A Survey of Texas HIV, Sexually Transmitted Disease, Tuberculosis, and Viral Hepatitis Providers' Billing and Reimbursement Capabilities.

The Affordable Care Act presents financial challenges and opportunities for publicly funded service providers. We assessed billing practices and anticipated barriers to third-party billing among organizations in Texas that provide publicly funded HIV, sexually transmitted diseases, tuberculosis, and viral hepatitis services. One third to one half of the organizations did not bill for medical services. The most common barrier to third-party billing was lack of staff knowledge about billing and coding. Future research must evaluate options for organizations and communities to maintain access to infectious disease services for vulnerable populations.

Parental feeding practices and concerns related to child underweight, picky eating, and using food to calm differ according to ethnicity/race, acculturation, and income.

The purpose of this study was to examine differences in parental feeding practices according to ethnicity/race, household income, parent education level, acculturation (for Hispanic participants only), and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program among parents living in a southern state in the United States. For this cross-sectional study, parents of children ages 1-5 years living throughout Texas were recruited through random digit dialing with screening questions during Fall 2006. Eligible parents who agreed to participate completed the Preschooler Feeding Questionnaire (PFQ) and a demographic questionnaire over the phone in either English or Spanish. The PFQ included five subscales: child overeating concerns, child underweight concerns, difficulty with picky eating, using food to calm, and pushing child to eat. Demographic questions assessed ethnicity/race, household income, parent education level, acculturation, and WIC participation. Structural Equation Modeling (SEM), with the demographic variables as predictors, was used to predict the five PFQ subscales. Complete data were obtained from 721 parents, 50% of whom were Hispanic. Significant differences for the PFQ subscales were noted for ethnicity/race, acculturation, and income level. Spanish-speaking Hispanic participants were significantly more worried about their child being underweight than English-speaking Hispanic participants. High-income non-WIC respondents were more likely to report that they have difficulty with picky eaters compared to WIC respondents. Spanish-speaking Hispanics and Black respondents were more likely than English-speaking Hispanics to use food to calm the child. Health practitioners need to be aware of differences in parental feeding practices and concerns among parents of diverse demographic backgrounds. Results from this study can be used to tailor health programs that promote healthy feeding practices among parents.

Preschooler feeding practices and beliefs: differences among Spanish- and English-speaking WIC clients.

This study explored preschooler feeding practices and beliefs among Spanish- and English-speaking WIC participants in Texas. The Preschooler Feeding Questionnaire examined 9 dimensions of the parent-child feeding interaction among 235 caregivers. Results from ANOVA and post hoc analyses demonstrated significant differences in reported preschooler feeding practices and beliefs among Spanish-speaking Hispanics in comparison with English-speaking Hispanics and non-Hispanics. No significant differences were found between English-speaking Hispanics and non-Hispanics. Results indicated that acculturation may impact behaviors apart from ethnicity. Nutrition professionals should understand and acknowledge the cultural context of the parent-child feeding interaction when developing programs.