduced price meals, daily, to millions of low income children. Despite intention to equalize opportunity for every child to have a healthy diet, USDA program rules may be contributing to child obesity disparities and health inequity. USDA program rules require child care centers and schools to provide meals that include a specified number of servings of particular types of foods and beverages. The rules are designed for the average, healthy weight child to maintain weight and growth. They are not designed for the underweight child to gain weight, obese child to normalize weight, or pre-diabetic child to avoid incident diabetes. The rules allow for only one meal pattern and volume, as opposed to a flexible spectrum of meal patterns and portion sizes. Parents of children who participate in the CACFP, SBP, and/or NSLP do not have control over the amount or composition of the subsidized meals. Parents of overweight, obese, or diabetic children who participate in the subsidized meal programs can request dietary change, special meals or accommodations to address their child's health status, but child care providers and schools are not required to comply with the request unless a licensed physician signs a "Medical statement to request special meals and/or accommodations". Although physicians are the only group authorized to change the foods, beverages, and portion sizes served daily to low income children, they are not doing so. Over the past three years, despite an overweight and obesity prevalence of 30% in San Francisco child care centers serving low income children, zero medical statements were filed to request special meals or accommodations to alter daily meals in order to prevent obesity, treat obesity, or prevent postprandial hyperglycemia. Low income children

Gender Disparities in the Food Insecurity-Overweight and Food Insecurity-Obesity Paradox among Low-Income Older Adults.

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Hernandez, Daphne C; Reesor, Layton; Murillo, Rosenda

2017-07-01

Obesity and obesity-related comorbidities are increasing among older adults. Food insecurity is a nutrition-related factor that coexists with obesity among low-income individuals. The majority of the research on the food insecurity-obesity paradox has been conducted on low-income mothers and children, with research lacking on large diverse samples of older adults. The purpose of this study was to assess gender disparities in the association between food insecurity and overweight and obesity among low-income older adults. Cross-sectional 2011 and 2012 National Health Interview Survey data were used. Food insecurity status was determined by ≥3 affirmative responses on the 10-item US Department of Agriculture Food Security Scale (FSS). Body mass index (BMI) was calculated as outlined by the Centers for Disease Control and Prevention based on self-reported height and weight. Adults included were low-income (≤1.99 federal poverty level [FPL]), older (aged ≥60 years), with a normal BMI (18.5) or greater who had complete data on FSS, BMI, and the following covariates: age, race or ethnicity, marital status, income, nativity status, physical activity, poor health status, health insurance coverage, problems paying medical bills or for medicine, and region of residency (N=5,506). Multivariate logistic regression models were stratified by gender to estimate the association between food insecurity and higher weight status. All models included covariates. In covariate-adjusted models, compared with low-income, food secure men, low-income, food-insecure men had 42% and 41% lower odds of being overweight and overweight or obese, respectively. Despite the high prevalence rate of obesity among low-income, food-insecure women, food insecurity was not significantly related to overweight, obesity, or overweight or obesity for older adult women in adjusted models. Food insecurity-overweight and -obesity paradox appears not to be present in older men. However, food insecurity and

A review of low income energy assistance measures adopted in other jurisdictions

International Nuclear Information System (INIS)

2008-01-01

Low-income energy assistance programs (LIEPs) have been established and implemented in many jurisdictions to help make electricity and natural gas more affordable. Low-income programs also serve many other public interest goals, such as safeguarding and protecting the public health and welfare of the citizens; augmenting incomes or standards of living for the lowest income energy customers; encouraging conservation and more efficient use of energy resources; reducing customer care costs for utilities; reducing uncollectible accounts and bad debt expense for utilities; and reducing carbon emissions and greenhouse gas levels. This report contained a summary of the policies, programs, and measures that have been implemented, mandated, or allowed by regulators in other jurisdictions to assist low-income energy consumers with electricity and natural gas costs. The report categorized the differing low income policies and programs that have been implemented and examined the effectiveness of those policies and programs as measured by the costs and benefits, as well the level of customer participation. These categories included rate discounts or waivers; modified rate designs; alternative billing methods; customer rebates; conservation and demand side management programs; budget or equal billing; payment plans for past due accounts; waivers of late payment charges; waivers or reductions of customer security deposits; limits on disconnections; and reduced or waived fees for reconnections. The report covered regulatory jurisdictions, including those in Canada, the United States, the United Kingdom, Australia, New Zealand, France, Spain, and Finland. The report also discussed the role of regulators, utilities, charitable organizations, and other interested parties in developing and implementing low-income energy assistance programs that were cost-effective and efficient. It was concluded that, in addition to rate discounts or waivers of the fixed monthly service charge, many

Maternal mental health, and child growth and development, in four low-income and middle-income countries.

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Bennett, Ian M; Schott, Whitney; Krutikova, Sofya; Behrman, Jere R

2016-02-01

Extend analyses of maternal mental health and infant growth in low- and middle-income countries (LMICs) to children through age eight years, and broaden analyses to cognitive and psychosocial outcomes. Community-based longitudinal cohort study in four LMICs (Ethiopia, India, Peru and Vietnam). Surveys and anthropometric assessments were carried out when the children were approximately ages 1, 5 and 8 years. Risk of maternal common mental disorders (rCMDs) was assessed with the Self-Reporting Questionnaire (SRQ)-20 (score ≥8). Rural and urban as well as low- and middle-income communities. 7722 mothers and their children. Child stunting and underweight (Z score ≤2 of height and weight for age), and development (Peabody Picture Vocabulary Test), and the psychosocial outcomes self pride and life satisfaction. A high rate of rCMD, stunting and underweight was seen in the cohorts. After adjusting for confounders, significant associations were found between maternal rCMDs and growth variables in the first year of life, with persistence to age 8 years in India and Vietnam, but not in the other countries. India and Vietnam also showed significant associations between rCMDs and lower cognitive development. After adjustment, rCMD was associated with low life satisfaction in Ethiopia but not in the other cohorts. Associations of maternal rCMD in the first year of life with child outcomes varied across the study cohorts and, in some cases, persisted across the first 8 years of life of the child, and included growth, cognitive development and psychosocial domains. 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/

The global burden of visual difficulty in low, middle, and high income countries.

Directory of Open Access Journals (Sweden)

Ellen E Freeman

Full Text Available Using a world-wide, population-based dataset of adults, we sought to determine the frequency of far visual difficulty and its associated risk factors.The World Health Survey (WHS was conducted in 70 countries throughout the world in 2003 using a random, multi-stage, stratified, cluster sampling design of adults ages 18 years and older. Far vision was assessed by asking "In the last 30 days, how much difficulty did you have in seeing and recognizing a person you know across the road (i.e. from a distance of about 20 meters?". Responses included none, mild, moderate, severe, or extreme/unable. The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank. Prevalence and regression estimates were adjusted to account for the complex sample design.21% of adults reported any visual difficulty. The rate varied by the income status of the country with the percentage who had any visual difficulty being 24%, 23%, and 13% in low, middle, and high income countries, respectively. Five percent of people reported severe or extreme visual difficulty with rates in low, middle, and high income countries of 6%, 5%, and 2% respectively. Risk factors for visual difficulty included older age, female sex, poorer socioeconomic status, little to no formal education, and diabetes (P<0.05.One out of five adults in the WHS reported some degree of far visual difficulty. Given the importance of vision to living an independent life, better access to quality eye care services and life course factors affecting vision health (e.g. repeated eye infections, diet lacking vitamin A must receive adequate attention and resources, especially in low and middle income countries.

The Impact of Negative Income Tax on Participation in Electoral Politics.

Science.gov (United States)

Heffernan, Joseph

This paper reports on the impact of the Rural Income Maintenance Experiment on participation in the electoral process. Paradigms of the left and of the right predict dramatically different consequences of universal income supplement, the left wing seeing such a program as essential for minimal democratic processes while the right sees in universal…

Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

Science.gov (United States)

Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo Yong; El Sadr, Wafaa; Wolf, Nicholas; Silkensen, Shannon; Brand, Nathan; Looi, Lai Meng; Pai, Sanjay A; Wilson, Michael L; Milner, Danny; Flanigan, John; Fleming, Kenneth A

2018-05-12

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan. Copyright © 2018 Elsevier Ltd. All rights reserved.

Associations of food stamp participation with dietary quality and obesity in children.

Science.gov (United States)

Leung, Cindy W; Blumenthal, Susan J; Hoffnagle, Elena E; Jensen, Helen H; Foerster, Susan B; Nestle, Marion; Cheung, Lilian W Y; Mozaffarian, Dariush; Willett, Walter C

2013-03-01

To determine if obesity and dietary quality in low-income children differed by participation in the Supplemental Nutrition Assistance Program (SNAP), formerly the Food Stamp Program. The study population included 5193 children aged 4 to 19 with household incomes ≤130% of the federal poverty level from the 1999-2008 NHANES. Diet was measured by using 24-hour recalls. Among low-income US children, 28% resided in households currently receiving SNAP benefits. After adjusting for sociodemographic differences, SNAP participation was not associated with a higher rate of childhood obesity (odds ratio = 1.11, 95% confidence interval [CI]: 0.71-1.74). Both SNAP participants and low-income nonparticipants were below national recommendations for whole grains, fruits, vegetables, fish, and potassium, while exceeding recommended limits for processed meat, sugar-sweetened beverages, saturated fat, and sodium. Zero percent of low-income children met at least 7 of 10 dietary recommendations. After multivariate adjustment, compared with nonparticipants, SNAP participants consumed 43% more sugar-sweetened beverages (95% CI: 8%-89%), 47% more high-fat dairy (95% CI: 7%, 101%), and 44% more processed meats (95% CI: 9%-91%), but 19% fewer nuts, seeds, and legumes (95% CI: -35% to 0%). In part due to these differences, intakes of calcium, iron, and folate were significantly higher among SNAP participants. Significant differences by SNAP participation were not evident in total energy, macronutrients, Healthy Eating Index 2005 scores, or Alternate Healthy Eating Index scores. The diets of low-income children are far from meeting national dietary recommendations. Policy changes should be considered to restructure SNAP to improve children's health.

Does Home Internet Use Influence the Academic Performance of Low-Income Children?

Science.gov (United States)

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

2006-01-01

HomeNetToo is a longitudinal field study designed to examine the antecedents and consequences of home Internet use in low-income families http://www.HomeNetToo.org). The study was done between December 2000 and June 2002. Among the consequences considered was children's academic performance. Participants were 140 children, mostly African…

Labor force participation and the influence of having back problems on income poverty in Australia.

Science.gov (United States)

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Percival, Richard; Kelly, Simon J; Passey, Megan E

2012-06-01

Cross-sectional study of 45- to 64-year-old Australians. To assess the relationship between chronic back problems and being in income poverty among the older working-aged population. Older workers who leave the labor force due to chronic back problems have fragile economic situations and as such are likely to have poorer living standards. Poverty is one way of comparing the living standards of different individuals within society. The 2003 Survey of Disability, Ageing and Carers data were used, along with the 50% of the median equivalized income-unit income poverty line to identify those in poverty. Logistic regression models were used to look at the relationship between chronic back problems, labor force participation, and poverty. Regardless of labor force participation status (employed full-time, part-time, or not in the labor force at all), those with chronic back problems were significantly more likely to be in poverty. Those not in the labor force due to chronic back problems were significantly more likely to be in poverty than those in the labor force full-time with no chronic health condition (Odds ratio [OR]: 0.07, 95% CI: 0.07-0.07, P poverty (OR: 0.52, 95% CI: 0.51-0.53, P poverty than those employed part-time or full-time (OR: 0.44, 95% CI: 0.43-0.44, P < 0.0001; OR: 0.10, 95% CI: 0.10-0.10, P < 0.0001, respectively). This highlights the need to prevent and effectively treat chronic back problems, as these conditions are associated with reduced living standards.

Healthy Lifestyle Fitness Camp: A Summer Approach to Prevent Obesity in Low-Income Youth.

Science.gov (United States)

George, Gretchen Lynn; Schneider, Constance; Kaiser, Lucia

2016-03-01

To examine the effect of participation in a summer camp focused on nutrition and fitness among low-income youth. In 2011-2012, overweight and obese youth (n = 126) from Fresno, CA participated in a free 6-week summer program, Healthy Lifestyle Fitness Camp (HLFC), which included 3 h/wk of nutrition education provided by University of California CalFresh and 3 hours of daily physical activity through Fresno Parks and Recreation. The researchers used repeated-measures ANOVA to examine changes in weight, waist circumference, and waist-to-height ratio (WHtR) between HLFC and the comparison group (n = 29). Significant pre-post WHtR reductions were observed in HLFC: 0.64 to 0.61 (P obesity prevention among low-income youth. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Evaluating the co-benefits of low-income energy-efficiency programmes

Energy Technology Data Exchange (ETDEWEB)

Heffner, Grayson; Campbell, Nina

2011-06-15

The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

Evaluating the co-benefits of low-income energy-efficiency programmes

Energy Technology Data Exchange (ETDEWEB)

Heffner, Grayson; Campbell, Nina

2011-06-15

The International Energy Agency's Energy Efficiency Unit (EEU) has begun a new programme of work on innovative energy-efficiency policies for mitigating fuel poverty. The IEA's current research focuses on the potential for low-income weatherisation programmes to address poor housing quality -- the main driver of fuel poverty -- as well as innovative methods for financing and evaluating such programmes. A common problem is that the energy-saving benefits accruing to fuel-poor households barely offset the investment required, suggesting a weak return on government spending. However, these investments have additional co-benefits for participants as well as for energy providers, property owners, local communities and society as a whole. This first IEA workshop focused on methods for incorporating the range of co-benefits into evaluation of low-income weatherisation programmes. The presentations given by top experts in the fuel poverty field are summarised in this report, along with conclusions and proposals for further research.

Availability, quality and price of produce in low-income neighbourhood food stores in California raise equity issues.

Science.gov (United States)

Gosliner, Wendi; Brown, Daniel M; Sun, Betty C; Woodward-Lopez, Gail; Crawford, Patricia B

2018-06-01

To assess produce availability, quality and price in a large sample of food stores in low-income neighbourhoods in California. Cross-sectional statewide survey. Between 2011 and 2015, local health departments assessed store type, WIC (Supplemental Nutrition Program for Women, Infants, and Children)/SNAP (Supplemental Nutrition Assistance Program) participation, produce availability, quality and price of selected items in stores in low-income neighbourhoods. Secondary data provided reference chain supermarket produce prices matched by county and month. t Tests and ANOVA examined differences by store type; regression models examined factors associated with price. Large grocery stores (n 231), small markets (n 621) and convenience stores (n 622) in 225 neighbourhoods. Produce in most large groceries was rated high quality (97 % of fruits, 98 % of vegetables), but not in convenience stores (25 % fruits, 14 % vegetables). Small markets and convenience stores participating in WIC and/or SNAP had better produce availability, variety and quality than non-participating stores. Produce prices across store types were, on average, higher than reference prices from matched chain supermarkets (27 % higher in large groceries, 37 % higher in small markets, 102 % higher in convenience stores). Price was significantly inversely associated with produce variety, adjusting for quality, store type, and SNAP and WIC participation. The study finds that fresh produce is more expensive in low-income neighbourhoods and that convenience stores offer more expensive, poorer-quality produce than other stores. Variety is associated with price and most limited in convenience stores, suggesting more work is needed to determine how convenience stores can provide low-income consumers with access to affordable, high-quality produce. WIC and SNAP can contribute to the solution.

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

Science.gov (United States)

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…

Neighborhood perceptions and hypertension among low-income black women: a qualitative study

Directory of Open Access Journals (Sweden)

Maliyhah Al-Bayan

2016-10-01

Full Text Available Abstract Background The majority of studies examining the role of neighborhoods and hypertension-related outcomes have been quantitative in nature and very few studies have examined specific disadvantaged populations, including low-income housing residents. The objective of this study was to use qualitative interviews to explore low-income Black women’s perceptions of their neighborhoods and to understand how those perceptions may affect their health, especially as it relates to blood pressure. Methods Seventeen Black female participants, living in public housing communities in New York City, completed one semi-structured, audiotaped interview in July of 2014. All interviews were transcribed, coded, and analyzed for emerging themes using N’Vivo 10 software. Results Three major themes emerged: (1 social connectedness, (2 stress factors, and (3 availability of food options. For example, factors that caused stress varied throughout the study population. Sources of stress included family members, employment, and uncleanliness within the neighborhood. Many participants attributed their stress to personal issues, such as lack of employment and relationships. In addition, the general consensus among many participants was that there should be a greater density of healthy food options in their neighborhoods. Some believed that the pricing of fresh foods in the neighborhoods should better reflect the financial status of the residents in the community. Conclusions Various neighborhood influences, including neighborhood disorder and lack of healthy food options, are factors that appear to increase Black women’s risk of developing high blood pressure. Implications of this research include the need to develop interventions that promote good neighborhood infrastructure (e.g. healthy food stores to encourage good nutrition habits and well-lit walking paths to encourage daily exercise, in addition to interventions that increase hypertension awareness in

The role of anxiety sensitivity in the relation between anxious arousal and cannabis and alcohol use problems among low-income inner city racial/ethnic minorities.

Science.gov (United States)

Paulus, Daniel J; Manning, Kara; Hogan, Julianna B D; Zvolensky, Michael J

2017-05-01

The current study explored anxiety sensitivity as a factor accounting for the association between anxious arousal and problems related to use of cannabis and alcohol among a health disparity sample (low income minorities). Specifically, participants were 130 low-income racial/ethnic minorities who reported daily cannabis use (M age =37.7 SD=10.0; 28.5% female). There were significant indirect associations of anxious arousal via anxiety sensitivity in relation to: cannabis use problems, cannabis withdrawal symptoms, use of cannabis to cope, as well as hazardous drinking, alcohol use problems, and alcohol consumption. These data indicate anxiety sensitivity is a possible mechanism underlying the relation between anxious arousal and substance use problems among low-income racial/ethnic minorities. Future work could evaluate the efficacy of cannabis and alcohol use treatments incorporating anxiety sensitivity reduction techniques to facilitate amelioration of anxiety and substance use and offset mental health inequalities for this population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Is the relative increase in income inequality related to tooth loss in middle-aged adults?

Science.gov (United States)

Goulart, Mariél de Aquino; Vettore, Mario Vianna

2016-01-01

To assess whether Brazilian middle-aged adults living in cities that experienced a relative increase on income inequality were more likely to have severe tooth loss and lack a functional dentition. Data on Brazilian adults aged 35-44 years from state capitals and Federal District from the 2010 Brazilian Oral Health Survey (SBBrasil 2010) were analyzed. Clinically assessed tooth loss outcomes were severe tooth loss (Income inequality was assessed by Gini Index in 1991, 2000, and 2003 using tertiles of distribution. Variation in Gini Index was assessed by changes in the tertiles distribution between years. Multilevel logistic regression models were used to estimate odds ratios (ORs) and 95 percent confidence intervals (95 percent CI) between variation in income inequality and tooth loss outcomes adjusting for individual socio-demographic characteristics. Prevalence of severe tooth loss and lack of functional dentition was 4.8 percent and 21.2 percent, respectively. Individuals living in cities with moderate and high increase in income inequality between 1991 and 2003 were more likely to have severe tooth loss and lack a functional dentition in 2010 compared with those living in cities with stable income inequality in the same period. Relationships between low family income and both tooth loss outcomes were significantly attenuated by relative increases in income inequality. Relative increases in income inequality were significantly associated with severe tooth loss and lack of a functional dentition in Brazilian middle-aged adults. © 2015 American Association of Public Health Dentistry.

Effect of national wealth on BMI: An analysis of 206,266 individuals in 70 low-, middle- and high-income countries

Science.gov (United States)

Reidpath, Daniel D.

2017-01-01

Background This study explores the relationship between BMI and national-wealth and the cross-level interaction effect of national-wealth and individual household-wealth using multilevel analysis. Methods Data from the World Health Survey conducted in 2002–2004, across 70 low-, middle- and high-income countries was used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as outcome variable. The potential determinants of individual-level BMI were participants’ sex, age, marital-status, education, occupation, household-wealth and location(rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP) and income inequality (Gini-index). A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries was fitted, treating BMI as a continuous outcome. Results The weighted mean BMI and standard-error of the 206,266 people from 70-countries was 23.90 (4.84). All the low-income countries were below the 25.0 mean BMI level and most of the high-income countries were above. All wealthier quintiles of household-wealth had higher scores in BMI than lowest quintile. Each USD10000 increase in GNI-PPP was associated with a 0.4 unit increase in BMI. The Gini-index was not associated with BMI. All these variables explained 28.1% of country-level, 4.9% of individual-level and 7.7% of total variance in BMI. The cross-level interaction effect between GNI-PPP and household-wealth was significant. BMI increased as the GNI-PPP increased in first four quintiles of household-wealth. However, the BMI of the wealthiest people decreased as the GNI-PPP increased. Conclusion Both individual-level and country-level factors made an independent contribution to the BMI of the people. Household-wealth and national-income had significant interaction effects. PMID:28662041

Poor Dietary Guidelines Compliance among Low-Income Women Eligible for Supplemental Nutrition Assistance Program-Education (SNAP-Ed

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Shinyoung Jun

2018-03-01

Full Text Available The Supplemental Nutrition Assistance Program-Education (SNAP-Ed program aims to improve nutritional intakes of low-income individuals (<185% poverty threshold. The objective of this study was to describe the compliance with Dietary Guidelines for Americans (DGA recommendations for fruits, vegetables, and whole grains among SNAP-Ed eligible (n = 3142 and ineligible (n = 3168 adult women (19–70 years nationwide and SNAP-Ed participating women in Indiana (n = 2623, using the NHANES 2007–2012 and Indiana SNAP-Ed survey data, respectively. Sensitivity analysis further stratified women by race/ethnicity and by current SNAP participation (<130% poverty threshold. Nationally, lower-income women were less likely to meet the fruit (21% vs. 25% and vegetable (11% vs. 19% guidelines than higher-income women, but did not differ on whole grains, which were ~5% regardless of income. The income differences in fruit and vegetable intakes were driven by non-Hispanic whites. Fewer SNAP-Ed-eligible U.S. women met fruit (21% vs. 55% and whole grain (4% vs. 18% but did not differ for vegetable recommendations (11% vs. 9% when compared to Indiana SNAP-Ed women. This same trend was observed among current SNAP participants. Different racial/ethnic group relationships with DGA compliance were found in Indiana compared to the nation. Nevertheless, most low-income women in the U.S. are at risk of not meeting DGA recommendations for fruits (79%, vegetables (89%, and whole grains (96%; SNAP-Ed participants in Indiana had higher compliance with DGA recommendations. Increased consumption of these three critical food groups would improve nutrient density, likely reduce calorie consumption by replacing high calorie choices, and improve fiber intakes.

Longitudinal effects of a two-generation preschool programme on receptive language skill in low-income Canadian children to age 10 years

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Mughal, Muhammad Kashif; Ginn, Carla S.; Perry, Robert L.; Benzies, Karen M.

2016-01-01

ABSTRACT We explored longitudinal effects of a two-generation preschool programme on receptive language scores in children (n = 78) at age 10 years, living with low income. Scores at four time-points, programme intake, exit, age 7, and age 10 years were measured using the Peabody picture vocabulary test (3rd ed.). Effects of culture (Aboriginal, other Canadian-born, and recent immigrant), and gender of the children were explored. Between programme intake and age 10, scores improved significantly, F(3, 75) = 21.11, p < .0005. There were significant differences among cultural groups at all time-points except age 10. Scores differed significantly for girls, but not boys, at age 10, F = 5.11, p = .01. Recent immigrant boys reached the Canadian average, while girls were two-thirds of the standard deviation below average. Early intervention programmes must include a focus on the unique circumstances of recent immigrant girls; supportive transition workers in schools are one recommendation. PMID:27453625

Associations between family food behaviors, maternal depression, and child weight among low-income children.

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McCurdy, Karen; Gorman, Kathleen S; Kisler, Tiffani; Metallinos-Katsaras, Elizabeth

2014-08-01

Although low-income children are at greater risk for overweight and obesity than their higher income counterparts, the majority of poor children are not overweight. The current study examined why such variation exists among diverse young children in poor families. Cross-sectional data were collected on 164 low-income, preschool aged children and their mothers living in two Rhode Island cities. Over half of the sample was Hispanic (55%). Mothers completed measures of family food behaviors and depression while trained assistants collected anthropometric data from children at seven day care centers and a Supplemental Nutrition Assistance Program outreach project. Multivariate analysis of covariance revealed that higher maternal depression scores were associated with lower scores on maternal presence when child eats (P maternal control of child's eating routines (P maternal presence whenever the child ate was significantly associated with lower child BMI z scores (β = .166, P Maternal depression did not modify the relationship between family food behaviors and child weight. Overall, caregiver presence whenever a child eats, not just at meals, and better parental food resource management skills may promote healthier weights in low-income preschoolers. Further research is needed to identify the mechanisms that connect caregiver presence and food resource management skills to healthier weights for this age group. Copyright © 2014 Elsevier Ltd. All rights reserved.

Why do low-income minority parents choose human papillomavirus vaccination for their daughters?

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Perkins, Rebecca B; Pierre-Joseph, Natalie; Marquez, Cecilia; Iloka, Sandra; Clark, Jack A

2010-10-01

To explore low-income minority parents' attitudes, intentions, and actions with regard to human papillomavirus (HPV) vaccination for their daughters. Semistructured interviews were conducted in English and Spanish with parents of girls aged 11-18 who were attending clinic visits in an urban medical center and a community health center. We assessed intention with formal scales, probed parents' attitudes regarding vaccination with open-ended questions, and reviewed medical records to determine vaccination rates. Data were analyzed using descriptive statistics and qualitative methods. Seventy-six parents participated (43% African American, 28% Latino, and 26% Caucasian). Most were mothers, had completed high school, and described themselves as religious; nearly one-half were immigrants. Intention correlated highly with receipt of the vaccine; 91% of parents intended to vaccinate their daughters against HPV, and 89% of the girls received vaccination within 12 months of the interview. Qualitative analysis revealed that most parents focused on the vaccine's potential to prevent cervical cancer. Some parents expressed concerns about unknown side effects and promotion of unsafe sexual practices, but these concerns did not hinder acceptance in most cases. The majority of the low-income minority parents surveyed viewed HPV vaccination as a way to protect their daughters from cancer, and thus chose to vaccinate their daughters. Copyright (c) 2010 Mosby, Inc. All rights reserved.

Low-income minority and homeless mothers' perceptions of their 9-13 year-old children's weight status, diet, and health.

Science.gov (United States)

Dammann, Kristen Wiig; Smith, Chery; Richards, Rickelle

2011-01-01

The purpose of this study was to examine low-income mothers' perceptions of their children's height and weight in relation to actual measures, and perceptions of dietary quality and health status. Demographic, anthropometric, and dietary quality/health status data were collected during a multi-phase nutrition research project with low-income Minnesotans, and a sub-set of non-pregnant mother-child dyads (mothers ages ≥ 18 years, children ages 9-13 years) were analyzed (n = 257). Participants were Caucasian, African American, American Indian, Hispanic, Asian, or Other/mixed race, and most were homeless. Relationships between maternal perceptions of their child's height and weight and the actual measures, and maternal perceptions of dietary quality and health status for the dyad, were examined using independent and paired samples t-tests, ANOVA, and paired samples correlations. Comparisons were also made by maternal and child body mass index (BMI) status and living situation. Mothers significantly underestimated their child's height and weight (-4.8 ± 13.9 cm, P = 0.000; -5.3 ± 8.5 kg, P = 0.000); greatest misperceptions of weight were among mothers of overweight/obese children (P = 0.000). Mothers not reporting estimates of their child's height and weight (n = 53) had higher BMIs (P = 0.029), and their children were younger (P = 0.000) and lighter (P = 0.021) compared to mothers who provided estimates. Inability to objectify children's weight status may contribute to the obesity epidemic affecting low-income minority populations. Underestimation of weight status may be influenced by cultural perceptions of body image and socioeconomic status.

