John Moraros
EDUCATION
Dr. John Moraros is currenly the Director of the iCAN Research Group, a fomer Director of the MPH Program and a Faculty member at the School of Public Health, University of Saskatchewan. He received his Medico y Cirurgano Diploma (MD) from Universidad Autonoma de Cuidad Juárez, Chihuahua, México; Master of Public Health (MPH) in Community Health from New Mexico State University, Las Cruces, New Mexico and Doctor of Philosophy in Molecular Biology (PhD) from New Mexico State University, Las Cruces, New Mexico.
AREA OF RESEARCH INTEREST:
Dr. Moraros is committed to a community based participatory research approach, which leads to practical public health interventions and utilizes culturally appropriate and sensitive strategies whether dealing with an entire community or a subpopulation group as a community. His areas of research interest includes: 1) Cancer epidemiology in minority populations; 2)Cancer prevention through lifestyle changes, such as dietary practices and smoking behaviour; 3) Cancer screening practices; 4)Health disparities; 5)Aboriginal health; 5)Immigrant and refugee health; 6)Intimate partner violence; 7) STI and HIV/AIDS; and 8) Alcohol and drug abuse.
GRANTS AND AWARDS:
During his academic career, Dr. Moraros was a recipient of various grants and awards. To mention a few, 1) Recipient of NMSU Outstanding Graduating Master's Student Award, 2004; 2) Recipient of SOPHE's 55th Annual Meeting Student Scholar Award, 2004; 3)Who's Who Among Graduate Students in American Universities & Colleges,1991, 2004-06; 4)First Place Overall for Research Poster Presentation, Hot Projects & Paso del Norte Foundation, New Mexico State University, 2004 & 2005; 5)Third Place Overall for Research Poster Presentation, Graduate Research & Arts Symposium, New Mexico State University, 2004; 6)Best Graduating Medical Student, Instituto de Ciencias Biomedicas, Universidad Autonoma de Ciudad Juarez, Juarez, Mexico, 2002; 7)First Place for Medical Student Paper Presentation, Universidad Autonoma de Ciudad Juarez, Mexico, Health Science Conference, 2001 & 2002; 8) Distinguished Individual Award in Community Health Service, Juarez, Mexico, 2002; 9)Distinguish Writing Award, New York College of Podiatric Medicine, New York, 1993; 10)Hermes Honors Fellow Podiatric Society and 11)Academic Fellow, Queens College, New York City, New York, 1988-1991.
Address: School of Public Health
University of Saskatchewan,
107 Wiggins Road
Saskatoon, SK. Canada
S7N 5E5
Dr. John Moraros is currenly the Director of the iCAN Research Group, a fomer Director of the MPH Program and a Faculty member at the School of Public Health, University of Saskatchewan. He received his Medico y Cirurgano Diploma (MD) from Universidad Autonoma de Cuidad Juárez, Chihuahua, México; Master of Public Health (MPH) in Community Health from New Mexico State University, Las Cruces, New Mexico and Doctor of Philosophy in Molecular Biology (PhD) from New Mexico State University, Las Cruces, New Mexico.
AREA OF RESEARCH INTEREST:
Dr. Moraros is committed to a community based participatory research approach, which leads to practical public health interventions and utilizes culturally appropriate and sensitive strategies whether dealing with an entire community or a subpopulation group as a community. His areas of research interest includes: 1) Cancer epidemiology in minority populations; 2)Cancer prevention through lifestyle changes, such as dietary practices and smoking behaviour; 3) Cancer screening practices; 4)Health disparities; 5)Aboriginal health; 5)Immigrant and refugee health; 6)Intimate partner violence; 7) STI and HIV/AIDS; and 8) Alcohol and drug abuse.
GRANTS AND AWARDS:
During his academic career, Dr. Moraros was a recipient of various grants and awards. To mention a few, 1) Recipient of NMSU Outstanding Graduating Master's Student Award, 2004; 2) Recipient of SOPHE's 55th Annual Meeting Student Scholar Award, 2004; 3)Who's Who Among Graduate Students in American Universities & Colleges,1991, 2004-06; 4)First Place Overall for Research Poster Presentation, Hot Projects & Paso del Norte Foundation, New Mexico State University, 2004 & 2005; 5)Third Place Overall for Research Poster Presentation, Graduate Research & Arts Symposium, New Mexico State University, 2004; 6)Best Graduating Medical Student, Instituto de Ciencias Biomedicas, Universidad Autonoma de Ciudad Juarez, Juarez, Mexico, 2002; 7)First Place for Medical Student Paper Presentation, Universidad Autonoma de Ciudad Juarez, Mexico, Health Science Conference, 2001 & 2002; 8) Distinguished Individual Award in Community Health Service, Juarez, Mexico, 2002; 9)Distinguish Writing Award, New York College of Podiatric Medicine, New York, 1993; 10)Hermes Honors Fellow Podiatric Society and 11)Academic Fellow, Queens College, New York City, New York, 1988-1991.
