Weaving latino cultural concepts into Preparedness Core Competency training.

INTRODUCTION: The New York • New Jersey Preparedness and Emergency Response Learning Center (NY•NJ PERLC) is one of 14 Centers funded by the Centers for Disease Control and Prevention designed to address the preparedness and response training and education needs of the public health workforce. One of the important niches, or focus areas for the Center, is training to improve the capacity of public health workers to respond with competence to the needs of vulnerable populations. BACKGROUND: During every phase of a disaster, racial and ethnic minorities, including Latinos, suffer worse outcomes than the general population. Communities with diverse cultural origins and limited English speakers often present more complex issues during public health emergencies. Training that incorporates cultural concepts into the Preparedness Core Competencies may improve the ability of public health workers to engage the Latino community in preparedness activities and ultimately improve outcomes during disasters. METHODS: This article describes initiatives undertaken by the NY•NJ PERLC to improve the capacity of the public health workforce to respond competently to the needs of Latino populations. In 2012, the Center collaborated with national, state, and local partners to develop a nationwide broadcast founded on the Preparedness Core Competencies, Latinos During Emergencies: Cultural Considerations Impacting Disaster Preparedness. The widely viewed broadcast (497 sites in 47 states and 13 nations) highlighted the commonalities and differences within Latino culture that can impact emergency preparedness and response and outlined practical strategies to enhance participation. OUTCOMES: The success of the broadcast spurred a number of partner requests for training and technical assistance. Lessons learned from these experiences, including our "undercover" work at local Points of Dispensing, are incorporated into subsequent interactive trainings to improve the competency of public health workers. NEXT STEPS: Participants recommended developing similar training addressing cultural differences, especially for other ethnic groups.

Relationship between objectively measured walkability and exercise walking among adults with diabetes.

Little is known about the relationship between objectively measured walkability and walking for exercise among adults with diabetes. Information regarding walking behavior of adults with diabetes residing in 3 Upstate New York counties was collected through an interview survey. Walkability measures were collected through an environmental audit of a sample of street segments. Overall walkability and 4 subgroup measures of walkability were aggregated at the ZIP level. Multivariate logistic regression was used for analysis. Study participants (n = 208) were 61.0% female, 56.7% non-Hispanic White, and 35.1% African-American, with a mean age of 62.0 years. 108 participants (51.9%) walked for exercise on community streets, and 62 (29.8%) met the expert-recommended level of walking for ≥150 minutes/week. After adjustment for age, gender, race/ethnicity, education, BMI, physical impairment, and social support for exercise, walking any minutes/week was associated with traffic safety (OR 1.34, 95% CI 1.15-1.65). Walking ≥150 minutes/week was associated with overall walkability of the community (2.65, 1.22, and 5.74), as well as sidewalks (1.73, 1.12-2.67), street amenity (2.04, 1.12-3.71), and traffic safety (1.92, 1.02-3.72). This study suggests that walkability of the community should be an integral part of the socioecologic approach to increase physical activity among adults with diabetes.

Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

Assessing sources of support for diabetes self-care in urban and rural underserved communities.

The ability of adults with diabetes to manage their illness properly and prevent complications is, in part, a function of support provided by the people and institutions surrounding them. Using data from over 200 adults with diabetes in two medically underserved communities--one urban and one rural--this study examines the self-care specific support provided by four key sources: family and friends, community organizations, one's neighbors and neighborhood, and resources in the wider community. More specifically, this study aims to assess the support needs of adults with diabetes in these communities by estimating their rates of various self-care behaviors, the amount of support provided by key sources, and the associations between support from these sources and adherence to recommended diabetes self-care behaviors. Descriptive findings indicate that close to 40% of the sample failed to report at least moderate levels of adherence, and that physical activity in the rural community, and smoking in the urban community represent particular problem areas. Individuals from the urban sub-sample reported receiving more support from all of the sources assessed. Logistic regression models indicated that one's neighbors and neighborhood resources appear to have a broad influence on adherence to diabetes self-care behaviors. Support from family and friends, as well as from community organizations, also seems to be important. These results have implications for the design of interventions aimed at bolstering support for diabetes self-care, and point to the need for an enhanced focus on strengthening the social environmental resources of adults with diabetes.