OREGON STATE UNIVERSITY

college of public health and human sciences

California’s new mental health system helps people live independently

CORVALLIS, Ore. – A new analysis by Oregon State University researchers of California’s mental health system finds that comprehensive, community-based mental health programs are helping people with serious mental illness transition to independent living.

Published in the October issue of the American Journal of Public Health, this study has important implications for the way that states finance and deliver mental health programs, and speaks to the effectiveness of well-funded, comprehensive community programs.

In November of 2004, California voters passed the Mental Health Services Act, which allocated more than $3 billion for comprehensive community mental health programs, known as Full Service Partnerships (FSP). While community-based, these programs are different from usual mental health services programs in most states because they provides a more intensive level of care and a broader range of mental health services and supports, such as medication management, crisis intervention, case management and peer support.

It also provides services such as food, housing, respite care and treatment for co-occurring disorders, such as substance abuse.

“We found that these programs promoted independent living in the community among people who had serious mental illness but had not been served or underserved previously,” said Jangho Yoon, an assistant professor of health policy and health economist in OSU’s College of Public Health and Human Sciences and lead author of the study. “Overall, it reduced their chance of living on the street or being incarcerated in jails and prisons.”

The researchers looked at data from 43 of California’s 53 counties, resulting in a sample of 9,208 adults over the course of four years. They found that participants who stayed enrolled in the program continuously, without interruption, were 13.5 percent more likely to successfully transition to independent living.

However, they found that non-white patients were less likely to live independently, and more likely to end up in jail or homeless.

“Although FSPs represent the most well-funded comprehensive community-based programs in the country, they are still community programs and therefore program participation is voluntary,” Yoon said.  “My guess is that minorities may not benefit fully from these programs in their communities possibly due to greater stigma, and less family/social supports. But it needs further investigation.”

Patients with schizophrenia and bipolar disorders were also less likely to benefit from the community programs, because of the nature and severity of their mental health issues.

Yoon is an expert on health management policy, specifically policy around the area of mental health. He said other states haven’t followed California’s lead, in part because of the cost of such extensive programming. Yoon said some of the funding made possible by the federal Patient Protection and Affordable Care Act, which includes $460 million for community mental health services for states to use, may help other states to create similar programs.

“Nobody would disagree that the public mental health system has historically been under-funded in the U.S.,” he said. “The message for other states is clear: investment in well-funded, recovery-oriented, comprehensive community mental health programs clearly improves lives of people with serious mental illness, and may also save money from reduced dependency and incarcerations in this population.”

Tim Bruckner of the University of California, Irvine, and Timothy Brown of the University of California, Berkeley, contributed to this study, which was jointly funded by the California Department of Mental Health and the California Health Care Foundation.

Media Contact: 
Source: 

Jangho Yoon, 541-737-3839

Autistic children with better motor skills more adept at socializing

CORVALLIS, Ore. – In a new study looking at toddlers and preschoolers with autism, researchers found that children with better motor skills were more adept at socializing and communicating.

Published online today in the journal Research in Autism Spectrum Disorders, this study adds to the growing evidence of the important link between autism and motor skill deficits.

Lead author Megan MacDonald is an assistant professor in the College of Public Health and Human Sciences at Oregon State University. She is an expert on the movement skills of children with autism spectrum disorder.

Researchers tested 233 children ages 14 to 49 months diagnosed with autism.

“Even at this early age, we are already seeing motor skills mapping on to their social and communicative skills,” MacDonald said. “Motor skills are embedded in everything we do, and for too long they have been studied separately from social and communication skills in children with autism.”

Developing motor skills is crucial for children and can also help develop better social skills. MacDonald said in one study, 12-year-olds with autism were performing physically at the same level as a 6-year-old.

“So they do have some motor skills, and they kind of sneak through the system,” she said. “But we have to wonder about the social implications of a 12-year-old who is running like a much younger child. So that quality piece is missing, and the motor skill deficit gets bigger as they age.”