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

Science.gov (United States)

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…

Income change alters default mode network connectivity for adolescents in poverty

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David G. Weissman

2018-04-01

Full Text Available Experiencing poverty during childhood and adolescence may affect brain function. However, income is dynamic, and studies have not addressed whether income change relates to brain function. In the present study, we investigated whether intrinsic functional connectivity of default mode network (DMN regions was influenced by mean family income and family income change. Parents of 68 Mexican-origin adolescents (35 females reported family income annually when adolescents were 10–16 years old. Intercept and slope of income at each of these ages were calculated for each participant. At age 16 years, adolescents completed a resting state functional neuroimaging scan. Adolescents from high and low income families did not differ in their functional connectivity, but for adolescents in families with lower incomes, their connectivity patterns depended on their income slope. Low-income adolescents whose income increased demonstrated greater connectivity between the posterior cingulate cortex (PCC and the medial prefrontal cortex (mPFC, both DMN regions, and between the PCC and the right inferior frontal gyrus. Increases in income were associated with greater connectivity of the mPFC with the right inferior frontal gyrus and the left superior parietal lobule regardless of mean income. Increases in income, especially among adolescents in poverty, may alleviate stressors, influencing the development of brain networks. Keywords: Adversity, Brain, fMRI, Resting state, Socio-economic status, Youth

Income change alters default mode network connectivity for adolescents in poverty.

Science.gov (United States)

Weissman, David G; Conger, Rand D; Robins, Richard W; Hastings, Paul D; Guyer, Amanda E

2018-04-01

Experiencing poverty during childhood and adolescence may affect brain function. However, income is dynamic, and studies have not addressed whether income change relates to brain function. In the present study, we investigated whether intrinsic functional connectivity of default mode network (DMN) regions was influenced by mean family income and family income change. Parents of 68 Mexican-origin adolescents (35 females) reported family income annually when adolescents were 10-16 years old. Intercept and slope of income at each of these ages were calculated for each participant. At age 16 years, adolescents completed a resting state functional neuroimaging scan. Adolescents from high and low income families did not differ in their functional connectivity, but for adolescents in families with lower incomes, their connectivity patterns depended on their income slope. Low-income adolescents whose income increased demonstrated greater connectivity between the posterior cingulate cortex (PCC) and the medial prefrontal cortex (mPFC), both DMN regions, and between the PCC and the right inferior frontal gyrus. Increases in income were associated with greater connectivity of the mPFC with the right inferior frontal gyrus and the left superior parietal lobule regardless of mean income. Increases in income, especially among adolescents in poverty, may alleviate stressors, influencing the development of brain networks. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Income trajectories affect treatment of dental caries from childhood to young adulthood: a birth cohort study.

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Peres, Marco Aurelio; Liu, Pingzhou; Demarco, Flavio Fernando; Silva, Alexandre Emidio Ribeiro; Wehrmeister, Fernando Cesar; Menezes, Ana Maria; Peres, Karen Glazer

2018-01-01

We aimed to analyze the effects of family income trajectories on the increase in dental caries from childhood to young adulthood. Data from the 1993 Pelotas (Brazil) birth cohort study, in which dental caries was measured at ages 6, 12, and 18 years, were analyzed. Family income of 302 participants was assessed at birth, and at 4, 11, 15, and 18 years of age. Mother's education, toothbrushing frequency, dental visiting, dental caries in primary dentition, and birth weight were covariates. A latent class growth analysis was conducted to characterize trajectories of time-varying variables. The influence of income trajectories on the increase in dental caries from age 6 to age 18 was evaluated by a generalized linear mixed model. After adjustment, the increases in numbers of decayed and missing teeth (DMT) from age 6 to age 18 were associated with family income trajectory. The incident rate ratios (IRR) of DMT compared with the group of stable high incomes were 2.36 for stable low incomes, 1.71 for downward, and 1.64 for upward. The IRR of teeth being filled in stable low-income groups compared with stable high-income groups was 0.55. Family income mobility affected treatment patterns of dental caries. Differences across income trajectory groups were found in the components of dental caries indices rather than in the experience of disease.

Energy-microfinance intervention for low income households in India

Science.gov (United States)

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

Concept of innovation in low-income market

Directory of Open Access Journals (Sweden)

Vitor Koki da Costa Nogami

2018-01-01

Full Text Available Purpose – Investigate the concept and the adoption of innovation in the low-income market. Design/methodology/approach – Four different studies were conducted. First, a Delphi study with 126 Marketing and Innovation professors from graduate programs. Second, interviews with 13 professionals, technical assistance professionals and retail managers. Third, two focus groups with low-income consumers. Fourth, survey with 390 respondents. Findings – The results indicate that innovations in the low-income markets are mainly characterized by adaptations and adjustments in products, with emphasis on incremental innovations, not radical. In addition, the adoption of innovation in this context is characterized as late, not initial. Originality/value – In terms of theoretical contributions, the present study reveals how the concept of innovation is built in the low-income market. From a perspective collectively constructed with information from different market agents (industry, retail and consumers, research findings become robust to understanding a phenomenon. Moreover, in addition to different market agents, different methods of data collection and analysis were also used, further enriching the results. This collective contribution, based theoretically on a literature of social construction, interviewing different market agents and using different methodological approaches, synergistically potentiated the development of this paper

A comparative analysis of avoidable causes of childhood blindness in Malaysia with low income, middle income and high income countries.

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Koay, C L; Patel, D K; Tajunisah, I; Subrayan, V; Lansingh, V C

2015-04-01

To determine the avoidable causes of childhood blindness in Malaysia and to compare this to other middle income countries, low income countries and high income countries. Data were obtained from a school of the blind study by Patel et al. and analysed for avoidable causes of childhood blindness. Six other studies with previously published data on childhood blindness in Bangladesh, Ethiopia, Nigeria, Indonesia, China and the United Kingdom were reviewed for avoidable causes. Comparisons of data and limitations of the studies are described. Prevalence of avoidable causes of childhood blindness in Malaysia is 50.5 % of all the cases of childhood blindness, whilst in the poor income countries such as Bangladesh, Ethiopia, Nigeria and Indonesia, the prevalence was in excess of 60 %. China had a low prevalence, but this is largely due to the fact that most schools were urban, and thus did not represent the situation of the country. High income countries had the lowest prevalence of avoidable childhood blindness. In middle income countries, such as Malaysia, cataract and retinopathy of prematurity are the main causes of avoidable childhood blindness. Low income countries continue to struggle with infections such as measles and nutritional deficiencies, such as vitamin A, both of which are the main contributors to childhood blindness. In high income countries, such as the United Kingdom, these problems are almost non-existent.

Financial stress, parent functioning and adolescent problem behavior: an actor-partner interdependence approach to family stress processes in low-, middle-, and high-income families.

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Ponnet, Koen

2014-10-01

The family stress model proposes that financial stress experienced by parents is associated with problem behavior in adolescents. The present study applied an actor-partner interdependence approach to the family stress model and focused on low-, middle-, and high-income families to broaden our understanding of the pathways by which the financial stress of mothers and fathers are related to adolescent outcomes. The study uses dyadic data (N = 798 heterosexual couples) from the Relationship between Mothers, Fathers and Children study in which two-parent families with an adolescent between 11 and 17 years of age participated. Path-analytic results indicated that in each of the families the association between parents' financial stress and problem behavior in adolescents is mediated through parents' depressive symptoms, interparental conflict, and positive parenting. Family stress processes also appear to operate in different ways for low-, middle-, and high-income families. In addition to a higher absolute level of financial stress in low-income families, financial stress experienced by mothers and fathers in these families had significant direct and indirect effects on problem behavior in adolescents, while in middle- and high-income families only significant indirect effects were found. The financial stress of a low-income mother also had a more detrimental impact on her level of depressive feelings than it had on mothers in middle-income families. Furthermore, the study revealed gender differences in the pathways of mothers and fathers. Implications for research, clinical practice, and policy are also discussed.

Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries.

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Vancampfort, Davy; Stubbs, Brendon; Firth, Joseph; Hallgren, Mats; Schuch, Felipe; Lahti, Jouni; Rosenbaum, Simon; Ward, Philip B; Mugisha, James; Carvalho, André F; Koyanagi, Ai

2017-10-15

There is a paucity of nationally representative data available on the correlates of physical activity (PA) among people with depression, especially in low- and middle-income countries (LMICs). Thus, we investigated PA correlates among community-dwelling adults with depression in this setting. World Health Survey data included 24,230 adults (43.1 ± 16.1 years; 36.1% male) with ICD-10 diagnoses of depression including brief depressive episode and subsyndromal depression aged ≥ 18 years from 46 LMICs. PA was assessed by the International Physical Activity Questionnaire. Participants were dichotomised into low and moderate-to-high physically active groups. Associations between PA and a range of sociodemographic, health behaviour and mental and physical health variables were examined using multivariable logistic regressions. 34.8% of participants with depression were physically inactive. In the multivariate analyses, inactivity was associated with male sex, older age, not being married/cohabiting, high socio-economic status, unemployment, living in an urban setting, less vegetable consumption, and poor sleep/ low energy. In addition, mobility difficulties and some somatic co-morbidity were associated with not complying with the 150min per week moderate-to-vigorous PA recommendations. The current data provide guidance for future population level interventions across LMICs to help people with depression engage in regular PA. Copyright © 2017 Elsevier B.V. All rights reserved.

Pesticide Poisonings in Low- and Middle-Income Countries

DEFF Research Database (Denmark)

Jørs, Erik; Neupane, Dinesh; London, Leslie

2018-01-01

Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'.......Aims and scope This editorial is an introduction to the papers making up the special issue on 'pesticide poisonings in low- and middle income countries'....

Policy options for the split incentive: Increasing energy efficiency for low-income renters

International Nuclear Information System (INIS)

Bird, Stephen; Hernández, Diana

2012-01-01

The split incentive problem concerns the lack of appropriate incentives to implement energy efficiency measures. In particular, low income tenants face a phenomenon of energy poverty in which they allocate significantly more of their household income to energy expenditures than other renters. This problem is substantial, affecting 1.89% of all United States' energy use. If effectively addressed, it would create a range of savings between 4 and 11 billion dollars per year for many of the nation's poorest residents. We argue that a carefully designed program of incentives for participants (including landlords) in conjunction with a unique type of utility-managed on-bill financing mechanism has significant potential to solve many of the complications. We focus on three kinds of split incentives, five concerns inherent to addressing split incentive problems (scale, endurance, incentives, savings, political disfavor), and provide a detailed policy proposal designed to surpass those problems, with a particular focus on low-income tenants in a U.S. context. - Highlights: ► We demonstrate the significant impact of the split incentive on low-income tenants. ► We discuss split incentive characteristics, and policy failures. ► We described an on-bill financing model with unique features. ► This policy has protections and incentives for tenants and landlords.

Tyrannies of thrift: Governmentality and older, low-income people’s energy efficiency narratives in the Illawarra, Australia

International Nuclear Information System (INIS)

Waitt, Gordon; Roggeveen, Kate; Gordon, Ross; Butler, Katherine; Cooper, Paul

2016-01-01

Social scientists are arguing that energy policies should pay more attention to everyday life to address energy efficiency. Scholars are now positing that energy policy needs to move beyond essentialised understandings of people positioned as the problem and seek to involve household members as part of the solution. Joining this conversation, we explore the energy narratives of low-income people aged 60 years and over, living in private sector housing. Participants shared their energy efficiency stories during focus groups conducted in the Illawarra, Australia. The paper explores how Foucault's concept of governmentality may help inform energy efficiency programs by paying close attention to the way in which individual energy choices made under certain circumstances create who an individual becomes. Learning from participants, our governmentality analysis revealed the tyrannies of thrifty domestic energy conduct. We illustrate our argument drawing on the examples of practices relating to clothing and lighting. We outline how governmentality analysis can be used by researchers, policy makers and practitioners to assist people to safely negotiate energy efficiency in their domestic lives. - Highlights: • We critically investigate domestic energy use of older low-income people. • We employ Foucault’s concept of governmentality. • Managing domestic energy use is discussed in terms of subjectivities. • The tyrannies of thrift are identified. • The implications of governmentality for energy programs are outlined.

Food choice, eating behavior, and food liking differs between lean/normal and overweight/obese, low-income women.

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Dressler, Heidi; Smith, Chery

2013-06-01

The higher rate of obesity among low-income women has widely been attributed to environmental barriers; however, many low-income women are still able to maintain a healthy weight despite obesogenic environments. To better understand personal and behavioral attributes related to food choice and weight, overweight/obese women and lean/normal weight women living in similar low-income environments, participated in focus groups, and taste testing sessions to investigate food liking (n=83). During focus groups, lean/normal weight participants reported that health was influential in food choice, while overweight/obese participants expressed cost as being more of a factor. Both BMI (kg/m(2)) groups reported that taste was of greatest importance. Personal factors, like emotional eating, and overeating were also discussed with differences noted between BMI (kg/m(2)) groups. Quantitative data also showed cost to be more important for overweight/obese women. Taste testing results revealed that overweight/obese participants had a higher overall liking for both healthy and less healthy foods, as well as other food categories. Additionally, these women had a higher liking of fat in the context of spreadable fats. Our results show that a variety of complex factors interact to influence eating behavior and present weight status of women living in similarly impoverished environments. However, findings from this exploratory study should be confirmed through further research. Copyright © 2013 Elsevier Ltd. All rights reserved.

School Readiness among Low-Income Black Children: Family Characteristics, Parenting, and Social Support

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Bono, Katherine E.; Sy, Susan R.; Kopp, Claire B.

2016-01-01

This study focuses on the associations between family variables and academic and social school readiness in low-income Black children. Analyses drew from the National Institute for Child Development (NICHD) Study of Early Child Care and Youth Development dataset. The participants included 122 children and their mothers. Data collection occurred…

States With Medically Needy Pathways: Differences in Long-Term and Temporary Medicaid Entry for Low-Income Medicare Beneficiaries.

Science.gov (United States)

Keohane, Laura M; Trivedi, Amal; Mor, Vincent

2017-10-01

Medically needy pathways may provide temporary catastrophic coverage for low-income Medicare beneficiaries who do not otherwise qualify for full Medicaid benefits. Between January 2009 and June 2010, states with medically needy pathways had a higher percentage of low-income beneficiaries join Medicaid than states without such programs (7.5% vs. 4.1%, p < .01). However, among new full Medicaid participants, living in a state with a medically needy pathway was associated with a 3.8 percentage point (adjusted 95% confidence interval [1.8, 5.8]) increase in the probability of switching to partial Medicaid and a 4.5 percentage point (adjusted 95% confidence interval [2.9, 6.2]) increase in the probability of exiting Medicaid within 12 months. The predicted risk of leaving Medicaid was greatest when new Medicaid participants used only hospital services, rather than nursing home services, in their first month of Medicaid benefits. Alternative strategies for protecting low-income Medicare beneficiaries' access to care could provide more stable coverage.

Social-Cognitive Predictors of Low-Income Parents' Restriction of Screen Time among Preschool-Aged Children

Science.gov (United States)

Lampard, Amy M.; Jurkowski, Janine M.; Davison, Kirsten K.

2013-01-01

Parents' rules regarding child television, DVD, video game, and computer use (screen time) have been associated with lower screen use in children. This study aimed to identify modifiable correlates of this behavior by examining social-cognitive predictors of parents' restriction of child screen time. Low-income parents ("N" = 147) of…

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2003-01-01

.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2002-01-01

The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2004-01-01

.... The purpose of the current study was to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women held toward breast cancer and breast cancer screening...

Factors Affecting African American Women's Participation in Breast Cancer Screening Programs: A Qualitative Study of Uninsured Low Income Women

National Research Council Canada - National Science Library

Lewis, Frances

2001-01-01

.... The purpose of the current study is to elaborate the beliefs and culturally embedded meanings that a population of low income, uninsured African American women hold toward breast cancer and breast cancer screening...

Maternal Correlates of Growth in Toddler Vocabulary Production in Low-Income Families

Science.gov (United States)

Pan, Barbara Alexander; Rowe, Meredith L.; Singer, Judith D.; Snow, Catherine E.

2005-01-01

This study investigated predictors of growth in toddlers' vocabulary production between the ages of 1 and 3 years by analyzing mother-child communication in 108 low-income families. Individual growth modeling was used to describe patterns of growth in children's observed vocabulary production and predictors of initial status and between-person…

Aging and low back pain among exercise participants: a follow-up study with psychological adaptation factors.

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Wilks, Scott E; Kadivar, Zahra; Guillory, Stephen A; Isaza, Jorge

2009-01-01

This study is a follow-up to a study previously published in this journal that reported the moderating function of exercise exertion amid the relationship between age and low back pain (LBP) among consistent exercise participants. The current study analyzed factors of psychological adaptation as potential mediators within the age--LBP relationship. Measures of psychological adaptation included psychological vulnerability, avoidant coping, resilient coping, and perceived resilience. The sample reported slightly moderate psychological vulnerability; a moderate extent of avoidant coping and resilient coping; and high resilience. Age inversely correlated with psychological vulnerability and avoidance coping. LBP correlated inversely with avoidant coping. Avoidant coping positively mediated (enhanced) age's effect on LBP. Results from this follow-up analysis highlight the importance of understanding and testing psychological factors in models with age and a physical health outcome.

The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling.

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Choi, Sunha; Lee, Sungkyu; Matejkowski, Jason

2018-06-01

This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

Growth faltering in low-income countries.

Science.gov (United States)

Prentice, Andrew M; Moore, Sophie E; Fulford, Anthony J

2013-01-01

Meta-analysis of growth data from over 50 low and low-middle income countries shows a consistent pattern of stunting and poor weight gain from about 3 months of age and persisting until at least 5 years. Children tend not to be wasted because their short stature offsets their underweight, leading to a rather adequately proportioned appearance. This frequently conceals the true levels of malnutrition in communities. At the macro-environmental level such growth faltering is due to the combined effects of poverty, food insecurity, low-dietary diversity, a highly infectious environment, poor washing facilities and poor understanding of the principles of nutrition and hygiene. These tend to be ameliorated as communities pass through the demographic transition with improved incomes and education. Because such changes will take generations to achieve, the global health community continues to search for effective interim solutions. Disappointingly, apart from intensive feeding programmes aimed at rehabilitating severely malnourished children, there are few examples of very successful nutrition interventions. This emphasizes the need for a better understanding of the etiology of growth failure. This paper uses anthropometric data collected over 6 decades in subsistence-farming communities from rural Gambia to illustrate the typical key features of growth faltering. Arising from this analysis, and from gaps in the published literature, the following issues are highlighted as still requiring a better resolution: (1) the pre-natal and inter-generational influences on growth failure; (2) the ontogeny of the infant immune system; (3) the exact nature of the precipitating insults that initiate gastroenteropathy; (4) the effects of both enteric and systemic infections on the hormonal regulation of growth; (5) interactions between macro- and micro-nutrient deficiencies and infections in causing growth failure, and (6) the role of the microbiome in modulating dietary influences on

Health outcomes in low-income children with current asthma in Canada.

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To, T; Dell, S; Tassoudji, M; Wang, C

2009-01-01

Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

Men and infant feeding: perceptions of embarrassment, sexuality, and social conduct in white low-income British men.

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Henderson, Lesley; McMillan, Brian; Green, Josephine M; Renfrew, Mary J

2011-03-01

The views of fathers have been shown to be important determinants of infant feeding decisions, but men's perceptions of breastfeeding and formula feeding are rarely explored. Our objectives were to address this gap and examine cultural associations and beliefs concerning infant feeding practices among men. Five focus groups were conducted with low-income men (n = 28) living in areas of social deprivation in Leeds, northeast of England, and low-income areas of Glasgow, west of Scotland. Participants were white British men, aged between 16 and 45 years, and included fathers, expectant fathers, and potential fathers. Overarching themes concerning sexuality, embarrassment, and social conduct were identified across all groups. Participants perceived breastfeeding as "natural" but problematic, whereas formula feeding was mainly considered as convenient and safe. Participants without direct experience of breastfeeding assumed that it involved excessive public exposure and attracted unwanted male attention. Underpinning these fears were strong cultural associations between breasts and sexuality and anxieties concerning appropriate gender roles. In some communities few opportunities may occur to witness breastfeeding, and thus existing fears concerning the activity as attracting predatory male attention remain unchallenged. Perceptions of breastfeeding as a sexual activity and the dominant mass media emphasis on breasts as a sexual site may present additional obstacles to breastfeeding. Antenatal or perinatal education with men should address not only practical issues but also provide advice on tackling problems generated by wider sociocultural issues of sexuality and masculinity. © 2010, Copyright the Authors. Journal compilation © 2010, Wiley Periodicals, Inc.

Perceived spatial stigma, body mass index and blood pressure: a global positioning system study among low-income housing residents in New York City

Directory of Open Access Journals (Sweden)

Dustin T. Duncan

2016-05-01

Full Text Available Previous research has highlighted the salience of spatial stigma on the lives of low-income residents, but has been theoretical in nature and/or has predominantly utilised qualitative methods with limited generalisability and ability to draw associations between spatial stigma and measured cardiovascular health outcomes. The primary objective of this study was to evaluate relationships between perceived spatial stigma, body mass index (BMI, and blood pressure among a sample of low-income housing residents in New York City (NYC. Data come from the community-based NYC Low-income Housing, Neighborhoods and Health Study. We completed a crosssectional analysis with survey data, which included the four items on spatial stigma, as well objectively measured BMI and blood pressure data (analytic n=116; 96.7% of the total sample. Global positioning systems (GPS tracking of the sample was conducted for a week. In multivariable models (controlling for individual-level age, gender, race/ethnicity, education level, employment status, total household income, neighborhood percent non-Hispanic Black and neighborhood median household income we found that participants who reported living in an area with a bad neighborhood reputation had higher BMI (B=4.2, 95%CI: -0.01, 8.3, P=0.051, as well as higher systolic blood pressure (B=13.2, 95%CI: 3.2, 23.1, P=0.01 and diastolic blood pressure (B=8.5, 95%CI: 2.8, 14.3, P=0.004. In addition, participants who reported living in an area with a bad neighborhood reputation had increased risk of obesity/overweight [relative risk (RR=1.32, 95%CI: 1.1, 1.4, P=0.02 and hypertension/pre-hypertension (RR=1.66, 95%CI: 1.2, 2.4, P=0.007. However, we found no differences in spatial mobility (based GPS data among participants who reported living in neighborhoods with and without spatial stigma (P>0.05. Further research is needed to investigate how placebased stigma may be associated with impaired cardiovascular health among individuals

Short Maternal Stature Increases Risk of Small-for-Gestational-Age and Preterm Births in Low- and Middle-Income Countries: Individual Participant Data Meta-Analysis and Population Attributable Fraction.

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Kozuki, Naoko; Katz, Joanne; Lee, Anne C C; Vogel, Joshua P; Silveira, Mariangela F; Sania, Ayesha; Stevens, Gretchen A; Cousens, Simon; Caulfield, Laura E; Christian, Parul; Huybregts, Lieven; Roberfroid, Dominique; Schmiegelow, Christentze; Adair, Linda S; Barros, Fernando C; Cowan, Melanie; Fawzi, Wafaie; Kolsteren, Patrick; Merialdi, Mario; Mongkolchati, Aroonsri; Saville, Naomi; Victora, Cesar G; Bhutta, Zulfiqar A; Blencowe, Hannah; Ezzati, Majid; Lawn, Joy E; Black, Robert E

2015-11-01

Small-for-gestational-age (SGA) and preterm births are associated with adverse health consequences, including neonatal and infant mortality, childhood undernutrition, and adulthood chronic disease. The specific aims of this study were to estimate the association between short maternal stature and outcomes of SGA alone, preterm birth alone, or both, and to calculate the population attributable fraction of SGA and preterm birth associated with short maternal stature. We conducted an individual participant data meta-analysis with the use of data sets from 12 population-based cohort studies and the WHO Global Survey on Maternal and Perinatal Health (13 of 24 available data sets used) from low- and middle-income countries (LMIC). We included those with weight taken within 72 h of birth, gestational age, and maternal height data (n = 177,000). For each of these studies, we individually calculated RRs between height exposure categories of < 145 cm, 145 to < 150 cm, and 150 to < 155 cm (reference: ≥ 155 cm) and outcomes of SGA, preterm birth, and their combination categories. SGA was defined with the use of both the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) birth weight standard and the 1991 US birth weight reference. The associations were then meta-analyzed. All short stature categories were statistically significantly associated with term SGA, preterm appropriate-for-gestational-age (AGA), and preterm SGA births (reference: term AGA). When using the INTERGROWTH-21st standard to define SGA, women < 145 cm had the highest adjusted risk ratios (aRRs) (term SGA-aRR: 2.03; 95% CI: 1.76, 2.35; preterm AGA-aRR: 1.45; 95% CI: 1.26, 1.66; preterm SGA-aRR: 2.13; 95% CI: 1.42, 3.21). Similar associations were seen for SGA defined by the US reference. Annually, 5.5 million term SGA (18.6% of the global total), 550,800 preterm AGA (5.0% of the global total), and 458,000 preterm SGA (16.5% of the global total) births may be associated

A pilot comparison of standardized online surgical curricula for use in low- and middle-income countries.

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Goldstein, Seth D; Papandria, Dominic; Linden, Allison; Azzie, Georges; Borgstein, Eric; Calland, James Forrest; Finlayson, Samuel R G; Jani, Pankaj; Klingensmith, Mary; Labib, Mohamed; Lewis, Frank; Malangoni, Mark A; O'Flynn, Eric; Ogendo, Stephen; Riviello, Robert; Abdullah, Fizan

2014-04-01

Surgical conditions are an important component of global disease burden, due in part to critical shortages of adequately trained surgical providers in low- and middle-income countries. To assess the use of Internet-based educational platforms as a feasible approach to augmenting the education and training of surgical providers in these settings. Access to two online curricula was offered to 75 surgical faculty and trainees from 12 low- and middle-income countries for 60 days. The Surgical Council on Resident Education web portal was designed for general surgery trainees in the United States, and the School for Surgeons website was built by the Royal College of Surgeons in Ireland specifically for the College of Surgeons of East, Central and Southern Africa. Participants completed an anonymous online survey detailing their experiences with both platforms. Voluntary respondents were daily Internet users and endorsed frequent use of both print and online textbooks as references. Likert scale survey questionnaire responses indicating overall and content-specific experiences with the Surgical Council on Resident Education and School for Surgeons curricula. Survey responses were received from 27 participants. Both online curricula were rated favorably, with no statistically significant differences in stated willingness to use and recommend either platform to colleagues. Despite regional variations in practice context, there were few perceived hurdles to future curriculum adoption. Both the Surgical Council on Resident Education and School for Surgeons educational curricula were well received by respondents in low- and middle-income countries. Although one was designed for US surgical postgraduates and the other for sub-Saharan African surgical providers, there were no significant differences detected in participant responses between the two platforms. Online educational resources have promise as an effective means to enhance the education of surgical providers in low

Ethics issues in social media-based HIV prevention in low- and middle-income countries.

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Chiu, Chingche J; Menacho, Luis; Fisher, Celia; Young, Sean D

2015-07-01

Questions have been raised regarding participants' safety and comfort when participating in e-health education programs. Although researchers have begun to explore this issue in the United States, little research has been conducted in low- and middle-income countries, where Internet and social media use is rapidly growing. This article reports on a quantitative study with Peruvian men who have sex with men who had previously participated in the Harnessing Online Peer Education (HOPE) program, a Facebook-based HIV education program. The survey assessed participants' ethics-relevant perspectives during recruitment, consent, intervention, and follow-up.

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

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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…

A Phenomenological Study to Discover Low-Income Adults' Perceptions and Expectations Regarding Financial Literacy

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Schaffer, Brigid Ann

2013-01-01

This phenomenological study explored the perceptions and expectations of low income adults regarding financial literacy to discover ways to increase attendance in financial literacy programs designs for this cohort. The study utilized interviews with closed-ended questions to establish the participants' backgrounds, then opened-ended questions to…

After-School Multifamily Groups: A Randomized Controlled Trial Involving Low-Income, Urban, Latino Children

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McDonald, Lynn; Moberg, D. Paul; Brown, Roger; Rodriguez-Espiricueta, Ismael; Flores, Nydia I.; Burke, Melissa P.; Coover, Gail

2006-01-01

This randomized controlled trial evaluated a culturally representative parent engagement strategy with Latino parents of elementary school children. Ten urban schools serving low-income children from mixed cultural backgrounds participated in a large study. Classrooms were randomly assigned either either to an after-school, multifamily support…

Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults.

