Purpose: This article describes early efforts of four community partnerships in Boston, El Paso, Houston, and Milwaukee to address governance and management structures in ways that promote the sustainability of innovative community-based long-term care system improvements. The four communities are grantees of the Community Partnerships for Older Adults Program, a national initiative of the Robert Wood Johnson Foundation that fosters local partnerships to improve long-term care and supportive-services systems in order to meet the current and future needs of older adults. Design and Methods: We examined community partnership approaches to governance and management, as well as evidence of the partnerships' influence in their communities, by using the conceptual framework of the community health partnerships typology developed by Shannon M. Mitchell and Stephen Shortell. Results: Addressing governance and management issues was critical to the early evolution of community partnerships for older adults. Early partnership experiences, particularly with regard to local funders and media, provide evidence of emerging centrality (importance and influence in the community), which forecasts sustainability. Observation over a longer period is needed in order to see whether early successes will be sustained, particularly once original grant funding ends. Implications: Community partnerships for older adults can become influential positive forces but must invest in adequate governance and management structures early on.
Rural youth are at greater risk than urban youth for obesity and physical inactivity. Active living research incorporates an ecological approach to promoting physical activity (PA) by recognizing that individual behavior, social environments, physical environments, and policies contribute to behavior change. Active living research and interventions have been limited primarily to urban settings. Because rural communities have unique environmental features and sociocultural characteristics, this project combines insights from current active living models with more focused consideration of the physical and social realities of rural areas. In this study, we report on our efforts to develop, test, and refine a conceptual model describing the interaction between the individual and the environment as it enhances or thwarts active living in rural communities. Our findings revealed a host of relevant "predisposing" and "enabling" factors, including sociodemographic, environmental, policy, and programmatic elements, that extend across the four domains of active living--transportation, recreation, occupation, and household. A one-size approach to PA promotion will not fit the needs of rural youth. Given the unique challenges that rural communities face, efforts to combat childhood obesity must consider rural residents a priority population. More research, interventions, and evaluations on ways to promote rural PA are needed.
Research by the authors with parents, child care providers, and other service providers found that parents of children with special needs face particular challenges trying to maintain stable employment while balancing work and family. These parents have more difficulty finding and keeping child care for children with special needs, and there is a lack of coordination of therapy with child care programs. Since the study was completed, Maine has taken several steps to begin to address these issues.
Objective: Develop rural-specific assessment tools to be used by researchers and practitioners to measure the activity-friendliness of rural communities. Method: The tools were created through a mixed-methods investigation into the determinants of physical activity among rural populations. This informed the development of a conceptual framework defining activity-friendly rural environments. Questions were generated to reflect applicable existing urban-based variables and rural conceptual model elements. Pilot testing was conducted in seven rural US communities during the fall of 2008. Inter-rater reliability was assessed. Results: The Rural Active Living Assessment (RALA) Tools include three components: Town-Wide (18 town characteristic questions, and inventory of 15 recreational amenities), Program and Policy (20 questions), and Street Segment (28 questions). We found that the Town-wide and Program and Policy tools were feasible for community members to implement. The observed agreement and k statistic across all items for the Street Segment Assessment were substantial (91.9% and 0.78, respectively). Conclusions: The RALA Tools were shown to be feasible and reliability was supported. They assess features believed to be supportive of active living in rural environments, offer users a resource to assess rural environments for activity-friendliness, and may also inform the design of interventions to help rural communities become more active and healthy. [Journal Abstract]
The authors discuss the increasing number of Maine children who are English language learners (ELL) or who are limited-English proficient (LEP), noting that insufficient attention has been paid to the preschool education of this group. The authors describe lessons learned from an Early Reading First Program in Portland, ME, which enhanced the school-readiness of preschool ELL children.
Opening the World of Learning (OWL) is a comprehensive pre-K curriculum that has a particular focus on language and literacy. This article describes the general structure and content of OWL and reports results of a secondary analysis that examined results from multiple waves of data collected from eight Early Reading First Programs that served over 3,000 children. Results indicate consistent positive effects across projects, with year-to-year improvements in children's scores, with substantial growth being observed after year one in language, print knowledge, and phonological awareness outcomes. Firsthand experiences of those implementing OWL provide insight into some of the challenges programs face as they implement the curriculum and strive to accelerate children's language and literacy development. [article abstract]
Researchers at the University of Southern Maine analyzed the consumption of sugar-sweetened beverages (such as soda and sports drinks) among students in seven high schools in Maine to determine the impact of school-based restrictions on the availability of these beverages.
The authors of this article conclude that, although consumption of the sugar-sweetened beverages decreased during the 2-year study, the impact of the school-based restrictions reducing the availability of these beverages may be limited. They suggest that because consumption of sugar-sweetened beverages is emerging a a potential factor in youth obesity, further research is needed with larger samples and more complex data analysis to show the efficacy of school food policies for youth especially susceptible to obesity.