In MacDonald’s study, children who tested higher for motor skills were also better at “daily living skills,” such as talking, playing, walking, and requesting things from their parents.

“We can teach motor skills and intervene at young ages,” MacDonald said. “Motor skills and autism have been separated for too long. This gives us another avenue to consider for early interventions.”

MacDonald said some programs run by experts in adaptive physical education focus on both the motor skill development and communicative side. She said because autism spectrum disorder is a disability that impacts social skills so dramatically, the motor skill deficit tends to be pushed aside.

“We don’t quite understand how this link works, but we know it’s there,” she said. “We know that those children can sit up, walk, play and run seem to also have better communication skills.

This study was coauthored by Catherine Lord of Weill Cornell Medical College and Dale Ulrich of the University of Michigan. It was supported by the National Institutes of Health, the Simons Foundation, First Words and Blue Cross Blue Shield Foundation of Michigan.

Media Contact: 
Source: 

Megan MacDonald, 541-737-3273

Multimedia Downloads
Multimedia: 

Megan MacDonald
Researcher Megan MacDonald practices important motor skills, like throwing a ball, with a child. (photo courtesy of OSU College of Public Health and Human Sciences)

No evidence that water birth poses harm to newborns, new OSU study finds

CORVALLIS, Ore. – There is no evidence that water births, where a baby is intentionally born under water in a tub or pool, poses any increased harm to the child, Oregon State University researchers have found.

Researchers examined outcome data for more than 6,500 midwife-attended water births in the United States and found that newborns born in water were no more likely to experience low Apgar scores, require transfer to the hospital after birth or be hospitalized in their first six weeks of life, than newborns who were not born in water.

The results were published this week in the Journal of Midwifery and Women's Health. The study is believed to be the largest study of water births to date and the first to examine the practice in the United States, said lead author, Marit Bovbjerg, an epidemiology instructor in the College of Public Health and Human Sciences at OSU. 

“The findings suggest that water birth is a reasonably safe, low-intervention option for women who face a low risk of complications during the birthing process,” Bovbjerg said. “These are decisions that should be made in concert with a medical professional.”

Co-authors of the study are Melissa Cheyney, a medical anthropologist and associate professor in OSU’s College of Liberal Arts, and Courtney Everson, a former OSU graduate student who recently completed her doctorate.

For the study, researchers analyzed birthing outcome data collected from 2004 through 2009 by the Midwives Alliance of North America Statistics Project, commonly referred to as MANA Stats. Most of the nearly 17,000 women in the study were attended by Certified Professional Midwives, who provided detailed reports on their cases from their medical records.

More than 6,500 women in the database gave birth in water, either at home or in a free-standing birthing center. The outcomes in those births were compared to the outcomes for non-water births. The study compared only births at home or in a birthing center and not those in hospitals. 

The researchers found that babies born in water were no more likely to require transfer or admission to a hospital, nor were the mothers who gave birth in water. However, the researchers found an 11 percent increase in perineal tearing among mothers who gave birth in water.

“For some women, that potential risk of tearing might be worth taking if they feel they will benefit from other aspects of a water birth, such as improved pain management,” Bovbjerg said. “There is no one correct choice. The risks and benefits of different birthing options should be weighed carefully by each individual.” 

The researchers’ findings are congruent with outcomes reported in other water birth studies, Cheyney said, but are contrary to the American College of Obstetricians and Gynecologists’ and the American Academy of Pediatrics’ Committee Opinion.

“Those groups support laboring in water, but caution against giving birth while immersed,” Cheyney said. “Our findings suggest that water birth is a reasonably safe option for low-risk women, especially when the risks associated with pharmacologic pain management, like epidural anesthesia, are considered.”

The researchers have shared their findings with a group that is developing a clinical bulletin designed to inform health care providers about the practice of water birth in both hospital and out-of-hospital settings.