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Waldersen, Brian W; Wolff, Jennifer L; Roberts, Laken; Bridges, Allysin E; Gitlin, Laura N; Szanton, Sarah L

2017-05-01

To describe functional goals and factors associated with goal attainment among low-income older adults with disabilities living in the community. Secondary analysis. Participants' homes. Older adults (N=226) with disability who participated in the Community Aging in Place, Advancing Better Living for Elders trial. A 5-month, home-based, person-directed, structured program delivered by an interprofessional team: occupational therapist, registered nurse, and handyman. Process of occupational therapist goal setting and attainment at the final occupational therapist visit. Participants identified 728 functional goals (mean of 3.2 goals per participant), most commonly related to transferring (22.0%; n=160 goals), changing or maintaining body position (21.4%; n=156 goals), and stair climbing (13.0%; n=95 goals). Participants attained 73.5% (n=535) of goals. Goal attainment was highest for stair climbing (86.3%), transferring (85.6%), and self-care (84.6%); walking goals were less likely attained (54.0%). Goal attainment was not associated with age, sex, education, depressive symptoms, function, or health-related quality of life but was less likely among participants who had severe pain compared with those without pain (adjusted odds ratio, 0.38; 95% confidence interval, 0.17-0.86). When participant readiness to change score increases by 1 point on the 4-point scale, goal attainment was 62% more likely (adjusted odds ratio, 1.62; 95% confidence interval, 1.14-2.29). Home-based collaborative goal setting between older adults and occupational therapists is feasible and particularly effective when individuals are ready or willing to adopt new strategies to achieve identified goals. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

Directory of Open Access Journals (Sweden)

So-Ra Kim

Full Text Available To investigate the effects of age and sex on the relationship between socioeconomic status (SES and the prevalence and control status of diabetes mellitus (DM in Korean adults.Data came from 16,175 adults (6,951 men and 9,227 women over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs and corresponding 95% confidence intervals (95% CI for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels.The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34 and 2.28 (1.29, 4.02 for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment. The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39 for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment. However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected.We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.

Authorship ethics in global health research partnerships between researchers from low or middle income countries and high income countries.

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Smith, Elise; Hunt, Matthew; Master, Zubin

2014-05-28

Over the past two decades, the promotion of collaborative partnerships involving researchers from low and middle income countries with those from high income countries has been a major development in global health research. Ideally, these partnerships would lead to more equitable collaboration including the sharing of research responsibilities and rewards. While collaborative partnership initiatives have shown promise and attracted growing interest, there has been little scholarly debate regarding the fair distribution of authorship credit within these partnerships. In this paper, we identify four key authorship issues relevant to global health research and discuss their ethical and practical implications. First, we argue that authorship guidance may not adequately apply to global health research because it requires authors to write or substantially revise the manuscript. Since most journals of international reputation in global health are written in English, this would systematically and unjustly exclude non-English speaking researchers even if they have substantially contributed to the research project. Second, current guidance on authorship order does not address or mitigate unfair practices which can occur in global health research due to power differences between researchers from high and low-middle income countries. It also provides insufficient recognition of "technical tasks" such as local participant recruitment. Third, we consider the potential for real or perceived editorial bias in medical science journals in favour of prominent western researchers, and the risk of promoting misplaced credit and/or prestige authorship. Finally, we explore how diverse cultural practices and expectations regarding authorship may create conflict between researchers from low-middle and high income countries and contribute to unethical authorship practices. To effectively deal with these issues, we suggest: 1) undertaking further empirical and conceptual research regarding

Socio-demographic patterns of disability among older adult populations of low-income and middle-income countries: results from World Health Survey.

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Hosseinpoor, Ahmad Reza; Bergen, Nicole; Kostanjsek, Nenad; Kowal, Paul; Officer, Alana; Chatterji, Somnath

2016-04-01

Our objective was to quantify disability prevalence among older adults of low- and middle-income countries, and measure socio-demographic distribution of disability. World Health Survey data included 53,447 adults aged 50 or older from 43 low- and middle-income countries. Disability was a binary classification, based on a composite score derived from self-reported functional difficulties. Socio-demographic variables included sex, age, marital status, area of residence, education level, and household economic status. A multivariate Poisson regression model with robust variance was used to assess associations between disability and socio-demographic variables. Overall, 33.3 % (95 % CI 32.2-34.4 %) of older adults reported disability. Disability was 1.5 times more common in females, and was positively associated with increasing age. Divorced/separated/widowed respondents reported higher disability rates in all but one study country, and education and wealth levels were inversely associated with disability rates. Urban residence tended to be advantageous over rural. Country-level datasets showed disparate patterns. Effective approaches aimed at disability prevention and improved disability management are warranted, including the inclusion of equity considerations in monitoring and evaluation activities.

Low-Income Community Solar: Utility Return Considerations for Electric Cooperatives

Energy Technology Data Exchange (ETDEWEB)

Aznar, Alexandra Y [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Gagne, Douglas A [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-04-05

The objective of this short report is to identify project structures that make low-income community solar projects more cost-effective, replicable, and scalable, for electric cooperative and municipal utilities. This report explores the tradeoffs between providing energy bill savings for low-income subscribers and utility project returns, as well as some of the key lessons learned from existing successful low-income community solar pilot projects.

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

Science.gov (United States)

2010-04-01

... Activities § 1000.142 What is the “useful life” during which low-income rental housing and low-income... recipient shall describe in its IHP its determination of the useful life of each assisted housing unit in... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What is the âuseful lifeâ during...

Motivators to engage in health promotion activities by low-income black fathers.

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Calvert, Wilma J; Isaac-Savage, E Paulette

2013-01-01

There has been increasing concern about the health status of low-income Black fathers. Little is known about their motivators to participate in health promotion activities. This descriptive qualitative research study explored these motivators. Focus groups were used to gather the data. Themes included avoiding specific diseases, helping others, a personal desire to learn, and modeling positive behaviors. These findings provide baseline data that might be used to develop community interventions targeting this group. Additional work will focus on validating these results and further exploration of some of the motivators verbalized by these participants.

Association between maternal age at childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration).

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Fall, Caroline H D; Sachdev, Harshpal Singh; Osmond, Clive; Restrepo-Mendez, Maria Clara; Victora, Cesar; Martorell, Reynaldo; Stein, Aryeh D; Sinha, Shikha; Tandon, Nikhil; Adair, Linda; Bas, Isabelita; Norris, Shane; Richter, Linda M

2015-07-01

Both young and advanced maternal age is associated with adverse birth and child outcomes. Few studies have examined these associations in low-income and middle-income countries (LMICs) and none have studied adult outcomes in the offspring. We aimed to examine both child and adult outcomes in five LMICs. In this prospective study, we pooled data from COHORTS (Consortium for Health Orientated Research in Transitioning Societies)-a collaboration of five birth cohorts from LMICs (Brazil, Guatemala, India, the Philippines, and South Africa), in which mothers were recruited before or during pregnancy, and the children followed up to adulthood. We examined associations between maternal age and offspring birthweight, gestational age at birth, height-for-age and weight-for-height Z scores in childhood, attained schooling, and adult height, body composition (body-mass index, waist circumference, fat, and lean mass), and cardiometabolic risk factors (blood pressure and fasting plasma glucose concentration), along with binary variables derived from these. Analyses were unadjusted and adjusted for maternal socioeconomic status, height and parity, and breastfeeding duration. We obtained data for 22 188 mothers from the five cohorts, enrolment into which took place at various times between 1969 and 1989. Data for maternal age and at least one outcome were available for 19 403 offspring (87%). In unadjusted analyses, younger (≤19 years) and older (≥35 years) maternal age were associated with lower birthweight, gestational age, child nutritional status, and schooling. After adjustment, associations with younger maternal age remained for low birthweight (odds ratio [OR] 1·18 (95% CI 1·02-1·36)], preterm birth (1·26 [1·03-1·53]), 2-year stunting (1·46 [1·25-1·70]), and failure to complete secondary schooling (1·38 [1·18-1·62]) compared with mothers aged 20-24 years. After adjustment, older maternal age remained associated with increased risk of preterm birth (OR 1

Maternal and child undernutrition and overweight in low-income and middle-income countries.

Science.gov (United States)

Black, Robert E; Victora, Cesar G; Walker, Susan P; Bhutta, Zulfiqar A; Christian, Parul; de Onis, Mercedes; Ezzati, Majid; Grantham-McGregor, Sally; Katz, Joanne; Martorell, Reynaldo; Uauy, Ricardo

2013-08-03

Maternal and child malnutrition in low-income and middle-income countries encompasses both undernutrition and a growing problem with overweight and obesity. Low body-mass index, indicative of maternal undernutrition, has declined somewhat in the past two decades but continues to be prevalent in Asia and Africa. Prevalence of maternal overweight has had a steady increase since 1980 and exceeds that of underweight in all regions. Prevalence of stunting of linear growth of children younger than 5 years has decreased during the past two decades, but is higher in south Asia and sub-Saharan Africa than elsewhere and globally affected at least 165 million children in 2011; wasting affected at least 52 million children. Deficiencies of vitamin A and zinc result in deaths; deficiencies of iodine and iron, together with stunting, can contribute to children not reaching their developmental potential. Maternal undernutrition contributes to fetal growth restriction, which increases the risk of neonatal deaths and, for survivors, of stunting by 2 years of age. Suboptimum breastfeeding results in an increased risk for mortality in the first 2 years of life. We estimate that undernutrition in the aggregate--including fetal growth restriction, stunting, wasting, and deficiencies of vitamin A and zinc along with suboptimum breastfeeding--is a cause of 3·1 million child deaths annually or 45% of all child deaths in 2011. Maternal overweight and obesity result in increased maternal morbidity and infant mortality. Childhood overweight is becoming an increasingly important contributor to adult obesity, diabetes, and non-communicable diseases. The high present and future disease burden caused by malnutrition in women of reproductive age, pregnancy, and children in the first 2 years of life should lead to interventions focused on these groups. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Value of Community Health Workers in Diabetes Management in Low-Income Populations: A Qualitative Study.

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Silverman, Julie; Krieger, James; Sayre, George; Nelson, Karin

2018-03-01

To describe community health workers (CHWs) roles in a diabetes self-management intervention. Retrospective qualitative inductive analysis of open text home visit encounter form from Peer Support for Achieving Independence in Diabetes (Peer AID), a randomized controlled trial in which low-income individuals with poorly controlled diabetes received either CHW home visits or usual care. Following visits, CHWs completed encounter forms documenting the health goal of the visit, the self-management strategies discussed and participant concerns. 634 encounter reports were completed for the 145 intervention participants. CHW notes revealed three main obstacles to optimal disease control: gaps in diabetes knowledge and self-management skills; socioeconomic conditions; and the complexity of the healthcare system. CHWs helped participants overcome these obstacles through extensive, hands-on education, connecting participants to community resources, and assistance navigating the medical system. In addition, the CHWs offered uncomplicated accessibility and availability to their clients. CHWs can be a valuable asset for low-income patients with chronic health conditions who may require more support than what can provided in a typical primary care visit.

The association of childhood asthma with mental health and developmental comorbidities in low-income families.

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Arif, Ahmed A; Korgaonkar, Purva

2016-01-01

The objective of the study was to determine the relationship of childhood asthma with mental health and developmental indicators in low-income families. Parents/guardians of approximately 400 children, aged 2-14 years, were recruited from a charity hospital serving low income neighborhoods in the outskirts of Karachi, Pakistan. Mothers of children were interviewed in their local language by a trained nurse. Eight self-reported comorbidities were grouped into two constructs based on factor analysis and conveniently labeled as mental health (anxiety, attention and behavioral problems) and developmental problems (learning, developmental delay, hearing impairment, sleep and speech problems). Data were analyzed using multiple logistic regression, adjusted for age, sex, presence of older siblings, number of people in the household, child birth weight, presence of mold, and family history of asthma or hay fever. Children with asthma had 18 times greater odds of mental health problems (adjusted OR = 18.0, 95% CI: 9.2, 35.1) as compared to children without asthma. The odds of developmental problems were more than 14 times greater for children with asthma (adjusted OR = 14.3, 95% CI: 7.8, 26.1) as compared to children without asthma. This study found mental and developmental adverse consequences of childhood asthma in low-income families. Identifying and treating asthma at an early age could reduce the burden of comorbidities in this population.

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.

Science.gov (United States)

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.

Generational status, health insurance, and public benefit participation among low-income Latino children.

Science.gov (United States)

DeCamp, Lisa Ross; Bundy, David G

2012-04-01

The objectives of this study were to (1) measure health insurance coverage and continuity across generational subgroups of Latino children, and (2) determine if participation in public benefit programs is associated with increased health insurance coverage and continuity. We analyzed data on 25,388 children income-eligible for public insurance from the 2003 to 2004 National Survey of Children's Health and stratified Latinos by generational status. First- and second-generation Latino children were more likely to be uninsured (58 and 19%, respectively) than third-generation children (9.5%). Second-generation Latino children were similarly likely to be currently insured by public insurance as third-generation children (61 and 62%, respectively), but less likely to have private insurance (19 and 29%, respectively). Second-generation Latino children were slightly more likely than third-generation children to have discontinuous insurance during the year (19 and 15%, respectively). Compared with children in families where English was the primary home language, children in families where English was not the primary home language had higher odds of being uninsured versus having continuous insurance coverage (OR: 2.19; 95% CI [1.33-3.62]). Among second-generation Latino children, participation in the Food Stamp (OR 0.26; 95% CI [0.14-0.48]) or Women, Infants, and Children (OR 0.40; 95% CI [0.25-0.66]) programs was associated with reduced odds of being uninsured. Insurance disparities are concentrated among first- and second-generation Latino children. For second-generation Latino children, connection to other public benefit programs may promote enrollment in public insurance.

Examining the feasibility of implementing behavioural economics strategies that encourage home dinner vegetable intake among low-income children.

Science.gov (United States)

Leak, Tashara M; Swenson, Alison; Rendahl, Aaron; Vickers, Zata; Mykerezi, Elton; Redden, Joseph P; Mann, Traci; Reicks, Marla

2017-06-01

To examine the feasibility of implementing nine behavioural economics-informed strategies, or 'nudges', that aimed to encourage home dinner vegetable intake among low-income children. Caregivers were assigned six of nine strategies and implemented one new strategy per week (i.e. 6 weeks) during three dinner meals. Caregivers recorded child dinner vegetable intake on the nights of strategy implementation and rated the level of difficulty for assigned strategies. Baseline data on home vegetable availability and child vegetable liking were collected to assess overall strategy feasibility. Participants' homes in a large Midwestern metropolitan area, USA. Low-income caregiver/child (aged 9-12 years) dyads (n 39). Pairwise comparisons showed that child dinner vegetable intake for the strategy 'Serve at least two vegetables with dinner meals' was greater than intake for each of two other strategies: 'Pair vegetables with other foods the child likes' and 'Eat dinner together with an adult(s) modelling vegetable consumption'. Overall, caregivers' mean rating of difficulty for implementing strategies was 2·6 (1='not difficult', 10='very difficult'). Households had a mean of ten different types of vegetables available. Children reported a rating ≥5 for seventeen types of vegetable on a labelled hedonic scale (1='hate it', 5-6='it's okay', 10='like it a lot'). Behavioural economics-informed strategies are feasible to implement during dinner meals, with some strategies differing by how much they influence vegetable intake among low-income children in the home.

"Broken windows": Relationship between neighborhood conditions and behavioral health among low-income African American adolescents.

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Voisin, Dexter R; Kim, Dong Ha

2018-03-01

This study explored the association between neighborhood conditions and behavioral health among African American youth. Cross-sectional data were collected from 683 African American youth from low-income communities. Measures for demographics, neighborhood conditions (i.e. broken windows index), mental health, delinquency, substance use, and sexual risk behaviors were assessed. Major findings indicated that participants who reported poorer neighborhood conditions compared to those who lived in better living conditions were more likely to report higher rates of mental health problems, delinquency, substance use, and unsafe sexual behaviors. Environmental factors need to be considered when addressing the behavioral health of low-income African American youth.

The family context of low-income parents who restrict child screen time.

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Lampard, Amy M; Jurkowski, Janine M; Davison, Kirsten K

2013-10-01

The American Academy of Pediatrics recommends that parents restrict child screen time to two hours per day, but many preschool-aged children exceed this viewing recommendation. Modifying children's viewing habits will require collaborating with parents, but little is known about the factors that influence parents' capacity for effective screen-related parenting. This study aimed to identify the demographic, family and community contextual factors associated with low-income parents' restriction of child screen time. Parents (N=146) of children (age 2-5 years) attending Head Start centers in the United States completed a self-report survey in 2010 assessing parent and child screen use (television, DVD, video, video games, and leisure-time computer use), parent restriction of child screen time, and family (parent stress, social support, and life pressures) and community (neighborhood safety and social capital) factors. Children were more likely to meet the American Academy of Pediatrics screen time recommendation if their parent reported high restriction of child screen time. Parent and child demographic characteristics were not associated with parents' restriction of child screen time. In multivariate analysis, less parent screen time, fewer parent life pressures, and greater social support were associated with parents' high restriction of screen time. Family contextual factors may play an important role in enabling low-income parents to restrict their children's screen time. When counseling low-income parents about the importance of restricting child screen time, practitioners should be sensitive to family contextual factors that may influence parents' capacity to implement this behavior change.

Prediction of cardiovascular disease risk among low-income urban dwellers in metropolitan Kuala Lumpur, Malaysia.

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Su, Tin Tin; Amiri, Mohammadreza; Mohd Hairi, Farizah; Thangiah, Nithiah; Bulgiba, Awang; Majid, Hazreen Abdul

2015-01-01

We aimed to predict the ten-year cardiovascular disease (CVD) risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS) models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM). Altogether 882 adults (≥30 years old with no CVD history) were randomly selected. The classic FRS model (figures in parentheses are from the modified model) revealed that 20.5% (21.8%) and 38.46% (38.9%) of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Prediction of Cardiovascular Disease Risk among Low-Income Urban Dwellers in Metropolitan Kuala Lumpur, Malaysia

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Tin Tin Su

2015-01-01

Full Text Available We aimed to predict the ten-year cardiovascular disease (CVD risk among low-income urban dwellers of metropolitan Malaysia. Participants were selected from a cross-sectional survey conducted in Kuala Lumpur. To assess the 10-year CVD risk, we employed the Framingham risk scoring (FRS models. Significant determinants of the ten-year CVD risk were identified using General Linear Model (GLM. Altogether 882 adults (≥30 years old with no CVD history were randomly selected. The classic FRS model (figures in parentheses are from the modified model revealed that 20.5% (21.8% and 38.46% (38.9% of respondents were at high and moderate risk of CVD. The GLM models identified the importance of education, occupation, and marital status in predicting the future CVD risk. Our study indicated that one out of five low-income urban dwellers has high chance of having CVD within ten years. Health care expenditure, other illness related costs and loss of productivity due to CVD would worsen the current situation of low-income urban population. As such, the public health professionals and policy makers should establish substantial effort to formulate the public health policy and community-based intervention to minimize the upcoming possible high mortality and morbidity due to CVD among the low-income urban dwellers.

Sun protection use behaviour among University students from 25 low, middle income and emerging economy countries.

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Pengpid, Supa; Peltzer, Karl

2015-01-01

The aim of this study was to investigate the sun protection use behaviour among university students from 25 low, middle income and emerging economy countries. Using anonymous questionnaires, data were collected from 18,687 undergraduate university students aged 18-30 years (mean age 20.8, SD=2.8) from 26 universities in 25 countries across Asia, Africa and the Americas. Overall, 57.2% of university students reported liking to sunbathe and of those only 48.1% used sun protection when sunbathing. In multivariate logistic regression, younger age, being female, coming from a wealthy or quite well off economic family background, living in an upper middle or high income country, lighter skin tone, and other health behaviours were found to be associated with sun protection use behaviour. Low sun protection use calls for health promotion programmes to prevent unprotected sun exposure.

Nutritional status of pre-school children from low income families

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de Oliveira Adriana G

2011-05-01

Full Text Available Abstract Background We evaluated growth and nutritional status of preschool children between 2 and 6 years old from low income families from 14 daycare centers. Methods Cross-sectional study with 1544 children from daycare centers of Santo Andre, Brazil. Body weight (W, height (H and body mass index (BMI were classified according to the 2000 National Center for Health Statistics (CDC/NCHS. Cutoff points for nutritional disorders: -2 z scores and 2.5 and 10 percentiles for malnutrition risk, 85 to 95 percentile for overweight and above BMI 95 percentile for obesity. Stepwise Forward Regression method was used including age, gender, birth weight, breastfeeding duration, age of mother at birth and period of time they attended the daycare center. Results Children presented mean z scores of H, W and BMI above the median of the CDC/NCHS reference. Girls were taller and heavier than boys, while we observed similar BMI between both genders. The z scores tended to rise with age. A Pearson Coefficient of Correlation of 0.89 for W, 0.93 for H and 0.95 for BMI was documented indicating positive association of age with weight, height and BMI. The frequency of children below -2 z scores was lower than expected: 1.5% for W, 1.75% for H and 0% for BMI, which suggests that there were no malnourished children. The other extremity of the distribution evidenced prevalence of overweight and obesity of 16.8% and 10.8%, respectively. Conclusion Low income preschool children are in an advanced stage of nutritional transition with a high prevalence of overweight.

Is youth smoking responsive to cigarette prices? Evidence from low- and middle-income countries.

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Kostova, Deliana; Ross, Hana; Blecher, Evan; Markowitz, Sara

2011-11-01

To estimate the price elasticity of cigarette demand among youth in low- and middle-income countries (LMIC). The Global Youth Tobacco Survey was used to obtain data on the smoking behaviour of 315,353 adolescents from 17 LMIC. Two-part model of cigarette demand with country fixed effects. The first part estimates the impact of prices on smoking participation while the second part estimates the impact of prices on the number of cigarettes smoked among current smokers. Besides controlling for individual characteristics such as Age, Gender, Parental Smoking and availability of Pocket Money, the authors control for confounding environmental factors such as anti-smoking sentiment, the prevalence of cigarette advertising and anti-tobacco media messAges, and ease of purchasing cigarettes. All countries in this study are represented with at least two observations over time, which allows us to control for unobserved country characteristics and/or policies that may influence smoking patterns within countries. Cigarette price is an important determinant of smoking. The estimated price elasticity of smoking participation is -0.74, and the estimated price elasticity of conditional cigarette demand is approximately -1.37. The total price elasticity of cigarette demand is -2.11, implying that an increase in price of 10% would reduce youth cigarette consumption by 21.1% at the mean.

Impact of Race Versus Education and Race Versus Income on Patients' Motivation to Participate in Clinical Trials.

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Kurt, Anita; Kincaid, Hope; Semler, Lauren; Jacoby, Jeanne L; Johnson, Melanie B; Careyva, Beth A; Stello, Brian; Friel, Timothy; Smulian, John C; Knouse, Mark C

2017-12-26

Our study investigates whether levels of motivation and barriers to participation in clinical trials vary with patients' education and income. A self-administered survey asked outpatients to rank potential influential factors on a "0" to "4" significance scale for their motivation to participate in clinical trials. Principal component analysis (PCA), analysis of variance (ANOVA), Kruskal-Wallis, and Mann-Whitney U tests analyzed the impact of race, education, and income on their motivation to participate. Analysis included 1841 surveys; most respondents had a high school education or some college, and listed annual income motivation scale 1 scores (p = .0261). Compared with their counterparts, subjects with less education/lower income ranked monetary compensation (p = .0420 and p motivator. Minorities and patients with less education and lower income appear to be more influenced by their desire to please the doctor, the race and sex of the doctor, and the language spoken by the doctor being the same as theirs. For all races, education appeared to have a direct relationship with motivation to participate, except for African-Americans, whose motivation appeared to decline with more education. Income appeared to have an inverse relationship with motivation to participate for all races.

Incidence of Obesity Among Young US Children Living in Low-Income Families, 2008–2011

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Pan, Liping; May, Ashleigh L.; Wethington, Holly; Dalenius, Karen; Grummer-Strawn, Laurence M.

2015-01-01

OBJECTIVE To examine the incidence and reverse of obesity among young low-income children and variations across population subgroups. METHODS We included 1.2 million participants in federally funded child health and nutrition programs who were 0 to 23 months old in 2008 and were followed up 24 to 35 months later in 2010–2011. Weight and height were measured. Obesity at baseline was defined as gender-specific weight-for-length ≥95th percentile on the 2000 Centers for Disease Control and Prevention growth charts. Obesity at follow-up was defined as gender-specific BMI-for-age ≥95th percentile. We used a multivariable log-binomial model to estimate relative risk of obesity adjusting for gender, baseline age, race/ethnicity, duration of follow-up, and baseline weight-for-length percentile. RESULTS The incidence of obesity was 11.0% after the follow-up period. The incidence was significantly higher among boys versus girls and higher among children aged 0 to 11 months at baseline versus those older. Compared with non-Hispanic whites, the risk of obesity was 35% higher among Hispanics and 49% higher among American Indians (AIs)/Alaska Natives (ANs), but 8% lower among non-Hispanic African Americans. Among children who were obese at baseline, 36.5% remained obese and 63.5% were nonobese at follow-up. The proportion of reversing of obesity was significantly lower among Hispanics and AIs/ANs than that among other racial/ethnic groups. CONCLUSIONS The high incidence underscores the importance of early-life obesity prevention in multiple settings for low-income children and their families. The variations within population subgroups suggest that culturally appropriate intervention efforts should be focused on Hispanics and AIs/ANs. PMID:24276843

Poverty and disability in low- and middle-income countries: A systematic review.

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Banks, Lena Morgon; Kuper, Hannah; Polack, Sarah

2017-01-01

Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of

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

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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…

Process Evaluation of a Parenting Program for Low-Income Families in South Africa

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Lachman, Jamie M.; Kelly, Jane; Cluver, Lucie; Ward, Catherine L.; Hutchings, Judy; Gardner, Frances

2018-01-01

Objective: This mixed-methods process evaluation examined the feasibility of a parenting program delivered by community facilitators to reduce the risk of child maltreatment in low-income families with children aged 3-8 years in Cape Town, South Africa (N = 68). Method: Quantitative measures included attendance registers, fidelity checklists,…

Promoting mother-infant interaction and infant mental health in low-income Korean families: attachment-based cognitive behavioral approach.

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Lee, Gyungjoo; McCreary, Linda; Breitmayer, Bonnie; Kim, Mi Ja; Yang, Soo

2013-10-01

This study evaluated the attachment-based cognitive behavioral approach (ACBA) to enhance mother-infant interaction and infant mental health. This quasi-experimental study used a pre-posttest control group design. Participants were 40 low-income, mother-infant (infant ages 12-36 months) dyads, 20 dyads per group. The ACBA group received 10 weekly 90-min sessions. Dependent variables were changes in mother-infant interaction and infant mental health. Additionally, we explored changes in mothers' attachment security. The groups differed significantly in changes in mother-infant interaction, infant mental health problems, and mothers' attachment security. ACBA may enhance mother-infant interaction and infants' mental health. © 2013, Wiley Periodicals, Inc.

Poject Managment Approach to Public Low Income Housing. | Ogbu ...

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This research assesses the impacts of project management (PM) variables on the socio-economic formation of public low-income housing (LIH) users in Abia and ... socio-economic impact of public low income housing (LIH) and the PM variables: project scope control (PS), project planning (PPC), project cost control (PC), ...

Risk factors for major antenatal depression among low-income African American women.

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Luke, Sabrina; Salihu, Hamisu M; Alio, Amina P; Mbah, Alfred K; Jeffers, Dee; Berry, Estrellita Lo; Mishkit, Vanessa R

2009-11-01

Data on risk factors for major antenatal depression among African American women are scant. In this study, we seek to determine the prevalence and risk factors for major antenatal depression among low-income African American women receiving prenatal services through the Central Hillsborough Healthy Start (CHHS). Women were screened using the Edinburgh Postnatal Depression Scale (EPDS) with a cutoff of > or =13 as positive for risk of major antenatal depression. In total, 546 African American women were included in the analysis. We used logistic regression to identify risk factors for major antenatal depression. The prevalence of depressive symptomatology consistent with major antenatal depression was 25%. Maternal age was identified as the main risk factor for major antenatal depression. The association between maternal age and risk for major antenatal depression was biphasic, with a linear trend component lasting until age 30, at which point the slope changed markedly tracing a more pronounced likelihood for major depression with advancing age. Women aged > or =30 were about 5 times as likely to suffer from symptoms of major antenatal depression as teen mothers (OR = 4.62, 95% CI 2.23-9.95). The risk for major antenatal depression increases about 5-fold among low-income African American women from age 30 as compared to teen mothers. The results are consistent with the weathering effect resulting from years of cumulative stress burden due to socioeconomic marginalization and discrimination. Older African American mothers may benefit from routine antenatal depression screening for early diagnosis and intervention.

