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San Antonio, TX, United States

Sosa E.T.,University of Texas at San Antonio | Biediger-Friedman L.,Texas State University | Banda M.,San Antonio Metropolitan Health District
Health Promotion Practice | Year: 2014

Background. Restaurant initiatives provide an efficient opportunity to impact large numbers of patrons. The purpose of this study is to measure patron purchasing behaviors during the ¡Por Vida! menu designation initiative. Method. This study used a cross-sectional design and survey data to assess 23 restaurants throughout Bexar County and 152 restaurant patrons. The Patron Awareness Questionnaire assessed if patrons noticed the logo; believed nutrition, cost, and taste were important in making purchasing decisions; and purchased a ¡Por Vida! item. Descriptive statistics, Spearman correlations, and logistic regression were used to analyze the data. Results. Most (93.4%) patrons considered taste very important when deciding what to eat. Cost was very important to 63.8% and nutrition was very important to 55.9% of the sample. The strongest predictors of purchasing a ¡Por Vida! item were the patrons' ages being between 18 and 35 years (odds ratio = 1.474; confidence interval = 0.017, 0.812; p<.05) and if patrons saw the logo (odds ratio = 4.327; confidence interval = 1.696-11.036; p<.01). Discussion/Conclusion. Menu logo designation initiatives can potentially influence patron purchasing behaviors among a segment of the population when the logo is visible. © 2012 Society for Public Health Education.

Schlenker T.,San Antonio Metropolitan Health District | Huber C.A.,University Health System
Journal of Public Health Management and Practice | Year: 2015

addition to the Affordable Care Act, states are more frequently turning to Medicaid waivers to achieve the "Triple Aim" goals of improving the experience of care, improving population health, and reducing per capita costs. These demonstration waivers provide opportunities to test innovative ways to finance and deliver care. Texas is currently implementing a waiver known as the Transformation and Quality Improvement Program. Its inclusion of public health agencies is a unique approach to a system typically limited to traditional providers. San Antonio Metropolitan Health District is one public health agency taking advantage of this new funding opportunity to implement 6 new or expanded programs targeting health issues of highest priority in this south Texas region. This article discusses the use of Medicaid waivers and the advantages and challenges of public health agency participation. © 2015 Wolters Kluwer Health.

Werling J.,San Antonio Metropolitan Health District | Alsip B.J.,San Antonio Metropolitan Health District | Alsip B.J.,University of Texas Health Science Center at San Antonio
Postgraduate Medicine | Year: 2010

Most children with meningococcal disease have apparent clinical signs of illness, but some do not initially present with clinical toxicity. These children with unsuspected meningococcal disease may potentially be discharged after outpatient evaluation and may deteriorate rapidly. We present the case of a 15-week-old infant boy who was brought to a private physician with symptoms of a common cold and was sent home. Three days later, his parents brought him to the hospital emergency department stating he was congested and crying a lot. He was again discharged. Another 2 days passed and his parents returned to the emergency department complaining that the infant was experiencing breathing problems. Following an examination, he was admitted to the hospital where symptoms worsened. Several hours after the infant was brought to the emergency room, he succumbed to what was later confirmed to be meningococcal disease. © Postgraduate Medicine.

Sunil T.S.,University of Texas at San Antonio | Spears W.D.,Wright State University | Hook L.,University Health Systems | Castillo J.,San Antonio Metropolitan Health District | Torres C.,San Antonio Metropolitan Health District
Maternal and Child Health Journal | Year: 2010

Healthy People 2010 goals set a target of 90% of mothers starting prenatal care in the first trimester of pregnancy. While there are questions about the value of prenatal care (PNC), there is much observational evidence of the benefits of PNC including reduction in maternal, fetal, perinatal, and infant deaths. The objective of this study was to understand barriers to PNC as well as factors that impact early initiation of care among low-income women in San Antonio, Texas. A survey study was conducted among low-income women seeking care at selected public health clinics in San Antonio. Interviews were conducted with 444 women. Study results show that women with social barriers, those who were less educated, who were living alone (i.e. without an adult partner or spouse), or who had not planned their pregnancies were more likely to initiate PNC late in their pregnancies. It was also observed that women who enrolled in the WIC program were more likely to initiate PNC early in their pregnancies. Women who initiated PNC late in pregnancy had the highest odds of reporting service-related barriers to receiving care. However, financial and personal barriers created no significant obstacles to women initiating PNC. The majority of women in this study reported that they were aware of the importance of PNC, knew where to go for care during pregnancy, and were able to pay for care through financial assistance, yet some did not initiate early prenatal care. This clearly establishes that the decision making process regarding PNC is complex. It is important that programs consider the complexity of the decision-making process and the priorities women set during pregnancy in planning interventions, particularly those that target low-income women. This could increase the likelihood that these women will seek PNC early in their pregnancies. © 2008 Springer Science+Business Media, LLC.

Schlenker T.,San Antonio Metropolitan Health District | Dresang L.T.,University of Wisconsin - Madison | Ndiaye M.,Public Health Madison and Dane County | Buckingham W.R.,University of Wisconsin - Madison | Leavitt J.W.,University of Wisconsin - Madison
Wisconsin Medical Journal | Year: 2012

Objectives: In Dane County, Wisconsin, the black-white infant mortality gap started decreasing from 2000 and was eliminated from 2004 to 2007. Unfortunately, it has reappeared since 2008. This paper examines risk factors and levels of prenatal care to identify key contributors to the dramatic decline and recent increase in black infant mortality and extremely premature birth rates. Methods: This retrospective cohort study analyzed approximately 100,000 Dane County birth, fetal, and infant death records from 1990 to 2007. Levels of prenatal care received were categorized as "less-than-standard," "standard routine" or "intensive." US Census data analysis identified demographic and socioeconomic changes. Infant mortality rates and extremely premature (≤ 28 weeks gestation) birth rates were main outcome measures. Contributions to improved outcomes were measured by calculating relative risk, risk difference and population attributable fraction (PAF). Mean income and food stamp use by race were analyzed as indicators of general socioeconomic changes suspected to be responsible for worsening outcomes since 2008. Results: Risk of extremely premature delivery for black women receiving standard routine care and intensive care decreased from 1990-2000 to 2001-2007 by 77.8% (95% CI = 49.9-90.1%) and 57.3% (95% CI = 27.6-74.8%) respectively. Women receiving less-than-standard care showed no significant improvement over time. Racial gaps in mean income and food stamp use narrowed 2002-2007 and widened since 2008. Conclusions: Prenatal support played an important role in improving black birth outcomes and eliminating the Dane County black-white infant mortality gap. Increasing socioeconomic disparities with worsening US economy since 2008 likely contributed to the gap's reappearance © 2012 Wisconsin Medical Society.

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