Browsing by Author "Staten, Lisa"

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    Communication to Cultivate a Culture of Health: Lessons From 5-Star Achievewell Organizations
    (2021-12) Martin, Natalie R.; Brann, Maria; Bute, Jennifer; Goering, Elizabeth; Staten, Lisa
    Creating a culture of health within an organization offers benefits such as reducing costs and supporting employees in becoming and staying healthy. A variety of health and wellness programs within an organization are important for establishing a culture of health. These programs are supported communicatively to encourage employee participation and healthful behavior changes. Recognized for their success in creating a culture of health, a group of organizations, distinguished as 5-Star AchieveWELL organizations, offer an opportunity to identify messaging strategies effective at promoting health and wellness within the workplace and therefore, creating a culture of health. The goals of this study included learning successful organization’s communication strategies utilized to create a culture of health, understanding how new employees are socialized into this culture, identifying how employees may resist the culture, and exploring how resistance is addressed. Based on in-depth interviews with 19 5-Star AchieveWELL organizational representatives and grounded theory analysis of collected data, evident themes related to the goals of this study were identified. Key communication strategies to support a culture of health include using multiple communication channels, demonstrating leadership support, and being willing to adapt and change over time. New employees are socialized into the culture of health during the recruitment process as well as new employee orientation. Resistance to health and wellness occurs in the form of non-participation and employee push-back, with this resistance often being met with compassion. These results offer practical implications for organizations desiring to create a culture of health as well as theoretical implications for scholars studying organizational socialization.
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    Community Health Workers: An Examination of State Policies and Analysis of a Healthcare-Based Intervention for Diabetes Management
    (2023-06) Hansotte, Elinor Alice; Stone, Cynthia; Dixon, Brian E.; Silverman, Ross; Staten, Lisa
    Community Health Workers (CHW) are trusted frontline members of the public health workforce with a unique understanding of the communities they serve. CHW interventions have been shown effective and economical in improving certain health outcomes, including diabetes-related complications and self-management. The ability of CHWs to relate to patients in a culturally appropriate manner positions them to better address social determinants of health and inequities than many allied health professionals. State-level CHW legislation varies by jurisdiction and can direct CHW processes including definitions, funding, and scope of practice. The Diabetes Project – Indianapolis Neighborhoods (DIP-IN) intervention employs clinic-based CHWs to work with high-risk patients with diabetes in three Indianapolis communities with disproportionately high diabetes prevalence rates. DIP-IN CHWs are based in select Eskenazi Health Federally Qualified Health Centers and deliver services to patients primarily through home visits or phone calls. This dissertation examines CHW policies and the impact of the DIP-IN CHW intervention on patient outcomes in relation to a comparison group. This dissertation includes three studies 1) a state-level policy surveillance exploring legislation that includes best practices for CHW policy, 2) a study using a difference-in-difference approach through the application of generalized linear mixed models to estimate the effect of DIP-IN on A1C and hospital outcomes, and 3) a study using multivariat regression and negative binomial modeling to estimate the impact of DIP-IN on COVID-19 hospitalization and length of stay. As financing influences duration and application of CHW interventions, this dissertation aims to explore the landscape over time of CHW legislation and evaluate a privately funded CHW program model intended to improve health outcome among high-risk patients with diabetes. It also aims to strengthen the knowledge base for CHW involvement in improving clinical-community linkages to support diabetes management.
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    Impact of a multimedia educational tool incorporating theoretical and mixed methods on the fruit and vegetable intakes of middle school children
    (2017-12-11) Whelan, JoAnne Louise; Arnold, Brent; Ernst, Judith; Staten, Lisa; Magee, Paula
    In the United States, over 30 percent of children are categorized as overweight or obese. Comorbid conditions, such as cardiovascular disease and other health complications related to obesity, are also on the rise. This public health issue is often related to disproportionate dietary intake and lack of physical activity. Efforts that promote fruits and vegetables (F/V) as preferred food choices over high fat and high sugar foods may help combat the increasing incidence of overweight and obesity. Other benefits from F/V include prebiotics or fiber that helps to create and maintain a healthy microbiota, which is now recognized as essential for long-term positive health outcomes. Many children, however, fall short in consuming the recommended daily amounts of F/V servings, and therefore, lack key nutrients such as vitamins, minerals, phytonutrients and fiber. This study is a pilot, quasi-experimental design that provides information related to the importance of eating F/V to children, ages 11-12 years, who attend a parochial school in Indianapolis, Indiana. The data from this study describe the amounts of F/V servings in home-prepared school lunches. The primary aim of this study is to determine if eight interactive multimedia lessons and activities delivered to one group of students (intervention) and a single lesson delivered to a different group of students in the same school and grade (control), affects the amount of lunch F/V servings, student knowledge, attitude, and self-efficacy/perception. This baseline data will contribute to the design and implementation of a health curriculum for middle school age students. Focus groups, adapted validated assessment tools as well as the on-site observation of F/V servings brought in lunches and consumed at lunch are compared between both groups to document any effects of the instruction. The results show that a statistically significant change in knowledge occurred within the intervention group following the implementation of this F/V education series. Favorable findings, with a positive upward trend in relative amounts of F/V, were identified and more research in this area is warranted.
