Discrimination and Depression among Urban Hispanics with Poorly Controlled Diabetes.

Objectives: We had three objectives for our study: 1) to describe the prevalence and burden of experiences of discrimination among Hispanics with poorly controlled diabetes; 2) to evaluate associations among discrimination experiences and their burden with comorbid depression among Hispanics with poorly controlled diabetes; and 3) to evaluate whether discrimination encountered in the health care context itself was associated with comorbid depression for Hispanic adults with diabetes.

Design: We conducted a cross-sectional analysis of baseline data of a randomized controlled trial (RCT).

Setting: We collected data in the context of an RCT in a clinical setting in New York City.

Female health workers at the doorstep: a pilot of community-based maternal, newborn, and child health service delivery in northern Nigeria.

Introduction: Nigeria has one of the highest maternal mortality ratios in the world. Poor health outcomes are linked to weak health infrastructure, barriers to service access, and consequent low rates of service utilization. In the northern state of Jigawa, a pilot study was conducted to explore the feasibility of deploying resident female Community Health Extension Workers (CHEWs) to rural areas to provide essential maternal, newborn, and child health services.

Community Health Worker Interventions to Improve Glycemic Control in People with Diabetes: A Systematic Review and Meta-Analysis.

Objectives: We set out to review the efficacy of Community Health Worker (CHW) interventions to improve glycemia in people with diabetes.

Methods: Data sources included the Cochrane Central Register of Controlled Trials, Medline, clinicaltrials.gov, Google Scholar, and reference lists of previous publications.

Registry-linked electronic influenza vaccine provider reminders: a cluster-crossover trial.

Objective: To determine the impact of a vaccination reminder in an electronic health record supplemented with data from an immunization information system (IIS).

Methods: A noninterruptive influenza vaccination reminder, based on a real-time query of hospital and city IIS, was used at 4 urban, academically affiliated clinics serving a low-income population. Using a randomized cluster-crossover design, each study site had "on" and "off" period during the fall and winter of 2011-2012.

Health & demographic surveillance system profile: the Nahuche Health and Demographic Surveillance System, Northern Nigeria (Nahuche HDSS).

The Nahuche Health and Demographic Surveillance System (HDSS) study site, established in 2009 with 137 823 individuals is located in Zamfara State, north western Nigeria. North-West Nigeria is a region with one of the worst maternal and child health indicators in Nigeria. For example, the 2013 Nigeria Demographic and Health Survey estimated an under-five mortality rate of 185 deaths per 1000 live births for the north-west geo-political zone compared with a national average of 128 deaths per 1000 live births.

Reinvigorating health systems and community-based services to improve maternal health outcomes: case study from northern Nigeria.

Background: Maternal health outcomes in Nigeria, the most populous African nation, are among the worst in the world, and urgent efforts to improve the situation are critical as the deadline (2015) for achieving the Millennium Development Goals draws near.

Objective: To evaluate the results of an integrated maternal, newborn, and child health (MNCH) program to improve maternal health outcomes in Northern Nigeria.

Design: The intervention model integrated critical health system and community-based improvements aimed at encouraging sustainable MNCH behavior change.

Lessons learned from setting up the Nahuche Health and Demographic Surveillance System in the resource-constrained context of northern Nigeria.

Background: The present time reflects a period of intense effort to get the most out of public health interventions, with an emphasis on health systems reform and implementation research. Population health approaches to determine which combinations are better at achieving the goals of improved health and well-being are needed to provide a ready response to the need for timely and real-world piloting of promising interventions.

Objective: This paper describes the steps needed to establish a population health surveillance site in order to share the lessons learned from our experience launching the Nahuche Health and Demographic Surveillance System (HDSS) in a relatively isolated, rural district in Zamfara, northern Nigeria, where strict Muslim observance of gender separation and seclusion of women must be respected by any survey operation.

Failure to return: parental, practice, and social factors affecting missed immunization visits for urban children.

Objective: To assess parental, practice, and social factors associated with missed immunization visits by young, urban children.

