Search

Introduction: Neighborhoods are often overlooked as a determinant of health. Among recent research, the focus on "place‐based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process‐driven theory. Method: A classic grounded theory approach was used in these studies. Data sources include individual in‐depth interviews, historical documents, and a member‐checking focus group, collected over 3‐years. Results: Analysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules‐based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging. Conclusions: We present the development of a process‐driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process. [ABSTRACT FROM AUTHOR]

The purpose of this study was to understand the experiences of agricultural workers during periods of heat and wildfire smoke exposure and to support the development and implementation of protective workplace interventions. Using community-engaged research and the Center for Disease Control (CDC) framework for policy evaluation, a qualitative descriptive study was conducted with current and former agricultural workers in Central Washington (WA). Twelve participants answered semi-structured questions via interviews or by attending a focus group. Interviews and focus groups were conducted in Spanish, recorded, transcribed, and translated into English; one interview was conducted in English. Using Braun and Clarke's Reflexive Thematic Analysis, five themes were identified among workers from various worksites: 1) Extreme weather and working conditions are becoming increasingly hazardous to worker health, 2) Employers and supervisors lack training and education on current labor laws, and health and safety rules, 3) Employers and supervisors use intimidation and retaliation to ensure productivity and to evoke feelings of replaceability among workers, 4) Workers do not trust regulatory agencies to enforce rules or hold employers accountable, 5) Solutions to climate-driven problems in the agricultural industry need to value worker health and safety, not just productivity. Participants reported experiencing adverse health symptoms related to heat and smoke exposure at work. Workers proposed solutions including improving education, training, and communication, and increased enforcement of existing and forthcoming occupational health and safety rules. The agricultural workforce is essential for ensuring a robust food supply and is facing extreme weather events due to climate change. Western states impacted by wildfires and heat are working to develop and implement occupational health and safety rules. Developing effective policies and interventions inclusive of worker perspectives is critical to adapt to a changing climate, retain a stable workforce and promote optimal health. [ABSTRACT FROM AUTHOR]

Asthma is a major cause of illness, missed school days, and hospitalization in children. One type of asthma common in children is exercise-induced asthma (EIA). EIA causes airway narrowing with symptoms of cough and shortness of breath during exercise. The purpose of this article is to review the literature relevant to screening children and adolescents for EIA and to inform development of a school nurse-led EIA screening program. A systematic review of EIA screening tests was conducted by searching PUBMED for key terms. Sixty-seven articles were identified; after review only seven met the inclusion criteria. The most common screening test was the 6-min exercise challenge. School-based screening programs have the potential to identify EIA among undiagnosed children and adolescents. School nurses are health professionals with the knowledge and skills necessary to develop successful screening programs in the school setting. Based on results of the literature review, we present implications for developing screening programs in schools to identify children with undiagnosed EIA.

Objective: The purpose of this study was to assess health‐related responses to wildfire smoke on social media. We examined whether seasonal wildfire smoke is an active topic on Twitter, the correlation between fine particulate matter (PM2.5) and Twitter search terms, and dimensions of community‐level expression to wildfire smoke through tweets. Design: Search terms were identified using a conceptual model developed and refined by healthcare providers and public health experts. Wildfire‐related tweets were downloaded from Twitter users in Spokane, Washington during the 2017 and 2018 wildfire seasons. PM2.5 data were correlated with the search terms. A subset of tweets was deductively and then inductively coded to identify perceptions and behavioral responses to wildfire smoke. Results: Seasonal wildfire smoke is an active topic on Twitter. The term "smoke" was strongly correlated with poor air quality and "unhealthy" was moderately correlated. Deductive analyses revealed a multidimensional response to wildfire smoke. Inductive analysis identified new areas of concern, such as pet and animal health. Conclusions: Social media is a lens through which public health professionals can assess and respond to local community needs. Findings will be used to broaden the conceptual model, enhance ongoing surveillance of community‐identified health risks, and communicate protective actions. [ABSTRACT FROM AUTHOR]

Objective(s): This study explored the feasibility, acceptability, preliminary impact, and functionality of two risk reduction mobile application (app) interventions on asthma outcomes as compared to a control arm during wildfire season. Design: Three‐arm, 8‐week randomized clinical trial. Sample: Sixty‐seven young adults with asthma were enrolled. Measurements: The Asthma Control Test, forced expiratory volume in one second (FEV1) and the System Usability Scale were measured at baseline, 4, and 8 weeks. The Research Attitude Scale was administered at 8 weeks. Twenty participants from the two intervention arms completed an optional survey and six were interviewed after completing the study. Intervention: Both intervention arms could access Smoke Sense Urbanova, an app that supports reducing risks from breathing wildfire smoke. The Smoke Sense Urbanova Plus arm also monitored their daily FEV1, received air quality notifications, and accessed preventive tips and a message board. Results: Most participants agreed the app and spirometer were usable and their privacy and confidentiality were maintained. No adverse events were reported. Conclusions: Participant‐identified recommendations will support intervention refinement and testing. This research supports asthma self‐management tools that public health nurses and community health workers can recommend for at‐risk populations. [ABSTRACT FROM AUTHOR]