National income inequality and ineffective health insurance in 35 low- and middle-income countries.

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Alvarez, Francisco N; El-Sayed, Abdulrahman M

2017-05-01

Global health policy efforts to improve health and reduce financial burden of disease in low- and middle-income countries (LMIC) has fuelled interest in expanding access to health insurance coverage to all, a movement known as Universal Health Coverage (UHC). Ineffective insurance is a measure of failure to achieve the intended outcomes of health insurance among those who nominally have insurance. This study aimed to evaluate the relation between national-level income inequality and the prevalence of ineffective insurance. We used Standardized World Income Inequality Database (SWIID) Gini coefficients for 35 LMICs and World Health Survey (WHS) data about insurance from 2002 to 2004 to fit multivariable regression models of the prevalence of ineffective insurance on national Gini coefficients, adjusting for GDP per capita. Greater inequality predicted higher prevalence of ineffective insurance. When stratifying by individual-level covariates, higher inequality was associated with greater ineffective insurance among sub-groups traditionally considered more privileged: youth, men, higher education, urban residence and the wealthiest quintile. Stratifying by World Bank country income classification, higher inequality was associated with ineffective insurance among upper-middle income countries but not low- or lower-middle income countries. We hypothesize that these associations may be due to the imprint of underlying social inequalities as countries approach decreasing marginal returns on improved health insurance by income. Our findings suggest that beyond national income, income inequality may predict differences in the quality of insurance, with implications for efforts to achieve UHC. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

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

2012-12-01

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

Population aging in the state of Parana and impact of pensions and retirements in income

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Carina Diane Nakatani-Macedo

2015-07-01

Full Text Available This article discusses the aging process of the population of Paraná municipalities and its consequences in participation of pensions in total income. Were used the Census database obtained from IPARDES 1980, 1991, 2000 and 2010, in 399 municipalities of Paraná. PNAD (National Research of Household Samples, from years 1988 to 2012, database were used to measure the evolution of rent share due by pensions and annuities, through the decomposition of the Gini index methodology. We concluded that within 30 years the share of elderly in the population increased over three times, on average, for the localities of the state, going from 3.81% in 1980 to 12.83% in 2010 and there is a higher concentration of elderly in the municipalities located further north of the state. Income from pensions and retirements expanded their shares over total income by 125%; in 1988 presented a share of 7.5% over total income, increasing to 15.9% in 2012.

Cancer Outcomes in Low-Income Elders

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U.S. Department of Health & Human Services — Cancer Outcomes in Low-Income Elders, Is There An Advantage to Being on Medicaid Because of reduced financial barriers, dual Medicare-Medicaid enrollment of...

Surviving spinal cord injury in low income countries

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Tone Øderud

2014-08-01

Objectives: The aims of this study were to explore life expectancy (life expectancy is the average remaining years of life of an individual and the situation of persons living with SCI in low income settings. Method: Literature studies and qualitative methods were used. Qualitative data was collected through semi-structured interviews with 23 informants from four study sites in Zimbabwe representing persons with SCI, their relatives and rehabilitation professionals. Results: There are few publications available about life expectancy and the daily life of persons with SCI in low income countries. Those few publications identified and the study findings confirm that individuals with SCI are experiencing a high occurrence of pressure sores and urinary tract infections leading to unnecessary suffering, often causing premature death. Pain and depression are frequently reported and stigma and negative attitudes are experienced in society. Lack of appropriate wheelchairs and services, limited knowledge about SCI amongst health care staff, limited access to health care and rehabilitation services, loss of employment and lack of financial resources worsen the daily challenges. Conclusion: The study indicates that life expectancy for individuals with SCI in low income settings is shorter than for the average population and also with respect to individuals with SCI in high income countries. Poverty worsened the situation for individuals with SCI, creating barriers that increase the risk of contracting harmful pressure sores and infections leading to premature death. Further explorations on mortality and how individuals with SCI and their families in low income settings are coping in their daily life are required to provide comprehensive evidences.

Influenza vaccines in low and middle income countries

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Ott, Jördis J.; Klein Breteler, Janna; Tam, John S.; Hutubessy, Raymond C.W.; Jit, Mark; de Boer, Michiel R.

2013-01-01

Objectives: Economic evaluations on influenza vaccination from low resource settings are scarce and have not been evaluated using a systematic approach. Our objective was to conduct a systematic review on the value for money of influenza vaccination in low- and middle-income countries. Methods: PubMed and EMBASE were searched for economic evaluations published in any language between 1960 and 2011. Main outcome measures were costs per influenza outcome averted, costs per quality-adjusted life years gained or disability-adjusted life years averted, costs per benefit in monetary units or cost-benefit ratios. Results: Nine economic evaluations on seasonal influenza vaccine met the inclusion criteria. These were model- or randomized-controlled-trial (RCT)-based economic evaluations from middle-income countries. Influenza vaccination provided value for money for elderly, infants, adults and children with high-risk conditions. Vaccination was cost-effective and cost-saving for chronic obstructive pulmonary disease patients and in elderly above 65 y from model-based evaluations, but conclusions from RCTs on elderly varied. Conclusion: Economic evaluations from middle income regions differed in population studied, outcomes and definitions used. Most findings are in line with evidence from high-income countries highlighting that influenza vaccine is likely to provide value for money. However, serious methodological limitations do not allow drawing conclusions on cost-effectiveness of influenza vaccination in middle income countries. Evidence on cost-effectiveness from low-income countries is lacking altogether, and more information is needed from full economic evaluations that are conducted in a standardized manner. PMID:23732900

Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low-Income and Middle-Income Countries: A Systematic Review

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Islam, Rakibul M; Billah, Baki; Hossain, Md Nassif; Oldroyd, John

2017-07-27

Background: Cervical cancer (CCa) and breast cancer (BCa) are the two leading cancers in women worldwide. Early detection and education to promote early diagnosis and screening of CCa and BCa greatly increases the chances for successful treatment and survival. Screening uptake for CCa and BCa in low and middle - income countries (LMICs) is low, and is consequently failing to prevent these diseases. We conducted a systematic review to identify the key barriers to CCa and BCa screening in women in LMICs. Methods: We performed a systematic literature search using Ovid MEDLINE, EMBASE, PsycINFO, SCOPUS, CINHAL Plus, and Google scholar to retrieve all English language studies from inception to 2015. This review was done in accordance with the PRISMA-P guidelines. Results: 53 eligible studies, 31 CCa screening studies and 22 BCa screening studies, provided information on 81,210 participants. We found fewer studies in low-income and lower - middle - income countries than in upper - middle - income countries. Lack of knowledge about CCa and BCa, and understanding of the role of screening were the key barriers to CCa and BCa screening in LMICs. Factors that are opportunities for knowledge acquisition, such as level of education, urban living, employment outside the home, facilitated CCa and BCa screening uptake in women in LMICs. Conclusions: Improvements to CCa and BCa screening uptake in LMICs must be accompanied by educational interventions which aim to improve knowledge and understanding of CCa and BCa and screening to asymptomatic women. It is imperative for governments and health policy makers in LMICs to implement screening programmes, including educational interventions, to ensure the prevention and early detection of women with CCa and BCa. These programmes and policies will be an integral part of a comprehensive population-based CCa and BCa control framework in LMICs. Creative Commons Attribution License

Education modifies the association of wealth with obesity in women in middle-income but not low-income countries: an interaction study using seven national datasets, 2005-2010.

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Aitsi-Selmi, Amina; Bell, Ruth; Shipley, Martin J; Marmot, Michael G

2014-01-01

Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15-49 years collected in the period 2005-2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented. In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction education the wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative). In the poorer countries (India, Nigeria, Benin), there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (Peducation may protect against the obesogenic effects of increased household wealth as countries develop. Further research could examine the factors explaining the country differences in education effects.

Education Modifies the Association of Wealth with Obesity in Women in Middle-Income but Not Low-Income Countries: An Interaction Study Using Seven National Datasets, 2005-2010

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Aitsi-Selmi, Amina; Bell, Ruth; Shipley, Martin J.; Marmot, Michael G.

2014-01-01

Background Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). Methods The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15–49 years collected in the period 2005–2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented Results In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative). In the poorer countries (India, Nigeria, Benin), there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (Pwealth as countries develop. Further research could examine the factors explaining the country differences in education effects. PMID:24608086

Priorities of low-income urban residents for interventions to address the socio-economic determinants of health.

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Danis, Marion; Kotwani, Namrata; Garrett, Joanne; Rivera, Ivonne; Davies-Cole, John; Carter-Nolan, Pamela

2010-11-01

To determine the priorities of low-income urban residents for interventions that address the socio-economic determinants of health. We selected and estimated the cost of 16 interventions related to education, housing, nutrition, employment, health care, healthy behavior, neighborhood improvement, and transportation. Low-income residents of Washington, D.C. (N=431) participated in decision exercises to prioritize these interventions. Given a budget valued at approximately twice an estimated cost of medical and dental care ($885), the interventions ultimately prioritized by the greatest percentage of individuals were: health insurance (95%), housing vouchers (82%) dental care (82%), job training (72%), adult education (63%), counseling (68%), healthy behavior incentives (68%), and job placement (67%). The percentages of respondents who received support for housing, adult education, and job training and placement were far less than the percentage who prioritized these interventions. Poor and low-income residents' priorities may usefully inform allocation of social services that affect health.

Low-Income Women's Feeding Practices and Perceptions of Dietary Guidance: A Qualitative Study.

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Savage, Jennifer S; Neshteruk, Cody D; Balantekin, Katherine N; Birch, Leann L

2016-12-01

Objectives Describe themes characterizing feeding behaviors of low-income women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and identify the attitudes, beliefs, and sources of information that inform these practices. Methods Formative research was conducted including focus groups and semi-structured individual phone interviews with a total of 68 low-income women participating in WIC. Qualitative data were recorded, transcribed, imported into NVivo 8.0, and analyzed for common themes. Results Mothers reported feeding behaviors inconsistent with guidance from WIC and the American Academy of Pediatrics. Three main themes were identified. First, mothers reported receiving conflicting messaging/advice from medical professionals, WIC nutritionists, and family members, which was confusing. Mothers also reported dissatisfaction with the "one size fits most" approach. Lastly, mothers reported relying on their "instincts" and that "all babies are different" when deciding and rationalizing what feeding guidance to follow. Conclusions Future interventions targeting this high-risk population should consider developing personalized (individualized) messaging, tailored to the needs of each mother-child dyad. Focused efforts are needed to build partnerships between WIC providers and other health care providers to provide more consistent messages about responsive feeding to prevent early obesity.

Depression improvement and parenting in low-income mothers in home visiting.

Science.gov (United States)

Ammerman, Robert T; Altaye, Mekibib; Putnam, Frank W; Teeters, Angelique R; Zou, Yuanshu; Van Ginkel, Judith B

2015-06-01

Research on older children and high-resource families demonstrates that maternal improvement in depression often leads to parallel changes in parenting and child adjustment. It is unclear if this association extends to younger children and low-income mothers. This study examined if In-Home Cognitive Behavioral Therapy (IH-CBT), a treatment for depressed mothers participating in home visiting programs, contributes to improvements in parenting and child adjustment. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and subsequent diagnosis of major depressive disorder (MDD). Measures of depression, parenting stress, nurturing parenting, and child adjustment were administered at pre-treatment, post-treatment, and 3 months follow-up. Results indicated that there were no differences between IH-CBT and controls on parenting and child adjustment. Low levels of depression were associated with decreased parenting stress and increased nurturing parenting. Improvement in depression was related to changes in parenting in low-income mothers participating in home visiting programs. IH-CBT was not independently associated with these improvements, although to the extent that treatment facilitated improvement; there were corresponding benefits to parenting. Child adjustment was not associated with maternal depression, a finding possibly attributed to the benefits of concurrent home visiting or measurement limitations. Future research should focus on longer-term follow-up, implications of relapse, and child adjustment in later years.

Outpatient case management in low-income epilepsy patients.

Science.gov (United States)

Tatum, William O; Al-Saadi, Sam; Orth, Thomas L

2008-12-01

Case management (CM) has been shown to improve the medical care of patients in several paradigms of general medicine. This study was undertaken to assess the impact of CM on low-income patients with epilepsy. From 2002 to 2003, 737 epilepsy patients had CM provided by a non-profit, state-supported, epilepsy service subserving a four county region in southeastern Florida. Standardized survey forms distributed by the Florida Department of Health were completed by 159 consecutive patients at program admission. Follow-up information regarding seizure frequency, antiepileptic drugs, and quality of life self-rating was performed after 1 year of CM. The patients evaluated were composed of 58.5% men, with a mean age of 41.0 years. After CM, an increase in self-reported seizure control was seen in 40.2% of patients (preduction of ED visits per patient from 1.83 per patient per year before CM to 0.14 per patient per year after CM (p<0.0001, Wilcoxon matched-pairs test). Following CM, fewer patients reported difficulty with friends, employers, problems socializing, and feelings of anger (p<0.05, Fisher's exact test). CM of low-income patients with epilepsy resulted in self-reported improvement in seizure control, QoL, and significantly reduced ED visitation. CM in epilepsy is feasible and represents a cost-effective improvement in outpatient epilepsy management.

Feminist Relational Advocacy: Processes and Outcomes from the Perspective of Low-Income Women with Depression

Science.gov (United States)

Goodman, Lisa A.; Glenn, Catherine; Bohlig, Amanda; Banyard, Victoria; Borges, Angela

2009-01-01

This article describes a qualitative study of how low-income women who are struggling with symptoms of depression experience feminist relational advocacy, a new model that is informed by feminist, multicultural, and community psychology theories. Using qualitative content analysis of participant interviews, the authors describe the processes and…

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

Science.gov (United States)

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

2016-10-01

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 findings 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. Copyright © 2016 Elsevier Ltd. All rights reserved.

Low-income consumers' attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables

NARCIS (Netherlands)

Dibsdall, L.A.; Lambert, N.; Bobbin, R.F.; Frewer, L.J.

2003-01-01

To determine low-income consumers' attitudes and behaviour towards fruit and vegetables, in particular issues of access to, affordability of and motivation to eat fruit and vegetables. Design and setting: Questionnaire survey mailed to homes owned by a large UK housing association. Participants:

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

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Baum-Snow, Nathaniel; Marion, Justin

2009-06-01

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

Cigarette Design Features in Low-, Middle-, and High-Income Countries

Directory of Open Access Journals (Sweden)

Rosalie V. Caruso

2012-01-01

Full Text Available Previous studies have shown that country income grouping is correlated with cigarette engineering. Cigarettes (=111 brands were purchased during 2008–2010 from 11 low-, middle-, and high-income countries to assess physical dimensions and an array of cigarette design features. Mean ventilation varied significantly across low- (7.5%, middle- (15.3%, and high-income (26.2% countries (≤0.001. Differences across income groups were also seen in cigarette length (=0.001, length of the tipping paper (=0.01, filter weight (=0.017, number of vent rows (=0.003, per-cigarette tobacco weight (=0.04, and paper porosity (=0.008. Stepwise linear regression showed ventilation and tobacco length as major predictors of ISO tar yields in low-income countries (=0.909, 0.047, while tipping paper (<0.001, filter length (<0.001, number of vent rows (=0.014, and per-cigarette weight (=0.015 were predictors of tar yields in middle-income countries. Ventilation (<0.001, number of vent rows (=0.009, per-cigarette weight (<0.001, and filter diameter (=0.004 predicted tar yields in high-income countries. Health officials must be cognizant of cigarette design issues to provide effective regulation of tobacco products.

Food Group Categories of Low-Income African American Women

Science.gov (United States)

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:…

Cost-effectiveness of In-Home Cognitive Behavioral Therapy for low-income depressed mothers participating in early childhood prevention programs.

Science.gov (United States)

Ammerman, Robert T; Mallow, Peter J; Rizzo, John A; Putnam, Frank W; Van Ginkel, Judith B

2017-01-15

To determine the cost-effectiveness of In-Home Cognitive Behavioral Therapy (IH-CBT) for low-income mothers enrolled in a home visiting program. A cost-utility analysis was conducted using results from a clinical trial of IH-CBT and standard of care for depression derived from the literature. A probabilistic, patient-level Markov model was developed to determine Quality Adjusted Life Years (QALYs). Costs were determined using the Medical Expenditure Panel Survey. A three-year time horizon and payer perspective were used. Sensitivity analyses were employed to determine robustness of the model. IH-CBT was cost-effective relative to standard of care. IH-CBT was expected to be cost-effective at a three-year time horizon 99.5%, 99.7%, and 99.9% of the time for willingness-to-pay thresholds of US$25,000, US$50,000, and US$100,000, respectively. Patterns were upheld at one-year and five-year time horizons. Over the three-year time horizon, mothers receiving IH-CBT were expected to have 345.6 fewer days of depression relative to those receiving standard home visiting and treatment in the community. IH-CBT is a more cost-effective treatment for low-income, depressed mothers than current standards of practice. These findings add to the growing literature demonstrating the cost-effectiveness of CBT for depression, and expand it to cover new mothers. From a payer perspective, IH-CBT is a sound option for treatment of depressed, low-income mothers. Limitations include a restricted time horizon and estimating of standard of care costs. Copyright © 2016 Elsevier B.V. All rights reserved.

Physical inactivity and associated factors among university students in 23 low-, middle- and high-income countries.

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Pengpid, Supa; Peltzer, Karl; Kassean, Hemant Kumar; Tsala Tsala, Jacques Philippe; Sychareun, Vanphanom; Müller-Riemenschneider, Falk

2015-07-01

The aim of this study was to determine estimates of the prevalence and social correlates of physical inactivity among university students in 23 low-, middle- and high-income countries. The International Physical Activity Questionnaire was used to collect data from 17,928 undergraduate university students (mean age 20.8, SD = 2.8) from 24 universities in 23 countries. The prevalence of physical inactivity was 41.4 %, ranging from 21.9 % in Kyrgyzstan to 80.6 % in Pakistan. In multivariate logistic regression, older age (22-30 years), studying in a low- or lower middle-income country, skipping breakfast and lack of social support were associated with physical inactivity. In men, being underweight, being overweight or obese, not avoiding fat and cholesterol, not having severe depression symptoms, low beliefs in the health benefits of physical activity, low personal control and knowledge of exercise-heart link, and in women, not trying to eat fibre, low personal mastery and medium personal control were additionally associated with physical inactivity. Four in each ten students are physically inactive, calling for strategic interventions by relevant professionals in higher educational institutions.

Nation's Capital to cover low-income women's abortions.

Science.gov (United States)

1994-04-15

Sharon Pratt Kelly, the mayor of the District of Columbia, has announced that, effective May 1, 1994, the city will use its Medical Charities Fund to pay for "medically appropriate" abortions for women with annual incomes of US$13,200 who do not have health insurance that covers abortions. This income level represents 185% of the federal poverty level for single women. The determination as to whether an abortion is "appropriate" will be made by the woman's physician. From 1989-93, there was a ban on the use of District of Columbia tax monies to cover abortions for local women. In 1988, however, approximately 4000 District women received funding for their abortions. The US$1 million Medical Charities Fund was originally set up to cover emergency room bills for low-income District residents who did not qualify for Medicaid. $650,000 is expected to be added to the fund; in addition, the District's 1995 budget will allocate funding earmarked for abortion coverage for low-income women.

Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study on Infant Feeding.

Science.gov (United States)

Barbosa, Cecilia E; Masho, Saba W; Carlyle, Kellie E; Mosavel, Maghboeba

2017-05-01

Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors. This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed. Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who had breastfed for 3 months or less. Positive deviant women had more schooling, higher income, breastfeeding intention, positive breastfeeding and unfavorable formula-feeding attitudes, higher self-efficacy, positive hospital and Special Supplemental Nutrition Program for Women, Infants, and Children experiences, more exclusive breastfeeding, and greater comfort breastfeeding in public. Short-term breastfeeding women varied in breastfeeding intention and self-efficacy, seemed to receive insufficient professional breastfeeding support, and supplemented breastfeeding with formula. Some showed ambivalence, concern with unhealthy behaviors, and discomfort with breastfeeding in public. Formula-feeding women intended to formula feed, feared breastfeeding, thought their behaviors were incompatible with breastfeeding, were comfortable with and found formula convenient, and received strong support to formula feed. Tapping into the strengths of positive deviants; tailoring interventions to levels of general and breastfeeding self-efficacy; increasing social, institutional, and community supports; and removing inappropriate formula promotion may offer promising strategies to increase breastfeeding among low-income African American women.

How many low birthweight babies in low- and middle-income countries are preterm?

Directory of Open Access Journals (Sweden)

Fernando C Barros

2011-06-01

Full Text Available OBJECTIVE: To assess the prevalence of preterm birth among low birthweight babies in low and middle-income countries. METHODS: Major databases (PubMed, LILACS, Google Scholar were searched for studies on the prevalence of term and preterm LBW babies with field work carried out after 1990 in low- and middle-income countries. Regression methods were used to model this proportion according to LBW prevalence levels. RESULTS: According to 47 studies from 27 low- and middle-income countries, approximately half of all LBW babies are preterm rather than one in three as assumed in studies previous to the 1990s. CONCLUSIONS: The estimate of a substantially higher number of LBW preterm babies has important policy implications in view of special health care needs of these infants. As for earlier projections, our findings are limited by the relative lack of population-based studies.

Project Promise: A Long-Term Follow-Up of Low-Income Gifted Students Who Participated in a Summer Enrichment Program

Science.gov (United States)

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

2016-01-01

"Overlooked gems" is the term used in gifted education to describe high-potential, low-income students who are unable to excel because of significant barriers in their homes, environments, and educational systems. To address these barriers, educators have offered enrichment and other types of talent development programs to this at-risk…

Electronic Payment Adoption in the Banking Sector of Low-Income Countries

OpenAIRE

Teshome Alemu; Tridib Bandyopadhyay; Solomon Negash

2015-01-01

Banks in low-income countries are launching e-banking services such as Internet banking, SMS banking, ATM banking, card banking, point of sales (PoS) and mobile banking. Among these planned services, ATM is the most matured service in many private and state owned banks in Ethiopia. ATM is a recent phenomenon in low-income countries (; ), and is still being introduced in financial sectors in low-income countries (Angeli, 2008; ) making investigation of factors of ICT technology adoption in low...

Distinctive role of income in the all-cause mortality among working age migrants and the settled population in Finland: A follow-up study from 2001 to 2014.

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Patel, Kishan; Kouvonen, Anne; Koskinen, Aki; Kokkinen, Lauri; Donnelly, Michael; O'Reilly, Dermot; Vaananen, Ari

2018-03-01

Although income level may play a significant part in mortality among migrants, previous research has not focused on the relationship between income, migration and mortality risk. The aim of this register study was to compare all-cause mortality by income level between different migrant groups and the majority settled population of Finland. A random sample was drawn of 1,058,391 working age people (age range 18-64 years; 50.4% men) living in Finland in 2000 and linked to mortality data from 2001 to 2014. The data were obtained from Statistics Finland. Cox proportional hazards models were used to investigate the association between region of origin and all-cause mortality in low- and high-income groups. The risk for all-cause mortality was significantly lower among migrants than among the settled majority population (hazards ratio (HR) 0.57; 95% confidence interval (CI) 0.53-0.62). After adjustment for age, sex, marital status, employment status and personal income, the risk of mortality was significantly reduced for low-income migrants compared with the settled majority population with a low income level (HR 0.46; 95% CI 0.42-0.50) and for high-income migrants compared with the high-income settled majority (HR 0.81; 95% CI 0.69-0.95). Results comparing individual high-income migrant groups and the settled population were not significant. Low-income migrants from Africa, the Middle East and Asia had the lowest mortality risk of any migrant group studied (HR 0.32; 95% CI 0.27-0.39). Particularly low-income migrants seem to display a survival advantage compared with the corresponding income group in the settled majority population. Downward social mobility, differences in health-related lifestyles and the healthy migrant effect may explain this phenomenon.

An Emic, Mixed-Methods Approach to Defining and Measuring Positive Parenting among Low-Income Black Families

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McWayne, Christine M.; Mattis, Jacqueline S.; Green Wright, Linnie E.; Limlingan, Maria Cristina; Harris, Elise

2017-01-01

Research Findings: This within-group exploratory sequential mixed-methods investigation sought to identify how ethnically diverse, urban-residing, low-income Black families conceptualize positive parenting. During the item development phase 119 primary caregivers from Head Start programs participated in focus groups and interviews. These…

"What do you think of when I say the word 'snack'?" Towards a cohesive definition among low-income caregivers of preschool-age children.

Science.gov (United States)

Younginer, Nicholas A; Blake, Christine E; Davison, Kirsten K; Blaine, Rachel E; Ganter, Claudia; Orloski, Alexandria; Fisher, Jennifer Orlet

2016-03-01

Despite agreement that snacks contribute significant energy to children's diets, evidence of the effects of snacks on health, especially in children, is weak. Some of the lack of consistent evidence may be due to a non-standardized definition of snacks. Understanding how caregivers of preschool-aged children conceptualize and define child snacks could provide valuable insights on epidemiological findings, targets for anticipatory guidance, and prevention efforts. Participants were 59 ethnically-diverse (White, Hispanic, and African American), low-income urban caregivers of children age 3-5 years. Each caregiver completed a 60-90 min semi-structured in-depth interview to elicit their definitions of child snacks. Data were coded by two trained coders using theoretically-guided emergent coding techniques to derive key dimensions of caregivers' child snack definitions. Five interrelated dimensions of a child snack definition were identified: (1) types of food, (2) portion size, (3) time, (4) location, and (5) purpose. Based on these dimensions, an empirically-derived definition of caregivers' perceptions of child snacks is offered: A small portion of food that is given in-between meals, frequently with an intention of reducing or preventing hunger until the next mealtime. These findings suggest interrelated dimensions that capture the types of foods and eating episodes that are defined as snacks. Child nutrition studies and interventions that include a focus on child snacks should consider using an a priori multi-dimensional definition of child snacks. Copyright © 2015 Elsevier Ltd. All rights reserved.

Economic Stress and Cortisol Among Postpartum Low-Income Mexican American Women: Buffering Influence of Family Support.

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Jewell, Shannon L; Luecken, Linda J; Gress-Smith, Jenna; Crnic, Keith A; Gonzales, Nancy A

2015-01-01

Low-income Mexican American women experience significant health disparities during the postpartum period. Contextual stressors, such as economic stress, are theorized to affect health via dysregulated cortisol output. However, cultural protective factors including strong family support may buffer the impact of stress. In a sample of 322 low-income Mexican American women (mother age 18-42; 82% Spanish-speaking; modal family income $10,000-$15,000), we examined the interactive influence of economic stress and family support at 6 weeks postpartum on maternal cortisol output (AUCg) during a mildly challenging mother-infant interaction task at 12 weeks postpartum, controlling for 6-week maternal cortisol and depressive symptoms. The interaction significantly predicted cortisol output such that higher economic stress predicted higher cortisol only among women reporting low family support. These results suggest that family support is an important protective resource for postpartum Mexican American women experiencing elevated economic stress.

Gender gap matters in maternal mortality in low and lower-middle-income countries: A study of the global Gender Gap Index.

Science.gov (United States)

Choe, Seung-Ah; Cho, Sung-Il; Kim, Hongsoo

2017-09-01

Reducing maternal mortality has been a crucial part of the global development agenda. According to modernisation theory, the effect of gender equality on maternal health may differ depending on a country's economic development status. We explored the correlation between the Global Gender Gap Index (GGI) provided by the World Economic Forum and the maternal mortality ratio (MMR) obtained from the World Development Indicators database of the World Bank. The relationships between each score in the GGI, including its four sub-indices (measuring gender gaps in economic participation, educational attainment, health and survival, and political empowerment), and the MMR were analysed. When the countries were stratified by gross national income per capita, the low and lower-middle-income countries had lower scores in the GGI, and lower scores in the economic participation, educational attainment, and political empowerment sub-indices than the high-income group. Among the four sub-indices, the educational attainment sub-index showed a significant inverse correlation with the MMR in low and lower-middle-income countries when controlling for the proportion of skilled birth attendance and public share of health expenditure. This finding suggests that strategic efforts to reduce the gender gap in educational attainment could lead to improvements in maternal health in low and lower-middle-income countries.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth.