Address: School of Public Health
University of Saskatchewan,
107 Wiggins Road
Saskatoon, SK. Canada
S7N 5E5
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Data sources: We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS.
Study selection: Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately.
Data extraction: Data on design, methods, interventions and key outcomes were extracted and collated.
Results of data synthesis: Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety.
Conclusion: While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings.
community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e.,
‘management’, ‘support received’, ‘duration of involvement’, and ‘average time spent per month’) and mediators
(i.e., ‘training received’, ‘motivation’, and ‘commitment’) influence distal outcomes (i.e., ‘performance’, ‘satisfaction’,
and ‘overall experience’) within a volunteer organization.
Methods: Participants were recruited through the use of an email list server. An online survey was used containing
multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data
analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on
constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05.
Results: In this study, there are several direct effects worthy of note. First, the proximal factor of ‘management’
plays an important role in influencing the mediators of ‘motivation’ (standardized beta = 0.55) and ‘training
received’ (0.65) by the student volunteers but has a relatively small impact on their ‘commitment’ (0.39) to the
organization. Second, the mediator of ‘motivation’ proved to have the strongest impact on the distal outcome of
volunteer ‘performance’ and ‘satisfaction’ levels (0.41 and 0.58 respectively), whereas ‘commitment’ (0.44) was the
key in determining their ‘overall experience’ with the organization. These results in turn, help contextualize the
indirect effects observed in our study. Namely, the proximal factor of ‘management’ played a distinctive role in
influencing the distal outcomes of volunteer ‘performance’ (0.32) and ‘overall experience’ (0.66), whereas the
organizational ‘support received’ by the volunteers was key to their ‘satisfaction’ (0.21).
Conclusions: The findings of the present study shed light into the direct and indirect effects of how proximal
factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results
provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation
specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers)
in their efforts to improve student volunteer satisfaction and performance outcomes.
Keywords: Volunteerism, Evaluation, Satisfaction, Performance, Overall experience, College students, Community-based
clinic
The present study was conducted in a multi service-learning, student managed and operated, community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e., ‘management’, ‘support received’, ‘duration of involvement’, and ‘average time spent per month’) and mediators (i.e., ‘training received’, ‘motivation’, and ‘commitment’) influence distal outcomes (i.e., ‘performance’, ‘satisfaction’, and ‘overall experience’) within a volunteer organization.
Methods
Participants were recruited through the use of an email list server. An online survey was used containing multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05.
Results
In this study, there are several direct effects worthy of note. First, the proximal factor of ‘management’ plays an important role in influencing the mediators of ‘motivation’ (standardized beta = 0.55) and ‘training received’ (0.65) by the student volunteers but has a relatively small impact on their ‘commitment’ (0.39) to the organization. Second, the mediator of ‘motivation’ proved to have the strongest impact on the distal outcome of volunteer ‘performance’ and ‘satisfaction’ levels (0.41 and 0.58 respectively), whereas ‘commitment’ (0.44) was the key in determining their ‘overall experience’ with the organization. These results in turn, help contextualize the indirect effects observed in our study. Namely, the proximal factor of ‘management’ played a distinctive role in influencing the distal outcomes of volunteer ‘performance’ (0.32) and ‘overall experience’ (0.66), whereas the organizational ‘support received’ by the volunteers was key to their ‘satisfaction’ (0.21).
Conclusions
The findings of the present study shed light into the direct and indirect effects of how proximal factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers) in their efforts to improve student volunteer satisfaction and performance outcomes.
Keywords
Volunteerism Evaluation Satisfaction Performance Overall experience College students Community-based clinic
Design Random-digit dialing telephone survey collected through the Canadian Community Health Survey by Statistics Canada.
Setting Saskatchewan.
Participants A total of 27 090 residents aged 20 years and older; each health region in Saskatchewan was represented.
Main outcome measures Overall, 178 variables related to demographic characteristics, socioeconomic factors, behaviour, life stress, disease intermediaries, health outcomes, and access to health care were analyzed to determine their unadjusted and adjusted effects on heart disease.
Results The mean age of the sample was 52.6 years. Women represented 55.9% of the sample. Most respondents were married (52.3%) and had some postsecondary or graduate education (52.5%). The mean personal income was $23 931 and the mean household income was $37 533. All models statistically controlled for age. Five covariates independently associated with heart disease included high blood pressure, household income of $29 999 or less per year, being a daily smoker, male sex, and being physically inactive. Five covariates independently associated with high blood pressure included being overweight or obese, being a daily smoker, household income of $29 999 or less per year, male sex, and being physically inactive. Five covariates independently associated with daily smoking included being a visible minority, household income of $29 999 or less per year, not being overweight or obese, education level of less than secondary school, and male sex. Six covariates independently associated with physical inactivity included being a visible minority, being overweight or obese, education level of less than secondary school, male sex, household income of $29 999 or less per year, and being a daily smoker.
