8 resultados para Social determinants of health

em Digital Commons at Florida International University


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BACKGROUND: The Pro Children Eating Habits Questionnaire has been evaluated as a valid and reliable tool in Europe to measure determinants of fruit and vegetable intake for children; however, it has not been validation for United States populations. The purpose of this study was to (1) assess the reliability and discrimination validity of fruit and vegetable correlates for the Pro Children Eating Habits Questionnaire; (2) investigate the predictive validity of determinants of fruit and vegetable consumption for multi-ethnic elementary school children; and, (3) to assess the association of social determinants with fruit and vegetable consumption. METHODS: One hundred and thirty elementary school students from the 3rd and 5th grades completed this cross-sectional study. RESULTS: Fruit and vegetable determinants, had satisfactory internal consistencies. No differences were found between the test and the retest for the individual questions with the exception of the question for mean perceived vegetable intake. The discriminatory validity indicated the questionnaire could show differences across grade and gender levels for barriers of fruit and vegetables but not for other factors. Grade together with gender explained barriers to eating fruit and vegetables. Greater availability of fruit in the home and school was associated with higher frequency of consumption. CONCLUSIONS: The results of this study indicate the Pro-Children Eating Habits Questionnaire may be a reliable and valid tool for assessing fruit and vegetable consumption of children in the United States.

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Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use.^ The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used.^ Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. ^ This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.^

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Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.

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Federal transportation legislation in effect since 1991 was examined to determine outcomes in two areas: (1) The effect of organizational and fiscal structures on the implementation of multimodal transportation infrastructure, and (2) The effect of multimodal transportation infrastructure on sustainability. Triangulation of methods was employed through qualitative analysis (including key informant interviews, focus groups and case studies), as well as quantitative analysis (including one-sample t-tests, regression analysis and factor analysis). ^ Four hypotheses were directly tested: (1) Regions with consolidated government structures will build more multimodal transportation miles: The results of the qualitative analysis do not lend support while the results of the quantitative findings support this hypothesis, possibly due to differences in the definitions of agencies/jurisdictions between the two methods. (2) Regions in which more locally dedicated or flexed funding is applied to the transportation system will build a greater number of multimodal transportation miles: Both quantitative and qualitative research clearly support this hypothesis. (3) Cooperation and coordination, or, conversely, competition will determine the number of multimodal transportation miles: Participants tended to agree that cooperation, coordination and leadership are imperative to achieving transportation goals and objectives, including targeted multimodal miles, but also stressed the importance of political and financial elements in determining what ultimately will be funded and implemented. (4) The modal outcomes of transportation systems will affect the overall health of a region in terms of sustainability/quality of life indicators: Both the qualitative and the quantitative analyses provide evidence that they do. ^ This study finds that federal legislation has had an effect on the modal outcomes of transportation infrastructure and that there are links between these modal outcomes and the sustainability of a region. It is recommended that agencies further consider consolidation and strengthen cooperation efforts and that fiscal regulations are modified to reflect the problems cited in qualitative analysis. Limitations of this legislation especially include the inability to measure sustainability; several measures are recommended. ^

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The objective of this study was to provide empirical evidence on the effects of relative price uncertainty and political instability on private investment. My effort is expressed in a single-equation model using macroeconomic and socio-political data from eight Latin American countries for the period 1970–1996. Relative price uncertainty is measured by the implied volatility of the exchange rate and political instability is measured by using indicators of social unrest and political violence. ^ I found that, after controlling for other variables, relative price uncertainty and political instability are negatively associated with private investment. Macroeconomic and political stability are key ingredients for the achievement of a strong investment response. This highlights the need to develop the state and build a civil society in which citizens can participate in decision-making and express consent without generating social turmoil. At the same time the government needs to implement structural policies along with relative price adjustments to eliminate excess volatility in price movements in order to provide a stable environment for investment. ^