Science.gov (United States)

Trude, Angela Cristina Bizzotto; Kharmats, Anna Yevgenyevna; Hurley, Kristen Marie; Anderson Steeves, Elizabeth; Talegawkar, Sameera A; Gittelsohn, Joel

2016-08-24

Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV) are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA) youth in Baltimore, MD. Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10-14 y) dyads participating in the baseline evaluation of the B'More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice) and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake) controlling for youth age, sex, BMI percentile, total calorie intake and household income. On average, youth consumed 1.5 ± 1.1 (M ± SD) servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth's healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06-1.41, ORvegetable 1.31; 1.15-1.51 and ORfiber 1.46; 1.23-1.74, Self-efficacy: ORfruit 1.07; 1.03-1.12, ORvegetable 1.04; 1.01-1.09, ORfiber 1.10; 1.04-1.16). Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9). In addition, youth shopping more frequently at supermarkets were more likely to have greater vegetable

Does higher quality early child care promote low-income children's math and reading achievement in middle childhood?

Science.gov (United States)

Dearing, Eric; McCartney, Kathleen; Taylor, Beck A

2009-01-01

Higher quality child care during infancy and early childhood (6-54 months of age) was examined as a moderator of associations between family economic status and children's (N = 1,364) math and reading achievement in middle childhood (4.5-11 years of age). Low income was less strongly predictive of underachievement for children who had been in higher quality care than for those who had not. Consistent with a cognitive advantage hypothesis, higher quality care appeared to promote achievement indirectly via early school readiness skills. Family characteristics associated with selection into child care also appeared to promote the achievement of low-income children, but the moderating effect of higher quality care per se remained evident when controlling for selection using covariates and propensity scores.

Evaluation of a mindfulness-based intervention program to decrease blood pressure in low-income African-American older adults.

Science.gov (United States)

Palta, Priya; Page, G; Piferi, R L; Gill, J M; Hayat, M J; Connolly, A B; Szanton, S L

2012-04-01

Hypertension affects a large proportion of urban African-American older adults.While there have been great strides in drug development, many older adults do not have access to such medicines or do not take them. Mindfulness-based stress reduction (MBSR)has been shown to decrease blood pressure in some populations. This has not been tested in low-income, urban African-American older adults. Therefore, the primary purpose of this pilot study was to test the feasibility and acceptability of a mindfulness-based program for low income, minority older adults provided in residence. The secondary purpose was to learn if the mindfulness-based program produced differences in blood pressure between the intervention and control groups. Participants were at least 62 years old and residents of a low-income senior residence. All participants were African-American, and one was male.Twenty participants were randomized to the mindfulness-based intervention or a social support control group of the same duration and dose. Blood pressure was measured with the Omron automatic blood pressure machine at baseline and at the end of the 8-week intervention. A multivariate regression analysis was performed on the difference in scores between baseline and post-intervention blood pressure measurements, controlling for age,education, smoking status, and anti-hypertensive medication use. Effect sizes were calculated to quantify the magnitude of the relationship between participation in the mindfulness-based intervention and the outcome variable, blood pressure. Attendance remained 980%in all 8 weeks of both the intervention and the control groups. The average systolic blood pressure decreased for both groups post-intervention. Individuals in the intervention group exhibited a 21.92-mmHg lower systolic blood pressure compared to the social support control group post-intervention and this value was statistically significant(p=0.020). The average diastolic blood pressure decreased in the

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

Science.gov (United States)

2010-01-01

... VENTURE CAPITAL (âNMVCâ) PROGRAM Financing of Small Businesses by NMVC Companies Determining the... of your Portfolio Concerns must be Low-Income Enterprises in which you have an Equity Capital... total dollars) in Equity Capital Investments in Low-Income Enterprises. (b) Non-compliance with this...

Factors contributing to background television exposure in low-income Mexican American preschoolers

Science.gov (United States)

Thompson, Darcy A.; Tschann, Jeanne M.

2016-01-01

Objective Background television (TV) exposure is harmful to young children, yet few studies have focused on predictors of exposure. This study’s objectives were to elucidate demographic, environmental, and behavioral correlates of background TV exposure in low-income Mexican American preschoolers and to explore caregiver beliefs about the impact of such exposure. Methods A convenience sample of low-income Mexican American female primary caregivers of preschoolers (3–5 years old, n=309), recruited in safety-net clinics, were surveyed by phone. Caregivers reported the frequency of their child’s exposure to background TV and responded to questions on the home media environment, TV use, and whether they had thought about background TV exposure and its impact on their child. Results Background TV exposure was common; 43% reported that their child was often, very often, or always exposed to background TV. More hours of TV viewing by the caregiver and greater frequency of TV viewing during meals were associated with an increased frequency of exposure to background TV. Only 49% of participants had ever thought about the impact of background TV. Believing that background TV is not harmful was associated with higher levels of background TV exposure. Conclusions Findings suggest that background TV exposure is frequent and caregiver awareness of its potential impact is low in low-income Mexican American families. Beliefs that background TV is not harmful may predict risk of exposure. Potential targets for interventions focused on reducing background TV exposure in this population include increasing caregiver awareness of the potential negative impact of such TV exposure. PMID:27007983

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

Science.gov (United States)

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…

A Supermarket Double-Dollar Incentive Program Increases Purchases of Fresh Fruits and Vegetables Among Low-Income Families With Children: The Healthy Double Study.

Science.gov (United States)

Polacsek, Michele; Moran, Alyssa; Thorndike, Anne N; Boulos, Rebecca; Franckle, Rebecca L; Greene, Julie C; Blue, Dan J; Block, Jason P; Rimm, Eric B

2018-03-01

To carry out a pilot study to determine whether a supermarket double-dollar fruit and vegetable (F&V) incentive increases F&V purchases among low-income families. Randomized controlled design. Purchases were tracked using a loyalty card that provided participants with a 5% discount on all purchases during a 3-month baseline period followed by the 4-month intervention. A supermarket in a low-income rural Maine community. A total of 401 low-income and Supplemental Nutrition Assistance Program (SNAP) supermarket customers. Same-day coupon at checkout for half-off eligible fresh, frozen, or canned F&V over 4 months. Weekly spending in dollars on eligible F&V. A linear model with random intercepts accounted for repeated transactions by individuals to estimate change in F&V spending per week from baseline to intervention. Secondary analyses examined changes among SNAP-eligible participants. Coupons were redeemed among 53% of eligible baskets. Total weekly F&V spending increased in the intervention arm compared with control ($1.83; 95% confidence interval [CI], $0.29 to $3.88). The largest increase was for fresh F&V ($1.97; 95% CI, $0.49 to $3.44). Secondary analyses revealed greater increases in F&V spending among SNAP-eligible participants who redeemed coupons ($5.14; 95% CI, $1.93 to $8.34) than among non-SNAP eligible participants who redeemed coupons ($3.88; 95% CI, $1.67 to $6.08). A double-dollar pricing incentive increased F&V spending in a low-income community despite the moderate uptake of the coupon redemption. Customers who were eligible for SNAP saw the greatest F&V spending increases. Financial incentives for F&V are an effective strategy for food assistance programs to increase healthy purchases and improve dietary intake in low-income families. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Associations of Low-Income Working Mothers' Daily Interactions with Supervisors and Mother-Child Interactions

Science.gov (United States)

Gassman-Pines, Anna

2011-01-01

This study investigated associations of low-income working mothers' daily interactions with supervisors and their interactions with children. Sixty-one mothers of preschool-aged children were asked to report on their interactions with their supervisors at work and their interactions with children for 2 weeks (N = 520 workdays). Results show…

Foreign Direct Investment Behaviour in Low and Middle Income ...

International Development Research Centre (IDRC) Digital Library (Canada)

Does FDI actually stimulate growth and development in low-income ... Does FDI help reduce poverty and inequality and if so, under what circumstances? ... countries that share key features such as income level or economic structure.

Benefits Access for College Completion: Innovative Approaches to Meet the Financial Needs of Low-Income Students

Science.gov (United States)

Center for Postsecondary and Economic Success, 2014

2014-01-01

Benefits Access for College Completion (BACC) was designed to help colleges develop new policies that increase low-income students' access to public benefits, easing their financial burden to allow them to finish school and earn postsecondary credentials. Colleges participating in BACC have developed and institutionalized scalable, sustainable…

Social Policy Trends- Housing Affordability for Families with Low Incomes Across Canada

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Margarita (Gres Wilkins

2017-06-01

Full Text Available HOUSING AFFORDABILITY FOR FAMILIES WITH LOW INCOMES ACROSS CANADA Percentage of income devoted to paying lowest-priced rent in a city, by low-income family type, select years, 1990-2015 Much public attention has been directed towards the issue of a Canada-wide housing crisis. The focus has typically been on the cost of housing for an average income Canadian family. Less attention has been paid to families with incomes much lower than those of the average Canadian household, for which the housing crisis is far more severe. Households and individuals with particularly low incomes are at the highest risk of experiencing the worst effects of a lack of housing affordability, including homelessness.

Education modifies the association of wealth with obesity in women in middle-income but not low-income countries: an interaction study using seven national datasets, 2005-2010.

Directory of Open Access Journals (Sweden)

Amina Aitsi-Selmi

Full Text Available Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs.The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15-49 years collected in the period 2005-2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented.In the four middle-income countries (Colombia, Peru, Jordan, and Egypt, an interaction was found between education and wealth on obesity (P-value for interaction <0.001. Among women with no/primary education the wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative. In the poorer countries (India, Nigeria, Benin, there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (P<0.001.The findings suggest that education may protect against the obesogenic effects of increased household wealth as countries develop. Further research could examine the factors explaining the country differences in education effects.

Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations

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... Weekly and Twice-Weekly Yoga Classes Offer Similar Low-Back Pain Relief in Low-Income Minority Populations Share: © Photodisc ... in minority and low-income populations with chronic low-back pain. Researchers from Boston University School of Medicine, Boston ...

75 FR 8392 - Low Income Housing Tax Credit Tenant Database

Science.gov (United States)

2010-02-24

... DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT [Docket No. FR-5376-N-11] Low Income Housing Tax Credit Tenant Database AGENCY: Office of the Chief Information Officer, HUD. ACTION: Notice. SUMMARY: The... Lists the Following Information Title Of Proposal: Low Income Housing Tax Credit Tenant Database. Omb...

Wilms Tumor Treatment Outcomes: Perspectives From a Low-Income Setting

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Festus Njuguna

2017-10-01

Full Text Available Purpose: Wilms tumor is the commonest renal malignancy in childhood. Survival in high-income countries is approximately 90%, whereas in low-income countries, it is less than 50%. This study assessed treatment outcomes of patients with Wilms tumor at a Kenyan academic hospital. Patients and Methods: We conducted a retrospective medical record review of all children diagnosed with Wilms tumor between 2010 and 2012. Data on treatment outcomes and various sociodemographic and clinical characteristics were collected. Results: Of the 39 patients with Wilms tumor, 41% had event-free survival, 31% abandoned treatment, 23% died, and 5% had progressive or relapsed disease. Most patients presented at an advanced stage: stage I (0%, II (7%, III (43%, IV (40%, or V (10%. The most likely treatment outcome in patients with low-stage (I to III disease was event-free survival (67%, whereas in those with high-stage (IV to V disease, it was death (40%. No deaths or instances of progressive or relapsed disease were recorded among patients with low-stage disease; their only reason for treatment failure was abandonment of treatment. Stage of disease significantly affected treatment outcomes (P = .014 and event-free survival estimates (P < .001. Age at diagnosis, sex, duration of symptoms, distance to hospital, and health insurance status did not statistically significantly influence treatment outcomes or event-free survival estimates. Conclusion: Survival of patients with Wilms tumor in Kenya is lower compared with that in high-income countries. Treatment abandonment is the most common cause of treatment failure. Stage of disease at diagnosis statistically significantly affects treatment outcomes and survival.

Should low-income countries invest in breast cancer screening?

Science.gov (United States)

Gyawali, Bishal; Shimokata, Tomoya; Honda, Kazunori; Tsukuura, Hiroaki; Ando, Yuichi

2016-11-01

With the increase in incidence and mortality of breast cancer in low-income countries (LICs), the question of whether LICs should promote breast cancer screening for early detection has gained tremendous importance. Because LICs have limited financial resources, the value of screening must be carefully considered before integrating screening programs into national healthcare system. Mammography-the most commonly used screening tool in developed countries-reduces breast cancer-specific mortality among women of age group 50-69, but the evidence is not so clear for younger women. Further, it does not reduce the overall mortality. Because the women in LICs tend to get breast cancer at younger age and are faced with various competing causes of mortality, LICs need to seriously evaluate whether mammographic screening presents a good value for the investment. Instead, we suggest a special module of clinical breast examination that could provide similar benefits at a very low cost. Nevertheless, we believe that LICs would obtain a much greater value for their investment if they promote primary prevention by tobacco cessation, healthier food and healthier lifestyle campaigns instead.

Researching Entrepreneurship in Low-income Settlements

DEFF Research Database (Denmark)

Gough, Katherine V.; Langevang, Thilde; Namatovu, Rebecca

2014-01-01

of entrepreneurship conducted in a low-income settlement, which combined participatory quantitative and qualitative approaches, highlighting the strengths and challenges of using participatory methods. The paper demonstrates how drawing on a range of participatory methods can contribute to creating more engaging...

Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries

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Karl Peltzer

2014-11-01

Full Text Available Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8 from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that 67.2% of students reported to brush their teeth twice or more times a day, 28.8% about once a day and 4.0% never. Regarding dental check-up visit, 16.3% reported twice a year, 25.6% once a year, 33.9% rarely and 24.3% never. In a multivariate logistic regression analysis, being a male, coming from a wealthy or quite well off family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, depression and PTSD symptoms, tobacco use and frequent gambling, low physical activity, and low daily meal and snacks frequency were associated with inadequate tooth brushing (age, coming from a not well off or poor family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, PTSD symptoms, illicit drug use, low physical activity, and low daily snacks frequency, skipping breakfast and inadequate fruit and vegetables consumption were associated with less than one annual dental care visit. Oral health behaviour among the students was found to be low. Various risk factors identified can be used to guide interventions to improve oral health behaviour among university students.

Gestational Weight Gain and Post-Partum Weight Loss Among Young, Low-Income, Ethnic Minority Women

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ROTHBERG, Bonnie E. Gould; MAGRIPLES, Urania; KERSHAW, Trace S.; RISING, Sharon Schindler; ICKOVICS, Jeannette R.

2010-01-01

Objective Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by Institute of Medicine (IOM). Methods Women aged 14-25 receiving prenatal care and delivering singleton infants at term (N=427). Medical record review and four structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Results Only 22% of participants gained gestational weight within IOM guidelines. 62% exceeded maximum recommendations -- more common among those overweight/obese (BMI≥25.0; phypertension; breastfeeding promoted postpartum weight loss (all p<.02). BMI by race interaction suggested healthier outcomes for Latinas (p=0.02). Conclusion Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. PMID:20974459

Acquired heart disease in low-income and middle-income countries.

Science.gov (United States)

Curry, Chris; Zuhlke, Liesl; Mocumbi, Ana; Kennedy, Neil

2018-01-01

The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Emergency general surgery in a low-middle income health care setting: Determinants of outcomes.

Science.gov (United States)

Shah, Adil A; Latif, Asad; Zogg, Cheryl K; Zafar, Syed Nabeel; Riviello, Robert; Halim, Muhammad Sohail; Rehman, Zia; Haider, Adil H; Zafar, Hasnain

2016-02-01

Emergency general surgery (EGS) has emerged as an important component of frontline operative care. Efforts in high-income settings have described its burden but have yet to consider low- and middle-income health care settings in which emergent conditions represent a high proportion of operative need. The objective of this study was to describe the disease spectrum of EGS conditions and associated factors among patients presenting in a low-middle income context. March 2009-April 2014 discharge data from a university teaching hospital in South Asia were obtained for patients (≥16 years) with primary International Classification of Diseases, 9(th) revision, Clinical Modification diagnosis codes consistent with an EGS condition as defined by the American Association for the Surgery of Trauma. Outcomes included in-hospital mortality and occurrence of ≥1 major complication(s). Multivariable analyses were performed, adjusting for differences in demographic and case-mix factors. A total of 13,893 discharge records corresponded to EGS conditions. Average age was 47.2 years (±16.8, standard deviation), with a male preponderance (59.9%). The majority presented with admitting diagnoses of biliary disease (20.2%), followed by soft-tissue disorders (15.7%), hernias (14.9%), and colorectal disease (14.3%). Rates of death and complications were 2.7% and 6.6%, respectively; increasing age was an independent predictor of both. Patients in need of resuscitation (n = 225) had the greatest rates of mortality (72.9%) and complications (94.2%). This study takes an important step toward quantifying outcomes and complications of EGS, providing one of the first assessments of EGS conditions using American Association for the Surgery of Trauma definitions in a low-middle income health care setting. Further efforts in varied settings are needed to promote representative benchmarking worldwide. Copyright © 2016 Elsevier Inc. All rights reserved.

Is income equality also better for your cognitive health? A multilevel analysis on trajectories of cognitive function at older ages

OpenAIRE

Leist, Anja; Chauvel, Louis

2016-01-01

This paper contributes to research on contextual associations with older-age cognitive function by investigating to which extent country-level income inequality is associated with older-age cognitive function and decline. Data came from the Survey of Health, Ageing and Retirement in Europe (SHARE), providing information on cognitive function (fluency, immediate and delayed recall) of respondents aged 50-80 years coming from a total of 16 European countries that participated in at least two wa...

A cross-sectional pilot study to examine food sufficiency and assess nutrition among low-income patients with injection-related venous ulcers.

Science.gov (United States)

Pieper, Barbara; Templin, Thomas N

2015-04-01

Adequate nutrition has long been considered a critical component for wound healing, but literature regarding the relationship between nutrition and venous ulcer (VU) healing is limited. A person's nutrition is affected by the availability of food as well as his/her overall health. Food sufficiency and nutrition are important concerns in the care of persons of low income with injection-related VUs, which tend to be large and slow to heal. A cross-sectional pilot study was conducted to explore the relationship between food sufficiency/security and nutrition with regard to demographic, wound, quality-of-life, physical activity, falls, and fall risk variables. Nutrition was examined using 2 well-developed instruments that measure food sufficiency/security and assess nutrition--the United States Department of Agriculture's Adult Food Sufficiency Questionnaire (FSQ) and the Nestle Mini Nutritional Assessment (MNA). All participants (N = 31, 54% men, mean age 56.1 ± 3.6 years, all African American) were recruited from an outpatient clinic. All had injection-related VUs from a history of injecting illicit substances. In terms of food sufficiency/security, most participants (26, 84%) reported having enough food in the house, but 10 (32%) worried about running out of food. From 16% to 22.6% of participants expressed concern with food sufficiency/security in terms of cutting meal size, eating less, hunger, and weight loss. Food sufficiency/security was high for 19 (61.3%), but 12 (39%) had marginal or lower food sufficiency/security. MNA scores showed 16 participants (52%) were at risk of malnutrition or malnourished. Low food sufficiency/security was significantly (P nutrition assessment scores were significantly associated (P nutrition assessment are important to assess in low-income persons with injection-related VUs. A number of significant relationships of the FSQ and MNA to other variables was found but needs further investigation with a larger sample.

What will happen to retirement income for 401(k) participants after the market decline?

Science.gov (United States)

VanDerhei, Jack

2010-04-01

This paper uses administrative data from millions of 401(k) participants dating back to 1996 as well as several simulation models to determine 401(k) plans' susceptibility to several alleged limitations as well as its potential for significant retirement wealth accumulation for employees working for employers who have chosen to sponsor these plans. What will happen to 401(k) participants after the 2008 market decline will be largely determined by the extent to which the features of automatic enrollment, automatic escalation of contributions, and automatic investment are allowed to play out. Simulation results suggest that the first two features will significantly improve retirement wealth for the lowest-income quartiles going forward, and the third feature (primarily target-date funds) suggest that a large percentage of those on the verge of retirement would benefit significantly by a reduction of equity concentrations to a more age-appropriate level.

Assessment of Stage of Change, Decisional Balance, Self-Efficacy, and Use of Processes of Change of Low-Income Parents for Increasing Servings of Fruits and Vegetables to Preschool-Aged Children

Science.gov (United States)

Hildebrand, Deana A.; Betts, Nancy M.

2009-01-01

Objective: Use the Transtheoretical Model of Behavior Change (TTM) to determine the proportionate stage of change of low-income parents and primary caregivers (PPC) for increasing accessibility, measured as servings served, of fruits and vegetables (FV) to their preschool-aged children and evaluate response differences for theoretical constructs.…

Phenotypes of asthma in low-income children and adolescents: cluster analysis

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Anna Lucia Barros Cabral

Full Text Available ABSTRACT Objective: Studies characterizing asthma phenotypes have predominantly included adults or have involved children and adolescents in developed countries. Therefore, their applicability in other populations, such as those of developing countries, remains indeterminate. Our objective was to determine how low-income children and adolescents with asthma in Brazil are distributed across a cluster analysis. Methods: We included 306 children and adolescents (6-18 years of age with a clinical diagnosis of asthma and under medical treatment for at least one year of follow-up. At enrollment, all the patients were clinically stable. For the cluster analysis, we selected 20 variables commonly measured in clinical practice and considered important in defining asthma phenotypes. Variables with high multicollinearity were excluded. A cluster analysis was applied using a twostep agglomerative test and log-likelihood distance measure. Results: Three clusters were defined for our population. Cluster 1 (n = 94 included subjects with normal pulmonary function, mild eosinophil inflammation, few exacerbations, later age at asthma onset, and mild atopy. Cluster 2 (n = 87 included those with normal pulmonary function, a moderate number of exacerbations, early age at asthma onset, more severe eosinophil inflammation, and moderate atopy. Cluster 3 (n = 108 included those with poor pulmonary function, frequent exacerbations, severe eosinophil inflammation, and severe atopy. Conclusions: Asthma was characterized by the presence of atopy, number of exacerbations, and lung function in low-income children and adolescents in Brazil. The many similarities with previous cluster analyses of phenotypes indicate that this approach shows good generalizability.

Parental supervision and discomfort with children walking to school in low-income communities in Cape Town, South Africa.

Science.gov (United States)

Simons, Abigail; Koekemoer, Karin; Niekerk, Ashley van; Govender, Rajen

2018-05-19

The risk of pedestrian injury is compounded for children living in low-income communities due to factors such as poor road and pedestrian infrastructure, reliance on walking as a means of transport, and compromised supervision. Parents play an important role in child pedestrian safety. The primary objective of this study was to examine the effects of child pedestrian variables on parental discomfort with regard to letting their child walk to and from school and on the frequency of adult supervision. A cross-sectional study was conducted using a convenience sample from 3 schools participating in a pedestrian safety school initiative. The schools are situated in low-income, high-risk communities in the City of Cape Town. A parent survey form was translated into isiXhosa and sent home with learners to those parents who had consented to participate. The response rate was 70.4%, and only parents of children who walk to and from school were included in the final sample (n = 359). Child pedestrian variables include the time taken to walk to school, parental rating of the child's ability to safely cross the road, and the frequency of adult supervision. More than half of parents reported that their child walked to and from school without adult supervision. About 56% of children took less than 20 min to walk to school. Most parents (61%) were uncomfortable with their child walking to school, although the majority of parents (55.7%) rated their child's ability to cross the road safely as better or significantly better than average (compared to peers). The parents did not perceive any differences in pedestrian risk factors between boys and girls or between younger (6-9 years) and older (10-15 years) children. The time spent by a child walking to school and parents' perceptions of their child's road-crossing ability were found to be significant predictors of parental discomfort (in letting their child walk). Younger children and children who spent less time walking were more

A Portrait of Low-Income Migrants in Contemporary Qatar

OpenAIRE

GARDNER, ANDREW; GARDNER, ANDREW; PESSOA, SILVIA; DIOP, ABDOULAYE; AL-GHANIM, KALTHAM; LE TRUNG, KIEN; HARKNESS, LAURA

2013-01-01

Though transnational labor migration in the Gulf States has increasingly been of scholarly interest, that scholarship has to date relied largely on qualitative ethnographic methodologies or small non-representative sampling strategies. This paper presents the findings of a large representative sample of low-income migrant laborers in Qatar. The data describe the basic characteristics of the low-income migrant population in Qatar, the process by which migrants obtain employment, the frequency ...

Cardiovascular Risk and Events in 17 Low-, Middle-, and High-Income Countries.

OpenAIRE

Yusuf, S; Rangarajan, S; Teo, K; Islam, S; Li, W; Liu, L; Bo, J; Lou, Q; Lu, F; Liu, T; Yu, L; Zhang, S; Mony, P; Swaminathan, S; Mohan, V

2014-01-01

: More than 80% of deaths from cardiovascular disease are estimated to occur in low-income and middle-income countries, but the reasons are unknown. : We enrolled 156,424 persons from 628 urban and rural communities in 17 countries (3 high-income, 10 middle-income, and 4 low-income countries) and assessed their cardiovascular risk using the INTERHEART Risk Score, a validated score for quantifying risk-factor burden without the use of laboratory testing (with higher scores indicating greater r...

Pilot of a diabetes primary prevention program in a hard-to-reach, low-income, immigrant Hispanic population.

Science.gov (United States)

Millard, Ann V; Graham, Margaret A; Wang, Xiaohui; Mier, Nelda; Sánchez, Esmeralda R; Flores, Isidore; Elizondo-Fournier, Marta

2011-10-01

An immigrant Hispanic population in the Texas-Mexico border region urgently requested assistance with diabetes. The project team implemented an exploratory pilot intervention to prevent type 2 diabetes in the general population through enhanced nutrition and physical activity. Social networks in low-income rural areas(colonias) participated in an adaptation of the Diabetes Empowerment Education Program. The program had a pre-post-test design with a comparison group. The intervention had a small but significant effect in lowering body mass index, the biological outcome variable. The process evaluation shows that the participants valued the pilot project and found it culturally and economically appropriate. This program was the first primary prevention program in diabetes to address a general population successfully. The study shows that low-income, rural Mexican American families will take ownership of a program that is participatory and tailored to their culture and economic situation.

The impact of the combination of income and education on the incidence of coronary heart disease in the prospective Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort study.

Science.gov (United States)

Lewis, Marquita W; Khodneva, Yulia; Redmond, Nicole; Durant, Raegan W; Judd, Suzanne E; Wilkinson, Larrell L; Howard, Virginia J; Safford, Monika M

2015-12-29

We investigated the association between income-education groups and incident coronary heart disease (CHD) in a national prospective cohort study. The REasons for Geographic And Racial Differences in Stroke study recruited 30,239 black and white community-dwelling adults between 2003 and 2007 and collected participant-reported and in-home physiologic variables at baseline, with expert adjudicated CHD endpoints during follow-up. Mutually exclusive income-education groups were: low income (annual household income events through December 31, 2011 (median follow-up 6.0 years; interquartile range 4.5-7.3 years). Those with low income/low education had the highest incidence of CHD (10.1 [95% CI 8.4-12.1]/1000 person-years). After full adjustment, those with low income/low education had higher risk of incident CHD (HR 1.42 [95% CI: 1.14-1.76]) than those with high income/high education, but findings varied by age. Among those aged independent effects of income and education are less pronounced.

Ambulatory Blood Pressure Monitoring: A Complementary Strategy for Hypertension Diagnosis and Management in Low-Income and Middle-Income Countries.

Science.gov (United States)

Abdalla, Marwah

2017-02-01

Ambulatory blood pressure monitoring (ABPM) can assess out-of-clinic blood pressure. ABPM is an underutilized resource in low-income and middle-income countries but should be considered a complementary strategy to clinic blood pressure measurement for the diagnosis and management of hypertension. Potential uses for ABPM in low-income and middle-income countries include screening of high-risk individuals who have concurrent communicable diseases, such as HIV, and in task-shifting health care strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

The relationship of sociodemographic and psychological variables with chronic pain variables in a low-income population.