Media Contact: 
Source: 

Melissa Cheyney, 541-737-4515, melissa.cheyney@oregonstate.edu; Marit Bovbjerg, 541-737-5313, Marit.Bovbjerg@oregonstate.edu

Exercise DVDs could be psychologically harmful for users

CORVALLIS, Ore. – Using fitness DVDs to work out at home may seem like a good way to get started on new exercise goals this year, but those DVDs may also include negative imagery and demotivating language.

A study of 10 popular commercial exercise DVDs showed that the imagery in the fitness videos may be perpetuating and reinforcing hyper-sexualized and unrealistic body images, said Brad Cardinal, a kinesiology professor in the College of Public Health and Human Sciences at Oregon State University. 

In addition, researchers found that one in every seven motivational statements on the DVDs was actually a demotivating statement that could reduce the effectiveness of the workout, diminish the user’s hope and potentially cause psychological harm, said Cardinal, the lead author of the study.

“These findings raise concerns about the value of exercise DVDs in helping people develop and commit to a workout program,” said Cardinal, who is a national expert on the benefits of physical activity. “There are a lot of exaggerated claims through the imagery and language of ‘do this and you’ll look like me.’ ” 

The findings are being published in the latest issue of the Sociology of Sport Journal. Co-authors of the study are: OSU graduate students Kim A. Rogers, Brian Kuo, Rosalee L. Locklear and Katelyn E. Comfort; and Professor Marita K. Cardinal of Western Oregon University.

Fitness DVDs are a $250 million a year industry but there is no scientific evidence about their safety and effectiveness or the accuracy of the information contained in them, and the industry is largely unregulated, Cardinal said. 

For the study, the researchers reviewed 10 popular, instructor-led fitness DVDs, evaluating both the imagery used in the videos as well as the motivational language used by the instructors. The goal was to better understand the visual and auditory messaging and how it might affect users.

Researchers found that most of the instructors and models were slim, female and white, and they typically wore revealing attire. That sends a subtle message about what people who are fit should look like, Cardinal said. This perpetuates objectification of the female body in particular and emphasizes physical appearance as opposed to improved health, he said.

The researchers also found that a quarter of the language used by instructors was motivational, but one of every seven motivational statements was considered negative. Negative statements included phrases such as “say hello to your sexy six-pack,” “you better be sweating,” and “you should be dying right now.” 

 

Those kinds of phrases focus on outcomes, encourage social comparison, and don’t take into account individual differences in health or fitness, Cardinal said. “Tough love” phrases and strategies can also have a harmful effect because they can lead to injuries or other adverse health outcomes, he said.

Such messages could be particularly harmful to users who are turning to exercise DVDs to start a new fitness routine or who are uncomfortable in a gym or fitness class setting, Cardinal said. The exercise videos were marketed to novice exercisers while the movement skills tended to be designed for intermediate or advanced levels of fitness, and the instructors’ verbal messages sometimes taunted observers to keep up. 

“You’re inviting into your home these images and messages that could make you feel bad about yourself, and ultimately hinder your efforts to improve your health,” he said. “If the experience is not positive, the likelihood the person is going to continue with an exercise program diminishes.”

Cardinal urged potential fitness DVD consumers to be mindful of the potential pitfalls of the product when selecting and using exercise videos. 

“Buyers should beware when making these purchases,” he said. “Remember that we all have different body shapes and styles, and our bodies may respond differently to the exercises being shown. Don’t expect to get the same results as what you see on the screen or compare yourself to others.”

The findings indicate that there is a need to further study commercial fitness DVDs, Cardinal said. Along with the language and imagery used in the videos, researchers should consider studying the effectiveness and safety of the types of exercises and techniques used, he said. In addition, many of the instructors appear to have little or no credentials in fitness instruction, he said. 

“We don’t think the videos are very psychologically safe,” Cardinal said. “There are also questions about some of the exercises, which could lead to injuries and pose a real danger to the user.”

Media Contact: 
Source: 

Brad Cardinal, 541-737-2506, brad.cardinal@oregonstate.edu

Multimedia Downloads
Multimedia: 

Brad Cardinal

brad_cardinal

Injuries among Dungeness crab fishermen examined

CORVALLIS, Ore. – Commercial Dungeness crab fishing on the West Coast is one of the highest risk occupations in the United States, based on fatality rates. But non-fatal injuries in the fishery appear to go largely unreported, a new study from Oregon State University shows.

