Homelessness History Impacts on Health Outcomes and Economic and Risk Behavior Intermediaries: New Insights from Population Data.

Using data from the Washington Behavioral Risk Factor Surveillance System, this study assesses the relationship between homelessness history and physical and mental health outcomes as well as between homelessness history and health risk behaviors and economic precariousness as important intermediaries of subsequent health outcomes. Study results indicate that persons with a history of adult homelessness have consistently poorer health outcomes as compared to never homeless persons, and that even after accounting for childhood adversity and social assets, adult homelessness remains a consistent and strong predictor of poor health. These findings indicate that adult homelessness is a key component in understanding cumulative risk and vulnerability.

Engaging in secondhand smoke reduction discussions with parents of hospitalized pediatric patients: a national survey of pediatric nurses in the United States.

Objective: To identify individual- and system-level predictors and barriers associated with US pediatric nurses' routine counseling about child secondhand smoke exposure for parents of hospitalized children.

Methods: In 2008, members of the Society of Pediatric Nurses completed a questionnaire assessing demographic, hospital systems, and work attitudes related to the following outcomes: asking about child secondhand smoke exposure, informing about sources of secondhand smoke exposure, counseling about the dangers of secondhand smoke exposure, and advising a smoke-free home policy.

Results: Of 1475 eligible nurses, 888 completed the survey.

The teachable moment captured: a framework for nurse-led smoking cessation interventions for parents of hospitalized children.

This article explores the topic of smoking cessation counseling for parents in the context of pediatric hospitalization. Teachable moments, a widely used concept in the literature, uses three key concepts including perception of risk, emotional response, and self-concept to precipitate change (McBride, Health Education Research, 18 [McBride, 2003], 156-170). The interweaving of these concepts with institutional systems; clinically trained personnel; parental smoking considerations; parent presence; and external supports, or collectively the novel idea of the "capturable moment", may allow for an increased rate of parental smoking cessation.

The Boston Health Care for the Homeless Program: a public health framework.

During the past 25 years, the Boston Health Care for the Homeless Program has evolved into a service model embodying the core functions and essential services of public health. Each year the program provides integrated medical, behavioral, and oral health care, as well as preventive services, to more than 11 000 homeless people. Services are delivered in clinics located in 2 teaching hospitals, 80 shelters and soup kitchens, and an innovative 104-bed medical respite unit.

Translating research evidence into practice to reduce health disparities: a social determinants approach.

Translating research evidence to reduce health disparities has emerged as a global priority. The 2008 World Health Organization Commission on Social Determinants of Health recently urged that gaps in health attributable to political, social, and economic factors should be closed in a generation. Achieving this goal requires a social determinants approach to create public health systems that translate efficacy documented by research into effectiveness in the community.