Science.gov (United States)

Newman, Andrea K; Van Dyke, Benjamin P; Torres, Calia A; Baxter, Jacob W; Eyer, Joshua C; Kapoor, Shweta; Thorn, Beverly E

2017-09-01

Chronic pain is a pervasive condition that is complicated by economic, educational, and racial disparities. This study analyzes key factors associated with chronic pain within an understudied and underserved population. The sample is characterized by a triple disparity with respect to income, education/literacy, and racial barriers that substantially increase the vulnerability to the negative consequences of chronic pain. The study examined the pretreatment data of 290 participants enrolled in the Learning About My Pain trial, a randomized controlled comparative effectiveness trial of psychosocial interventions (B.E.T., Principal Investigator, Patient-Centered Outcomes Research Institute Contract No. 941; clinicaltrials.gov identifier NCT01967342) for chronic pain. Hierarchical multiple regression analyses evaluated the relationships among sociodemographic (sex, age, race, poverty status, literacy, and education level) and psychological (depressive symptoms and pain catastrophizing) variables and pain interference, pain severity, and disability. The indirect effects of depressive symptoms and pain catastrophizing on the sociodemographic and pain variables were investigated using bootstrap resampling. Reversed mediation models were also examined. Results suggested that the experience of chronic pain within this low-income sample is better accounted for by psychological factors than sex, age, race, poverty status, literacy, and education level. Depressive symptoms and pain catastrophizing mediated the relationships between age and pain variables, whereas pain catastrophizing mediated the effects of primary literacy and poverty status. Some reversed models were equivalent to the hypothesized models, suggesting the possibility of bidirectionality. Although cross-sectional findings cannot establish causality, our results highlight the critical role psychological factors play in individuals with chronic pain and multiple health disparities.

achieving improved financing for low-income producers

African Journals Online (AJOL)

KEY WORDS: Approaches, Improved Access, Finance, Low-income, Producers. INTRODUCTION .... either by setting up a dual-purpose financial institution, or by making ..... management information systems (Braverman and. Huppi, 1991).

Low-Income Urban Mothers' Experiences with the Supplemental Nutrition Assistance Program.

Science.gov (United States)

Robbins, Sarah; Ettinger, Anna K; Keefe, Carolyn; Riley, Anne; Surkan, Pamela J

2017-10-01

Food insecurity remains a public health concern in the United States, particularly among low-income urban ethnically diverse families, even with the Supplemental Nutrition Assistance Program (SNAP). Limited phenomenologic data exist to capture how programmatic changes to SNAP address the needs of users and why a gap in SNAP use may exist. The primary aim of this study was to examine the experiences of low-income, Baltimore, MD, mothers in applying for and maintaining access to SNAP. Secondary aims included understanding participants' perspectives on the influence of changes in SNAP over a 3-year period and how SNAP fits into the overall system of social services for families. In this qualitative, phenomenologic study, in-depth interviews were conducted with 13 mothers and three focus groups with 20 mothers, for a total sample of 33 mothers receiving SNAP benefits. Ten mothers participated in the first round of data collection (January to May 2010), and 23 in the second round (February to May 2013). Participants were 33 mothers receiving SNAP benefits in Baltimore City, MD. Baltimore SNAP users' experiences with applying for and maintaining access to SNAP, as well as with program changes to the SNAP program. Data were analyzed using an iterative emergent design and phenomenologic approach. A constructivist perspective was implemented throughout the coding process. SNAP functioned as a valuable support system within the broader social safety net for mothers living in poverty, yet participants expressed frustration about the processes of applying for and maintaining benefits due to communication problems and poor integration of services. In applying for and accessing SNAP, positive interactions with caseworkers and previous knowledge of the SNAP program were important for maintaining benefits. Interviews and focus group discussions revealed the need for additional outreach and education about the implemented program changes to build trust and improve access to SNAP

Anxiety sensitivity explains associations between anxious arousal symptoms and smoking abstinence expectancies, perceived barriers to cessation, and problems experienced during past quit attempts among low-income smokers.

Science.gov (United States)

Zvolensky, Michael J; Paulus, Daniel J; Langdon, Kirsten J; Robles, Zuzuky; Garey, Lorra; Norton, Peter J; Businelle, Michael S

2017-05-01

Disproportionately more smokers report low-income and mental health problems relative to non-smokers. Low-income smokers may use smoking to alleviate negative emotional states resulting from exposure to multiple stressors. Yet, little work has been devoted to elucidating mechanisms that may explain the association between negative emotional states and smoking-related processes among low-income smokers. The present study sought to address this gap by examining anxiety sensitivity, a transdiagnostic factor related to both anxiety and smoking, as a potential mediator for the influence of anxiety symptoms on smoking-related processes, including threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. Participants included treatment-seeking daily cigarette smokers (n=101; 68.3% male; M age =47.1; SD=10.2). Results indicated that anxiety symptoms exerted a significant indirect effect through anxiety sensitivity for threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. The present results provide empirical support that anxiety sensitivity may be an underlying mechanism that partially explains the relation between anxiety symptoms and smoking processes among low-income treatment-seeking smokers. Findings broaden current theoretical understanding of pathways through which anxiety symptoms contribute to maladaptive smoking processes and cognitions among socioeconomically disadvantaged smokers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Why some do but most don't. Barriers and enablers to engaging low-income groups in physical activity programmes: a mixed methods study

Directory of Open Access Journals (Sweden)

Fox Kenneth R

2011-06-01

Full Text Available Abstract Background The beneficial effect of physical activity for the prevention of a range of chronic diseases is widely acknowledged. These chronic conditions are most pronounced in economically disadvantaged groups where physical activity levels are consistently lower, yet this group is particularly difficult to recruit and retain in physical activity programmes. This study examined the perceptions of participants, non-participants, and exercise leaders in a low-income area regarding barriers, motives, and enabling factors for organised physical activity with a view to improving recruitment and retention. Methods A mixed methods research approach was adopted to guide data collection and analysis. A survey, incorporating the Motivation for Physical Activity Measure - Revised (MPAM-R, was used to assess the motivations of 152 physical activity session participants in a highly deprived suburban neighbourhood. The MPAM-R data were analysed using t tests, analyses of variance to estimate age, body mass index, and activity mode differences and Pearson's correlation coefficient to address associations. Semi-structured interviews were also conducted with 33 local residents who did not participate in activity sessions and with 14 activity session leaders. All interviews were audio-taped, transcribed verbatim and analyzed using an inductive thematic approach. Results Participants reported cost, childcare, lack of time and low awareness as barriers to joining activity classes. The need for support, confidence and competence in order to take up activity was widely expressed, particularly among women. Once people are active, high levels of social interaction, interest and enjoyment are associated with improved levels of retention, with different types of physical activity scoring differently on these factors. Conclusions This study suggests that some factors such as cost, the fear of 'walking in alone', accessibility of facilities, and appropriate

Estimating costs of care for meningitis infections in low- and middle-income countries.

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Portnoy, Allison; Jit, Mark; Lauer, Jeremy; Blommaert, Adriaan; Ozawa, Sachiko; Stack, Meghan; Murray, Jillian; Hutubessy, Raymond

2015-05-07

Meningitis infections are often associated with high mortality and risk of sequelae. The costs of treatment and care for meningitis are a great burden on health care systems, particularly in resource-limited settings. The objective of this study is to review data on the costs of care for meningitis in low- and middle-income countries, as well as to show how results could be extrapolated to countries without sound data. We conducted a systematic review of the literature from six databases to identify studies examining the cost of care in low- and middle-income countries for all age groups with suspected, probable, or confirmed meningitis. We extracted data on treatment costs and sequelae by infectious agent and/or pathogen, where possible. Using multiple regression analysis, a relationship between hospital costs and associated determinants was investigated in order to predict costs in countries with missing data. This relationship was used to predict treatment costs for all 144 low- and middle-income countries. The methodology of conducting a systematic review, extrapolating, and setting up a standard database can be used as a tool to inform cost-effectiveness analyses in situations where cost of care data are poor. Both acute and long-term costs of meningitis could be extrapolated to countries without reliable data. Although only bacterial causes of meningitis can be vaccine-preventable, a better understanding of the treatment costs for meningitis is crucial for low- and middle-income countries to assess the cost-effectiveness of proposed interventions in their country. This cost information will be important as inputs in future cost-effectiveness studies, particularly for vaccines. Copyright © 2014 Elsevier Ltd. All rights reserved.

Validation of a home food inventory among low-income Spanish- and Somali-speaking families.

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Hearst, Mary O; Fulkerson, Jayne A; Parke, Michelle; Martin, Lauren

2013-07-01

To refine and validate an existing home food inventory (HFI) for low-income Somali- and Spanish-speaking families. Formative assessment was conducted using two focus groups, followed by revisions of the HFI, translation of written materials and instrument validation in participants’ homes. Twin Cities Metropolitan Area, Minnesota, USA. Thirty low-income families with children of pre-school age (fifteen Spanish-speaking; fifteen Somali-speaking) completed the HFI simultaneously with, but independently of, a trained staff member. Analysis consisted of calculation of both item-specific and average food group kappa coefficients, specificity, sensitivity and Spearman’s correlation between participants’ and staff scores as a means of assessing criterion validity of individual items, food categories and the obesogenic score. The formative assessment revealed the need for few changes/additions for food items typically found in Spanish-speaking households. Somali-speaking participants requested few additions, but many deletions, including frozen processed food items, non-perishable produce and many sweets as they were not typical food items kept in the home. Generally, all validity indices were within an acceptable range, with the exception of values associated with items such as ‘whole wheat bread’ (k = 0.16). The obesogenic score (presence of high-fat, high-energy foods) had high criterion validity with k = 0.57, sensitivity = 91.8%, specificity = 70.6% and Spearman correlation = 0.78. The revised HFI is a valid assessment tool for use among Spanish and Somali households. This instrument refinement and validation process can be replicated with other population groups.

Low Income Consumer Utility Issues: A National Perspective

Energy Technology Data Exchange (ETDEWEB)

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.

Correlates and Consequences of Spanking and Verbal Punishment for Low-Income White, African American, and Mexican American Toddlers

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Berlin, Lisa J.; Ispa, Jean M.; Fine, Mark A.; Malone, Patrick S.; Brooks-Gunn, Jeanne; Brady-Smith, Christy; Ayoub, Catherine; Bai, Yu

2009-01-01

This study examined the prevalence, predictors, and outcomes of spanking and verbal punishment in 2,573 low-income White, African American, and Mexican American toddlers at ages 1, 2, and 3. Both spanking and verbal punishment varied by maternal race/ethnicity. Child fussiness at age 1 predicted spanking and verbal punishment at all 3 ages.…

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

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

2010-05-01

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

Nutrition Knowledge and Behaviours of Low-Income Latino Parents of Preschoolers: Associations with Nutrition-Related Parenting Practices

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Slusser, Wendelin; Erausquin, Jennifer Toller; Prelip, Michael; Fischer, Heidi; Cumberland, William G.; Frankel, Fred; Neumann, Charlotte

2012-01-01

Parents are in an ideal position to promote long-term healthy dietary behaviours for their children. This study aimed to determine parent and child characteristics and to test their associations in a cross-sectional sample of urban low-income, low-education Latino immigrants with preschool-age children. Also determined were family demographic…

The Effect of Tier 2 Intervention for Phonemic Awareness in a Response-to-Intervention Model in Low-Income Preschool Classrooms

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Koutsoftas, Anthony D.; Harmon, Mary Towle; Gray, Shelley

2009-01-01

Purpose: This study assessed the effectiveness of a Tier 2 intervention that was designed to increase the phonemic awareness skills of low-income preschoolers who were enrolled in Early Reading First classrooms. Method: Thirty-four preschoolers participated in a multiple baseline across participants treatment design. Tier 2 intervention for…

Association between carotid intima-media thickness and fasting blood glucose level: A population-based cross-sectional study among low-income adults in rural China.

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Gao, Liu; Bai, Lingling; Shi, Min; Ni, Jingxian; Lu, Hongyan; Wu, Yanan; Tu, Jun; Ning, Xianjia; Wang, Jinghua; Li, Yukun

2017-11-01

Carotid intima-media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. We aimed to identify the association between CIMT and blood glucose, as well as the risk factors associated with increased CIMT in a low-income Chinese population. Stroke-free and cardiovascular disease-free residents aged ≥45 years were recruited. B-mode ultrasonography was carried out to measure CIMT. There were 2,643 participants (71.0%) in the normal group, 549 (14.7%) in the impaired fasting glucose group and 533 (14.3%) in the diabetes mellitus group. The determinants of increased CIMT were older age; male sex; low education; hypertension; smoking; high levels of systolic blood pressure, fasting blood glucose and low-density lipoprotein cholesterol; and low levels of diastolic blood pressure, triglycerides and high-density lipoprotein cholesterol, after adjusting for covariates. Age and hypertension were the common risk factors for increased CIMT in all three groups. Furthermore, male sex, smoking and high low-density lipoprotein cholesterol level were positively associated with the mean CIMT in the normal group; high triglycerides levels were negatively associated with the mean CIMT in the impaired fasting glucose group; and alcohol consumption was an independent risk factor for mean CIMT in the diabetes mellitus group. Hypertension was the greatest risk factor for increased CIMT. These findings suggest that it is crucial to manage and control traditional risk factors in low-income populations in China in order to decelerate the recent dramatic increase in stroke incidence, and to reduce the burden of stroke. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Use of statins and beta-blockers after acute myocardial infarction according to income and education

DEFF Research Database (Denmark)

Rasmussen, Jeppe Nørgaard; Gislason, Gunnar H; Rasmussen, Søren

2007-01-01

OBJECTIVE: To study the initiation of and long-term refill persistency with statins and beta-blockers after acute myocardial infarction (AMI) according to income and education. DESIGN AND SETTING: Linkage of individuals through national registers of hospitalisations, drug dispensation, income...... and education. PARTICIPANTS: 30 078 patients aged 30-74 years surviving first hospitalisation for AMI in Denmark between 1995 and 2001. MAIN OUTCOME MEASURES: Initiation of statin or beta-blocker treatment (out-patient claim of prescriptions within 6 months of discharge) and refill persistency (first break.......66-0.82) and medium (HR 0.82; 95% CI 0.74-0.92) income compared with low income, whereas there was a trend in the opposite direction concerning a break in beta-blocker treatment. There was no gradient in re-initiation of treatment. CONCLUSION: Patients with low compared with high income less frequently initiated...

Food Insecurity and Perceived Diet Quality Among Low-Income Older Americans with Functional Limitations.

Science.gov (United States)

Chang, Yunhee; Hickman, Haley

2018-05-01

To evaluate how functional limitations are associated with food insecurity and perceived diet quality in low-income older Americans. Nationwide repeated cross-sectional surveys regarding health and nutritional status. The National Health and Nutrition Examination Surveys, 2007-2008, 2009-2010, and 2011-2012. Individuals aged ≥65 years with household incomes ≤130% of the federal poverty level (n = 1,323). Dependent variables included dichotomous indicators of food insecurity and poor-quality diet, measured with the household food security survey module and respondents' own ratings, respectively. Independent variable was presence of limitations in physical functioning. Weighted logistic regressions with nested controls and interaction terms. Functional limitations in low-income older adults were associated with 1.69 times higher odds of food insecurity (P food insecurity; 3.07 for poor-quality diet; P functional limitations are exposed to significant nutritional risk. Resources should be directed to facilitating their physical access to healthful foods. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Reproductive tract infections (RTIs) among married non-pregnant women living in a low-income suburb of Beirut, Lebanon.

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Ramia, Sami; Kobeissi, Loulou; El Kak, Faysal; Shamra, Sarah; Kreidieh, Khalil; Zurayk, Huda

2012-09-17

This study aimed to identify reproductive tract infections (RTIs) in married, non-pregnant women, aged 18 to 49 years, living in a low-income suburb of Beirut, and to investigate the relationship between demographic and socioeconomic factors and these infections. Among 1,015 women recruited for the study, 502 were found eligible and 441 were medically examined. Appropriate specimens were collected for Nisseria gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, candidiasis, and bacterial vaginosis. The results showed a relatively high prevalence of RTIs (28.2%). The prevalence rates of different agents were as follows: 22.9% of the women were positive for T. vaginalis, 8.8% for candidiasis, 4.5% for bacterial vaginosis, and 1% for N. gonorrhea; none of the women were positive for C. trachomatis. Regression analysis showed that women between the ages of 30 and 39 were twice more likely to have T. vaginalis as compared to younger women. Furthermore, women whose husbands were taxi drivers were at higher risk of acquiring T. vaginalis (OR = 2.2) as compared with women whose husbands occupation was listed as skilled/unskilled. This conclusion can be drawn for the odds of developing any RTI (OR = 2.15). Moreover, those participants with the lowest income were twice as likely to have any RTI compared to those with higher incomes. This study shows a relatively high prevalence of RTIs (T. vaginalis mainly). It urges further in-depth research on cultural practices and economic factors to understand the pattern of sexual behavior in this community.

Challenges associated with informed consent in low- and low-middle-income countries

Directory of Open Access Journals (Sweden)

Melissa Upjohn

2016-10-01

Full Text Available Frontiers in Veterinary Medicine endorse the Helsinki declaration and guidelines of the International Committee of Medical and Journal Editors, including the requirement to obtain informed consent from all research participants. Whilst the concept of informed consent is well understood in western research environments, its components require further consideration when reviewing studies involving humans and owned animals in low- and middle-income countries (LMICs in order to take account of different social, educational and research norms. This piece identifies some of the challenges that need to be considered and how they might affect the process of obtaining informed consent. It explains the approach taken by an animal welfare non-governmental organization working in LMICs to addressing these challenges. It also identifies questions that reviewers might consider when asked to comment on work originating in this context.

Reduction in Vegetable Intake Disparities With a Web-Based Nutrition Education Intervention Among Lower-Income Adults in Japan: Randomized Controlled Trial.

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Nakamura, Saki; Inayama, Takayo; Harada, Kazuhiro; Arao, Takashi

2017-11-24

No existing Web-based nutrition education interventions have been evaluated in light of socioeconomic status just in Japan. The aim was to investigate the effect of a Web-based intervention program on reducing vegetable intake disparities between low- and middle-income Japanese adults. In this randomized controlled trial, participants were assessed at three time points-baseline, postintervention (5 weeks later), and a follow-up after 3 months-from October 2015 to March 2016. We collected data via a Japanese online research service company from 8564 adults aged 30 to 59 years. Participants were stratified according to national population statistics for gender and age, and randomly selected. They were then randomly allocated into intervention (n=900) and control (n=600) groups such that both groups contained an equal number of individuals with low and middle income. The intervention program encouraged behavior change using behavioral theories and techniques tailored to their assumed stage of change. The outcome was vegetable intake servings per day (1 serving being approximately 70 g). Out of 900 participants who started, 450 were from the middle income group (of which 386 or 85.7% completed the intervention), and 450 were from the low income group (of which 371 or 82.4% completed). In the intervention group, vegetable intake increased in the low-income participants from baseline to postintervention (0.42 servings, 95% CI 0.11-0.72). A two-way analysis of variance showed that low-income participants had significant main effects of group (η2=0.04, P=.01) and time (η2=0.01, Pincome participants also had a significant main effect of time (η2=0.01, P=.006) and a significant interaction (η2=0.01, P=.046). This Web-based nutritional education intervention could fill the vegetable intake gap between low- and middle-income adults in Japan, and is expected to prevent noncommunicable and lifestyle-related diseases. Further intervention program improvements are necessary to

Prenatal care and child growth and schooling in four low- and medium-income countries.

Science.gov (United States)

Liu, Xiaoying; Behrman, Jere R; Stein, Aryeh D; Adair, Linda S; Bhargava, Santosh K; Borja, Judith B; da Silveira, Mariangela Freitas; Horta, Bernardo L; Martorell, Reynaldo; Norris, Shane A; Richter, Linda M; Sachdev, Harshpal S

2017-01-01

The effectiveness of prenatal care for improving birth and subsequent child outcomes in low-income countries remains controversial, with much of the evidence to date coming from high-income countries and focused on early-life outcomes. We examined associations between prenatal care visits and birth weight, height-for-age at 24 months and attained schooling in four low- and middle-income countries. We pooled data from prospective birth-cohort studies from Brazil, Guatemala, Philippines and South Africa. We created a prenatal care utilization index based on the number and timing of prenatal visits. Associations were examined between this index and birth weight, height-for-age at 24 months, and highest attained schooling grade until adulthood. Among 7203 individuals in the analysis, 68.9% (Philippines) to 96.7% (South Africa) had at least one prenatal care visit, with most having at least four visits. Over 40% of Brazilians and Guatemalans had their first prenatal visit in the first trimester, but fewer Filipinos (13.9%) and South Africans (19.8%) did so. Prenatal care utilization was not significantly associated with birth weight (p>0.05 in pooled data). Each unit increase in the prenatal care utilization index was associated with 0.09 (95% CI 0.04 to 0.15) higher height-for-age z-score at 24 months and with 0.26 (95% CI 0.17 to 0.35) higher schooling grades attained. Although there was some heterogeneity and greater imprecision across sites, the results were qualitatively similar among the four different populations. While not related to birth weight, prenatal care utilization was associated with important outcomes later in life, specifically higher height-for-age at 24 months and higher attained school grades. These results suggest the relevance of prenatal care visits for human capital outcomes important over the lifecycle.

Wealth and Its Associations with Enteric Parasitic Infections in a Low-Income Community in Peru: Use of Principal Component Analysis

Science.gov (United States)

Nundy, Shantanu; Gilman, Robert H.; Xiao, Lihua; Cabrera, Lilia; Cama, Rosa; Ortega, Ynes R.; Kahn, Geoffrey; Cama, Vitaliano A.

2011-01-01

The association of wealth and infections with Giardia, Cryptosporidium, Cyclospora, and microsporidia were examined in a longitudinal cohort conducted in Peru from 2001 to 2006. Data from 492 participants were daily clinical manifestations, weekly copro-parasitological diagnosis, and housing characteristics and assets owned (48 variables), and these data were used to construct a global wealth index using principal component analysis. Data were analyzed using continuous and categorical (wealth tertiles) models. Participant's mean age was 3.43 years (range = 0–12 years), with average follow-up of 993 days. Univariate and multivariate analyses identified significant associations between wealth and infections with Giardia and microsporidia. Participants with greater wealth indexes were associated with protection against Giardia (P 14 days). For microsporidia, greater wealth was protective (P = 0.066 continuous and P = 0.042 by tertiles). Contrarily, infections with Cryptosporidium and Cyclospora were independent of wealth. Thus, subtle differences in wealth may affect the frequency of specific parasitic infections within low-income communities. PMID:21212198

Water End-Uses in Low-Income Houses in Southern Brazil

Directory of Open Access Journals (Sweden)

Ana Kelly Marinoski

2014-07-01

Full Text Available Knowing water consumption patterns in buildings is key information for water planning. This article aims to characterize the water consumption pattern and water end-uses in low-income houses in the region of Florianópolis, Southern Brazil. Data were collected by interviewing householders, as well as by measuring the flow rate of existing water fixtures and appliances. The results indicated that the shower was the fixture with the largest water consumption in households, i.e., about 30%–36% of total water consumption on average, followed by the toilet (18%–20%. The surveyed households consumed from 111 to 152 L/capita·day on average, based on different income ranges. No correlation was found between income and water consumption. The results of this study can be used to estimate the consumption of water for new buildings, as well as to develop integrated water management strategies in low-income developments, in Florianópolis, such as water-saving plumbing fixtures, rainwater harvesting, and greywater reuse. Likely, there would be a deferral of capital investments in new water assets for enhancing water and wastewater services by saving water in low-income houses.

Low-Income Parents: How Do Working Conditions Affect Their Opportunity To Help School-Age Children at Risk?

Science.gov (United States)

Heymann, S. Jody; Earle, Alison

2000-01-01

Examined the working conditions faced by parents who has at least one child in need of help for educational or behavioral problems using data for 1,878 families from the National Longitudinal Survey of Youth-Mother and Child Survey. Data show that low-income parents often lack the paid leave and flexibility they need to help children with…

Food (In)Security in Rapidly Urbanising, Low-Income Contexts.

Science.gov (United States)

Tacoli, Cecilia

2017-12-11

Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

Food (InSecurity in Rapidly Urbanising, Low-Income Contexts

Directory of Open Access Journals (Sweden)

Cecilia Tacoli

2017-12-01

Full Text Available Urbanisation in low and middle-income nations presents both opportunities and immense challenges. As urban centres grow rapidly, inadequate housing and the lack of basic infrastructure and services affect a large and growing proportion of their population. There is also a growing body of evidence on urban poverty and its links with environmental hazards. There is, however, limited knowledge of how these challenges affect the ways in which poor urban residents gain access to food and secure healthy and nutritious diets. With some important exceptions, current discussions on food security continue to focus on production, with limited attention to consumption. Moreover, urban consumers are typically treated as a homogenous group and access to food markets is assumed to be sufficient. This paper describes how, for the urban poor in low and middle-income countries, food affordability and utilisation are shaped by the income and non-income dimensions of poverty that include the urban space.

Examining neighborhood and interpersonal norms and social support on fruit and vegetable intake in low-income communities.

Science.gov (United States)

Dulin, Akilah; Risica, Patricia M; Mello, Jennifer; Ahmed, Rashid; Carey, Kate B; Cardel, Michelle; Howe, Chanelle J; Nadimpalli, Sarah; Gans, Kim M

2018-04-05

We examined whether neighborhood-, friend-, and family- norms and social support for consumption and purchase of fruits and vegetables (F&V) were associated with F&V intake among low-income residents in subsidized housing communities. We examined baseline data from a study ancillary to the Live Well/Viva Bien intervention. Participants included 290 residents in four low-income subsidized housing sites who were ≥ 18 years of age, English and/or Spanish speaking, and without medical conditions that prevented consumption of F&V. Linear regression models examined associations of norms and social support with F&V intake after adjustments for sociodemographic characteristics. In the analysis, neighborhood social support for F&V was associated with a 0.31 cup increase in F&V intake (95% CI = 0.05, 0.57). The family norm for eating F&V and family social support for eating F&V were associated with a 0.32 cup (95% CI = 0.13, 0.52) and 0.42 cup (95% CI = 0.19, 0.64) increase in F&V intake, respectively. To our knowledge, no other studies have examined neighborhood, family, and peer norms and social support simultaneously and in relation to F&V intake. These findings may inform neighborhood interventions and community-level policies to reduce neighborhood disparities in F&V consumption.

Household, psychosocial, and individual-level factors associated with fruit, vegetable, and fiber intake among low-income urban African American youth

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Angela Cristina Bizzotto Trude

2016-08-01

Full Text Available Abstract Background Childhood obesity, one of the greatest challenges to public health, disproportionately affects low-income urban minority populations. Fruits and vegetables (FV are nutrient dense foods that may be inversely associated with excessive weight gain. We aimed to identify the individual characteristic, psychosocial, and household factors influencing FV and fiber consumption in low-income African-American (AA youth in Baltimore, MD. Methods Cross-sectional analysis of data collected from 285 low-income AA caregiver-youth (age range: 10–14 y dyads participating in the baseline evaluation of the B’More Healthy Communities for Kids obesity prevention trial. The Kid's Block FFQ was used to estimate daily intakes of FV (including 100 % fruit juice and dietary fiber. Questionnaires were used to assess household socio-demographics, caregiver and youth food purchasing and preparation behavior, and youth psychosocial information. Ordered logit regression analyses were conducted to examine psychosocial and food-related behavior associated with FV and dietary fiber intake (quartile of intake controlling for youth age, sex, BMI percentile, total calorie intake and household income. Results On average, youth consumed 1.5 ± 1.1 (M ± SD servings of fruit, 1.8 ± 1.7 serving of vegetables, and 15.3 ± 10.9 g of fiber/day. There were no differences by gender, age or household income. Greater youth’s healthy eating intentions and self-efficacy scores were associated with greater odds ratio for higher intake of FV and fiber (Intention: ORfruit 1.22; 95 % CI: 1.06–1.41, ORvegetable 1.31; 1.15–1.51 and ORfiber 1.46; 1.23–1.74, Self-efficacy: ORfruit 1.07; 1.03–1.12, ORvegetable 1.04; 1.01–1.09, ORfiber 1.10; 1.04–1.16. Youth receiving free/low-cost breakfast were more than twice as likely to have higher fiber intake than those who did not receive free breakfast (OR 2.7; 1.10; 6.9. In addition, youth shopping more

Self-Efficacy, Health Literacy, and Nutrition and Exercise Behaviors in a Low-Income, Hispanic Population.

Science.gov (United States)

Guntzviller, Lisa M; King, Andy J; Jensen, Jakob D; Davis, LaShara A

2017-04-01

Public health goals have emphasized healthy nutrition and exercise behaviors, especially in underserved populations. According to social cognitive theory (SCT), self-efficacy and capability (e.g., health literacy) may interact to predict preventative behaviors. We surveyed 100 low-income, native Spanish-speakers living in the United States who were low in English proficiency and predominantly of Mexican heritage. Participants reported their nutritional and exercise self-efficacy, Spanish health literacy, and nutrition and physical activity behaviors. Consistent with SCT, the interaction of self-efficacy and health literacy significantly predicted fruit and vegetable consumption and weekly exercise, and marginally predicted avoidance of high fat foods. For all three interactions, higher health literacy levels strengthened the positive relationship between self-efficacy and health behaviors. The results offer support for the tenets of SCT and suggest-for low-income, Spanish-speaking adults-that a combination of behavioral confidence and literacy capability are necessary to enact appropriate health behaviors.