While the fatality rates in the Dungeness crab fleet have been reported in the past, the incidence of non-fatal injuries have not been previously studied, said Laurel Kincl, an assistant professor of environmental and occupational health and safety in the OSU College of Public Health and Human Sciences.

“The commercial Dungeness fishing fleet, which operates along the coast of Oregon, Washington and Northern California, is a vital economic commodity,” she said. “Injuries can be life-threatening and life-altering, leading to disability, decreased quality of life and lost wages.”

Understanding the type and nature of fatalities and injuries, including describing and categorizing the types of injuries, is the first step in identifying safety issues and pinpointing areas for prevention, she said.

Kincl and a team of researchers examined 12 years of death and injury data, and found that 28 people died while commercially fishing for Dungeness crab from 2002-2014. In that same period, 45 injuries were reported to the U.S. Coast Guard.

The fatality rate among Dungeness crab fishermen is several times higher than the national rate for commercial fishing. But the injury rate among Dungeness fishermen is much lower than injury rates in other commercial fishing fleets that have been studied.

“Fatal injuries are tracked in a national system, but non-fatal injuries are not,” Kincl said. “We knew there was likely underreporting, but we had no idea how low the injury numbers were until now.”

The findings, published in the latest issue of the journal International Maritime Health, are the first step to better understanding fishing injuries among Dungeness crab fishermen. The research is part of an OSU-led research project to identify and reduce the risks of injuries in the industry, Kincl said.

The Fishermen Led Injury Prevention Program, or FLIPP, is designed to take a new approach to fishing industry injury prevention by working with commercial Dungeness crab fishermen to identify and reduce injury risks. The project is supported by a three-year, $825,000 grant from the National Institutes for Occupational Safety and Health. Kincl is the principal investigator.

The lead author of the paper, Samantha Case, is a researcher in the NIOSH office in Alaska. Other co-authors are OSU Associate Professor Viktor Bovbjerg; OSU doctoral student Laura Syron and Devin Lucas, who earned his doctorate at OSU and works at NIOSH.

The researchers found that the majority of the fatalities, about 71 percent, occurred during vessel disasters, such as boats capsizing or sinking. The other deaths were the result of a fisherman drowning or falling overboard. Fractures were the most commonly reported injury, at 40 percent, followed by hypothermia, lacerations and digit amputations.

Working with Oregon Sea Grant and community researchers in local fishing communities, Kincl and her colleagues are meeting with focus groups of fishermen and surveying fishing crews along the Pacific coast to learn more about safety and injuries in the industry.

“No one has ever gone up and down the coast and learned from the fishermen,” Kincl said. “What are they doing to stay safe? Are there things that can be improved? How can we share that information among the various crews?”

By the end of the project, researchers plan to come up with and test several interventions that could help reduce injuries among crab fishermen.

“We want to identify some things that might work, but we don’t want to tell them what to do,” Kincl said. “We want to let them decide what would be most helpful.”

Media Contact: 
Source: 

Laurel Kincl, 541-737-1445, Laurel.kincl@oregonstate.edu

Multimedia Downloads
Multimedia: 

Crab pots on the Oregon Coast

 

Public Health and Sea Grant

Researcher Laurel Kincl

Laurel Kincl Lab

Safe spaces play important role in community-based HIV prevention, research finds

CORVALLIS, Ore. – The creation and sustainment of “safe spaces” may play a critical role in community-based HIV prevention efforts by providing social support and reducing environmental barriers for vulnerable populations, a new study from an Oregon State University researcher has found.

Safe spaces often are run by community-based organizations working with vulnerable populations. They can be used to provide social support and services such as job and education assistance and health testing and treatment. Such spaces appear to be an important but under-used public health tool for prevention and treatment of HIV, said Jonathan Garcia, lead author of the study and an assistant professor in OSU’s College of Public Health and Human Sciences.

