General Public Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21713
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Browsing General Public Health by Author "Chhetri, Shlesma"
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Item Improving Lives of Most Vulnerable: The Relationship between Diet, Physical Activity, and Quality of Life among Permanent Supportive Housing Residents(2016-03-23) Suzuki, Sumihiro; Spence-Almaguer, Emily; Walters, Scott; Chhetri, ShlesmaBackground: Chronic homelessness is a complex public health concern in the United States. People experiencing chronic homelessness are much more likely to suffer from mental illness and substance use, and to be overweight or obese (Tsai & Rosenheck, 2013; Tsemberis, Kent, & Respress, 2012). Housing First is an approach to place people who are chronically homeless into Permanent Supportive Housing (PSH) (Rog el at., 2014). There is clear evidence PSH programs increase housing retention and, reduce healthcare and criminal justice costs (Tsemberis & Eisenberg, 2014; McLaughlin, 2010). However, becoming housed does not necessarily improve a person’s overall quality of life (QOL) (Wolf et al., 2001). Improvement in diet and physical activity may be one way to improve QOL among vulnerable populations (Blissmer et al., 2006). However, this association has not been explored among PSH residents. The purpose of this study was to explore the patterns of change and relationship between diet, physical activity and QOL among PSH residents enrolled in a health coaching program. Method: We used data collected during baseline and follow up interviews from m.chat – a health coaching program for PSH residents in Fort Worth. The program utilizes motivational interviewing and wellness incentives to help people achieve health goals. Specifically, we examined demographic characteristics, diet, physical activity and overall QOL from 230 participants enrolled in the m.chat program. Paired t-test and mixed model analysis was performed utilizing SPSS software. Results: We found a significant improvement in the total QOL scores from baseline to follow-up. A random intercept model showed a positive association between change in diet and the improvement in QOL. Physical activity was not significantly related to improved QOL; however, there was large variation in the physical activity data. Conclusion: This study is the first to look at changes in QOL among PSH residents enrolled in a health coaching program. Interventions that encourage diet and physical activity may improve overall QOL among PSH residents.Item The Challenges of a Second Chance: Exploring the Role of Social Support among Females who were Previously Incarcerated(2016-03-23) Cantu, Katherine; Chhetri, Shlesma; Spence-Almaguer, Emily MSW, PhD; Rohr, Danielle; Andrews, Alita R.Objective: The incarceration rate for women in the United States has increased by 31% in the last decade (Minton, 2012). Community reentry following incarceration is a complex process, leading to approximately 45% of women recidivating (Brown, 2010). Upon release, women are in need of comprehensive services including empowerment programs with opportunities to achieve self-sufficiency (Richie, 2001). However, studies show providing housing, employment and treatment alone are not sufficient in addressing recidivism, fortifying the need for additional support systems (Adritti & Few, 2008; Makarios, Steiner, & Travis, 2010). The Second Chance Mentoring program (SCM) coordinated by Family Pathfinders of Tarrant County provides re-entry mentoring services for formerly incarcerated females. Volunteer mentors focus on providing support during this integral transition. This study aimed to evaluate the effectiveness of the social support triangular relationship between mentors, mentees, and the SCM staff members. Methods: This study utilized a mixed method design using secondary data from 58 women enrolled in the SCM program between 2010-2015. Individual case notes, risk scores, and data related to recidivism were analyzed using qualitative and quantitative methods. Textual data were coded using content analysis procedures to investigate key themes from progress notes. Data associated with recidivism were analyzed using SPSS. Qualitative and quantitative findings were triangulated in iterative cycles to develop an understanding of variable/theme interactions. Results: Using the Ohio Risk Assessment System (ORAS), the level of family/social support and their attitudes towards crime reflect that 44.6% of the participants reported low social support with criminal activity, 37.5% had moderate levels of social support, and 18% had high social support with criminal activity. Additionally, ORAS yielded a score based on peer associations and their attitudes towards crime, resulting in: 53.8% with high peer association risk, 46.2% of moderate risk, none of the sample had positive associations. Through qualitative data analysis, the triangular relationship between the participants, mentors, and staff members was examined to assess supportive influences associated with varying levels of risks and needs. Conclusion: The results indicate that the triangular relationship serves an important role in addressing the needs of reintegrating women, and staff members provide a strong scaffolding influence. Navigating a complex system of internal and external barriers requires both strong social support and tangible resources.