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PubMed2004

Provider counseling, health education, and community health workers: the Arizona WISEWOMAN project.

BACKGROUND: The Arizona Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) project used provider counseling, health education, and community health workers (CHWs) to target chronic disease risk factors in uninsured, primarily Hispanic women over age 50. METHODS: Participants were recruited from two Tucson clinics participating in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Women were randomly assigned into one of three intervention groups: (1) provider counseling, (2) provider counseling and health education, or (3) provider counseling, health education, and CHW support. At baseline and 12 months (1998-2000), participants were measured for height, weight, waist and hip circumference, and blood pressure. Blood tests were conducted to check blood glucose, cholesterol, and triglyceride levels. At each time point, participants also completed 24-hour dietary recalls and questionnaires focusing on their physical activity levels. RESULTS: A total of 217 women participated in baseline and 12-month follow-up. Three fourths were Hispanic. All three intervention groups showed an increase in self-reported weekly minutes of moderate-to-vigorous physical activity, with no significant differences between the groups. Significantly more women who received the comprehensive intervention of provider counseling, health education, and CHW support progressed to eating five fruits and vegetables per day, compared with participants who received only provider counseling or provider counseling plus health education. CONCLUSIONS: All three interventions increased moderate-to-vigorous physical activity but not fruit and vegetable consumption. The intervention group with provider counseling, health education, and CHW support significantly increased the number of women meeting national recommendations for fruit and vegetable consumption.

Aged↗
PubMed1999

Women, the welfare state, and their transnational dimension: the case of Mexico's community health worker programs.

Feminist scholarship has shown that the welfare state is not only a set of agencies and policies to distribute services, but is engaged in the promotion of normative concepts of the female through its structural arrangements and the content of its programs and policies. Yet, this scholarship conceptualizes the state as a national entity and free from external influences, ignoring its transnational dimension. States are embedded in an international network consisting of other states, international agencies, and corporations that influence the practices and discursive frame of the welfare state. To uncover the process by which the welfare state institutionalizes and promotes female identities and the transnational dimension of this process, the author analyzes the case of community health worker programs conducted by the Mexican state from the 1970s to the early 1990s. The analysis corroborates the gender practices of the welfare state and suggests a reconceptualization that takes into account the transnational dimension of the state practices. The implications for feminist theories on the welfare state and for analyses of health promotion policies and programs are discussed.

Community Health Services↗
PubMed1988

Simple tricoloured measuring tapes for identification of low birthweight babies by community health workers.

A total of 446 singleton neonates were subjected to measurements of birthweight, chest circumference (CC) and mid-arm circumference (MAC). A high degree of correlation between birthweight and CC as well as MAC was observed. Chest circumference correlated better with birthweight than MAC. Further analysis of data showed that CC measurements of less than or equal to 30.0 cm and less than or equal to 27.5 cm reliably identify neonates less than 2500 g and less than 2000 g, respectively, with a high degree of specificity and predictive value. The corresponding values for MAC were less than or equal to 9.0 cm and less than or equal to 8.5 cm, respectively. Using these inferences, two tricoloured measuring tapes, one each for CC and MAC, are proposed as simple screening tools for use by primary health workers for identifying low-birthweight neonates in the community without resorting to weighing scales.

Anthropometry↗