“These safe spaces serve as surrogate homes, creating an environment with a brotherhood or family undertone for men who have often been marginalized by their families and communities and do not trust public institutions such as churches, schools or law enforcement agencies,” he said. “Often they have no other place to go.”

Garcia studies how social experiences influence health, with a focus on developing new public health approaches to address needs of vulnerable populations and communities. His latest research was published recently in the journal PLOS ONE.

Co-authors of the paper are Caroline Parker, Richard G. Parker and Patrick A. Wilson and Jennifer S. Hirsch of Columbia University and Morgan M. Philbin of the HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute. The research was supported by a grant from the National Institute of Mental Health.

For the study, researchers spent nearly a year conducting observations and in-depth interviews with 31 black men who were gay or bisexual, or who may not have identified as such but who had sex with other men. They also interviewed 17 others with knowledge of the men and the safe spaces they frequented in the New York City area. 

They focused on black men who have sex with other men because that population is considered particularly vulnerable to HIV, Garcia said. While these men make up just 2 percent of the U.S. population, they accounted for about 75 percent of new HIV infections between 2008 and 2010.

About half of the men interviewed were homeless or were living in unstable housing situations and nearly half were unemployed. About two-thirds of the men had some kind of health insurance, with 17 receiving federal Medicaid. 

The researchers found that these men were using safe spaces as places to hang out and connect, but they also served to address vulnerabilities, including exposure to violence; lack of social support; feelings of fear or mistrust against institutions or law enforcement; and limited employment opportunities.

Addressing those issues and providing a safe, community environment provides a better basis for which men are open and amenable to seeking HIV testing and treatment, Garcia said. 

“The meaning of safety is different for people who don’t feel like they are safe at home, or that the police are on their side,” Garcia said. “Safe spaces help create that feeling of security not found elsewhere.”

The findings are already being used to help shape a clinical trial that is now under way. Men who are at substantial risk of exposure to HIV are given daily HIV medication even though they have not contracted the disease. The goal of this pre-exposure prophylaxis, or PREP, is to prevent HIV infection from taking hold if the person is exposed. The trial incorporates the use of safe spaces, both in person and in online settings, for the men receiving the treatment, Garcia said. 

Safe spaces also could be used in prevention and treatment of other diseases that carry a stigma, including sexually-transmitted infections and Hepatitis C, which is common among intravenous drug users, he said.

One problem facing organizations that operate safe spaces is funding, Garcia said. The safe spaces often are the first thing eliminated when a group or organization experiences a funding shortfall. The rationale is to use funds first on treatment or prevention services. 

“Safe spaces are recognized as something important but are more unofficial,” he said. But the spaces can play such a critical role in educating and providing health services to the affected men that eliminating the spaces could reduce the effectiveness of health programs, Garcia said.

“If that support is what they are lacking, then providing it is likely to help them continue to seek treatment and services,” he said.

Media Contact: 
Source: 

Jonathan Garcia, 541-737-1609, jonathan.garcia@oregonstate.edu

Multimedia Downloads
Multimedia: 

Jonathan Garcia

Jonathan Garcia

Changing habits to improve health: New study indicates behavior changes work

CORVALLIS, Ore. – Improving your heart health may be as simple as making small behavioral changes – a new study of behavioral health interventions suggests that they are effective at helping people alter their lifestyles and lead to physical changes that could improve overall health.

The findings also indicate a shift is needed in the way such interventions are evaluated by researchers and used by health care providers, said Veronica Irvin of Oregon State University, a co-author of the study just published in the Annals of Behavioral Medicine

Behavioral treatments such as individual counseling or group training to improve nutrition or physical activity, reduce or stop smoking, or adhere to a drug treatment plan, often are overlooked because medical care providers tend to believe it is too difficult for people the make changes to their established lifestyles, said Irvin, an assistant professor in the College of Public Health and Human Sciences at OSU.