Conclusion Household income was strongly and independently associated with heart disease; its main disease intermediary, high blood pressure; and its main behavioural risk factors, smoking and physical inactivity. Income inequality is a neglected risk factor worthy of appropriate public debate and policy intervention.
The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.
Methods
This is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.
Results
The total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).
Conclusions
In this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.
Maternal mental health problems affect up to 20% of women, with potentially deleterious effects to the mother and family. To address this serious problem, a Maternal Mental Health Program (MMHP) using a shared care approach was developed. A shared care approach can promote an efficient use of limited specialized maternal mental health services, strengthen collaboration between the maternal mental health care team and primary care physicians, increase access to maternal mental health care services, and promote primary care provider competence in treating maternal mental health problems. Aim The purpose of this research was to evaluate the impact of a MMHP using a shared care approach on maternal anxiety and depression symptoms of participants, the satisfaction of women and referring physicians, and whether the program met the intents of shared care approach (such as quick consultation, increased knowledge, and confidence of primary care physicians).
METHODS:
We used a pre and post cross-sectional study design to evaluate women's depression and anxiety symptoms and the satisfaction of women and their primary care health provider with the program. Findings Depression and anxiety symptoms significantly improved with involvement with the program. Women and physicians reported high levels of satisfaction with the program. Physician knowledge and confidence treating maternal mental health problems improved.
CONCLUSIONS:
Shared care can be an effective and efficient way to provide maternal mental health care in primary health care settings where resources are limited.
The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.
Methods
This is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.
Results
The total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).
Conclusions
In this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.
Data sources: We conducted a systematic literature review of Medline, PubMed, Cochrane Library, CINAHL, Web of Science, ABI/Inform, ERIC, EMBASE and SCOPUS.
Study selection: Peer reviewed articles were included if they examined a Lean intervention and included quantitative data. Methodological quality was assessed using validated critical appraisal checklists. Publically available data collected by the Saskatchewan Health Quality Council and the Saskatchewan Union of Nurses were also analysed and reported separately.
Data extraction: Data on design, methods, interventions and key outcomes were extracted and collated.
Results of data synthesis: Our electronic search identified 22 articles that passed methodological quality review. Among the accepted studies, 4 were exclusively concerned with health outcomes, 3 included both health and process outcomes and 15 included process outcomes. Our study found that Lean interventions have: (i) no statistically significant association with patient satisfaction and health outcomes; (ii) a negative association with financial costs and worker satisfaction and (iii) potential, yet inconsistent, benefits on process outcomes like patient flow and safety.
Conclusion: While some may strongly believe that Lean interventions lead to quality improvements in healthcare, the evidence to date simply does not support this claim. More rigorous, higher quality and better conducted scientific research is required to definitively ascertain the impact and effectiveness of Lean in healthcare settings.
community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e.,
‘management’, ‘support received’, ‘duration of involvement’, and ‘average time spent per month’) and mediators
(i.e., ‘training received’, ‘motivation’, and ‘commitment’) influence distal outcomes (i.e., ‘performance’, ‘satisfaction’,
and ‘overall experience’) within a volunteer organization.
Methods: Participants were recruited through the use of an email list server. An online survey was used containing
multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data
analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on
constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05.
Results: In this study, there are several direct effects worthy of note. First, the proximal factor of ‘management’
plays an important role in influencing the mediators of ‘motivation’ (standardized beta = 0.55) and ‘training
received’ (0.65) by the student volunteers but has a relatively small impact on their ‘commitment’ (0.39) to the
organization. Second, the mediator of ‘motivation’ proved to have the strongest impact on the distal outcome of
volunteer ‘performance’ and ‘satisfaction’ levels (0.41 and 0.58 respectively), whereas ‘commitment’ (0.44) was the
key in determining their ‘overall experience’ with the organization. These results in turn, help contextualize the
indirect effects observed in our study. Namely, the proximal factor of ‘management’ played a distinctive role in
influencing the distal outcomes of volunteer ‘performance’ (0.32) and ‘overall experience’ (0.66), whereas the
organizational ‘support received’ by the volunteers was key to their ‘satisfaction’ (0.21).
Conclusions: The findings of the present study shed light into the direct and indirect effects of how proximal
factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results
provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation
specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers)
in their efforts to improve student volunteer satisfaction and performance outcomes.
Keywords: Volunteerism, Evaluation, Satisfaction, Performance, Overall experience, College students, Community-based
clinic
The present study was conducted in a multi service-learning, student managed and operated, community-based clinic. Its aim was to measure the direct and indirect effects of how proximal factors (i.e., ‘management’, ‘support received’, ‘duration of involvement’, and ‘average time spent per month’) and mediators (i.e., ‘training received’, ‘motivation’, and ‘commitment’) influence distal outcomes (i.e., ‘performance’, ‘satisfaction’, and ‘overall experience’) within a volunteer organization.
