Biomedical subjects

Deborah Parra-Medina

Publications and source records attributed to Deborah Parra-Medina.

10 recordsLinked to original sources

PubMed2006

Factors influencing help-seeking from informal networks among African American victims of intimate partner violence.

The purpose of this study was to gain an understanding of the challenges African-American women in abusive relationships face when they consider seeking-help from their informal networks. Data are reported from interviews with 15 African-American women who were self-identified as having survived physical intimate partner violence. A 13-item, semi-structured interview guide was developed in order to elicit information from participants. All of the interviews were audio-recorded, transcribed, and coded for analysis. This analysis revealed emergent themes from these interviews concerning the social factors and perceptions that influence help-seeking behavior. Participants perceived their informal networks as willing to offer instrumental support. However, informal networks were not emotionally supportive. Participants also noted that the African-American community at-large believes victims of violence to be "stupid" for remaining in violent relationships. Additional results are also discussed. Results may be used to help enhance efforts to reduce the rates of intimate partner violence among African-Americans.

Adult↗

PubMed2004

Successful recruitment and retention strategies for a randomized weight management trial for people with diabetes living in rural, medically underserved counties of South Carolina: the POWER study.

We evaluated the feasibility of recruiting overweight adults with diabetes, living in rural, medically underserved communities, to a weight management intervention consisting of a 12-month clinical trial of two weight management programs and usual care. The sampling frame consisted of adults ages 45 years and older with clinically diagnosed diabetes from two community health centers. The recruitment process included medical record review, prescreening telephone call, two screening visits, and a randomization visit. Over 1,400 medical records were reviewed; 78.6% met eligibility criteria; 60.1% were contacted for telephone prescreening, and 35.5% remained eligible and were interested in participating. Of these, 187 completed visit 1, 164 completed visit 2, and 143 were randomized. Forty-six people were randomized who entered the study as walk-ins at screening visit 1, resulting in 189 subjects. The final yield was 21.5%. Subject mean age was 60.4 years, mean body mass index was 36.4 kg/m(2), 80% were African-American, and 46.6% had less than a high school education. Retention at 12 months was 81.5%. Successful strategies included partnering with community health centers, positive reinforcement and social supportiveness, monitoring progress, and free transportation. This work provides a useful example of an academic-community partnership designed to reach groups previously considered hard to reach.

Black or African American↗

PubMed2004

A replicable process for redesigning ethnically relevant educational materials.

BACKGROUND: To serve the populations targeted by Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) effectively, healthcare providers need educational materials that are evidence based and ethnically relevant and can be easily incorporated into busy clinic settings. We describe a replicable process used to redesign and tailor physical activity and diet education materials for African American women in the southeastern United States. METHODS: The process consists of seven phases. Quantitative and qualitative analyses were used on data gathered in 2000 from two expert panels and eight focus groups. RESULTS: Expert panelists preferred materials perceived to be high quality, easy to understand, organized to facilitate use by healthcare providers, and with content relevant to African American women. Focus group participants were mostly concerned with the visual appeal and content of educational materials. They liked high-quality materials that are brief; avoid jargon and use simple language, bright colors, and photographs; and provide useful information that acknowledges the context of their lives, including their family roles. CONCLUSIONS: The redesign process can produce ethnically and culturally appropriate educational materials for use by WISEWOMAN providers and other healthcare providers in conjunction with cardiovascular (CVD) risk reduction and behavioral counseling. To be effective, materials must address the needs and concerns of both providers and patients.

Black or African American↗

PubMed2004

Pounds off with empowerment (POWER): a clinical trial of weight management strategies for black and white adults with diabetes who live in medically underserved rural communities.

OBJECTIVES: We evaluated lifestyle interventions for diabetic persons who live in rural communities. METHODS: We conducted a 12-month randomized clinical trial (n = 152) of "intensive-lifestyle" (modeled after the NIH Diabetes Prevention Program) and "reimbursable-lifestyle" (intensive-lifestyle intervention delivered in the time allotted for Medicare reimbursement for diabetes education related to nutrition and physical activity) interventions with usual care as a control. RESULTS: Modest weight loss occurred by 6 months among intensive-lifestyle participants and was greater than the weight loss among usual-care participants (2.6 kg vs 0.4 kg, P<.01). At 12 months, a greater proportion of intensive-lifestyle participants had lost 2 kg or more than usual-care participants (49% vs 25%, P<.05). No differences in weight change were observed between reimbursable-lifestyle and usual-care participants. Glycated hemoglobin was reduced among all groups (P<.05) but was not different between groups. CONCLUSIONS: Improvement in both weight and glycemia was attainable by lifestyle interventions designed for persons who had type 2 diabetes and lived in rural communities.

Black or African American↗

PubMed2003

Evaluation of statewide teen pregnancy prevention initiatives: challenges, methods, and lessons learned.