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    Obstacles to Wellness: A Study of Psychosocial Stress and Support Systems in Community Health Programming for Black Americans
    (2024-11) Carey, Christopher J.; Keith, NiCole; Staten, Lisa; Elmendorf, Jeffrey; Kaushal, Navin
    Type 2 Diabetes (T2D) poses a significant public health challenge, disproportionately affecting Black Americans. This dissertation investigates the efficacy of exercise interventions tailored for the management of T2D, emphasizing the interplay of psychosocial stress and community-based support systems within this demographic. Chapter I provides details about the pathophysiology of T2D and the compounded impact of psychosocial stressors and exercise, establishing the groundwork for targeted interventions. Chapter II conducts a systematic review to ascertain the effectiveness of various exercise modalities in improving T2D health outcomes. It highlights that combined aerobic and resistance training at moderate to high intensity significantly enhances insulin sensitivity and glucose metabolism. Chapter III examines a community-based exercise program, "Max Impact," focusing on how race-related stress affects the program’s efficacy. The study reveals that while exercise improves metabolic health indicators among participants, the effects are not statistically significant. This finding emphasizes that underlining factors, such as psychosocial stress, could have mediated this relationship, which highlights the necessity of better understanding psychosocial stress’s effect on health interventions and outcomes. Chapter IV explores qualitative insights from the participants of the Max Impact program, uncovering the complex barriers and supports for physical activity. It stresses the importance of accessible and relatable health education and community support in fostering sustained engagement in physical activity. The final chapter, V, synthesizes these findings, discussing the practical implications of integrating psychosocial elements into exercise prescriptions for T2D management. It calls for more comprehensive approaches that address both the physiological and psychological facets of health disparities faced by Black Americans. This research contributes to the literature on health disparities by highlighting the critical role of culturally sensitive, community-focused interventions in managing chronic diseases like T2D.
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    Perinatal smoking and its related factors
    (2018-07-12) Jones, Ashley; Shieh, Carol; Staten, Lisa; Carter-Harris, Lisa; Stiffler, Deborah; Macy, Jon
    The smoking rate of low-income pregnant women is almost 4 times the rate for higher-income women. A better understanding of smoking within the low-income population is needed. The purpose of this dissertation was to study smoking and related factors for pregnant and postpartum women living in poverty. The first component used Rodger’s evolutionary concept analysis method and uncovered three attributes, four antecedents, and three consequences for smoking cessation. The second (N = 1,554) and third (N = 71,944) components were a secondary data analysis of first-pregnancy Medicaid-eligible women enrolled in the Nurse-Family Partnership program from 2011-2016. The second component explored patterns of smoking and depression and their associations. Eight distinct patterns of smoking and depression were found. Smokers were more likely than nonsmokers to have depressive symptoms at the end of pregnancy (OR = 1.37 [1.04, 1.81] and 12 months post-delivery (OR = 1.93 [1.47, 2.51]. The third component investigated covariates present during early pregnancy and their relationships with smoking status and sought to find best fitting predictive models. Multivariable logistic regression showed cigarette use in the 3 months prior to pregnancy and at program intake were significant predictors for smoking status at the end of pregnancy and 12 months post-delivery. Interactive Matrix Language, Structured Query Language, and iterations of logistic regression identified 5 covariates (high school education, cigarette use prior to pregnancy, smoking status at pregnancy baseline, depression, and self-mastery) for the best fitting model at the end of pregnancy and three additional covariates (post-secondary education, marital status, and race) for the 12 months post-delivery model. The area under the receiver operator characteristic curve was 0.9681 for the end of pregnancy model and 0.9269 for 12 months post-delivery model, indicating excellent prediction ability of the models. Results can be integrated in smoking prevention education, screening, and cessation intervention programs.
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    The Diabetes Impact Project: Partnering With Communities and Organizations to Reduce Diabetes Burden and Improve Quality of Life
    (Center for Translating Research Into Practice, IU Indianapolis, 2022-11-11) Staten, Lisa
    During this presentation, Dr. Lisa Staten discusses the "Diabetes Impact Project – Indianapolis Neighborhoods (DIP-IN)". This a multi-year, multisector, community engaged project with a holistic approach to reducing the diabetes burden in three Indianapolis communities. She provides an overview of the project and then focuses on the diverse partnerships that are central to the project.
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    Worlds Further Apart
    (Richard M. Fairbanks School of Public Health, 2021-08) Weathers, Tess; Comer, Karen; Staten, Lisa
    In our updated analysis of 104 ZIP codes in the Indianapolis metro area (2014-2018), we identified the northern suburb of Fishers as our longest living community and just 17 miles away, within the Indianapolis city limits, is the shortest living community within the metro area. Though only 17 miles of distance separate them, their life expectancy is worlds apart.