The organizational trauma-informed practices tool (O-TIPs): Development and preliminary validation.

The goal of the study was to develop and validate a simple, short, easy to self-administer, and cost-effective tool to assess organizational trauma-informed practices (O-TIPs), by building on existing tools. The tool was developed through a series of steps involving detailed examination, selection, and modification of existing trauma-informed (TI) frameworks and tools, which resulted in a 31-item questionnaire with three domains and eight subscales. The O-TIPs was evaluated for known-group construct validity to determine the degree to which it could discriminate between groups of organizations that were higher and lower on the extent to which they were implementing TIPs, by administering it online to staff at seven federally qualified health centers at two-time points. The domains, subscales, and the overall measure showed high internal consistency and discriminated significantly between known groups of centers at baseline and follow-up. In addition, the tool captured change over time in the extent to which the organizations were implementing TIPs. These findings provide preliminary support for the future use of the O-TIPs tool by service-delivery organizations.

Opportunities for psychologists to enact community change through adverse childhood experiences, trauma, and resilience networks.

A growing body of evidence on the inequitable distribution of adverse childhood experiences (ACEs; e.g., Merrick et al., 2018) and their impact throughout the life-course (e.g., Metzler et al., 2017) has highlighted the need to focus on their underlying causes (Ellis & Dietz, 2017). This increasing recognition of ACEs as a preventable public health problem (Bellis et al., 2019) with roots in the community environment has spurred collective responses (e.g., Srivastav et al., 2020), including the emergence of multisector, community-based networks organized to address ACEs and trauma and foster resilience, or "ATR networks" (Jones et al., 2017). ATR networks provide a platform for psychologists to contribute their theoretical, clinical, and research skills to community-level ACEs prevention and mitigation efforts collectively designed by a diverse group comprising professionals from a range of disciplines, advocates, grass-roots leaders, and community residents. Using evidence from an evaluation of Mobilizing Action for Resilient Communities, a recent multisite initiative of 14 ATR networks, this article describes the structure, operation, and accomplishments of these networks to make a case for the ways in which psychologists, working with other professionals and grassroots leaders, can contribute to these efforts. Findings highlight how sectors in which psychologists typically work, play pivotal roles in ATR networks, the ways in which network members in these sectors both influence and are influenced by the networks, and the types of outcomes achieved by the networks within these sectors. Suggestions are offered for the roles psychologists can play to enhance network efforts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Meeting Report: The Role of Beliefs and Perception on Body Size. Proceedings of the 26th Aschauer Soiree, Held at Aschauhof, Altenhof, Germany, May 26th, 2018.

Thirty-one scientists met at Aschauhof, Germany to discuss the role of beliefs and self-perception on body size. In view of apparent growth stimulatory effects of dominance within the social group that is observed in social mammals, they discussed various aspects of competitive growth strategies and growth adjustments. Presentations included new data from Indonesia, a cohort-based prospective study from Merida, Yucatan, and evidence from recent meta-analyses and patterns of growth in the socially deprived. The effects of stress experienced during pregnancy and adverse childhood events were discussed, as well as obesity in school children, with emphasis on problems when using z-scores in extremely obese children. Aspects were presented on body image in African-American women, and body perception and the disappointments of menopause in view of feelings of attractiveness in different populations. Secular trends in height were presented, including short views on so called 'racial types' vs bio-plasticity, and historic data on early-life nutritional status and later-life socioeconomic outcomes during the Dutch potato famine. New tools for describing body proportions in patients with variable degrees of phocomelia were presented along with electronic growth charts. Bio-statisticians discussed the influence of randomness, community and network structures, and presented novel tools and methods for analyzing social network data.

Developing a Community-Wide Initiative to Address Childhood Adversity and Toxic Stress: A Case Study of The Philadelphia ACE Task Force.

The Philadelphia ACE Task Force is a community based collaborative of health care providers, researchers, community-based organizations, funders, and public sector representatives. The mission of the task force is to provide a venue to address childhood adversity and its consequences in the Philadelphia metropolitan region. In this article we describe the origins and metamorphosis of the Philadelphia ACE Task Force, which initially was narrowly focused on screening for adverse childhood experiences (ACEs) in health care settings but expanded its focus to better represent a true community-based approach to sharing experiences with addressing childhood adversity in multiple sectors of the city and region. The task force has been successful in developing a research agenda and conducting research on ACEs in the urban context, and has identified foci of local activity in the areas of professional training and workforce development, community education, and local practical interventions around adversity, trauma, and resiliency. In this article we also address the lessons learned over the first 5 years of the task force's existence and offers recommendations for future efforts to build a local community-based ACEs collaborative.

