RESUMEN
Rural poverty and lack of access to education has led to urban migration and fed the constant growth of urban slums in Lima, Peru. Inhabitants of these informal settlements lack land rights and access to a public water supply, resulting in poor sanitation, an inability to grow food, and suboptimal health outcomes. A repeated measures longitudinal pilot study utilizing participatory design methods was conducted in Lima between September 2013 and September 2014 to determine the feasibility of implementing household gardens and the subsequent impact of increased green space on well-being. Anthropometric data and a composite of five validated mental health surveys were collected at the baseline, 6-months, and 12-months after garden construction. Significant increases from the baseline in all domains of quality of life, including: physical (p < 0.01), psychological (p = 0.05), social (p = 0.02), environmental (p = 0.02), and overall social capital (p < 0.01) were identified 12 months after garden construction. Life-threatening experiences decreased significantly compared to the baseline (p = 0.02). There were no significant changes in parent or partner empathy (p = 0.21), BMI (p = 0.95), waist circumference (p = 0.18), or blood pressure (p = 0.66) at 6 or 12 months. Improved access to green space in the form of a household garden can significantly improve mental health in an urban slum setting.
Asunto(s)
Jardines , Salud Mental , Áreas de Pobreza , Adulto , Ciudades , Femenino , Jardinería , Humanos , Masculino , Persona de Mediana Edad , Perú , Proyectos Piloto , Calidad de Vida , Encuestas y Cuestionarios , Población Urbana/estadística & datos numéricos , Adulto JovenRESUMEN
OBJECTIVES: To examine the effect of race/ethnicity and fear characteristics on the initiation and maintenance of digital rectal examination (DRE) screening. METHODS: A total of 533 men from Brooklyn, New York, aged 45-70 years, were classified into 4 race/ethnic groups: U.S.-born whites, U.S.-born African-American, Jamaican, and Trinidadian/Tobagonian. The participants recorded the number of DREs in the past 10 years. The demographics and structural variables and prostate cancer worry and screening fear were measured using validated tools. RESULTS: Overall, 30% of subjects reported never having a DRE, and 24% reported annual DREs. African-American, Jamaican, and Trinidadian/Tobagonian men had greater prostate cancer worry and screening fear scores than did the white men (all P < .05). African-American, Jamaican, and Trinidadian/Tobagonian men were less likely to maintain annual DREs than white men (odds ratio 0.17, 0.26, and 0.16, respectively, all P < .05). The men with low screening fear were more likely to have had an initial DRE (OR 2.3, P < .05 vs high screening fear) but were no more or less likely to undergo annual DREs. Having a regular physician, comprehensive physician discussion, and annual visits were also associated with undergoing DREs. CONCLUSIONS: We identified several ethnically varying barriers and facilitators to DRE screening. African-American and African-Caribbean men undergo DRE less often and have greater prostate cancer worry and screening fear scores than did white men. Screening fear predicts the likelihood of undergoing an initial, but not annual, DRE screening. Access to a physician and annual visits facilitate DRE screening. Interventions that include both culturally sensitive education and patient navigation and considered whether patients should be initiating or maintaining screening might facilitate guideline-consistent screening.