Risk Factors Among the Minority and Underserved


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  • What are the major chronic disease that you know about?
  • Define a chronic disease How many of you have family members who suffer fro these diseases?
  • Churches are particulary relevenat. Health promption programs in schools, health care ceterns, etc. are able to target interventions in specific population groups, while other perhaps more sendentary groups are missed. Places of worship may be particulary important for underserved, often neglected populations, whichi in the context in which a healthy body, mind and soul are equally valued. Aas are most committed racial groups Useful resources for health promotion- meeting rooms, recruitment enviroment and often advocate postive health practices … Because church settings offer an acceptable and sustainable infrastructure for the deliverary of health promotion programs, partnerships with churches are indicated in the development of new treatments, etc.
  • From all the negative health behaviors tobacco use(smoking, chewing tobacco, etc) greatly increases the chance of developing chronic disease Does anyone smoke? Have a family member of friend who smokes?
  • The major chronic diseases caused by smoking
  • Our aim is to is to link the spiritual teachings on health made by our Imams with the compelling scientific evidence that now links lifestyle and chronic disease According to our faith human development combines the physical, mental and spiritual aspects of development Our Imams have spoken about the relationship between health and spiritual development These teachings are compiled in a book “Gems of Health”
  • Risk Factors Among the Minority and Underserved

    1. 1. Chronic/Disabling Diseases and Their Risk Factors Among Minority and Underserved Populations - Alex and Kentya
    2. 2. Leading Chronic/Disabling Diseases in the U.S. <ul><li>Heart Disease / Stroke </li></ul><ul><li>Cancer </li></ul><ul><li>Diabetes </li></ul><ul><li>Arthritis </li></ul><ul><li>Hiv/Aids </li></ul><ul><li>Mental health(Depression/Psychological Distress) </li></ul>
    3. 3. Chronic Disease Overview * <ul><li>Chronic diseases are illnesses that are prolonged in duration and are rarely cured completely. </li></ul><ul><li>Account for 7 out of every 10 deaths annually </li></ul><ul><li>50% of Americans live with at least one chronic disease </li></ul><ul><li>Chronic diseases are Preventable </li></ul><ul><li>Chronic Diseases are a result of what people do or do not do </li></ul><ul><li>* The Center for Disease Control, National Center for Chronic Disease Prevention and Health Promotion (June 1, 2009) </li></ul>
    4. 4. Health Behaviors among underserved Minorities that Increase Risk of Disease <ul><li>Tobacco Use </li></ul><ul><li>Illicit Drug Use and Abuse </li></ul><ul><li>Unhealthy Sex </li></ul><ul><li>Obesity(lack of physical activity/poor diet) </li></ul><ul><li>STRESS / DISTRESS </li></ul>
    5. 5. Places of worship and health promotion <ul><li>May be particularly relevant settings to reach people, particularly minorities </li></ul><ul><ul><li>Pew Research center found that AAs are the most religiously committed racial/ethnic group in the country </li></ul></ul><ul><ul><ul><li>58% attending religious services at least one as week </li></ul></ul></ul><ul><ul><ul><li>76% praying at least daily </li></ul></ul></ul><ul><ul><li>Useful resources for health promotion </li></ul></ul><ul><ul><li>Advocate for positive health (e.g., avoidance of substance use) </li></ul></ul><ul><ul><ul><li>Recent meta-analysis indicated that smoking cessation interventions may be relevant in church setting </li></ul></ul></ul>Campbell et al., 2007; Webb, 2008
    6. 6. Tobacco Use Morbidity/Mortality <ul><li>87% of all lung cancers </li></ul><ul><li>30% of all deaths from cancer </li></ul><ul><li>Contributes to diabetes, heart disease stroke, birth defects and other diseases </li></ul><ul><li>Annually, tobacco kills more people than alcohol, heroin, cocaine, suicide, auto accidents, fire and AIDS combined </li></ul><ul><li>Secondhand smoke kills 49,000 nonsmoking Americans from heart disease and lung cancer </li></ul><ul><li>Nicotine is as addictive as heroin and cocaine </li></ul>
    7. 8. Impact of Smoking on Lungs <ul><li>Lung severely damaged </li></ul><ul><li>from smoking </li></ul>
    8. 9. Definition of Stress <ul><li>Psychophysiological process, usually a negative emotional state that is both the product of appraisal of situational and psychological factors and an impetus for coping. </li></ul><ul><li>- Alejandro </li></ul>
    9. 10. <ul><li>Academic exams </li></ul><ul><li>Caregiving </li></ul><ul><li>Bereavement and divorce </li></ul><ul><li>Job loss </li></ul><ul><li>Disasters </li></ul><ul><li>Laboratory stressors </li></ul><ul><li>Medical </li></ul>Stressors
    10. 11. Stress <ul><li>Indirect </li></ul><ul><li>Behaviorally-Mediated </li></ul><ul><li>Effects </li></ul><ul><li>increased drug use </li></ul><ul><li>decreased nutrition </li></ul><ul><li>decreased sleep </li></ul><ul><li>Indirect Health Behavior Effects </li></ul><ul><li>de creased compliance </li></ul><ul><li>delay in seeking care </li></ul><ul><li>obscured symptom profile </li></ul><ul><li>Direct Physiological Effects </li></ul><ul><li>elevated HR and BP </li></ul><ul><li>Immune dysregulation </li></ul><ul><li>increased hormonal activity </li></ul><ul><li>increased platelet activity </li></ul>
