Abstract
Non-responsive feeding practices and risk of overweight and obesity among Chinese immigrant children: A systematic review
Ana Cristina Lindsay, DDS, MPH, DrPH1 and Qun Le, BSN2
(1)Harvard T.H. Chan School of Public Health, Boston, RI, (2)University of Massachusetts Boston, Boston, MA
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Childhood obesity is a significant global public health problem. Ethnic origins of minority populations imply differences in an array of culturally mediated variables that are potentially relevant to obesity prevention. Chinese comprise a fast-growing immigrant population group in several countries around the world including the United States, Canada and Australia. As childhood is a crucial period for the development of lifelong lasting eating habits, information on factors influencing parental feeding practices of immigrant Chinese parents related to risk of overweight and obesity is needed. The objectives of this systematic review were to: (1) identify and summarize findings from existing studies examining associations between parental feeding practices and risk of overweight and obesity amongChinese immigrant children aged 2–12 years, and (2) generate suggestions for future research.
Methods: Following guidelines by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) we searched selected academic databases to identify and summarize findings of studies assessing the relationship between parental feeding practices and risk of child overweight and obesity among Chinese immigrant children aged 2-12. Study eligibility included being peer-reviewed, published in English between January 2000 and November 2017. We initially identified 877 articles, of which nine met all the inclusion criteria and were selected for final review.
Results: Findings revealed several non-responsive parental feeding practices including controlling and monitoring of child’s food intake, pressure to eat, weight-based food restriction associated with increased risk of overweight and obesity among Chinese immigrant children.
Conclusions: Parental feeding practices play an important role in the risk of child overweight and obesity among immigrant Chinese children. Preventing and controlling childhood obesity among minority population groups such as Chinese immigrants will require multifaceted and community-wide programs and policies that are tailored to the socio-cultural needs of this population, with parents having a critical role to play.
Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences
Abstract
Water- health nexus in urban Managua, Nicaragua
Jessica Alicea Planas, PhD, RN, MPH, CHES1 and William Vazquez, PhD2
(1)Fairfield University, Fairfield, CT, (2)Fairfield University, Fairfield
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Purpose: Roughly 85% of Nicaraguans have access to improved drinking water but only 52% are using improved sanitation facilities (PAHO, 2104). Nueva Vida is a community located on the outskirts of urban Managua where many continue to lack basic sanitation and clean water infrastructure. The community (over 1700 households and 8,000 inhabitants) struggles with lack of a sewerage system, poor drainage and proximity to a municipal dump. In this context of extreme poverty, we investigated household behaviors, perceptions, and preferences related to water and sanitation and perceived health consequences. Methods: An interdisciplinary team of researchers (US and Nicaragua) designed a survey based on semi-structured interviews with residents, conversations with staff of a local NGOs, and field observations. The final questionnaire had a total of 38 multi-part questions. Results: The survey was administered via in-person interviews to a geographically-stratified random sample of 398 Nueva Vida households in 2016. While the majority (71%) felt that it was safer to drink some form of treated water, 92% drink unpurified water straight from the tap. Households identified mosquito-borne illnesses (e.g. Chikungunya, Dengue) and gastrointestinal issues (like diarrhea, stomach aches) as problematic over the last year, and 95% of the sample felt that the puddling of water (due to lack of drainage) was the main cause of health issues. 63% preferred to hear health information from a doctor and 62% would not use the internet to seek health information. Implications: These data will inform future health promotion interventions for this marginalized community, like cost-effective ways to prevent mosquito breeding and helped to identify the most appropriate means for communicating health information.
Planning of health education strategies, interventions, and programs Public health or related education Public health or related nursing
Abstract
Association between substance abuse and concurrent sexual relationships among urban slum dwellers in Kenya
Dawit Woldu, PhD1, Zelalem Haile, PhD, MPH2, Steve Howard, PhD3, Aggrey Otieno, MA4, Christine Walther, PhD5 and Bennet Lado, MA3
(1)University of Houston, Houston, TX, (2)Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, (3)Ohio University, Athens, OH, (4)Pambazukomashinani, Nairobi, Kenya, (5)University of Houston-Clear Lake, Houston, TX
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Introduction: Health outcomes associated with concurrent sexual partnership and substance abuse are well established. However, there is a dearth of literature examining the context in which substance abuse influences concurrent sexual relationships among urban slum dwellers. This study examines the association between substance abuse and concurrent sexual relationships in one of the largest urban slums in Kenya.
Methods: This study utilized a mixed methods design. The qualitative component utilized free listing, semi-structured interviews (N=53), and focus group discussions to address community perspectives and perceptions on substance abuse and concurrent sexual relationships. The quantitative component of the study examined the association between substance abuse and concurrent sexual relationships using multivariable regression models using data from a convenience sample of informants (N=509).