But large clinical drug trials for potential new medications often fail to show that those treatments make patients better, and drugs sometimes are associated with undesirable side effects, she said. Modification of health behavior is another option for health providers and their patients, Irvin explained, but is underutilized in clinical medical practice as well as in public health policy because many providers remain unconvinced that people can change their behavior to improve their health. 

She and her co-author, Robert M. Kaplan of the Agency for Healthcare Research and Quality, conducted a comprehensive and systematic review of large-budget studies funded by the National Institutes of Health that involved behavioral interventions such as individual counseling or group training to improve nutrition or physical activity, reduce or stop smoking, or adhere to a drug treatment plan.

More than 80 percent of the randomized clinical trials that included a behavioral intervention reported a significant improvement for the targeted behavior and a significant physiological impact such a reduction in weight or blood pressure. Greater improvements were observed when the intervention simultaneously targeted two behaviors, such as nutrition and physical activity, which are considered lifestyle behaviors. 

“This research suggests that behavioral interventions should be taken more seriously,” Irvin said. “It indicates that people are able to achieve realistic behavioral changes and improve their cardiovascular health.”

But the researchers also noted that few of the studies documented morbidity and mortality outcomes that are often required for drug trials. Previous research by Irvin and Kaplan found that most drug trials fail to reduce mortality. Behavioral interventions should be studied in a similar fashion, Irvin said. 

“There are more positive outcomes with these trials, but they don’t often measure mortality,” Irvin said.

“The next step for behavioral trials should be to measure results using clinical outcomes, such as the number of heart attacks and hospitalizations, experienced by participants.”  

Most behavior interventions reviewed for the study showed benefits using surrogate markers for these kinds of clinical events. For example, treatments for high cholesterol have the goal of reducing heart attacks and extending life. Measures of cholesterol are surrogate markers because they are believed to be related to the clinical goal of reducing deaths. 

But the surrogate markers are not always predictive of clinical outcomes, which is a potential concern for medical researchers. Future behavioral trials should investigate these clinical events as they would be in a traditional drug trial, Irvin said.

In this study, 17 trials reported a morbidity outcome, with seven showing a significant effect on reducing morbidity outcomes such as hospitalization or cardiovascular events. 

Irvin and Kaplan began work on the study while the two worked together in the National Institutes of Health’s Office of Behavior and Social Science Research. They reviewed all large-budget clinical trials evaluating behavioral interventions for the treatment or prevention of cardiovascular disease that had received funding from the National Heart, Lung and Blood Institute or the National Institute of Diabetes & Digestive and Kidney Diseases between 1980 and 2012.

In all, 38 studies were included in the research. They were did not include 20 large-budget trials from the period in this study because no results from those trials have been published. 

This underscores the need for more publication of research even if the outcomes were not as expected, Irvin said. Publishing these null outcomes prevents the unnecessary replication of studies and also may inform doctors and patients about which treatments are not likely to be helpful.

Media Contact: 
Source: 

Veronica Irvin, 541-737-1074, Veronica.Irvin@oregonstate.edu

Multimedia Downloads
Multimedia: 

Veronica Irvin

Veronica Irvin

Gene therapy could aid weight loss without affecting bone loss, new research finds

CORVALLIS, Ore. – Delivering the hormone leptin directly to the brain through gene therapy aids weight loss without the significant side effect of bone loss, according to new collaborative research from Oregon State University and University of Florida.

Rapid or significant weight loss through dieting can trigger bone loss. Loss of bone density, in turn, can lead to increased susceptibility to bone fractures in older adults, which can have a debilitating effect on quality of life. 

The bone loss is most concerning in people whose weight fluctuates due to “yo-yo” dieting, or repeated cycles of weight gain and loss, because bone lost during weight loss is not typically regained when the person gains weight again, said Urszula Iwaniec, an associate professor in the College of Public Health and Human Sciences at OSU.

“Weight loss is generally good for you if you are seriously overweight, but bone loss can cause significant problems later in life,” said Iwaniec, whose research focuses on metabolic bone disease and bone health. “What we are trying to determine is whether there is a way to lose excessive weight while preserving bone density.” 