    11. 12. Mind-body Programs <ul><li>Reduce distress </li></ul><ul><li>Reduce sympathetic arousal </li></ul><ul><li>Reduce pain and discomfort </li></ul><ul><li>Buffer immune suppression </li></ul><ul><li>Improve quality of life </li></ul><ul><li>Enhance survival </li></ul><ul><li>Reduce health care costs </li></ul>
    13. 14. Spirituality, religion and health: evidence and research <ul><li>A 2001 publication identified over 1200 studies that examined the relationship between religious belief and some indicator of health. Most studies found a positive association between religion and physical and mental health * </li></ul><ul><li>Studies of adolescent behavior have found that higher levels of religious involvement are inversely related to alcohol and drug use, smoking, sexual activity, depressive symptoms and suicide risk ** </li></ul><ul><li>*Koenig HG, McCullough ME, Larson DB. Handbook of religion and health. New York: Oxford University Press, 2001. </li></ul><ul><li>** Rew L, Wong YJ. A systematic review of associations among religiosity/ spirituality and adolescent health attitudes and behaviors. J Adolesc Health 2006 </li></ul>
    14. 15. Social Support and Smoking Abstinence <ul><li>Particular types of counseling strategies are especially effective. Practical counseling and the provision of intra-treatment social support are accociated with significant increases in abstinence rates - Treating Tobacco Use and Dependence, Clinical Practice Guidelines, 2008 </li></ul><ul><li>Recent Study(NEJM): thousands of smokers and nonsmokers followed for 32 years, 1971-2003, as part of a large network of relatives, co-workers, and friends - “ The Collective Dynamics of Smoking in a Large Social Network, Nicholas A. Christakis and James H. Fowler, N Engl J Med 2008” </li></ul><ul><li>Results: smoking cessation programs work best if they focus on groups rather than individuals. Quitting can have a ripple effect prompting an entire social network to break the habit. </li></ul>
    15. 16. Primary Aims of Our Study <ul><li>Specific Aim 1: To develop and implement a health education curriculum addressing tobacco use and other health risks in collaboration with members of religiously diverse congregations </li></ul><ul><li>- to establish effective partnerships with underserved religiously diverse congregations in Houston area and </li></ul><ul><li>- to enhance our science-based health behavior programs with religious teachings and mind-body spiritual practices. </li></ul><ul><li>- develop a training curricula addressing these multiple health behaviors </li></ul><ul><li>- M. D. Anderson’s Tobacco Outreach Education Program (TOEP) for healthcare providers will provide a model for the new training program. </li></ul>
    16. 17. Primary Aims of Our Study(cont’d) <ul><li>Specific Aim 2: To evaluate the feasibility of the training program and its impact on recipients of the training </li></ul><ul><li>- increase the ability, confidence and intention to address tobacco use and other health risks among trainees </li></ul><ul><li>- have a positive impact on knowledge, attitudes and beliefs regarding health risks among members of the congregation </li></ul><ul><li>Specific Aim 3: To establish a dialogue across faiths with regard to religion, spirituality and health </li></ul><ul><li>Salma </li></ul>
    17. 18. The Religious and Spiritual Dimension <ul><li>The study will be designed to explore the role of religion and spirituality in health behavior change </li></ul><ul><li>Our behavioral theory-guided intervention will be combined with relevant religious/spiritual messages and counseling. </li></ul><ul><li>The training will incorporate the spiritual dimension of health including religious and spiritually based teachings and counseling practices with regard to health, the healing power of prayer, spiritual transformation through mind-body contemplative practices and social support networking within congregations. </li></ul><ul><li>The spiritually based teachings, prayers and the mind-body component of the intervention will be in accordance with and with the appropriate language of each religion. Relapse prevention will be specifically addressed </li></ul><ul><li>Alejandro </li></ul>
    18. 19. Sources of Funding <ul><li>NCMHD Innovative Faith-Based Approaches to Health Disparities Research (R21) </li></ul><ul><li>City of Houston Department of Health and Human Services </li></ul><ul><li>U. S. Dept of Health and Human Services: New Funding Opportunities (Announced 2011) </li></ul><ul><li>- Community and State Prevention Programs </li></ul><ul><li>- Tobacco and other risk Prevention Programs </li></ul><ul><li>Sara </li></ul>
    19. 20. BENEFITS <ul><li>Ground Breaking (Never Been Done Before) </li></ul><ul><li>Advancement of Communities by promoting health care prevention/intervention </li></ul><ul><li>Ownership of the Spirituality/Health Intervention Model </li></ul><ul><li>Opportunity for Interfaith Dialogue and advancing the peace effort </li></ul><ul><li>Sara </li></ul>
    20. 21. FAQ <ul><li>What kind of a time commitment does this require from our congregation? </li></ul><ul><li>Can you provide a brief timeline of how this project will be executed? </li></ul><ul><li>Who will develop the intervention? </li></ul><ul><li>How many participants are required from our congregation? </li></ul><ul><li>Are there financial incentives involved? </li></ul>