Results: Findings from free list analysis produced 29 types of substances currently used in the community, of which 12 substances have a significant salience index. Focus group and semi-structured interviews revealed that substance abuse contributes to concurrent sexual relationships because of the economic and social capital it holds in this community. In the structured survey, approximately 82.6% reported ever having concurrent relationships and 70.2% reported using substance in the past three months. Greater proportion of participants who reported using substance in the past three month reported ever having concurrent relationship (86.2% vs. 74.0%; p=0.002). In the multivariable model, substance abuse in the past three months was positively associated with ever having concurrent relationships, independent of potential confounders such as such as age, sex, marital status, education, socioeconomic status, employment status and access to information odds ratio, 95% confidence interval 2.51(1.37–4.59; p=0.003).
Conclusion: In highly impoverished and socially marginalized settings substance abuse may be a driving force to establishing concurrent sexual relationships. Findings highlight the need for context specific prevention strategies to reduce substance abuse and concurrent sexual relationships.
Diversity and culture Epidemiology Provision of health care to the public Public health or related education Public health or related research Social and behavioral sciences
Abstract
Assessing the Physical Characteristics of Slums: Pilot Testing a Slum Rating Scale in 5 Communities across Kampala, Uganda
Monica H. Swahn, PhD1, Rogers Kasirye, MA2, Charles Chandia and Malikah Waajid, Graduate Research Assistant1
(1)Georgia State University, Atlanta, GA, (2)Uganda Youth Development Link, Kampala, Uganda
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Introduction: Residents in the slums of Kampala, Uganda have been recognized to have a high prevalence of health-risk behaviors and adverse health outcomes. Research has also demonstrated large community variations in specific health behaviors and outcomes. We developed and pilot tested a new slum rating scale to differentiate the characteristics of the physical environment across slums in Kampala to better understand community health needs and to assist in service provision.
Methods: Environmental assessments were conducted in 2015 across five of the largest Kampala Slums (i.e., Bwaise, Kamwokya, Makindye, Nakulabye, Nateete) by a trained team of four community members. The target area for each assessment was based on the locations of the Uganda Youth Development Link operated drop-in centers for vulnerable youth. Each environmental assessment included 9 data collection points within a circle (25 meter radius). The slum rating scale assessed basic physical characteristics of the visible structures, the types of vendors and products sold, presence of betting and pleasure halls, bars and alcohol marketing, livestock, trash burning, abandoned structures, evidence of flooding/standing water or fire damage, sanitation trenches, latrines and barb wire.
Results: Across the five communities, the physical features varied substantially, particularly with respect to the materials used and the number (density) of the physical structures. Similarly, there were variability in the presence and types of vendors such as game halls, bars and pleasure halls. Similarly communities varied with respect to flooding, fire damage, and presence of sanitation trenches, and latrines.
Conclusions: The slums in Kampala vary substantially across several domains pertaining to the physical environment. Innovative strategies for how to best summarize and depict the variability of the physical environment are considered and will be important for providing profiles of community needs to better address health-risk behaviors and adverse health outcomes in the most vulnerable communities.
Program planning Public health or related research
Abstract
Determinants of Overweight and Obesity Among Kenyan Women
Rahma Mkuu, PhD, MPH, CPH1, Katrina Epnere, BS, MPHc2 and Muhammad Abdul Baker Chowdhury, MPH, MPS, MS3
(1)Texas A&M University, College Station, TX, (2)Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, (3)University of Florida, Gainesville, FL
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: Overweight and obesity are associated with increased chronic disease morbidly and mortality globally. In Kenya, there is growing evidence of increasing overweight and obesity prevalence among women, however, there is a gap in knowledge of nationwide risk factors for overweight and obesity among women.
Methods: We used cross-sectional data from the 2014 Kenya Demographic and Health Survey (KDHS). A total of 13, 455 women (aged 15-49 years) whose BMI information was available were analyzed. We used World Health Organization’s Body Mass index (BMI) classification: a BMI of ≥25 kg/m2 was considered overweight or obese. Multivariable logistic regressions were used to assess the correlates of overweight and obesity.
Results: Overall, 22.70% were overweight and 10.07% are obese. Almost half, (52.66%) of women living in urban areas and 47.33% in rural areas were overweight and obese. Women who were older than 35 years (OR: 3.05, CI: 2.53-3.67), had higher education (OR: 1.89, CI: 1.51-2.29), married or living with a partner (OR: 1.95, CI: 1.63 -2.32), employed (OR: 1.28, CI: 1.10-1.49), and in the highest wealth index (richer and richest) were more likely to be overweight or obese (OR: 4.37, CI: 3.51-5.43 and OR: 6.23, CI: 4.87-7.96).
Conclusion: A high proportion of women in Kenya are overweight or obese with those living in urban areas and of high socioeconomic status being at higher odds of obesity. More studies are needed to provide in-depth analysis of ecological risk factors for obesity to identify impactful obesity prevention strategies.
Chronic disease management and prevention Public health or related education Public health or related research Social and behavioral sciences