In the study, rats who received leptin had a weight reduction of about 20 percent, but they did not have any bone loss. The rats that lost weight were able to maintain that weight loss. They also had large reductions of abdominal fat, also known as “bad” fat, which is known to contribute to weight-related health problems.

The findings were published this week in the Journal of Endocrinology. Co-authors of the paper included Russell Turner, director of OSU’s Skeletal Biology Lab, and several Oregon State University faculty, as well as researchers from the University of Florida. The study was supported by grants from the National Institutes of Health and the Department of Defense. 

Leptin is required for normal skeletal growth and maintenance. The hormone also plays a significant role in the body’s ability to maintain weight, telling your brain how much fat you have and if fat stores are sufficient. But people appear to develop leptin resistance with weight gain, and the brain no longer receives accurate messages, Iwaniec said.

“Using leptin at the level of the hypothalamus to control weight is where, at some point, we believe we’re going to be able to control weight gain,” she said. “When the brain tells us to lose weight, it works. When we try to lose weight and the brain tells us not to, it doesn’t work.” 

To better understand the role of leptin in both weight and bone loss, researchers injected the gene for leptin directly into the hypothalamus of rats and analyzed the effects on their weight and bones. Injecting the leptin into the brain allows the hormone to bypass the blood-brain barrier, which reduces the ability of leptin to enter the brain, Iwaniec said.

But this type of gene therapy, which is essentially permanent, may have other risks or side-effects that are not yet known, the researchers said, and much more study is needed before gene therapy becomes a treatment for weight loss in humans. 

“This kind of therapy has the potential for being far less invasive than something like bariatric surgery,” Turner said. “But it’s forever. It seems like a very extreme procedure, from that standpoint.”


Editor’s Note: This research was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under grant number R01AR060913.

Media Contact: 
Source: 

Urszula Iwaniec, 541-737-9925, urszula.iwaniec@oregonstate.edu

Multimedia Downloads
Multimedia: 

Urszula Iwaniec

Researcher Urszula Iwaniec

Young Latinos experience discrimination when obtaining health care, research shows

CORVALLIS, Ore. – Young Latinos living in rural areas say they face discrimination when they obtain health care services – a factor that could contribute to disparities in their rates for obtaining medical care and in their health outcomes, a new study from Oregon State University has found.

Perceived discrimination is considered a barrier to obtaining health care services for underrepresented populations, including Latinos, according to lead researcher Daniel López-Cevallos, associate director of research for the Center for Latino/a Studies and Engagement at OSU.

The findings were published recently in the Journal of Immigrant and Minority Health. The research was co-authored by S. Marie Harvey, associate dean and professor in the College of Public Health and Human Sciences. Harvey received funding from the Centers for Disease Control and Prevention to support the study.

Researchers conducted interviews with 349 young adult Latinos, ages 18 to 25, living in rural Oregon. Nearly 40 percent of those interviewed said they had experienced health care discrimination, such as being prevented from accessing services; being hassled; or being made to feel inferior in some way.

“What matters is the perception,” Harvey said. “If a person is less likely to seek out services because of that perception, it needs to be addressed.”

Latinos are considered an underserved group because they are less likely to obtain regular health care services and have higher rates of chronic disease such as diabetes than the general population, leading to disparities in their overall health and well-being. 

The researchers’ goal was to better understand the role perceived discrimination plays in Latinos’ access to and use of health care services. Much of the past research on discrimination in health care has focused on African-Americans and people living in urban settings. This study emphasizes the experience of Latinos living in rural areas, a trend emerging as Latino populations move to rural areas across the nation, Lopez-Cevallos said.

“We have a different population here, so we want to be able to address concerns in Oregon and other states with growing rural Latino communities,” he said.

Addressing health care barriers facing Latinos and other underrepresented groups is important because when health care issues go undiagnosed or untreated, health care costs tend to rise. Prevention, early diagnosis and disease management are critical components of health care reform under the federal Affordable Care Act.