Study Design: Parents of children ≤ 36 months(n = 705) were surveyed. The primary outcome was missed immunization visit, by parental report.

Awareness, use, and unmet need for family planning in rural northern Nigeria.

Access to quality reproductive health and family planning services remain poor in Nigeria. We present results on family planning awareness and use from a survey of 3,080 women (age 15-49 years) in Jigawa, Katsina, Yobe, and Zamfara States. About 43.

High rates of depressive symptoms in low-income urban Hispanics of Caribbean origin with poorly controlled diabetes: correlates and risk factors.

Little is known about diabetes and depression in disadvantaged urban Hispanic subgroups, particularly those of Caribbean origin. Using data from 360 urban Hispanics of Caribbean origin with poorly controlled diabetes, our objectives were to examine the prevalence and correlates of depressive symptoms and depression using the Euro-D, and the association of depressive symptoms and depression with diabetes self-management and clinical parameters of diabetes control, employing multivariate analyses. The prevalence of depression was 52.

Results of the northern Manhattan diabetes community outreach project: a randomized trial studying a community health worker intervention to improve diabetes care in Hispanic adults.

OBJECTIVE The Northern Manhattan Diabetes Community Outreach Project evaluated whether a community health worker (CHW) intervention improved clinically relevant markers of diabetes care in adult Hispanics. RESEARCH DESIGN AND METHODS Participants were adult Hispanics, ages 35-70 years, with recent hemoglobin A1c (A1C) ≥8% (≥64 mmol/mol), from a university-affiliated network of primary care practices in northern Manhattan (New York City, NY). They were randomized to a 12-month CHW intervention (n = 181), or enhanced usual care (educational materials mailed at 4-month intervals, preceded by phone calls, n = 179).

Comparison of high- versus low-intensity community health worker intervention to promote newborn and child health in Northern Nigeria.

Background: In Northern Nigeria, infant mortality rates are two to three times higher than in the southern states, and, in 2008, a partnership program to improve maternal, newborn, and child health was established to reduce infant and child mortality in three Northern Nigeria states. The program intervention zones received government-supported health services plus integrated interventions at primary health care posts and development of community-based service delivery (CBSD) with a network of community volunteers and community health workers (CHWs), who focus on educating women about danger signs for themselves and their infants and promoting appropriate responses to the observation of those danger signs, consistent with the approach of the World Health Organization Integrated Management of Neonatal and Childhood Illness strategy. Before going to scale in the rest of the state, it is important to identify the relative effectiveness of the low-intensity volunteer approach versus the more intensive CBSD approach with CHWs.

Early results of an integrated maternal, newborn, and child health program, Northern Nigeria, 2009 to 2011.

Background: This paper describes early results of an integrated maternal, newborn, and child health (MNCH) program in Northern Nigeria where child mortality rates are two to three times higher than in the southern states. The intervention model integrated critical health systems changes needed to reinvigorate MNCH health services, together with community-based activities aimed at mobilizing and enabling women to make changes in their MNCH practices. Control Local Government Areas received less-intense statewide policy changes.

Awareness of critical danger signs of pregnancy and delivery, preparations for delivery, and utilization of skilled birth attendants in Nigeria.

Maternal mortality in northern Nigeria is among the highest in the world. To understand better the pathways through which the socio-demographic environment affects awareness of obstetric danger signs (i.e.

Building a consensus on community health workers' scope of practice: lessons from New York.

Objectives: We evaluated efforts in New York to build a consensus between community health workers (CHWs) and employers on CHWs' scope of practice, training standards, and certification procedures.

Methods: We conducted multiple-choice surveys in 2008 and 2010 with 226 CHWs and 44 employers. We compared CHWs' and employers' recommendations regarding 28 scope of practice elements.

Using community-based research to shape the design and delivery of maternal health services in Northern Nigeria.