The socio-economic determinants of infant mortality in Nepal: analysis of Nepal Demographic Health Survey, 2011.

BACKGROUND: Infant mortality reflects not only the health of infants but societal well-being as a whole. This study explores distal socioeconomic and related proximate determinants of infant mortality and provides evidence for designing targeted interventions. METHODS: Survival information on 5391 live born infants (2006-2010) was examined from the nationally representative Nepal Demographic Health Survey 2011. Bivariate logistic regression and multivariate hierarchical logistic regression approaches were performed to analyze the distal-socioeconomic and related proximate determinants of infant mortality. RESULTS: Socio-economic distal determinants are important predictors for infant mortality. For example, in reference to infants of the richest class, the adjusted odds ratio of infant mortality was 1.66 (95% CI: 1.00-2.74) in middle class and 1.87 (95% CI: 1.14-3.08) in poorer class, respectively. Similarly, the populations of the Mountain ecological region had a higher odds ratio (aOR =1.39, 95% CI: 0.90-2.16) of experiencing infant mortality compared with the populations of the Terai plain region. Likewise, the population of Far-western development region had a higher adjusted odds ratio (aOR =1.62, 95% CI: 1.02-2.57) of experiencing infant mortality than the Western development region. Moreover, the association of proximate determinants with infant mortality was statistically significant. For example, in reference to size at birth, adjusted odds ratio of infant dying was higher for infants whose birth size, as reported by mothers, was very small (aOR = 3.41, 95% CI: 2.16-5.38) than whose birth size was average. Similarly, fourth or higher birth rank infants with a short preceding birth interval (less than or equal to 2 years) were at greater risk of dying (aOR =1.74, 95% CI: 1.16-2.62) compared to the second or third rank infants with longer birth intervals. A short birth interval of the second or the third rank infants also increased the odds of infant death (aOR = 2.03, 95% CI: 1.23-3.35). CONCLUSIONS: Socioeconomic distal and proximate determinants are associated with infant mortality in Nepal. Infant mortality was higher in the poor and middle classes than the wealthier classes. Population of Mountain ecological region and Far western development region had high risk of infant mortality. Similarly, infant dying was higher for infants whose birth size, as reported by mothers, was very small and who has higher birth rank and short preceding birth interval. This study uniquely addresses both broader socioeconomic distal and proximate determinants side by side at the individual, household and community levels. For this, both comprehensive, long-term, equity-based public health interventions and immediate infant care programs are recommended.

"Proceedings of the 22nd Aschauer Soiree on Growth and Health Screening", held at Altenhof, Germany, November 15th, 2014.

Twenty-five scientists met at Aschauhof, Altenhof, Germany, to discuss various aspects of the complex network of modern health screening, focusing on current scientific topics including medical sciences, human biology, and mathematics; on problems in implementing these results at the practical level of physicians, nurses, technicians, and engineers; and the level of administrative and political decisions. Whereas major scientific advancements have been published in the understanding and the bio-statistical evaluation of anthropometric screening parameters such as serial measurements of height and weight for preventive medical check-ups, BMI screening and surveillance in schools, etc., the implementation of these advancements into current health screening concepts, strategies and decision-making is poor. Fear of discrimination, misperception of body image, behavioural responses and political concerns, meanwhile dominate and negatively interfere with the implementation of recent scientific results into public health screening concepts and practices.

Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey.