Nearly 45 percent of foreign-born Latinos, reported discrimination, compared to about 32 percent of Latinos born in the U.S. Researchers did not ask participants in the study about their immigration status.

Some Latinos may feel discriminated against simply because they are not eligible for health care programs and cannot get the access to services that they need, Lopez-Cevallos said.

Immigration reform policies, such as the Deferred Action for Childhood Arrivals policy enacted by President Obama in 2012, could also open access for Latinos who are not eligible for care under the Affordable Care Act. People who qualify for the program have access to employment, and employment often leads to access to health care, Lopez-Cevallos said.

The findings also suggest a need to improve “cultural competency” among health care providers, from the doctors to the receptionists to the lab technicians, so Latinos are treated with respect and dignity, the researchers said.

“It’s not all on the doctor, it’s up to the whole health care team,” Lopez-Cevallos said.

“For young adult Latinos, ‘confianza,’ a term that encompasses trust, respect, level of communication and confidentiality, is really important,” Harvey added. “If they don’t feel like they are treated with confianza, they may view that as discrimination.”

Media Contact: 
Source: 

Daniel López-Cevallos, 541-737-3850, Daniel.lopez-cevallos@oregonstate.edu; S. Marie Harvey, 541-737-3824, Marie.harvey@oregonstate.edu

New book from OSU expert shows teachers, parents how to help preschoolers thrive

CORVALLIS, Ore. – Teachers and parents of preschoolers have a new resource from Oregon State University professor Megan McClelland and OSU graduate Shauna Tominey, whose new book demonstrates how to help 3-to-6-year-olds flourish during their formative years.

Much of McClelland’s research focuses on the important role of self-regulation skills – the social and emotional skills that help children pay attention, follow directions, stay on task, form healthy friendships and persist through difficulty. Children with stronger self-regulation are more likely to do well in school and graduate from college compared to children with weaker self-regulation.

“Stop, Think, Act: Integrating Self-regulation in the Early Childhood Classroom,” (Routledge) is a guide to help preschool teachers and parents understand self-regulation and help children ages 3-6 build those skills through developmentally appropriate games, songs and more. 

Recent research by McClelland and her colleagues has found that these types of activities can significantly improve children’s self-regulation and early academic achievement skills.

McClelland, the Katherine E. Smith Healthy Children and Families Professor in Human Development and Family Sciences at OSU, and Tominey, an associate research scientist and the director of Early Childhood Programming and Teacher Education at the Yale Center for Emotional Intelligence, wrote the book in an effort to meet increasing demands for information about self-regulation and the activities that boost it. 

“Teachers, and parents, too, are desperate for resources to help support young children,” McClelland said. “This book offers practical tools and activities you can do with your children at home or in the classroom.”

The book offers early childhood education teachers the latest research, a wide variety of hands-on activities to help children learn and practice self-regulation techniques, as well as tips and tools for integrating those activities into early learning settings.

But “Stop, Think, Act” also would be useful for parents of children ages 3-6 who are looking for ways to help prepare their children for schools, said McClelland, a nationally-recognized expert in child development. 

“The kids love playing the games,” she said. “There are some key elements, but you can play them in lots of different ways.”

One game is “Red Light, Purple Light,” which is similar to “Red Light, Green Light.” The teacher or leader serves as a stoplight, holding up construction-paper circles to represent stop and go. Children follow color cues, such as purple is stop and orange is go, and then switched to the opposite, where purple is go and orange is stop. 

Additional rules are added later to increase the complexity of the game. The game requires children to listen and remember instructions, pay attention to the adult leading the game and resist impulses to stop or go.

“It’s about helping the children practice better control,” McClelland said. “The games help them learn to stop, think and then act.”  

Media Contact: 
Source: 

Megan McClelland, 541-737-9225, megan.mcclelland@oregonstate.edu 

Multimedia Downloads
Multimedia: 

Megan McClelland

Megan McClelland

"Stop, Think, Act"

Stop Think Act