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ABSTRACT: The Preventive Health Education and Medical Home Project (PHEMHP) is a predictive and contextual model intended to reduce low levels of health services utilization and improve preventive health techniques and disease self-management for low-income families in South Central Los Angeles, with the ultimate goal of attaching each child to a medical home. The model is designed to be implemented through educational and case management strategies. This paper presents the conceptual framework, critical intervention activities, and the different implementation variations the PHEMHP has already assumed. Implications for research, policy, and practice are discussed.
Social Work in Public Health 11/2009; 24(6):491-510. · 0.31 Impact Factor
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ABSTRACT: The primary objective of this study was to assess the role of alcohol use and depression in intimate partner violence (IPV) victimization and perpetration among Blacks and Hispanics in an underserved urban emergency department population.
This cross-sectional study surveyed male and female patients presenting to an urban emergency department. The outcome measures were physical or sexual IPV victimization and perpetration in the previous 12 months. The independent predictors included demographic variables, alcohol and drug use, and depressive symptoms. Logistic regression analyses calculated the adjusted odds ratio (AOR) and 95% confidence interval (CI) for predictors of IPV victimization and perpetration in separate models.
The prevalence of IPV victimization among Blacks and Hispanics were similar (14% and 10%, respectively) but blacks were nearly twice as likely to report IPV perpetration (17% vs. 9%, respectively). Predictors of IPV perpetration were Black race, married or living with a partner, heavy drinking, illicit drug use, and current depression. Depression, but not substance use, also predicted IPV victimization, in addition to Black race, married or living with a partner, and younger age. Screening for substance abuse and depression in an inner city emergency department population may help to identify individuals at high risk of IPV, particularly IPV perpetration.
The American Journal of Drug and Alcohol Abuse 02/2005; 31(2):225-42. · 1.55 Impact Factor
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ABSTRACT: To facilitate the identification of ED patients at risk for intimate partner violence (IPV), we assessed the relationship of acute violence-related injury and history of IPV victimization or perpetration.
: This cross-sectional study systematically sampled patients presenting to an urban ED. Reason for visit, past year history of IPV victimization and perpetration, alcohol and drug use and abuse, and sociodemographic factors were assessed. We hypothesized that violence-related injury would be positively associated with a history of IPV victimization and with IPV perpetration.
The odds of violence-related injury was increased three-fold among persons with a history of IPV victimization and nearly two-fold (although not statistically significant) among those with IPV perpetration history. Male gender, younger age, and problem drinking were independent risk factors in both models.
Screening for IPV among individuals presenting with a violence-related injury may be helpful in identifying individuals at risk of partner violence.
The Journal of trauma 09/2004; 57(2):352-9. · 2.48 Impact Factor
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ABSTRACT: to compare brief screening instruments for alcohol use disorders, the RAPS4, RAPS4-QF, and AUDIT, against DSM-IV criteria for alcohol dependence and alcohol abuse among African Americans and Hispanics in a sample of inner city emergency department (ED) patients.
a probability sample of 395 African American and Hispanic patients seeking care at King Drew Medical Center Emergency Department were interviewed regarding items related to the screening and diagnostic instruments, quantity and frequency of drinking and demographic characteristics.
no difference was found between the RAPS4 and AUDIT for alcohol dependence. Sensitivity of the RAPS4-QF (the RAPS4 plus a quantity item and a frequency item) was significantly better than the AUDIT for African Americans and Hispanics, and for males, but not for females, although the RAPS4-QF identified all of those women positive for alcohol abuse criteria, compared to 93% identified by the AUDIT.
the data suggest the RAPS4 and the RAPS4-QF perform well for identifying alcohol dependence and alcohol abuse, respectively, among minority ED patients. Additional research is needed to evaluate the RAPS4-QF as a stand-alone instrument and to evaluate both instruments across gender and ethnic subgroups in other populations and in other cultural settings.
Drug and Alcohol Dependence 10/2003; 71(3):275-80. · 3.38 Impact Factor
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ABSTRACT: This study was conducted to determine the predictors of screening mammography among women 40 years old and older residing in South Central Los Angeles, California. The population is predominately African American and Hispanic. Using Computer Assisted Telephone Interview (CATI) software and the Random Digit Dialing (RDD) method, a 54-item, 20-min questionnaire was administered to 505 women. All interviews were conducted in English or Spanish. The Health Belief Model provided the conceptual framework for the design of the questionnaire. A majority (81.8%) of the participants reported having at least one mammogram in their lifetime, with African Americans reporting the lowest rate (74.7%). Multiple logistic regression analyses found that 4 of the 23 independent variables assessed were predictive of ever users of mammography (p < 0.05), while 6 independent variables were predictive of never users of mammography (p < 0.05). A significant finding of this study is the lower rate of screening mammography utilization in this sample compared to estimates for the general population. The results of this study also suggest that substantial improvements in the rate of screening mammography could be achieved if women in their 40s, who are without health insurance, were referred by their physicians to have affordable mammograms every year or two.
Journal of the National Medical Association 02/2002; 94(1):5-14. · 1.16 Impact Factor