BACKGROUND: Antenatal Care (ANC), use of skilled delivery attendants and postnatal care (PNC) services are key maternal health services that can significantly reduce maternal mortality. Understanding the factors that affect service utilization helps to design appropriate strategies and policies towards improvement of service utilization and thereby reduce maternal mortality. The objective of this study was to identify factors that affect utilization of maternal health services in Ethiopia. METHODS: Data were drawn from the 2011 Ethiopia Demographic and Health Survey. The dependent variables were use of ANC, skilled delivery attendants and PNC services. The independent variables were categorized as socio-cultural, perceived needs and accessibility related factors. Data analysis was done using SPSS for windows version 20.0. Bivariate and multivariate logistic regression models were used in the analysis. RESULTS: Thirty four percent of women had ANC visits, 11.7% used skilled delivery attendants and 9.7% of women had a postnatal health checkup. Education of women, place of residence, ethnicity, parity, women's autonomy and household wealth had a significant association with the use of maternal health services. Women who completed higher education were more likely to use ANC (AOR = 3.8, 95% CI = 1.8-7.8), skilled delivery attendants (AOR = 3.4, 95% CI = 1.9-6.2) and PNC (AOR = 3.2, 95% CI = 2.0-5.2). Women from urban areas use ANC (AOR = 2.3, 95% CI = 1.9-2.9), skilled delivery attendants (AOR = 4.9, 95% CI = 3.8-6.3) and PNC services (AOR = 2.6, 95% CI = 2.0-3.4) more than women from rural areas. Women who have had ANC visits during the index pregnancy were more likely to subsequently use skilled delivery attendants (AOR = 1.3, 95% CI = 1.1-1.7) and PNC (AOR = 3.4, 95% CI = 2.8-4.1). Utilization of ANC, delivery and PNC services is more among more autonomous women than those whose spending is controlled by other people. CONCLUSION: Maternal health service utilization in Ethiopia is very low. Socio-demographic and accessibility related factors are major determinants of service utilization. There is a high inequality in service utilization among women with differences in education, household wealth, autonomy and residence. ANC is an important entry point for subsequent use of delivery and PNC services. Strategies that aim improving maternal health service utilization should target improvement of education, economic status and empowerment of women.

Global prevalence of overweight and obesity in preschoolers.

Twenty-three studies reporting cross-sectional and longitudinal data were conducted in 14 different countries between 1998 and 2008. The number of preschool age children totaled more than 43,837 with one study not reporting a sample size. Studies used both international (i.e., International Obesity Task Force (IOTF), World Health Organization (WHO)) and national reference standards (i.e., United States - Centers for Disease Control and Prevention (CDC), Spain - SRS, Italy - Luciano) to classify children as overweight or obese. Within the same sample the percentage of children classified in these categories often showed a 1.5- to 2-fold difference in the prevalence of overweight/obesity with greatest differences in the between country-specific standards (CDC vs. Luciano). WHO percentages frequently exceeded the IOTF percentages. The prevalence of overweight/obese children escalated with increasing age from 2-5 years in both boys and girls with girls showing higher frequencies in 2/3rds of the 72 sex-paired comparisons. The results indicate a recent high prevalence of overweight and obesity in middle and high income countries, among both well-off and lower income segments of populations, in both rural and urban areas, and among all ethnic and racial groups represented. Because a high proportion of preschool overweight/ obese children will continue to increase their adiposity and are at risk for the early onset of metabolic syndrome, cardiovascular disease, type 2 diabetes, musculoskeletal disorders and behavioral problems, concerted public health efforts are needed to coordinate culturally-appropriate parental and caregiver education, home lifestyle changes, dietary and exercise modifications that will reverse the current trajectory.

Evolutionary and anthropological perspectives on optimal foraging in obesogenic environments.

The nutrition transition has created an obesogenic environment resulting in a growing obesity pandemic. An optimal foraging approach provides cost/benefit models of cognitive, behavioral and physiological strategies that illuminate the causes of caloric surfeit and consequent obesity in current environments of abundant food cues; easy-access and reliable food patches; low processing costs and enormous variety of energy-dense foods. Experimental and naturalistic observations demonstrate that obesogenic environments capitalize on human proclivities by displaying colorful advertising, supersizing meals, providing abundant variety, increasing convenience, and utilizing distractions that impede monitoring of food portions during consumption. The globalization of fast foods propels these trends.

Using chart reviews to assess postpartum substance abuse. A pilot study.

The use of chart reviews to assess substance use one-year postpartum was examined in this pilot study by comparing interviews with chart reviews for 23 women assessed positive for risk during pregnancy. There was no indication that providers asked about alcohol use in 83 percent of the charts, drug use in 57 percent of the charts, and tobacco use in 26 percent of the charts. Few positive or negative matches between interviews and chart reviews were found because substance use was generally not noted. These findings underscore the need to interview women to obtain postpartum substance use information and suggest that providers may not adequately address this issue.

Interactive learning for congregate nutrition site nutrition education: a pilot study.

