The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.
SMJ // Article
Original Article
Impact of Neighborhood Environments on Health Consciousness, Information Seeking, and Attitudes among US-Born and Non–US-Born Free Clinic Patients
Abstract
Objectives: This study examined the impact of neighborhood environments on health consciousness, information seeking, and attitudes among uninsured free clinic patients to better understand the specific needs of the population for health promotion and prevention efforts.Methods: US-born English-speaking, non–US-born English-speaking, and Spanish-speaking free clinic patients completed a self-administered survey using reliable measures in autumn 2014 (N = 769).
Results: The results of this study suggest that social cohesion is positively associated with health consciousness, information seeking, and attitudes. Lower levels of available healthy food in the community were associated with higher levels of health consciousness. Although Spanish speakers reported lower levels of the availability of healthy food, social cohesion, and access to the Internet or text messaging compared with US-born or non–US-born English speakers, they were more likely to be health conscious and have higher levels of health information seeking. Spanish speakers as well as non–US-born English speakers, were more likely to attend health education classes compared with US-born English speakers.
Conclusions: Health education programs for free clinic patients should include strategies to increase social cohesion. Health education programs should consider the diverse needs of these individual populations to maximize the effectiveness of the programs for free clinic patients.
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References
1. Geller S, Taylor BM, Scott HD. Free clinics helping to patch the safety net. J Health Care Poor Underserved 2004;15:42-51.
2. Gertz AM, Frank S, Blixen CE. A survey of patients and providers at free clinics across the United States. J Community Health 2011;36:83-93.
3. Nadkarni MM, Philbrick JT. Free clinics: a national survey. Am J Med Sci 2005;330:25-31.
4. Darnell JS. Free clinics in the United States: a nationwide survey. Arch Intern Med 2010;170:946-953.
5. Keis RM, DeGeus LG, Cashman S, et al. Characteristics of patients at three free clinics. J Health Care Poor Underserved 2004;15:603-617.
6. Kamimura A, Christensen N, Tabler J, et al. Patients utilizing a free clinic: physical and mental health, health literacy, and social support. J Community Health 2013;38:716-723.
7. Gorrindo P, Peltz A, Ladner TR, et al. Medical students as health educators at a student-run free clinic: improving the clinical outcomes of diabetic patients. Acad Med 2014;89:625-631.
8. Kamimura A, Christensen N, Tabler J, et al. Depression, somatic symptoms, and perceived neighborhood environments among US-born and non-US-born free clinic patients. South Med J 2014;107:591-596.
9. Kamimura A, Christensen N, Mo W, et al. Knowledge and perceptions of breast health among free clinic patients. Womens Health Issues 2014;24:e327-e333.
10. Kamimura A, Myers K, Ashby J, et al. Women in free clinics: an assessment of health-related quality of life for prevention and health education. J Community Health 2015;40:793-801.
11. Foley KL, Pockey JR, Helme DW, et al. Integrating evidence-based tobacco cessation interventions in free medical clinics: opportunities and challenges. Health Promot Pract 2012;13:687-695.
12. Weaver JB 3rd, Mays D, Weaver SS, et al. Health information-seeking behaviors, health indicators, and health risks. Am J Public Health 2010;100:1520-1525.
13. Dutta-Bergman MJ. Developing a profile of consumer intention to seek out additional information beyond a doctor: the role of communicative and motivation variables. Health Commun 2005;17:1-16.
14. Jetter KM, Cassady DL. The availability and cost of healthier food alternatives. Am J Prev Med 2006;30:38-44.
15. Lynch JW, Kaplan GA. Understanding how inequality in the distribution of income affects health. J Health Psychol 1997;2:297-314.
16. Chuang YC, Chuang KY, Yang TH. Social cohesion matters in health. Int J Equity Health 2013;12:87.
17. Rios R, Aiken LS, Zautra AJ. Neighborhood contexts and the mediating role of neighborhood social cohesion on health and psychological distress among Hispanic and non-Hispanic residents. Ann Behav Med 2012;43:50-61.
18. Dutta-Bergman MJ. Primary sources of health information: comparisons in the domain of health attitudes, health cognitions, and health behaviors. Health Commun 2004;16:273-288.
19. Gould SJ. Health consciousness and health behavior: the application of a new health consciousness scale. Am J Prev Med 1990;6:228-237.
20. Mujahid MS, Diez Roux AV, Morenoff JD, et al. Assessing the measurement properties of neighborhood scales: from psychometrics to ecometrics. Am J Epidemiol 2007;165:858-867.
21. McCloskey J, Tollestrup K, Sanders M. A community integration approach to social determinants of health in New Mexico. Fam Community Health 2011;34(Suppl 1):S79-S9.
22. Hurdle DE. Social support: a critical factor in women’s health and health promotion. Health Soc Work 2001;26:72-79.
23. Neville L, Furber S, Thackway S, et al. A health impact assessment of an environmental management plan: the impacts on physical activity and social cohesion. Health Promot J Austr 2005;16:194-200.
24. Ruijsbroek A, Droomers M, Groenewegen PP, et al. Social safety, self-rated general health and physical activity: changes in area crime, area safety feelings and the role of social cohesion. Health Place 2015;31:39-45.
25. Martin KS, Havens E, Boyle KE, et al. If you stock it, will they buy it? Healthy food availability and customer purchasing behaviour within corner stores in Hartford, CT, USA. Public Health Nutr 2012;15:1973-1978.
26. Budzynska K, West P, Savoy-Moore RT, et al. A food desert in Detroit: associations with food shopping and eating behaviours, dietary intakes and obesity. Public Health Nutr 2013;16:2114-2123.
27. US Department of Agriculture. Creating access to healthy, affordable food. https://apps.ams.usda.gov/fooddeserts/AccessHealthyFood.pdf. Published December 2010. Accessed September 22, 2015.
28. Bjornstrom EES, Ralston ML, Kuhl DC. Social cohesion and self-rated health: the moderating effect of neighborhood physical disorder. Am J Community Psychol 2013;52:302-312.
29. Hong S, Zhang W, Walton E. Neighborhoods and mental health: exploring ethnic density, poverty, and social cohesion among Asian Americans and Latinos. Soc Sci Med 2014;111:117-124.
