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Cover page of Reducing Information Inequality: A Participatory Intervention in a Rural, Diverse Community

Reducing Information Inequality: A Participatory Intervention in a Rural, Diverse Community

(2021)

Background: CDC-funded Partnerships to Improve Community Health (PICH) is a collaborative of over 40 community organizations working together to create a culture of health in Merced County. Underlying the policies, systems, and environmental approach that guided PICH projects is a comprehensive communication plan. As part of that plan, formative evaluation conducted at the start of the project found that residents and community organizations identified a weak information infrastructure as a major barrier to health: Residents struggle to find timely, relevant information that can help them improve their health, while stakeholders face challenges knowing how to reach diverse audiences with critical health-related information.

Aim: In this manuscript, I describe the process of conducting a participatory health communication intervention designed to address issues identified in communication infrastructure. The process includes adaptation of this method and intervention, developed in urban Los Angeles, to the rural context of Merced County.

Methods: Participatory health communication asset mapping (PHCAM), a method and intervention, was used to identify structures (safe, trusted spaces that serve distinct health communication needs: Informational, conversational, connection).

Development: A six-step process in which community leaders/residents identify & validate communication structures.

Implementation: Successful implementation of the map will be indicated from its use by (1) organizations (to disseminate information) and (2) residents (to obtain information). For the first, potential uses of the map were demonstrated at a convening with all partners, followed by one-on-one training and toolkit dissemination. To promote community knowledge/use, multiple resident convenings will be held at sites on the map.

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Understanding Smoking Preferences: Results from a Discrete Choice Experiment Amongst U.S. Adults

(2021)

E-cigarette (vaping) use has increased dramatically in recent years. While switching to vaping might benefit cigarette smokers, there is a risk of increased use by nonsmokers. Adults (N=525) aged 18 to 88 years made choices between two alternatives that differed in policy-relevant characteristics. Nonsmokers preferred e-cigarettes over all other tobacco products (WTP $1.34). Nonsmokers showed a strong aversion to the addictiveness of the products and long-term health risks. Light and heavy smokers differed in their attitudes toward health risks, with heavy smokers being relatively unsensitive to long-term health risks compared to light smokers. Cost was a particularly important factor for nonsmokers. Marginal analysis suggests smokers were relatively unsensitive to price increases alone. Vaping is attractive for nonsmokers when they perceived health risks are low, suggesting that behavior change campaigns should focus on the health risks. Results also suggest that it may be difficult to get smokers to shift to vaping.

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Cover page of  Education and Life’s Simple 7: An evaluation of differential returns by sex, race, and childhood socioeconomic status

 Education and Life’s Simple 7: An evaluation of differential returns by sex, race, and childhood socioeconomic status

(2021)

Few studies have examined whether the benefits of education for health differ across sociodemographic subgroups. We investigated whether educational attainment is associated with cardiovascular health, as measured by the Life’s Simple 7 (LS7) score, and whether the association differs by demographic characteristics. Data were obtained from the REasons for Geographic and Racial Differences in Stroke study (N=8,759 participants; mean age=63.8).

We used linear regression analyses with interactions by sex, race, childhood socioeconomic status (SES), and geography. Socially vulnerable groups (i.e., men from low childhood SES backgrounds, White people from low childhood SES backgrounds, Black people from low childhood SES backgrounds) benefitted less from each additional year of education than socially advantaged groups in predicting LS7 scores. However, we did not find evidence that differential returns extended to every group. Findings suggest that the inequalities present in the education system may further exacerbate the gap between advantaged and disadvantaged.

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Cover page of Determinants of Health Provider Advice for Tobacco Cessation and Sugar-Sweetened Beverage Intake in Stanislaus and Madera Counties. A Patient Perspective Study.

Determinants of Health Provider Advice for Tobacco Cessation and Sugar-Sweetened Beverage Intake in Stanislaus and Madera Counties. A Patient Perspective Study.

(2021)

Background: Oral health is an essential aspect of overall health. A national epidemic of poor oral health outcomes exists among those living under poverty, the elderly and several minority groups. Tobacco use and consumption of sugar-sweetened beverages (SSB) are preventable risk factors that contribute to poor oral health. Dental providers are considered a primary line of defense to deliver tobacco cessation and SSB consumption interventions. This study seeks to examine the prevalence and predictors of receiving such interventions in the dental setting in two counties in California’s Central Valley.

Methods:  Data for 419 participants used in this cross-sectional study were collected throughout Madera and Stanislaus counties. Sociodemographic and dental health characteristics were used to examine their effect on the receipt of advice about tobacco cessation and the consumption of SSBs by a dental provider. A series of logistic regression models were constructed to define what characteristics influenced the odds of receipt of advice in such setting.

Results: Among the overall total of participants included in this analysis, 32% indicated the receipt of advice about tobacco cessation while 53% indicated the receipt of SSB advice by their dental health provider. Measures such as teeth appearance satisfaction, employment, and county of residence had significant effects on the odds of the receipt of tobacco cessation advice. While measures for perception of the importance of preventative visits to the dentist, dental appearance satisfaction, reason for dental visit, tooth flossing frequency, Denti-Cal insurance and being 65 years or older were significant in predicting the odds of receiving SSB consumption advice.

Conclusion:  There is a need of implementing system changes within the dental practice to ensure that all patients get tobacco and SSB related interventions.