Older adults who participate in the Older Americans Act Title III-C Elderly Nutrition Program often are at moderate to high nutritional risk. Although nutrition education is a component of the Elderly Nutrition Program, there are numerous barriers to promoting behavior change in older adults. Nutrition education programs targeted to congregate nutrition site participants must address their unique nutritional needs, while engaging them in activities that promote learning and motivate them to make positive behavior changes. This paper describes a pilot study of a theory-driven, five-lesson educational module designed to promote healthful eating behaviors among congregate nutrition site participants through interactive learning.

Body image among older, rural, African-American women with type 2 diabetes.

Type 2 diabetes and obesity co-occur in high prevalence among African-American women. The positive value placed on large body size has both historic and contemporary biosocial relevance. The maintenance of weight at medically recommended levels is a cornerstone of both prevention and treatment of Type 2 diabetes. This study of overweight, elderly, rural African-American women with Type 2 diabetes found they generally preferred smaller body sizes compared to previous studies. Normal to slim body images as presented in a photographic array were selected as being more attractive, less likely to have diabetes and hypertension, healthier and to be more medically compliant than obese, grossly obese or very thin images. Body image is a psychosocial variable that should be included in weight control initiatives.

Dietary, evolutionary, and modernizing influences on the prevalence of type 2 diabetes.

An evolutionary perspective is used to elucidate the etiology of the current epidemic of type 2 diabetes estimated at 151 million people. Our primate legacy, fossil hominid, and hunting-gathering lifestyles selected for adaptive metabolically thrifty genotypes and phenotypes are rendered deleterious through modern lifestyles that increase energy input and reduce output. The processes of modernization or globalization include the availability and abundance of calorically dense/low-fiber/high-glycemic foods and the adoption of sedentary Western lifestyles, leading to obesity among both children and adults in developed and developing countries. These trends are projected to continue for a number of decades.

Perinatal substance abuse intervention in obstetric clinics decreases adverse neonatal outcomes.

OBJECTIVE: To evaluate the effect of Early Start, a managed care organization's obstetric clinic-based perinatal substance abuse treatment program, on neonatal outcomes. STUDY DESIGN: Study subjects were 6774 female Kaiser Permanente members who delivered babies between July 1, 1995 and June 30, 1998 and were screened by completing prenatal substance abuse screening questionnaires and urine toxicology screening tests. Four groups were compared: substance abusers screened, assessed, and treated by Early Start ("SAT," n=782); substance abusers screened and assessed by Early Start who had no follow-up treatment ("SA," n=348); substance abusers who were only screened ("S," n=262); and controls who screened negative ("C," n=5382). RESULTS: Infants of SAT women had assisted ventilation rates (1.5%) similar to control infants (1.4%), but lower than the SA (4.0%, p=0.01) and S groups (3.1%, p=0.12). Similar patterns were found for low birth weight and preterm delivery. CONCLUSION: Improved neonatal outcomes were found among babies whose mothers received substance abuse treatment integrated with prenatal care. The babies of SAT women did as well as control infants on rates of assisted ventilation, low birth weight, and preterm delivery. They had lower rates of these three neonatal outcomes than infants of either SA or S women.

A new visual tool and technique for nutrition education in the Caribbean

This paper presents a technique and tool for use in the collection of dietary information and for nutrition education among a wide range of clients, including those with low literacy, children, and persons with impaired hearing. The tool is a set of two-dimensional food models that are mounted on cardboard or heavy paper and then laminated. This paper descibes their use for the collection of food frequency data, data on food beliefs and attitudes, and meal planning especially among the Caribbean population. The technique is also useful to assess the effect of nutrition education when used in a pre-test/post-test protocol. The tool and technique are inexpensive and can be used repeatedly.(AU)

A new visual tool and technique for nutrition education in the Caribbean

This paper presents a technique and tool for use in the collection of dietary information and for nutrition education among a wide range of clients, including those with low literacy, children, and persons with impaired hearing. The tool is a set of two-dimensional food models that are mounted on cardboard or heavy paper and then laminated. This paper descibes their use for the collection of food frequency data, data on food beliefs and attitudes, and meal planning especially among the Caribbean population. The technique is also useful to assess the effect of nutrition education when used in a pre-test/post-test protocol. The tool and technique are inexpensive and can be used repeatedly.