Exposure to unprecedented levels of wildfire smoke is increasing cardiopulmonary mortality and is especially catastrophic to people with preexisting respiratory conditions such as asthma. Wildfire smoke is a mixture of hazardous air pollutants and airborne particulate matter and wildfires are burning larger areas of land and lasting longer, extending the smoke season. The wildfire season is also expected to lengthen as a result of the changing climate. This scoping review examines publications related to wildfires and health in order to explore the ways in which nursing science contributes to research on the health effects of wildfires and strategies to decrease exposure to wildfires and/or wildfire smoke. Nursing's contribution to wildfire research needs to increase to meet the demands of this rapidly growing, international problem. Nurses have an opportunity to protect the public's health through interventional research focused on preventing exposure and applying what is learned to practice. [ABSTRACT FROM AUTHOR]

Objective(s): The study aims were to: (1) Identify health promoters'; perceptions of housing issues faced by farmworker families in an agricultural community, and (2) Strengthen community capacity to promote healthy and affordable housing. Design and Sample: Photovoice was used to identify participants'; perceptions about farmworker housing. Thematic analysis was used to analyze participant interviews. Freudenberg's “Community Capacity for Environmental Health Promotion” framework was used to organize activities that contributed to strengthening community capacity. Purposive sampling was used to recruit six bilingual health promoters into the study. Measures: A demographic questionnaire was administered to characterize participants. An interview guide was used to inquire about housing conditions and the research process. A tracking tool was used to document capacity‐building activities 2 years post data collection. Results: Housing issues faced by farmworker families included housing availability, poor conditions, and invisibility. All dimensions of community capacity were represented. Most occurred on an individual level. Conclusions: Health promoters identified housing issues and built community capacity to support farmworker housing. Nurses can support housing initiatives by assessing housing status, using data to support healthy housing, supporting health promoter programs in new service delivery models, and leading coalitions to address housing as a social determinant of health. [ABSTRACT FROM AUTHOR]

Background: The purpose of this paper is to report: 1) strategies used to engage Hispanic women and their families in a longitudinal birth cohort study, and 2) comparisons of Hispanic and non- Hispanic groups that received those strategies. This paper augments the current literature by reporting methods and results specific to a subpopulation of Hispanic women, that of selfidentified Mexican women. Comparisons between Hispanic and non-Hispanic groups that received those strategies will build the evidence base that supports effective outreach and engagement strategies. Methods: Cultural responsiveness theory was used to structure outreach and engagement, including: 1) assembling a culturally competent team; 2) partnering with community organizations; and 3) creating a personalized marketing and media campaign. For the purposes of evaluating the effectiveness of the outreach and engagement strategies, respondents were asked two questions about outreach and engagement efforts during a screening interview. Results: Hispanic women were proportionally represented in the sample. Just over 43% of the women who completed the pregnancy screening instrument were Hispanic. This rate is similar to the percentage of age-eligible Hispanic women living in the recruitment area. Over half (52%) of the consented women were Hispanic. Overall, 63% of the respondents (n=1273) reported having heard about the study during the screening interview. Among Hispanic respondents (n=871), a little over half (52%, n=453) responded affirmatively. Among non-Hispanic respondents (n=1135), most (72%, n=813) had heard of the NCS. The top three ways that both Hispanic and Non-Hispanic respondents heard about the NCS were through the advance letter, household enumeration, and radio. Both groups reported hearing about the NCS through "Community partners/outreach events" with similar frequency. Discussion: Demographic changes in America speak to the importance of developing outreach and engagement plans tailored to Hispanic populations. Cultural responsiveness theory provided a multi-faceted framework that was used to engage Hispanic families in a study of children's health and their environment. [ABSTRACT FROM AUTHOR]

Asthma is an important environmental justice concern for first generation Mexican-Americans. Families experience disparities in housing conditions, access to care, and legal marginalization. Little is known about how Hispanic/Latina mothers of children with asthma navigate these oppressions. Problem: The purpose of this paper is to describe the discourses of environmental justice of a group Hispanic/Latina caregivers of children with asthma. Method: A photovoice design was used with Hispanic/Latina mothers (n=11) in Tacoma, Washington, to take, discuss, select and display phototexts to policymakers that communicated their experiences and opinions in managing asthma for their child. Using critical narrative analysis, phototexts were analyzed for the use of agency and structure in confronting environmental threats to asthma. Results: Participants produced 33 phototexts taking on the roles of teacher, parent, advocate, investigator, and storyteller. Narratives identified environmental threats (breathable, meteorological, medical, social, emotional, and ingestible) and promoted protective actions and social advocacy against such threats. Conclusion: Mothers' actions as teachers and advocates in the phototexts provided opportunities for promoting empowerment and solidarity with others in the face of multiple environmental oppressions. Critical narrative analysis of photo-texts provided an opportunity to identify important opportunities for furthering environmental justice in new immigrant groups. [ABSTRACT FROM AUTHOR]