Park access and mental health among parents and children during the COVID-19 pandemic.

BACKGROUND: Time spent outdoors and in nature has been associated with numerous benefits to health and well-being. We examined relationships between park access and mental health for children and parents during the COVID-19 pandemic. We also explored associations between park access and co-participation of parent and child in time outdoors, and child and parent physical activity. METHODS: We used data from 1,000 respondents to a nationally representative U.S. survey of parent-child dyads during October-November 2020. Park access was defined as an affirmative response to: "do you have a park that you can safely walk to within 10 min of your home?" Child mental health was operationalized as the Strengths and Difficulties Questionnaire (SDQ) total difficulties score. The Patient Health Questionnaire-4 (PHQ-4) total score assessed parent mental health and the International Physical Activity Questionnaire (IPAQ) assessed parent physical activity. Child physical activity and co-participation in outdoor activity were reported as number of days in the prior week. Linear regression was used to examine relationships between park access and health outcomes in models adjusted for child and parent characteristics and COVID-19 impact. RESULTS: Our sample included 500 parents of children ages 6-10 years, and 500 parent-child dyads of children ages 11-17 years. Park access was associated with a lower SDQ total score among children (ß: -1.26, 95% CI: -2.25, -0.27) and a lower PHQ-4 total score among parents (ß: -0.89, 95% CI: -1.39, -0.40). In models stratified by child age, these associations were observed for SDQ scores among adolescents ages 11-17 and for PHQ-4 scores among parents of children ages 6-10 years. Park access was also associated with 0.50 more days/week of co-participation in outdoor time (95% CI: 0.16, 0.84), and higher levels of parent physical activity (ß: 1009 MET-min/week, 95% CI: 301, 1717), but not child physical activity (ß: 0.31 days/week, 95% CI: -0.03, 0.66). CONCLUSIONS: Park access was associated with better mental health among children and parents, and more parent physical activity and parent-child co-participation in outdooractivity during the COVID-19 pandemic. Access to nearby parks may be an important resource to promote health and well-being, for both individuals and families.

The feasibility of an air purifier and secondhand smoke education intervention in homes of inner city pregnant women and infants living with a smoker.

OBJECTIVES: Secondhand smoke (SHS) and other air pollutants adversely affect the health of pregnant women and infants. A feasibility study aimed at reducing air pollution in homes of pregnant women or infants living with a smoker was completed. METHODS: In collaboration with the Baltimore City Health Department, women ≥ 18 years of age and either pregnant nonsmokers, or post-partum (any smoking status) with an infant age 0-12 months were recruited. Homes had at least one smoker. Intervention included two air purifiers and secondhand smoke education. Outcomes included feasibility, change in fine particulate matter (PM2.5), air nicotine, and salivary cotinine pre- and post-intervention. RESULTS: Fifty women were enrolled (mean age 27 years, 92% African American, 71% single, 94% Medicaid eligible, 34% reported smoking) and 86% completed the study. Of the 50 women, 32 had infants and 18 were pregnant at time of enrollment. Post- intervention, 70% of participants reported smokers were less likely to smoke indoors, and 77% had at least one air purifier turned on at the final visit. Participant satisfaction was high (91%) and 98% would recommend air purifiers. Indoor PM2.5 was significantly decreased (P < 0.001). Salivary cotinine was significantly decreased for non-smoking women (P < 0.01) but not infants, and no significant change in air nicotine occurred (P = 0.6). CONCLUSIONS: Air purifiers with SHS education is a feasible intervention in homes of women and infants. These data demonstrate reduction in indoor PM2.5 and salivary cotinine in non-smoking adults. Air purifiers are not an alternative for smoking cessation and a home/ car smoking ban. Smoking cessation should be strongly encouraged for all pregnant women, and nonsmoking mothers with infants should be counseled to completely avoid SHS exposure. This study provides support for a future intervention evaluating clinical endpoints.

Family Planning in Substance Use Disorder Treatment Centers: Opportunities and Challenges.

BACKGROUND: Alcohol, tobacco, and drug use during pregnancy can cause a range of adverse birth outcomes. Promoting family planning among women with substance use disorders (SUD) can help reduce substance exposed pregnancies. OBJECTIVES: We conducted qualitative research to determine the acceptability and feasibility of offering family planning education and services SUD treatment centers. METHODS: Focus groups and in-depth interviews were conducted with clients, staff and medical providers at three treatment centers. Interviews were transcribed and data was analyzed using a flexible coding scheme. RESULTS: Clients reported being interested in family planning services while they were in treatment. Most preferred to receive these services onsite. Providers also felt that services should be received onsite, though cited several barriers to implementation, including time constraints and staff levels of comfort with the subject. CONCLUSIONS/IMPORTANCE: Women in SUD treatment are open to the integration of family planning services into treatment. Treatment centers have the opportunity to serve as models of client-centered health homes that offer a variety of educational, preventive, and medical services for women in both treatment and recovery.

Using the PRECEDE Planning Approach to Develop a Physical Activity Intervention for African American Men Who Visit Barbershops: Results From the FITShop Study.

African American (AA) men have a higher prevalence of many chronic disease risk behaviors compared to Caucasian men, including physical inactivity. Innovative ways to reach AA men with interventions to increase physical activity (PA) and decrease other key risk factors are needed to reduce health disparities in this population. The barbershop is a natural but underutilized setting for reaching AA men. In the Fitness in the Shop (FITShop) study, shop owners, barbers, and customers were recruited from four local barbershops to complete structured interviews and customer focus groups. We assessed knowledge, perceived barriers, and interests/concerns about PA, as well as explored how to best intervene in the barbershop. Barbers and customers endorsed the idea of receiving health and PA information in the barbershop. These formative research results generated information and strategies for developing a multilevel barbershop-based health intervention to promote PA in the barbershop. This article describes the formative research results and how PRECEDE was used to develop a culturally and contextually appropriate, multilevel barbershop-based intervention designed to promote PA and to reduce chronic disease disparities among AA men.