Relationship of depression in participants with nonspecific acute or subacute low back pain and no-pain by age distribution

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Calvo-Lobo C

2017-01-01

Full Text Available Cesar Calvo-Lobo,1 Juan Manuel Vilar Fernández,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Marta Elena Losa-Iglesias,4 David Rodríguez-Sanz,5 Patricia Palomo López,6 Daniel López López7 1Physical Therapy Department, Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimiento, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid; 2Modeling, Optimization and Statistical Inference Research Group, Universidade da Coruña, A Coruña; 3School of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid; 4Faculty of Health Sciences, Universidad Rey Juan Carlos, Madrid; 5Physical Therapy & Health Sciences Research Group, Facultad de Ciencias de la Salud, el Ejercicio y el Deporte, Universidad Europea de Madrid, Madrid; 6University Center of Plasencia, Universidad de Extremadura, Badajoz; 7Research, Health and Podiatry Unit, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, A Coruña, Spain Background and purpose: Nonspecific low back pain (LBP is the most prevalent musculoskeletal condition in various age ranges and is associated with depression. The aim of this study was to determine the Beck Depression Inventory (BDI scores in participants with nonspecific LBP and no-pain by age distribution.Methods: A case–control study was carried out following the Strengthening the Reporting of Observational Studies in Epidemiology criteria. A sample of 332 participants, divided into the following age categories: 19–24 (n=11, 25–39 (n=66, 40–64 (n=90, 65–79 (n=124, and ≥80 (n=41 years was recruited from domiciliary visits and an outpatient clinic. The BDI scores were self-reported in participants with nonspecific acute or subacute (≤3 months LBP (n=166 and no-pain (n=166.Results: The BDI scores, mean ± standard deviation, showed statistically significant differences (p<0.001 between participants with nonspecific acute or

The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

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Ali Batouli

2014-06-01

Conclusions: The analysis of this study suggested that cancer MIR is greater in middle/low-income countries. Furthermore, the WHO healthcare score was associated with improved cancer outcomes in middle/low-income countries while absolute levels of financial resources and infrastructure played a more important role in high-income countries.

Online health consultation: examining uses of an interactive cancer communication tool by low-income women with breast cancer.

Science.gov (United States)

Lu, Hsueh-Yi; Shaw, Bret R; Gustafson, David H

2011-07-01

To examine how psychosocial variables predicted use of an online health consultation service among low-income breast cancer patients and in turn how using this service affected these same psychosocial outcomes. This retrospective study included 231 recently diagnosed, low-income (at or below 250% of the federal poverty level) breast cancer patients provided a free computer with 16 weeks of access to the Internet-based 'Ask an Expert' service offered as part of the Comprehensive Health Enhancement Support System (CHESS) "Living with Breast Cancer" program. The use activity included a total of 502 messages submitted to the online health consultation service. The data included five psychosocial variables: information seeking, social support, health self efficacy, participation in health care, and doctor-patient relationship, were collected at both the pre-test and 16-week post-test after using the service. Correlation tests were conducted to examine the relationship between pre- and post-test, and use activity. A multiple regression model was formed for each of five psychosocial variables to examine how use activity of the consultation service was associated with various psychosocial measurements. In total, 865 distinct consulting queries from 502 messages were identified as measurement of patients' use activities (3.74 consulting queries per participant). Use activity had significant negative relationships with pre-test scores across all five psychosocial variables. The regression models found significant positive main effects (use activity) associated with three of these psychosocial variables: health self efficacy, participation in health care and doctor-patient relationship. Use activity of the online consultation service did not have significant relationships with the dependent variables of information seeking and perceived social support. Low-income breast cancer patients sought out information from an online cancer information expert. Patients with more

Participation of Public Benefit Organizations in Income Tax – Financial and Legal Issues

Directory of Open Access Journals (Sweden)

Robert Musiałkiewicz

2014-03-01

Full Text Available The purpose of the article is a legal analysis of the participation of public benefit organizations in personal income tax. The author defines public benefit organizations, indicating the conditions that they need to meet in order to be able to participate in the personal income tax. Broad considerations relate to the analysis of the legal structure of the 1% tax deduction, its scope and the procedures for transfer of funds from the State budget to eligible entities. The article also presents the scale of the issues against the background of the practical functioning of the public finances. The article summarizes the reflection on the rationality and the essence of the transfer of public funds to public benefit organizations.

Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines.

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Bernstein, Steven L; Rosner, June-Marie; Toll, Benjamin

2016-08-01

Quitlines (QLs) are free, effective sources of treatment for tobacco dependence. Although the QL number is toll-free, the use of cell phones as the sole source of telephony may impose an unintended cost, in terms of cell minutes. To quantify the use of cell-only telephony among self-pay or Medicaid smokers, assess their calling plans, and estimate the impact of a typical course of QL counseling. A survey of smokers age at least 18 years visiting an American urban emergency department from April to July, 2013. Seven-hundred seventy-three smokers were surveyed, of whom 563 (72.8%) were low-income, defined as having Medicaid or no insurance. All low-income smokers had at least one phone: 48 (8.5%) reported land-lines only, 159 (28.2%) land-lines and cells, and 356 (63.2%) cells only. Of the cell phone owners, monthly calling plans provided unlimited minutes for 339/515 (65.8%), at most 250 minutes for 124 (24.1%), and more than 250 minutes for 52 (10.0%). Another recent trial found that QL users make a median of 1 call lasting 28 minutes, with the 75th and 90th percentiles of calls and minutes at 3 and 4 calls, and 48 and 73.6 minutes, respectively. Thus, robust use of QL services could consume 11%-29% of a low-income smoker's typical 250 monthly cell minutes. Among low-income smokers, cell phones are often the sole telephone. Robust use of the QL may impose a substantial burden on low-income smokers' calling plans, and therefore deter use of the QL. Exempting calls to QLs from counting against smokers' plans may help promote QL utilization. Low-income individuals have high rates of smoking, and are more likely to own only cell phones, not landlines, for telephone access. Because cell phone calling plans often have limited numbers of monthly minutes, cell-only individuals may have to spend a substantial proportion of their monthly minutes on QL services. This may act as a deterrent to using an otherwise free, effective means of treatment for tobacco dependence

Poverty and health-related quality of life of people living in Hong Kong: comparison of individuals from low-income families and the general population.

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Lam, Cindy Lo Kuen; Guo, Vivian Yawei; Wong, Carlos King Ho; Yu, Esther Yee Tak; Fung, Colman Siu Cheung

2017-06-01

To assess health-related quality of life (HRQOL) among Chinese adults from low-income households in Hong Kong, and to explore any threshold of household income that impaired HRQOL. A cross-sectional analysis was conducted on 298 adults from low-income families when they enrolled into a cohort study between 2012 and 2014. HRQOL was measured by the 12-item Short-Form Health Survey-version 2 (SF-12v2). Their mean SF-12v2 subscale and summary scores were compared with those of 596 age-sex-matched subjects randomly selected from a database of 2763 adults from the Hong Kong general population (ratio = 1:2). Multiple linear regressions were conducted to determine any association between monthly household income and HRQOL. Subjects from low-income households had significantly lower SF-12v2 bodily pain, general health, vitality and physical component summary (PCS) scores than the age-sex matched subjects from the general population. Subgroup analysis showed that a household income income in Hong Kong (HK$10 000 ≈ US$1290, i.e. poverty line in Hong Kong) was independently associated with poorer PCS and mental component summary (MCS) scores after adjustment for socio-demographics and co-morbidities. Chinese adults from low-income households had poorer HRQOL, and income seems to be the threshold for impairment of both physical and mental HRQOL. The findings support the current definition of the poverty line. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Prevalence of Hypertension in Low- and Middle-Income Countries

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Sarki, Ahmed M.; Nduka, Chidozie U.; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A.

2015-01-01

Abstract We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4–35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1–45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0–40.6) and lowest across low-income countries (23.1%, 95% CI 20.1–26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the various socio-demographic subgroups. On average, about 1 in 3 adults in the developing world is hypertensive. The findings of this study will be useful for the design of hypertension screening and treatment programmes in low- and middle-income

Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level.

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Hiza, Hazel A B; Casavale, Kellie O; Guenther, Patricia M; Davis, Carole A

2013-02-01

An index that assesses the multidimensional components of the diet across the lifecycle is useful in describing diet quality. The purpose of this study was to use the Healthy Eating Index-2005, a measure of diet quality in terms of conformance to the 2005 Dietary Guidelines for Americans, to describe the diet quality of Americans by varying sociodemographic characteristics in order to provide insight as to where diets need to improve. The Healthy Eating Index-2005 scores were estimated using 1 day of dietary intake data provided by participants in the 2003-2004 National Health and Nutrition Examination Survey. Mean daily intakes of foods and nutrients, expressed per 1,000 kilocalories, were estimated using the population ratio method and compared with standards that reflect the 2005 Dietary Guidelines for Americans. Participants included 3,286 children (2 to 17 years), 3,690 young and middle-aged adults (18 to 64 years), and 1,296 older adults (65+ years). Results are reported as percentages of maximum scores and tested for significant differences (P ≤ 0.05) by age, sex, race/ethnicity, income, and education levels. Children and older adults had better-quality diets than younger and middle-aged adults; women had better-quality diets than men; Hispanics had better-quality diets than blacks and whites; and diet quality of adults, but not children, generally improved with income level, except for sodium. The diets of Americans, regardless of socioeconomic status, are far from optimal. Problematic dietary patterns were found among all sociodemographic groups. Major improvements in the nutritional health of the American public can be made by improving eating patterns. Published by Elsevier Inc.

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

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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…

Visual impairment in urban school children of low-income families in Kolkata, India.

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Ghosh, Sambuddha; Mukhopadhyay, Udayaditya; Maji, Dipankar; Bhaduri, Gautam

2012-01-01

To evaluate pattern of visual impairment in school children from low-income families in Kolkata, India, an institutional cross-sectional study was conducted among 2570 children of 10 primary schools. Ocular examination including refraction was done and pattern of visual impairment and refractive error was studied. The age range was 6-14 years. Refractive error was seen in 14.7%. Only 4 children were already wearing correction. Myopia and hypermetropia was present in 307 (11.9%) and 65 (2.5%) children, respectively. Visual acuity of less than 6/12 in better eye was present in 109 (4.2%) and 5 (0.2%) children pre- and post-correction, respectively. Eighteen children had amblyopia. Although prevalence of refractive error in this group is less compared to school children of all income categories reported from other cities of India, it is more compared to school children of all income categories from the same city. Refractive error mostly remains uncorrected in this group.

25-Hydroxyvitamin D Status of Healthy, Low-Income, Minority Children in Atlanta, Georgia

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Cole, Conrad R.; Grant, Frederick K.; Tangpricha, Vin; Swaby-Ellis, E. Dawn; Smith, Joy L.; Jacques, Anne; Chen, Huiping; Schleicher, Rosemary L.; Ziegler, Thomas R.

2010-01-01

OBJECTIVES The goals were to determine the prevalence of vitamin D deficiency among minority children in a southern US city, to examine differences in serum 25-hydroxyvitamin D levels between non-Hispanic black and Hispanic children, and to determine dietary sources of vitamin D. METHODS Low-income, minority children (N = 290; mean age: 2.5 ± 1.2 years) were recruited during well-child clinic visits. Serum 25-hydroxyvitamin D and calcium levels were measured and dietary information was assessed. RESULTS The mean 25-hydroxyvitamin D3 level was 26.2 ± 7.6 ng/mL, whereas 25-hydroxyvitamin D2 was not detected. Overall, 22.3% of children had deficient serum 25-hydroxyvitamin D3 levels (≤20 ng/mL), 73.6% had less-than-optimal serum 25-hydroxyvitamin D levels (≤30 ng/mL), and 1.4% had low serum calcium levels (≤9 mg/dL). A significantly larger proportion of non-Hispanic black children, compared with Hispanic children, had vitamin D deficiency (26% vs 18%; P<.05). Age and season of recruitment were significantly associated with vitamin D deficiency and low serum calcium levels. Older children (≥3 years) were less likely to have vitamin D deficiency (odds ratio [OR]: 0.89 [95% confidence interval [CI]: 0.81– 0.96]; P < .001). Study enrollment during spring and summer reduced the likelihood of vitamin D deficiency by ~20% (spring, OR: 0.85 [95% CI: 0.73– 0.98]; P = .03; summer, OR: 0.82 [95% CI: 0.73– 0.92]; P < .01). Fortified milk provided most dietary vitamin D (62%), with Hispanic children reporting greater intake. CONCLUSIONS Suboptimal vitamin D status was common among apparently healthy, low-income, minority children. Age and season were significant predictors of vitamin D deficiency. PMID:20351012

Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: results from the World Health Survey.

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Hosseinpoor, Ahmad Reza; Bergen, Nicole; Mendis, Shanthi; Harper, Sam; Verdes, Emese; Kunst, Anton; Chatterji, Somnath

2012-06-22

Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups. Using 2002-04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality. Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality. Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators.

Promoting Broad and Stable Improvements in Low-Income Children's Numerical Knowledge through Playing Number Board Games

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Ramani, Geetha B.; Siegler, Robert S.

2008-01-01

Theoretical analyses of the development of numerical representations suggest that playing linear number board games should enhance young children's numerical knowledge. Consistent with this prediction, playing such a game for roughly 1 hr increased low-income preschoolers' (mean age = 5.4 years) proficiency on 4 diverse numerical tasks: numerical…

Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women: A Randomized Clinical Trial.

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Phelan, Suzanne; Hagobian, Todd; Brannen, Anna; Hatley, Karen E; Schaffner, Andrew; Muñoz-Christian, Karen; Tate, Deborah F

2017-06-20

Postpartum weight retention increases lifetime risk of obesity and related morbidity. Few effective interventions exist for multicultural, low-income women. To test whether an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) for low-income postpartum women could produce greater weight loss than the WIC program alone over 12 months. A 12-month, cluster randomized, assessor-blind, clinical trial enrolling 371 adult postpartum women at 12 clinics in WIC programs from the California central coast between July 2011 and May 2015 with data collection completed in May 2016. Clinics were randomized to the WIC program (standard care group) or the WIC program plus a 12-month primarily internet-based weight loss program (intervention group), including a website with weekly lessons, web diary, instructional videos, computerized feedback, text messages, and monthly face-to-face groups at the WIC clinics. The primary outcome was weight change over 12 months, based on measurements at baseline, 6 months, and 12 months. Secondary outcomes included proportion returning to preconception weight and changes in physical activity and diet. Participants included 371 women (mean age, 28.1 years; Hispanic, 81.6%; mean weight above prepregnancy weight, 7.8 kg; mean months post partum, 5.2 months) randomized to the intervention group (n = 174) or standard care group (n = 197); 89.2% of participants completed the study. The intervention group produced greater mean 12-month weight loss compared with the standard care group (3.2 kg in the intervention group vs 0.9 kg in standard care group, P income postpartum women, an internet-based weight loss program in addition to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC program) compared with the WIC program alone resulted in a statistically significant greater weight loss over 12 months. Further research is needed to

Social benefit payments and acute injury among low-income mothers.

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Redelmeier, Donald A; Chan, William K; Mullainathan, Sendhil; Shafir, Eldar

2012-01-01

Human error due to risky behaviour is a common and important contributor to acute injury related to poverty. We studied whether social benefit payments mitigate or exacerbate risky behaviours that lead to emergency visits for acute injury among low-income mothers with dependent children. We analyzed total emergency department visits throughout Ontario to identify women between 15 and 55 years of age who were mothers of children younger than 18 years, who were living in the lowest socio-economic quintile and who presented with acute injury. We used universal health care databases to evaluate emergency department visits during specific days on which social benefit payments were made (child benefit distribution) relative to visits on control days over a 7-year interval (1 April 2003 to 31 March 2010). A total of 153 377 emergency department visits met the inclusion criteria. We observed fewer emergencies per day on child benefit payment days than on control days (56.4 v. 60.1, p = 0.008). The difference was primarily explained by lower values among mothers age 35 years or younger (relative reduction 7.29%, 95% confidence interval [CI] 1.69% to 12.88%), those living in urban areas (relative reduction 7.07%, 95% CI 3.05% to 11.10%) and those treated at community hospitals (relative reduction 6.83%, 95% CI 2.46% to 11.19%). No significant differences were observed for the 7 days immediately before or the 7 days immediately after the child benefit payment. Contrary to political commentary, we found that small reductions in relative poverty mitigated, rather than exacerbated, risky behaviours that contribute to acute injury among low-income mothers with dependent children.

Promoting food security of low income women in central Uganda

DEFF Research Database (Denmark)

Midtvåge, Runa; Hiranandani, Vanmala Sunder; Nambuanyi, Lekunze Ransom

• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014.......• Midtvåge, R., Hiranandani, V. S., & Lekunze, R. (2014). Promoting food security of low income women in central Uganda. Poster presentation, Sustainability Science Congress, University of Copenhagen, Denmark, October 22-24, 2014....

Measurement and verification of low income energy efficiency programs in Brazil: Methodological challenges

Energy Technology Data Exchange (ETDEWEB)

Martino Jannuzzi, Gilberto De; Rodrigues da Silva, Ana Lucia; Melo, Conrado Augustus de; Paccola, Jose Angelo; Dourado Maia Gomes, Rodolfo (State Univ. of Campinas, International Energy Initiative (Brazil))

2009-07-01

Electric utilities in Brazil are investing about 80 million dollars annually in low-income energy efficiency programs, about half of their total compulsory investments in end-use efficiency programs under current regulation. Since 2007 the regulator has enforced the need to provide evaluation plans for the programs delivered. This paper presents the measurement and verification (MandV) methodology that has been developed to accommodate the characteristics of lighting and refrigerator programs that have been introduced in the Brazilian urban and peri-urban slums. A combination of household surveys, end-use measurements and metering at the transformers and grid levels were performed before and after the program implementation. The methodology has to accommodate the dynamics, housing, electrical wiring and connections of the population as well as their ability to pay for the electricity and program participation. Results obtained in slums in Rio de Janeiro are presented. Impacts of the programs were evaluated in energy terms to households and utilities. Feedback from the evaluations performed also permitted the improvement in the design of new programs for low-income households.

The consequences of high cigarette excise taxes for low-income smokers.

Directory of Open Access Journals (Sweden)

Matthew C Farrelly

Full Text Available BACKGROUND: To illustrate the burden of high cigarette excise taxes on low-income smokers. METHODOLOGY/PRINCIPAL FINDINGS: Using data from the New York and national Adult Tobacco Surveys from 2010-2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000-$59,999; and more than $60,000. The 2010-2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1% than nationally (22.2% and is strongly associated with income in New York and nationally (P<.001. Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010-2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003-2004 and 14.2% nationally. Daily cigarette consumption is not related to income. CONCLUSIONS/SIGNIFICANCE: Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers.

After-school programs for low-income children: promise and challenges.

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Halpern, R

1999-01-01

Children's out-of-school time, long a low-level source of public concern, has recently emerged as a major social issue. This, in turn, has heightened interest in the heterogeneous field of after-school programs. This article provides a profile of after-school programs for low-income children, focusing on supply and demand, program emphases, and program sponsors and support organizations. It also discusses the major challenges facing the field in the areas of facilities, staffing, and financing. Details and examples are drawn from the ongoing evaluation of a specific after-school program initiative called MOST (Making the Most of Out-of-School Time), which seeks to strengthen after-school programs in Boston, Chicago, and Seattle. Looking ahead, the article highlights the pros and cons of options for increasing coverage to reach more low-income children, strengthening programs, expanding funding, and articulating an appropriate role for after-school programs to fill in the lives of low-income children.

Federally Funded Education and Job Training Programs for Low-Income Youth

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Dworsky, Amy

2011-01-01

With the growing demand for highly skilled workers and declining wages for those who are less skilled, low-income youth with limited education and no work experience have few opportunities for gainful employment. Since the Great Depression, the federal government has been funding programs that provide low-income, out-of-school, and unemployed…

Diet quality is related to eating competence in cross-sectional sample of low-income females surveyed in Pennsylvania.

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Lohse, Barbara; Bailey, Regan L; Krall, Jodi Stotts; Wall, Denise E; Mitchell, Diane C

2012-04-01

Women participants of two federally administered nutrition education programs (n=149, 56% white, 64% food secure, 86% 18-50 years of age,) completed telephone interviews that included three 24-hour dietary recalls and the Satter Eating Competence Inventory. Eating competence is delineated by an Inventory score≥32. Competent eaters had significantly greater intakes of fiber, vitamin A, vitamin E, vitamin C, most B-vitamins, magnesium, iron, zinc, potassium and a higher Healthy Eating Index. Two dietary patterns defined as Prudent and Western were observed. The Prudent pattern was correlated with eating competence and characterized by more healthful foods such as fruits, vegetables and low-fat dairy products. The Western pattern, characterized by foods higher in fat, salt, and sugar, was not related to eating competence. Findings suggest that dietary guidance using an eating competence approach for low-income women is compatible with goals to improve dietary quality and eating patterns. Copyright © 2011 Elsevier Ltd. All rights reserved.

A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries.

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Adebayo, Esther F; Uthman, Olalekan A; Wiysonge, Charles S; Stern, Erin A; Lamont, Kim T; Ataguba, John E

2015-12-08

Low-income and middle-income countries (LMICs) have difficulties achieving universal financial protection, which is primordial for universal health coverage. A promising avenue to provide universal financial protection for the informal sector and the rural populace is community-based health insurance (CBHI). We systematically assessed and synthesised factors associated with CBHI enrolment in LMICs. We searched PubMed, Scopus, ERIC, PsychInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL, Cochrane Library, conference proceedings, and reference lists for eligible studies available by 31 October 2013; regardless of publication status. We included both quantitative and qualitative studies in the review. Both quantitative and qualitative studies demonstrated low levels of income and lack of financial resources as major factors affecting enrolment. Also, poor healthcare quality (including stock-outs of drugs and medical supplies, poor healthcare worker attitudes, and long waiting times) was found to be associated with low CBHI coverage. Trust in both the CBHI scheme and healthcare providers were also found to affect enrolment. Educational attainment (less educated are willing to pay less than highly educated), sex (men are willing to pay more than women), age (younger are willing to pay more than older individuals), and household size (larger households are willing to pay more than households with fewer members) also influenced CBHI enrolment. In LMICs, while CBHI schemes may be helpful in the short term to address the issue of improving the rural population and informal workers' access to health services, they still face challenges. Lack of funds, poor quality of care, and lack of trust are major reasons for low CBHI coverage in LMICs. If CBHI schemes are to serve as a means to providing access to health services, at least in the short term, then attention should be paid to the issues that militate against their success.

High economic inequality leads higher-income individuals to be less generous.

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Côté, Stéphane; House, Julian; Willer, Robb

2015-12-29

Research on social class and generosity suggests that higher-income individuals are less generous than poorer individuals. We propose that this pattern emerges only under conditions of high economic inequality, contexts that can foster a sense of entitlement among higher-income individuals that, in turn, reduces their generosity. Analyzing results of a unique nationally representative survey that included a real-stakes giving opportunity (n = 1,498), we found that in the most unequal US states, higher-income respondents were less generous than lower-income respondents. In the least unequal states, however, higher-income individuals were more generous. To better establish causality, we next conducted an experiment (n = 704) in which apparent levels of economic inequality in participants' home states were portrayed as either relatively high or low. Participants were then presented with a giving opportunity. Higher-income participants were less generous than lower-income participants when inequality was portrayed as relatively high, but there was no association between income and generosity when inequality was portrayed as relatively low. This research finds that the tendency for higher-income individuals to be less generous pertains only when inequality is high, challenging the view that higher-income individuals are necessarily more selfish, and suggesting a previously undocumented way in which inequitable resource distributions undermine collective welfare.

Stability of leisure participation from school-age to adolescence in individuals with cerebral palsy.

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Majnemer, Annette; Shikako-Thomas, Keiko; Schmitz, Norbert; Shevell, Michael; Lach, Lucy

2015-12-01

With increasing age, youth with disabilities are at risk for decreased participation in leisure activities, a key component for physical and mental health. This prospective study describes changes in leisure participation and leisure preferences from school-age to adolescence in children with cerebral palsy (CP). Participants were recruited at school-age (6-12 years) for a study on participation and reassessed for a second study on adolescents (12-19 years) if >12 years. Thirty-eight children (24 males) with CP who could actively participate in the completion of the Children's Assessment of Participation and Enjoyment (CAPE) and the Preferences for Activities of Children (PAC) comprised the sample. Average time between assessments was 5.0 ± 1.3 years. Most children were ambulatory (32/38 Gross Motor Function Classification System I-II). In addition to the CAPE and PAC, children were evaluated using the Gross Motor Function Measure-66 and parents completed a socio-demographic questionnaire. Paired t-tests revealed a significant decline in leisure participation diversity and intensity (CAPE) for recreation (p.05). Diversity of active-physical activities increased modestly (p=.06) although intensity of participation in this activity domain decreased (p=.003). There was also a decline in enjoyment of leisure activities. Preferences for these leisure activities remained unchanged between school-age and adolescence, except for recreational activities. Gender, maternal education, family income and gross motor ability were not related to differences in CAPE/PAC scores with increasing age. Findings suggest that over time, children with CP's participation in leisure activities diminishes, which is of concern to their functioning and well-being. Parents may be more involved in early childhood in facilitating participation whereas in adolescence, youth may be faced with more environmental barriers and a greater awareness of challenges to participation. Adolescents

Is There a Link between Low Parental Income and Childhood Obesity?

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Shackleton, Nichola

2017-01-01

The association between familial socioeconomic status and child obesity has created the expectation that low familial income increases the risk of child obesity. Yet, there is very little evidence in the United Kingdom to suggest that this is the case. This article focuses on whether low familial income and family poverty are associated with an…

Trajectories of psychopathology and risky behaviors associated with childhood abuse and neglect in low-income urban African American girls.

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Wilson, Helen W; Samuelson, Sarah L; Staudenmeyer, Anna H; Widom, Cathy Spatz

2015-07-01

The current study examined patterns of psychopathology, drug and alcohol use, and sexual behavior associated with childhood abuse and neglect in a high-risk sample of low-income African American girls seeking mental health treatment. Participants (N=177) were African American girls recruited from mental health clinics serving low-income communities in Chicago, IL and followed over six waves of data collection (T1-T6) reflecting early (mean age 14) to late (mean age 17) adolescence. Child abuse and neglect history was determined from adolescent and caregiver reports. Latent curve modeling examined patterns of internalizing and externalizing psychopathology, drug and alcohol use, sexual experience, and risky sexual behavior reported by girls and associations with reported child abuse and neglect. Overall, these trajectories indicated a decrease in internalizing and externalizing symptoms, stability of drug and alcohol use, and an increase in sexual experience and risky sexual behaviors over time. Child abuse and neglect was associated with increased internalizing symptoms and sexual experience at baseline and with externalizing symptoms and risky sexual behavior both at baseline and the final point. Child abuse and neglect was not significantly associated with alcohol or drug use. This study adds to the literature on the long-term consequences of child abuse and neglect by demonstrating patterns of psychopathology and risky behavior that persist over time in a high-risk group of girls with self or parent reported histories of abuse and neglect. Interventions that address externalizing problems and health risk behaviors may be of particular importance for this population. Copyright © 2015. Published by Elsevier Ltd.

"It's an Uphill Battle Everyday": Intersectionality, Low-Income Black Heterosexual Men, and Implications for HIV Prevention Research and Interventions.

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Bowleg, Lisa; Teti, Michelle; Malebranche, David J; Tschann, Jeanne M

2013-01-01

This interview study, the initial qualitative phase of a larger mixed methods HIV prevention study focused on Black heterosexual men, used intersectionality as a theoretical framework to explore: (1) How a sample of Black heterosexual men describe and experience the multiple intersections of race, gender, and SES; and (2) How these descriptions reflected interlocking systems of social inequality for Black men at the social-structural level. Participants were 30 predominantly low-income self-identified Black heterosexual men between the ages of 18 and 44. Analyses highlighted four themes that demonstrate how participants' individual-level experiences as Black men reflect macro social-structural inequality: (1) racial discrimination and microaggressions; (2) unemployment; (3) incarceration; and (4) police surveillance and harassment. We discuss the study's findings within the context of social-structural factors that disproportionately and adversely impact Black men. We also highlight the implications of the intersectionality perspective for HIV prevention research and interventions for Black heterosexual men.