Maternal mortality ratios in northern Nigeria are among the worst in the world, over 1,000 per 100,000 live births in 2008, with a very low level and quality of maternity services. In 2009, we carried out a study of the reasons for low utilisation of antenatal and delivery care among women with recent pregnancies, and the socio-cultural beliefs and practices that influenced them. The study included a quantitative survey of 6,882 married women, 119 interviews and 95 focus group discussions with community and local government leaders, traditional birth attendants, women who had attended maternity services and health care providers.

Factors related to weight loss attempt among Dominican immigrants.

To assess weight loss attempt among a Latino immigrant population from the Dominican Republic we analyzed data on 585 overweight and obese Dominicans from a cross-sectional survey using Chi-square statistics, Student's t-tests, and logistic regression models. We found 58% of the overweight and obese tried to lose weight. Female gender (OR 2.

Maternal mortality in northern Nigeria: findings of a health and demographic surveillance system in Zamfara State, Nigeria.

The aim of this study was to estimate: (1) the lifetime risk (LTR) of maternal death; and (2) the maternal mortality ratio (MMR) in the Zamfara State of northern Nigeria. Data from the Nahuche Health and Demographic Surveillance System were utilized using the 'sisterhood method' for estimating maternal mortality. Female respondents (15-49 years) from six districts in the surveillance area were interviewed, creating a retrospective cohort of their sisters who had reached the reproductive age of 15 years.

Determinants of influenza vaccination among young children in an inner-city community.

Few studies have examined potential factors that contribute to low influenza vaccination rates among minority children. This study aimed to assess the prevalence of early childhood influenza vaccination among young black and Latino children, living in inner-city neighborhoods, and examine the effects of child, caregiver and health system factors. Secondary data analysis was performed using a survey about medical home experiences conducted from May 2007-June 2008.

A community-based strategy for improving asthma management and outcomes for preschoolers.

Although almost one in ten (8.6%) preschool children has been diagnosed with asthma, few asthma management programs are designed for parents of preschool children. The Asthma Basics for Children program addressed this need in 2003-2008 by implementing a multi-layered approach that offered educational activities to center staff, parents, and children and PACE training to physicians in 31 Northern Manhattan daycare centers.

FluAlert: a qualitative evaluation of providers' desired characteristics and concerns regarding computerized influenza vaccination alerts.

Objective: To explore pediatric providers' perceived barriers to influenza vaccine delivery, and desired characteristics and potential concerns regarding an influenza vaccine alert integrated into the electronic health record (EHR).

Methods: Four focus groups with providers (n=21) and five individual interviews with practice leaders in an urban, pediatric primary care network affiliated with an academic medical center in New York City were conducted. Data were collected during the 2009-10 influenza season and analyzed using thematic analysis.

Hemoglobin A(₁c) criterion for diabetes diagnosis among Hispanic and non-Hispanic populations.

Objective: To report on the performance of the recently recommended hemoglobin A(₁c) (A1C) criterion for diabetes diagnosis in comparison with the standard fasting plasma glucose and 2-hour post-glucose challenge (PG) test criteria across racial and ethnic groups.

Methods: We evaluated local and national survey data from 689 Dominican, 4,862 Hispanic, 4,694 African American, and 6,883 white study subjects. We compared rates of diabetes classification by diagnostic criteria, agreement and disagreement between A1C and PG criteria for diagnosing diabetes, and differences in cardiometabolic risk among the 3 diagnostic groups across racial and ethnic stratifications.

Change in parental reasons for use of an urban pediatric emergency department in the past decade.

Objective: To assess changes over the past decade in parental reasons associated with nonurgent visits to pediatric emergency departments (PEDs) during regular primary care office hours.

Methods: Secondary analysis of cross-sectional surveys of families of children younger than 3 years visiting a PED in a low-socioeconomic area in New York City conducted in 1997 and 2006. We performed multivariable analyses to assess differences in parental reported reasons for PED use over the period, controlling for sociodemographic factors.

Effective strategies for integrating immunization promotion into community programs.

Most immunization coalitions have originated with health care providers, potentially excluding families without medical homes. This study focused on a community-based approach to providing timely vaccinations. A coalition of 23 organizations developed an immunization program in a low-income community in New York City.