Methods
Participants were recruited through the use of an email list server. An online survey was used containing multi-item measures from validated scales. Data were collected from 170 volunteers from July to August 2013. Data analysis used a structural equation modeling (SEM) framework for the estimation of direct and indirect effects on constructs and variables of interest. Only statistically significant relationships were reported at p < 0.05.
Results
In this study, there are several direct effects worthy of note. First, the proximal factor of ‘management’ plays an important role in influencing the mediators of ‘motivation’ (standardized beta = 0.55) and ‘training received’ (0.65) by the student volunteers but has a relatively small impact on their ‘commitment’ (0.39) to the organization. Second, the mediator of ‘motivation’ proved to have the strongest impact on the distal outcome of volunteer ‘performance’ and ‘satisfaction’ levels (0.41 and 0.58 respectively), whereas ‘commitment’ (0.44) was the key in determining their ‘overall experience’ with the organization. These results in turn, help contextualize the indirect effects observed in our study. Namely, the proximal factor of ‘management’ played a distinctive role in influencing the distal outcomes of volunteer ‘performance’ (0.32) and ‘overall experience’ (0.66), whereas the organizational ‘support received’ by the volunteers was key to their ‘satisfaction’ (0.21).
Conclusions
The findings of the present study shed light into the direct and indirect effects of how proximal factors and mediators, influence student volunteers distal outcomes within a community-based clinic. These results provide useful information and serve as a valuable tool to higher education (curriculum experts, accreditation specialists, students, faculty and administrators) and non-profit community organizations (clients, staff and managers) in their efforts to improve student volunteer satisfaction and performance outcomes.
Keywords
Volunteerism Evaluation Satisfaction Performance Overall experience College students Community-based clinic
Design Random-digit dialing telephone survey collected through the Canadian Community Health Survey by Statistics Canada.
Setting Saskatchewan.
Participants A total of 27 090 residents aged 20 years and older; each health region in Saskatchewan was represented.
Main outcome measures Overall, 178 variables related to demographic characteristics, socioeconomic factors, behaviour, life stress, disease intermediaries, health outcomes, and access to health care were analyzed to determine their unadjusted and adjusted effects on heart disease.
Results The mean age of the sample was 52.6 years. Women represented 55.9% of the sample. Most respondents were married (52.3%) and had some postsecondary or graduate education (52.5%). The mean personal income was $23 931 and the mean household income was $37 533. All models statistically controlled for age. Five covariates independently associated with heart disease included high blood pressure, household income of $29 999 or less per year, being a daily smoker, male sex, and being physically inactive. Five covariates independently associated with high blood pressure included being overweight or obese, being a daily smoker, household income of $29 999 or less per year, male sex, and being physically inactive. Five covariates independently associated with daily smoking included being a visible minority, household income of $29 999 or less per year, not being overweight or obese, education level of less than secondary school, and male sex. Six covariates independently associated with physical inactivity included being a visible minority, being overweight or obese, education level of less than secondary school, male sex, household income of $29 999 or less per year, and being a daily smoker.
Conclusion Household income was strongly and independently associated with heart disease; its main disease intermediary, high blood pressure; and its main behavioural risk factors, smoking and physical inactivity. Income inequality is a neglected risk factor worthy of appropriate public debate and policy intervention.
The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.
Methods
This is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.
Results
The total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).
Conclusions
In this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.
Maternal mental health problems affect up to 20% of women, with potentially deleterious effects to the mother and family. To address this serious problem, a Maternal Mental Health Program (MMHP) using a shared care approach was developed. A shared care approach can promote an efficient use of limited specialized maternal mental health services, strengthen collaboration between the maternal mental health care team and primary care physicians, increase access to maternal mental health care services, and promote primary care provider competence in treating maternal mental health problems. Aim The purpose of this research was to evaluate the impact of a MMHP using a shared care approach on maternal anxiety and depression symptoms of participants, the satisfaction of women and referring physicians, and whether the program met the intents of shared care approach (such as quick consultation, increased knowledge, and confidence of primary care physicians).
METHODS:
We used a pre and post cross-sectional study design to evaluate women's depression and anxiety symptoms and the satisfaction of women and their primary care health provider with the program. Findings Depression and anxiety symptoms significantly improved with involvement with the program. Women and physicians reported high levels of satisfaction with the program. Physician knowledge and confidence treating maternal mental health problems improved.
CONCLUSIONS:
Shared care can be an effective and efficient way to provide maternal mental health care in primary health care settings where resources are limited.
The role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.
Methods
This is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.
Results
The total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).
Conclusions
In this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.