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Since 1999, Venezuela has experienced a dramatic transformation of its political system with the coming to power of Hugo Chávez and his movement, known in Venezuela as Chavismo. Chávez has dismantled the previous political system and established neo-populist structures that rely on his personal appeal and the close collaboration of the armed forces. Chávez has relied heavily on significant support from the poor and those who felt economically and politically excluded by the “Punto Fijo system.” President Chávez has built an impressive record of electoral victories; winning every electoral contest except one since coming to power in 1999. He continues to receive relatively high levels of support among sectors of Venezuelan society. However, there is evidence of growing discontent with high crime rates, high levels of inflation, and significant corruption in the public administration. Using data from the AmericasBarometer surveys conducted in 2007, 2008 and 2010, this paper seeks to examine the basis of Chávez’s popular support. In general, the AmericasBarometer findings suggest that Venezuelans support for President Chávez is closely linked to the access to social programs and that as long as the government is able to fund these social programs or missions, particularly MERCAL and Barrio Adentro, it will possess an important tool to garner and sustain support for President Chávez. Our analysis, however, also indicates that evaluations of the national economic situation, more than crime or insecurity, are a key factor that could undermine support for the regime.

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The prevalence of waterpipe smoking exceeds that of cigarettes among adolescents in the Middle East where waterpipe is believed as less harmful, less addictive and can be a safer alternative to cigarettes. This dissertation tested the gateway hypothesis that waterpipe can provide a bridge to initiate cigarette smoking, identified the predictors of cigarette smoking progression, and identified predictors of waterpipe smoking progression among a school-based sample of Jordanian adolescents (mean age ± SD) (12.7 ±0.61) years at baseline. Data for this research have been drawn from Irbid Longitudinal Study of smoking behavior, Jordan (2008-2011). The grouped-time survival analysis showed that waterpipe smoking was associated with a higher risk of cigarette smoking initiation compared to never smokers (P < 0.001) and this association was dose dependent (P < 0.001). Predictors of cigarette smoking progression were peer smoking and attending public schools for boys, siblings’ smoking for girls, and the urge to smoke for both genders. Predictors of waterpipe smoking progression were enrollment in public schools, frequent physical activity, and low refusal self-efficacy for boys, ever smoking cigarettes, friends’ and siblings’ waterpipe smoking for girls. Awareness of harms of waterpipe among boys and seeing warning labels on the tobacco packs by girls were protective against waterpipe smoking progression. In Conclusion, waterpipe can serve as a gateway to cigarette smoking initiation among adolescents. Waterpipe and cigarette smoking progressions among initiators were solely family-related among girls, and mainly peer-related among boys. The unique gender differences for both cigarette and waterpipe smoking among Jordanian adolescents in Irbid call for cultural and gender-specific smoking prevention interventions to prevent the progression of smoking among initiators.

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The purpose of this study was to investigate the role of hardiness in health perception and psychosocial adaptation in adult hispanics with chronic hepatitis C (n = 32). The Health Related Hardiness Scale and the Psychosocial Adaptation to Illness Scale were administered to 32 adult hispanics diagnosed with chronic heptitis C at a gastroenterology center. The results indicate that a comparison of subjects with low and high hardiness scores did not reveal significant differences on any of the PAIS domains (health care orientation, sexual relationships, psychological distress, vocational, domestic and social environments). Furthermore, hardiness subscales of control and committment did not have any influence on patient's psychosocial adaptation nor in its domains. However, a comparison of subjects with low and high challenge scores indicates that those with low challenge had lower total psychosocial adaptation scores (M = 5.55, SD = 2.13) than subjects with high challenge scores (M = 4.24, SD = .67) ,t = (1, 30) = 2.34, p < 0.05. Differences were also found for the domains of health care orientation, psychological distress, social and vocational environment. Lastly, there were significant differences on perceived health rating (poor, fair, and good) for the total hardiness score (F = (2,29) =5.49, p < 0.05), control (F =(2,29) = 4.09, p < 0.05), committment (F=(2,29) = 3.76, p < 0.05) and challenge (F=(2,29)= 4.92, p < 0.05). Thus, those patients who rated their health as poor had lower hardiness levels. Findings have implications for promoting hardiness for better health perception and in certain aspects of psychosocial adaptations in adult hispanics with chronic hepatitis C.