Using social media to communicate child health information to low-income parents.

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Stroever, Stephanie J; Mackert, Michael S; McAlister, Alfred L; Hoelscher, Deanna M

2011-11-01

The objective of this study was to determine the value of using social media to communicate child health information to low-income parents. We evaluated qualitative data obtained through focus groups with low-income, predominantly Hispanic parents. Results were mixed; lack of time and credibility were the primary objections parents cited in using social media to obtain information about their children's health. Social media has value as part of an overall communication strategy, but more work is needed to determine the most effective way to use this channel in low-income populations.

Galvanizing mental health research in low- and middle- income countries: the role of scientific journals.

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2004-07-01

The Department of Mental Health and Substance Abuse, World Health Organization, organized a meeting on Mental Health Research in Developing Countries: Role of Scientific Journals in Geneva on 20 and 21 November 2003 that was attended by twenty-five editors representing journals publishing mental health research. A number of other editors reviewed and contributed to the background and follow-up material. This statement is issued by all participants jointly (see Appendix B for the list of journals/organizations and their representatives). Research is needed to address the enormous unmet mental health needs of low- and middle-income (LAMI) countries. Scientific journals play an important role in production and dissemination of research. However, at present, only a minute proportion of research published in widely accessible mental health and psychiatric journals is from or about these countries. Yet over 85% of the world's population lives in the 153 countries categorized as low and middle income, according to World Bank criteria. Even more worrying is the observation that the gap between these and high-income countries may be widening in terms of their number of publications. The meeting was aimed at finding ways of resolving this unsatisfactory situation.

Religiousness and headache: is there a relation? Results from a representative sample of adults living in a low-income community.

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Lucchetti, Giancarlo; Lucchetti, Alessandra L G; Peres, Mario F Prieto

2015-03-01

The use of religious behaviors to alleviate the consequences of stressful life circumstances is a frequent strategy employed by pain sufferers. Specifically in the field of headache research, to date, few studies have assessed spiritual and religious beliefs. The objective of this article is to investigate the relation between religiousness (organizational, non-organizational and intrinsic) and headache disorders in a representative sample of adults living in a low-income community. This was a cross-sectional, population-based study. In 2005, we conducted door-to-door interviews with 439 people, aged more than 18 years, randomly selected from a low-income community in Brazil. Four regression models were created to explain the relationships between religious involvement and headache, controlling for demographics, depression/anxiety and alcohol use and smoking. Of the 439 households contacted, at least one member from 383 (87.2%) households participated. We interviewed more women (74.4%) and more subjects aged 18-39 years. The mean age was 41.7 (SD 8.5) years. Bivariate analysis shows that high religious attendance, non-organizational religiousness and intrinsic religiousness were associated with presence of headache and presence of migraine. After the logistic regression models, only high non-organizational religiousness remained associated with presence of headache (odds ratio (OR): 1.22 (1.01-1.49)). All other religious variables were unrelated to the presence of headache and its types. There is a modest relationship between high non-organizational religiousness and presence of headache. Headache sufferers may use coping strategies such as private religious behaviors to try to overcome suffering. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Xerostomia Among Older Adults With Low Income: Nuisance or Warning?

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Lee, Young-Shin; Kim, Hee-Gerl; Moreno, Kim

2016-01-01

The purpose of this study was to identify the prevalence of xerostomia and related factors among low-income older adults in South Korea. A cross-sectional, population-based study. Using data from the Home Healthcare Service Project, a population-based interview survey with home healthcare service, a total of 9,840 adults 65 years of age and older were assessed for the presence of xerostomia in association with aspects of health lifestyles, chronic disease, oral conditions, and oral function. Overall, 40% of participants reported experiencing xerostomia. Multivariate regression analysis indicated xerostomia was more likely to be reported by women having symptoms of gingival bleeding/pain, having difficulty swallowing liquid or chewing solid food, and having multiple chronic diseases. Interestingly, older adults who live alone and drink alcohol (two or more times per week) reported fewer problems with xerostomia. Increased focus on the detrimental health consequences of xerostomia would make treatment a higher priority. Improved assessment of at-risk populations, particularly among the elderly, could lead to earlier preventative interventions, lessening the negative impact on quality of life. Health professionals along with the general public need increased knowledge about the detrimental effects of xerostomia on overall health. There is a need for earlier assessment and treatment to facilitate optimal health promotion and disease prevention. © 2015 Sigma Theta Tau International.

Science for Agriculture and Rural Development in Low-Income Countries

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Barros, Vicente

2008-09-01

During recent months, another sign of the global fragility to sustain the increasing human demand for resources has appeared with merciless cruelty. Increasing food prices, paradoxically driven to a large extent by the rapid economic growth of vast regions of the emerging world, are affecting hundreds of millions of the poorest people in Africa, Asia, and Latin America. As described in Science for Agriculture and Rural Development in Low-Income Countries, most of the poorest people in these low-income countries live in rural areas and are engaged in agriculture or related activities. Because many people in these areas are engaged in subsistence agriculture, they do not share in the added income derived from higher market prices for food.

Determinants of disciplinary practices in low-income black mothers.

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Kelly, M L; Power, T G; Wimbush, D D

1992-06-01

Disciplinary attitudes and practices of low-income black mothers were examined. Mothers were interviewed about their parenting attitudes and control practices, and their responses were coded in terms of the degree to which they took a parent-versus a child-oriented approach to discipline. Mothers in the sample varied widely in their attitudes toward physical punishment, and mothers who used power-assertive techniques were as likely to take the child's perspective and give input into the socialization process as those who did not. Factors associated with maternal disciplinary styles included: maternal education, father absence, maternal age, and self-reported religious beliefs. Findings are discussed in terms of the variability in disciplinary practices in this population, as well as the factors contributing to these individual differences.

Factors contributing to the psychological well-being for Hong Kong Chinese children from low-income families: a qualitative study.

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Ho, Ka Yan; Li, William H C; Chung, Joyce Oi Kwan; Lam, Katherine Ka Wai; Chan, Sophia S C; Xia, Wei

2016-01-01

Despite compelling evidence demonstrating the negative impact of poverty and income disparity on children's psychological well-being, there has been a lack of qualitative information which addresses its contributing factors. This study aimed to shed light on this area by comparing the experiences toward daily life between children living in low- and high-income families. A qualitative study using a phenomenological approach was conducted from May 2012 to January 2013. A random sample of 42 children aged 10-13, with 25 from low- and 17 from high-income families were asked to voluntarily response to a demographic sheet and undergo individual semi-structured interviews which lasted about 25-30 min. Content analysis was used to analyze the data. Approval for the study was obtained from the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (reference UW 12-237). The findings of this study revealed that the living environment, physical health, social life and ability to function at school of children from low-income families are severely impaired. It fills a gap in the literature by showing how poverty and income disparity affect the daily lives of children from low-income families on different levels. Also, adopting a sedentary lifestyle and unhealthy eating habits are possible factors mediating the effects of poverty and income disparity on the psychological well-being of children from low-income families. It is vital for healthcare professionals going beyond their normal roles to give advice on healthy lifestyles and behaviors by building multidisciplinary partnerships with schools and the community. Additionally, healthcare professionals should also target on these two possible factors to develop and implement appropriate interventions for promoting the psychological well-being among children living in poverty. Trial registration NCT02877719. 19 August 2016 retrospectively registered.

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

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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

Maternal feeding styles and food parenting practices as predictors of longitudinal changes in weight status in Hispanic preschoolers from low-income families

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The aim was to investigate the influence of feeding styles and food parenting practices on low-income children's weight status over time. Participants were 129 Latina parents and their Head Start children participating in a longitudinal study. Children were assessed at baseline (4 to 5 years old) an...

Feeding practices of low-income mothers: how do they compare to current recommendations?

OpenAIRE

Power, Thomas G; Hughes, Sheryl O; Goodell, L Suzanne; Johnson, Susan L; Duran, J Andrea Jaramillo; Williams, Kimberly; Beck, Ashley D; Frankel, Leslie A

2015-01-01

Background Despite a growing consensus on the feeding practices associated with healthy eating patterns, few observational studies of maternal feeding practices with young children have been conducted, especially in low-income populations. The aim of this study was to provide such data on a low income sample to determine the degree to which observed maternal feeding practices compare with current recommendations. Methods Eighty low-income mothers and their preschool children were videotaped a...

Low-Income Urban High School Students' Use of the Internet to Access Financial Aid

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Venegas, Kristan M.

2006-01-01

This article focuses on the Web-based resources available to low-income students as they build their perceptions, make their decisions, and engage in financial aid activities. Data are gathered from the results of six focus groups with low-income high school students attending urban high schools. Findings suggest that low-income students do have…

To Work or Not to Work: Student Employment, Resiliency, and Institutional Engagement of Low-Income, First-Generation College Students

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Martinez, Edward F.; Bilges, Dolores C.; Shabazz, Sherrille T.; Miller, Rhoda; Morote, Elsa-Sofia

2012-01-01

This exploratory study examines the difference between two college persistence factors--resiliency and institutional engagement--for low-income, working, first-generation college students. Participants in the study consisted of 52 respondents to the Family History Knowledge and College Persistence Survey. Among respondents, 50 students reported…

Babies, soft drinks and snacks: a concern in low- and middle-income countries?

OpenAIRE

Huffman, Sandra L; Piwoz, Ellen G; Vosti, Stephen A; Dewey, Kathryn G

2014-01-01

Undernutrition in infants and young children is a global health priority while overweight is an emerging issue. Small-scale studies in low- and middle-income countries have demonstrated consumption of sugary and savoury snack foods and soft drinks by young children. We assessed the proportion of children 6?23 months of age consuming sugary snack foods in 18 countries in Asia and Africa using data from selected Demographic and Health Surveys and household expenditures on soft drinks and biscui...

Air Quality, Energy Budget, and Offset Policy in South Africa's Low-Income Settlements

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Hersey, S. P.; Piketh, S.; Burger, R.

2014-12-01

Urban and exurban residential populations in South Africa reside primarily in low-income settlements, including many townships remaining from Apartheid. Over 3 million free government homes have been built in the last 20 years, but the number of people living in informal settlements is the same as at the end of Apartheid in 1994 - a consequence of rapid urbanization. Despite availability of electricity to the vast majority of South Africans, ~80% of electrified homes in low-income areas also burn coal and/or wood as supplementary fuels for cooking and heating. These domestic burning activities represent 70-85% of total PM10mass during winter in South Africa's low-income settlements. Here we analyze data from observations of human-atmosphere systems in: 1) 19 ground monitoring sites in Gauteng Province (Johannesburg and Pretoria), and 2) an intensive sampling campaign in a township in Mpumalanga Province (Industrial Highveld). From ground monitoring, we quantitatively describe seasonal and diurnal trends in PM10 and PM2.5 typical in low-income settlements as compared with industrial and developed suburban areas, and demonstrate the impact of low-income settlements on regional air quality. We also explore the implications of economic development in townships (increased household income, expanded commercialization and widespread electricity usage) on local and regional air quality. Data from the intensive township sampling study provides a seasonal energy budget for domestic burning in low-income settlements and suggests that indoor and ambient air quality are independent systems requiring unique interventions. We conclude with a preview of innovative strategies being developed by industry, government, and academic stakeholders for a not-like-for-like emissions offset policy in South Africa, focused on investments directly into low-income settlements that are aimed at reducing PM exposure.

Trends in overweight by educational level in 33 low- and middle-income countries: The role of parity, age at first birth and breastfeeding

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Lopez-Arana, Sandra; Burdorf, Alex; Avendano, Mauricio

2013-01-01

Summary This study examined trends in overweight among women of reproductive age by educational level in 33 low- and middle income countries, and estimated the contribution of parity, age at first birth and breastfeeding to these trends. We used repeated cross-sectional demographic health surveys (DHS) of 255,828 women aged 25-49 years interviewed between 1992 and 2009. We applied logistic regression to model overweight (> 25 kg/m2) as a function of education, reproductive variables and time period by country and region. The prevalence of overweight ranged from 3.4% in South and Southeast Asia to 73.7% in North Africa West/Central Asia during the study period. The association between education and overweight differed across regions. In North Africa West/Central Asia and Latin American, lower education was associated with higher overweight prevalence, while the inverse was true in South/Southeast Asia and Sub-Saharan Africa. In all regions, there was a consistent pattern of increasing overweight trends across all educational groups. Older age at first birth, longer breastfeeding, and lower parity were associated with less overweight, but these variables did not account for the association or the increasing trends between education and overweight. PMID:23782957

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

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Tester, June M; Laraia, Barbara A; Leung, Cindy W; Mietus-Snyder, Michele L

2016-02-11

Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth.

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Keenan-Devlin, Lauren S; Ernst, Linda M; Ross, Kharah M; Qadir, Sameen; Grobman, William A; Holl, Jane L; Crockett, Amy; Miller, Gregory E; Borders, Ann E B

2017-08-01

Objective  This study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation. Study Design  A total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors. Results  Overall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28; p  = 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53; p  = 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14; p  = 0.36). Results remained significant after adjustment for maternal age, race, and marital status. Conclusion  Chronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Climacteric complaints among very low-income women from a tropical region of Brazil

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Sebastião Freitas de Medeiros

Full Text Available CONTEXT AND OBJECTIVE: Climacteric symptoms may vary between different countries and cultures. Socioeconomic factors and climate may be implicated. The aim of this study was to identify climacteric symptomatology among very low-income Brazilian women, living in a hot and humid region. DESIGN AND SETTING: This cross-sectional population-based study was conducted in Cuiabá, at Júlio Müller University Hospital, a tertiary institution. METHODS: The study enrolled 354 climacteric women. The variables analyzed were social class, symptomatology and abnormal concurrent conditions. The study was approved by the hospital's research ethics committee. RESULTS: Sixty-five percent of the participants (232/354 were very poor and had had little schooling. The number of symptoms per woman was 8.0 ± 5.7. Hot flushes, nervousness, forgetfulness and fatigue were each found in nearly 60.0%. Tearfulness, depression, melancholy and insomnia were also frequent. Sexual problems were reported by 25%. The most relevant concurrent abnormal conditions reported were hypertension (33.9%, obesity (26.5%, arthritis/arthrosis (15.0% and diabetes mellitus (9.6%. Hot flushes were associated with tearfulness, nervousness and forgetfulness. CONCLUSION: Brazilian climacteric women of low income and low schooling present multiple symptoms. Vasomotor and psychosexual symptoms were the most prevalent disorders. Hot flushes were associated with nervousness, forgetfulness and tearfulness.

The support gap: New teachers' early experiences in high-income and low-income schools

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Susan Moore Johnson

2004-10-01

Full Text Available In this article, the authors consider three sources of support for new teachers—hiring practices, relationships with colleagues, and curriculum—all found in earlier research to influence new teachers’ satisfaction with their work, their sense of success with students, and their eventual retention in their job. They find that a "support gap" exists: new teachers in low-income schools are less likely than their counterparts in high-income schools to experience timely and information-rich hiring, to benefit from mentoring and support by experienced colleagues, and to have a curriculum that is complete and aligned with state standards, yet flexible for use in the classroom. Such patterns of difference between high-income and lowincome schools warrant careful consideration because they reveal broad patterns of inequity, which can have severe consequences for low-income students. Survey data for this study were collected from random samples of teachers in five states. One survey, focusing on hiring practices and teachers’ relationships with colleagues, was administered to 374 first-year and secondyear teachers in Florida, Massachusetts, and Michigan. A second survey, focusing on curriculum, was administered to 295 second-year elementary school teachers in Massachusetts, North Carolina, and Washington. The inequitable patterns of support for teachers reported here have important implications for the work of state policymakers, school district administrators, and principals. The authors describe these and offer recommendations for policy and practice in the conclusion.

[Influence of income, income inequalities and social capital on the health of persons aged 65 and over in Spain in 2007].

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Karlsdotter, Kristina; Martín Martín, José Jesús; López del Amo González, María del Puerto

2011-12-01

The aim of this study is to evaluate the influence of personal income [absolute income hypothesis (AIH)], income inequality and welfare [relative income hypothesis (RIH)], and social capital on the health of older people. Multi-level, cross-sectional logit models are calculated separately for women and men. The database employed was the Spanish Life Conditions Survey for 2007. The population consists of 6,259 persons aged over 65 years living in the 17 autonomous regions of Spain. The results confirm the AIH hypothesis: higher personal income is associated with better health. Education is also associated with better self-perceived health. The RIH hypothesis is partially confirmed due to the association between the Gini coefficient, regional per capita welfare and self-perceived health in older people, but only for women. Two different measures of social capital are used: the value of services of social capital and the percentage of people aged over 65 belonging to an association. Both factors are statistically associated with better self-perceived health in women. This study is the first to contrast the associations among income, income inequalities, social capital and the health of elders in Spain. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Travel patterns and characteristics of low-income subpopulation in New York state

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Reuscher, Tim [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hwang, Ho-Ling [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Lim, Hyeonsup [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-10-01

Studies have shown that people residing in poverty face more mobility challenges in their daily travels as compared to those living in higher income households. In many cities, the lack of a public transportation systems and investments in low-income areas are making it difficult for those living in poverty to access jobs, goods, and services (schools, groceries, health cares, etc. In this study, Oak Ridge National Laboratory was tasked by the New York State (NYS) Department of Transportation to conduct a detailed examination of the travel behaviors and identify patterns and trends of the low-income residents within NYS. The 2009 National Household Travel Survey data was used as the primary information source to analyze subjects associated with poverty and mobility, as well as to address questions such as are there differences in traveler demographics between the low-income population and those of others who live in various NYS regions (e.g., New York City, other urban areas of NYS)? How do they compare with the population at large (e.g., rest of the country) or with findings from previous years (i.e., trend)? Are there any regional differences (e.g., urban versus rural)? Do any unique travel characteristics or patterns exist within the low-income group? Through this study, various key findings on low-income population sizes, household characteristics, travel patterns, and mobility limitations were identified and summarized in this report.

Early Childhood Caries and Body Mass Index in Young Children from Low Income Families

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Maria Goretti Queiroz

2013-03-01

Full Text Available The relationship between early childhood caries (ECC and obesity is controversial. This cross-sectional survey investigated this association in children from low-income families in Goiania, Goias, Brazil and considered the role of several social determinants. A questionnaire examining the characteristics of the children and their families was administered to the primary caregiver during home visits. In addition, children (approximately 6 years of age had their height, weight, and tooth condition assessed. The primary ECC outcome was categorized as one of the following: caries experience (decayed, missing, filled tooth: “dmft” index > 0, active ECC (decayed teeth > 0, or active severe ECC (decayed teeth ≥ 6. Descriptive, bivariate and logistic regression analyses were conducted. The participants in the current study consisted of 269 caregiver-child dyads, 88.5% of whom were included in the Family Health Program. Caregivers were mostly mothers (67.7%, were 35.3 ± 10.0 years old on average and had 9.8 ± 3.1 years of formal education. The mean family income was 2.3 ± 1.5 times greater than the Brazilian minimum wage. On average, the children in the current study were 68.7 ± 3.8 months old. Of these, 51.7% were boys, 23.4% were overweight or obese, 45.0% had active ECC, and 17.1% had severe ECC. The average body mass index (BMI of the children was 15.9 ± 2.2, and their dmft index was 2.5 ± 3.2. BMI was not associated with any of the three categories of dental caries (p > 0.05. In contrast, higher family incomes were significantly associated with the lack of caries experience in children (OR 1.22, 95%CI 1.01–1.50, but the mother’s level of education was not significantly associated with ECC.

Nutritional and Weight-Management Behaviors in Low-Income Women Trying to Conceive

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Berenson, Abbey B.; Pohlmeier, Ali M.; Laz, Tabassum H.; Rahman, Mahbubur; McGrath, Christine J.

2014-01-01

Objective To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared to women not trying to conceive. Methods This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16–40 years who were low-income, racially diverse, (n=1,711) and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. Results At total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements or herbs (13.5% vs. 8.8%; adjusted odds ratio (aOR) 1.97, 95% confidence interval (CI) 1.11–3.49;), using laxatives or diuretics or inducing vomiting (7.7% vs. 3.0%; aOR 2.70, CI 1.23–5.91;), and fasting for 24 hours (10.7% vs. 5.5%; aOR 2.15, CI 1.03–4.51;). There were no significant differences between the two groups in amount of exercise, current smoking status or current alcohol consumption Further, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. Conclusion This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. PMID:25162259

Nutritional and weight management behaviors in low-income women trying to conceive.

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Berenson, Abbey B; Pohlmeier, Ali M; Laz, Tabassum H; Rahman, Mahbubur; McGrath, Christine J

2014-09-01

To evaluate the nutritional habits and weight management strategies of women trying to conceive as compared with women not trying to conceive. This was a cross-sectional survey of health behaviors including nutritional habits and weight management strategies of women aged 16-40 years who were low income, racially diverse, (n=1,711), and attending reproductive health clinics. Multivariable logistic regression analyses were performed to examine the association between pregnancy intention and various health behaviors after adjusting for demographic variables, gravidity, and obesity status. A total of 8.9% (n=153) of the participants stated they were trying to get pregnant. Women trying to conceive were more likely than those not trying to have participated in a number of unhealthy weight loss practices in the past year. These included taking diet pills, supplements, or herbs (13.5% compared with 8.8%; adjusted odds ratio [OR] 1.97, 95% confidence interval [CI] 1.11-3.49), using laxatives or diuretics or inducing vomiting (7.7% compared with 3.0%; adjusted OR 2.70, CI 1.23-5.91), and fasting for 24 hours (10.7% compared with 5.5%; adjusted OR 2.15, CI 1.03-4.51). There were no significant differences between the two groups in amount of exercise, current smoking status, or current alcohol consumption Furthermore, fruit, green salad and other vegetables, and intake of soda and fast food were unrelated to pregnancy intention. This study highlights that women trying to conceive are more likely to participate in unhealthy and potentially dangerous weight loss practices than women not trying to conceive. II.

Improving fruit and vegetable consumption among low-income customers at farmers markets: Philly Food Bucks, Philadelphia, Pennsylvania, 2011.

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Young, Candace R; Aquilante, Jennifer L; Solomon, Sara; Colby, Lisa; Kawinzi, Mukethe A; Uy, Nicky; Mallya, Giridhar

2013-10-03

We evaluated whether Philly Food Bucks, a bonus incentive program at farmers markets, is associated with increased fruit and vegetable consumption and Supplemental Nutrition Assistance Program (SNAP) sales at farmers markets in low-income areas. A convenience sample of 662 customers at 22 farmers markets in low-income neighborhoods in Philadelphia, Pennsylvania, was surveyed via face-to-face interviews. Questions addressed shopping characteristics, self-reported change in fruit and vegetable consumption, whether customers tried new fruits or vegetables, use of Philly Food Bucks, and demographic information. Market-level SNAP sales and Philly Food Bucks redemption data were also collected to monitor sales patterns. Philly Food Bucks users were significantly more likely than nonusers to report increasing fruit and vegetable consumption (OR, 2.4; 95% CI, 1.6-3.7; P < .001) and to report trying new fruits or vegetables (OR 1.8; 95% CI, 1.2-2.7; P = .006). At the market level, average SNAP sales more than doubled at farmers markets in low-income areas in the first 2 years of the Philly Food Bucks program. At the city's largest farmers market in a low-income area, the program was associated with an almost 5-fold higher increase in annual SNAP sales compared with baseline. Results from this study demonstrate that a bonus incentive program tied to SNAP was associated with self-reported increases in fruit and vegetable consumption and increased SNAP sales at participating farmers markets in low-income communities. More research is warranted to evaluate the long-term impact of bonus incentives on farmers market use, dietary behaviors, and health outcomes.

An optimization algorithm for simulation-based planning of low-income housing projects

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Mohamed M. Marzouk

2010-10-01

Full Text Available Construction of low-income housing projects is a replicated process and is associated with uncertainties that arise from the unavailability of resources. Government agencies and/or contractors have to select a construction system that meets low-income housing projects constraints including project conditions, technical, financial and time constraints. This research presents a framework, using computer simulation, which aids government authorities and contractors in the planning of low-income housing projects. The proposed framework estimates the time and cost required for the construction of low-income housing using pre-cast hollow core with hollow blocks bearing walls. Five main components constitute the proposed framework: a network builder module, a construction alternative selection module, a simulation module, an optimization module and a reporting module. An optimization module utilizing a genetic algorithm enables the defining of different options and ranges of parameters associated with low-income housing projects that influence the duration and total cost of the pre-cast hollow core with hollow blocks bearing walls method. A computer prototype, named LIHouse_Sim, was developed in MS Visual Basic 6.0 as proof of concept for the proposed framework. A numerical example is presented to demonstrate the use of the developed framework and to illustrate its essential features.

Race, homelessness, and other environmental factors associated with the food-purchasing behavior of low-income women.

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Dammann, Kristen Wiig; Smith, Chery

2010-09-01

Observance of the hunger-obesity paradox in urban Minnesota has ignited interest in the quality of low-income households' food purchases. This cross-sectional study investigated low-income, urban Minnesotan women's past-month food purchases and their associations with race, homelessness, and aspects of the food system, including food shelf (ie, food pantry) and food store usage, factors believed to influence food choice and grocery shopping behavior. The survey included demographics, the US Department of Agriculture's 18-item Household Food Security Survey Module, and grocery shopping questions related to food purchases and food stores visited in the past month. Participants were a convenience sample of 448 low-income, urban Minnesotan women, and data were collected from February through May 2008. The sample was 44% African American, 35% American Indian, 10% white, and 11% other/mixed race; 37% were homeless. Rates of "less healthy" food group purchases were higher compared to "healthy" food group purchases. Significant racial differences were found with respect to purchasing healthy protein food groups (Pfood groups, regardless of nutrient density (PFood shelf and food store usage mainly increased the odds of purchasing "less healthy" food groups (Pfood resources within their local food system. Copyright 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Economic aspects of low labour-income farming

NARCIS (Netherlands)

Luning, H.A.

1967-01-01

Conflicting views on the relevance of economic theory, as developed in the West, to low-income peasant societies had been advanced ever since Boeke's time.

Recent literature pointed out that available economic theories did not seem to fit the behavioral motivation, assumed in economic logic. The

Cigarette smoking and food insecurity among low-income families in the United States, 2001.

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Armour, Brian S; Pitts, M Melinda; Lee, Chung-Won

2008-01-01

To quantify the association between food insecurity and smoking among low-income families. A retrospective study using data from the 2001 Panel Study of Income Dynamics (PSID), a longitudinal study of a representative sample of U.S. men, women, and children and the family units in which they reside. Low-income families. Family income was linked with U.S. poverty thresholds to identify 2099 families living near or below 200% of the federal poverty level. Food insecurity (i.e., having insufficient funds to purchase enough food to maintain an active and healthy lifestyle) was calculated from the 18-core-item food security module of the U.S. Department of Agriculture. Current smoking status was determined. Smoking prevalence was higher among low-income families who were food insecure compared with low-income families who were food secure (43.6% vs. 31.9%; p < .01). Multivariate analysis revealed that smoking was associated with an increase in food insecurity of approximately six percentage points (p < .01). Given our finding that families near the federal poverty level spend a large share of their income on cigarettes, perhaps it would be prudent for food-assistance and tobacco-control programs to work together to help low-income people quit smoking.

Sexual Intimacy Constructions of Heterosexual Couples Living in a Low-Income, "Colored," Farmworker Community in South Africa.

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Lesch, Elmien; Adams, Arlene R

2016-01-01

This study has been motivated by the scarcity of research that adopts an unproblematic focus on sexuality in South African Black and Colored low-income communities. We explored the sexual intimacy constructions of 15 Colored married/cohabiting couples who live in a low-income, historical South African farmworker community. Using a social constructionist thematic analysis method, we identified four themes: (a) metaphoric and indirect sexual language; (b) the use of a romantic discourse to talk about sexual experiences; (c) male-centered sexual relationships; and (d) lack of privacy brings both restriction and pleasure. We consider how these themes may be linked to the participants' community context and colonial and apartheid history. Finally, we emphasize the need for research that also explores positive sex functions and experiences rather than focuses narrowly on problematic sexual behavior.

Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance.

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Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M