Evaluation of community-based, teen pregnancy prevention initiatives is complex. This article describes the challenges encountered and solutions derived while creating a comprehensive evaluation of teen pregnancy prevention initiatives across 46 counties in a southeastern state. Background information on the evaluation and highlights of the data collection constructs, methods, and tools are provided. In particular, the efforts to appropriately scope the evaluation activities and the use of qualitative and quantitative methods are discussed. In addition, the key lessons learned from the evaluation are presented. This article's discussion of contextual influences and evaluation planning and implementation efforts may benefit program practitioners and evaluators in their future evaluation activities.

Adolescent↗

PubMed2003

The Program Plan Index: an evaluation tool for assessing the quality of adolescent pregnancy prevention program plans.

To assess process, impacts, and outcomes among 45 distinct county teen pregnancy prevention initiatives, several standardized data collection procedures, instruments, and protocols were developed including the Program Plan Index (PPI). The PPI was developed to determine if program plans met legislative requirements and were consistent with best practices in public health program planning and teen pregnancy prevention. Analysis of proposals from 45 counties revealed that 12 county plans were evaluated as deficient, 14 as low, 14 as acceptable, 4 as good, and 1 as excellent. Explanations for overall performance included the following: criteria used to develop the PPI based on an in-depth understanding of best practices, variations in the criteria for county request for proposals, lack of prevention expertise at the local level, and minimal time for grantees to draw down funds. Statewide efforts to improve funded community-based teen pregnancy prevention planning, implementation, and empowerment evaluation efforts are ongoing.

Adolescent↗

PubMed2002

Tobacco and alcohol use-prevention program for Hispanic migrant adolescents.

OBJECTIVE: Evaluate a community-based tobacco/alcohol use-prevention program group compared with an attention-control condition (first aid/home safety) group. METHODS: A total of 660 adolescents and 1 adult caregiver for each were recruited through the Migrant Education Program to participate in an 8-week intervention. Random assignment to the two groups occurred in 22 schools. Seventy 8-week intervention groups (37 tobacco/alcohol and 33 attention-control) were conducted. Assessments occurred at baseline, immediate post-intervention, and 1- and 2-year follow-ups. Susceptibility to smoking and alcohol as well as smoking and drinking over the past 30 days were the primary outcomes of interest. RESULTS: Following intervention, no between-group differences in smoking or drinking were significant. Thirty-day smoking started and remained at very low levels, with the highest group prevalence at any measurement period being 4.7% and the lowest 2.5%. Those considered susceptible to smoking dropped by nearly 40% in the attention-control group and by 50% in the intervention group from baseline to the final follow-up. (The overall reduction from post-test to final follow-up was statistically significant.) Less-acculturated children were less likely to report drinking in the past 30 days. CONCLUSIONS: The current intervention was not demonstrated to be effective in preventing cigarette or alcohol consumption. This perhaps is due to very low baseline levels of smoking and drinking in the migrant youth participants.

Adolescent↗

PubMedDate not supplied

Adult roles in community-based youth empowerment programs: implications for best practices.

Current literature on community-based youth empowerment programs provides few specific operational descriptions of adult roles. This research addressed that gap by exploring the perspectives and experiences of adults actively engaged with youth empowerment programs. Data were gathered through in-depth interviews, field observations, and interactive group discussions with adult program leaders. The following dimensions of adults' work were identified: putting youth first; raising the bar for youth performance; creating the space and making things happen; being in relationships; exerting influence, control, and authority; and communicating and connecting with the broader community. These findings provide guidance for the development of best practices in community-based youth empowerment programs.

Adolescent↗

PubMedDate not supplied

Covariations of adolescent weight-control, health-risk and health-promoting behaviors.

OBJECTIVES: To assess the prevalence of dieting and investigate clusters of risk behaviors among adolescents. METHODS: Data were secured from a random sample of adolescents (4,636) and analyzed using bivariate methods and logistic regression. RESULTS: From the survey sample, 19.2% adolescents were classified as extreme, 43.2% as moderate dieters, 37.2% as nondieters. Extreme dieters were more likely to use alcohol, cigarettes, and/or marijuana and to attempt suicide and less likely to practice vigorous exercise. Moderate dieters were less likely to use cigarettes, marijuana and more likely to engage in vigorous exercise, with differences across gender-race categories. CONCLUSIONS: Results have relevance for developing multicomponent programs for adolescents.

Adolescent↗

PubMedDate not supplied

Predicting adolescent risk behaviors based on an ecological framework and assets.

OBJECTIVES: To examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years. METHODS: Linear regression models for African American and white males and females predicted an aggregate risk score. RESULTS: After adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive. CONCLUSIONS: Taking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors.

Adolescent↗