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Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …

A Demographic Analysis Of Metro/Nonmetro Differences In Adult Normal Weight, Overweight, And Obesity, P. Johnelle Sparks, Susanne Schmidt

Journal of Rural Social Sciences

Overweight and obesity prevalence is increasing throughout the United States, and these two health conditions seem to disproportionately affect certain segments of the adult population. To date little research has examined adult differences in normal weight, overweight, and obesity by metropolitan or nonmetropolitan residential status while controlling for important demographic, socioeconomic, behavioral, and health status characteristics. This research helps to fill this gap. We used data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to empirically assess predictors of overweight and obesity risk for all adults and then by residential location. Multinomial logistic regression techniques were used to estimate …

A Portrait Of Rural Health In America, Jin Young Choi

Journal of Rural Social Sciences

introduction to special issue

Assessing Barriers To Health Care Services For Hispanic Residents In Rural Georgia, Michele Vitale, Conner Bailey

Journal of Rural Social Sciences

Since the 1990s, many Hispanics have been relocating to the rural South and their permanency (although beneficial to the economy) poses new challenges at the institutional level. One area of major concern is the adequate provision of health care. Our article evaluates the socioeconomic, cultural, and geographic/transportation barriers that Hispanic residents face when seeking primary health care services in Toombs County, Georgia. Data were acquired through personal interviews with Hispanic residents, local health professionals, and key community informants by using a combination of opportunity sampling and a snowball approach. Results indicate that the local health system and the county as …

Ruptured Identity Of Male Farmers: Subjective Crisis And The Risk Of Suicide, Anthony Hogan, Edward Scarr, Stewart Lockie, Brett Chant, Sylvia Alston

Journal of Rural Social Sciences

Suicide among male farmers is frequently discussed in the literature. While a wide range of factors are associated, a coherent theoretical framework that incorporates the various factors associated with male farmer suicide has not been developed. Moreover, the insights offered to date have not opened a more systemic approach to prevention. Drawing on substantive contributions from sociological theory, this paper proposes a framework for progressing understanding of the causes of this phenomenon and offers insights for prevention. The paper argues that ontological security is central to identity and social competence, and that loss of the coherency of identity and the …

Using Hermeneutics To Understand Burnout And Coping Strategies Utilized By Occupational Therapists, Sangeeta Gupta, Margo Paterson, Claudia Von Zweck, Rosemary Lysaght

The Qualitative Report

This research article explores the use of the hermeneutic approach in understanding practice challenges for occupational therapists in the contemporary health care arena. It provides insights into factors that lead to therapist burnout and the strategies they utilize to maintain competent practice. In this mixed methods study, hermeneutics was chosen as the qualitative approach to help understand the meanings occupational therapists ascribe to stressful situations at work and how they cope with those situations. Data was collected by conducting focus groups and semi-structured interviews with seven participants. Demands on time, conflict, lack of respect and autonomy emerged as the main …

Lived Experiences Of Diversity Visa Lottery Immigrants In The United States, Tekleab Elos Hailu, Bernadette M. Mendoza, Maria K.E. Lahman, Veronica M. Richard

The Qualitative Report

Every year approximately 50,000 people immigrate to the United States through the avenue referred to as the Diversity Visa (DV) Lottery. In this article, the authors present a literature review of immigration to the U.S. through the DV Lottery, reflect on their own immigration histories, and utilize phenomenology to investigate and describe participant feelings, expectations, and experiences as DV Lottery immigrants. Participants experienced mixed feelings, including high expectations prior to and difficulties after immigrating to the U.S. Findings presented include (a) life experienced in the U.S.; (b) access to learning and training opportunities; and (c) recommended support future DV Lottery …

Teachers’ Perceptions Of A Multiple High-Risk Behavior Prevention Program And Delivery Of Universal Programming, Crystal Collier, Richard C. Henriksen Jr.

The Qualitative Report

Much of the success of high-risk behavior prevention programs rests with teachers who deliver the curriculum however; few studies have investigated teachers' perceptions of program implementation. The objective of this phenomenological study was to answer the question, “What are the experiences of teachers who are asked to be involved in the implementation process when their school adopts a multiple high-risk behavior prevention program”? Participants included 10 teachers at a local, private high school in the Southern United States. Five themes emerged: (a) lack of consistent historical effort, (b) need for program, (c) positive but tentative perceptions, (d) challenges with implementation, …

Adolescent Dating Violence Prevention And Intervention In A Community Setting: Perspectives Of Young Adults And Professionals, Donna S. Martsolf, Crystal Colbert, Claire B. Drauker

The Qualitative Report

Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne’s (2008) interpretive description methods to determine participants’ perspectives on community views on ADV, community ADV prevention/intervention programs, and ideal ADV prevention/intervention strategies. Participants perceived most communities as being blind to ADV. They perceived prevention programs as unavailable, inappropriate, or impersonal. Young adults indicated that professionals should use a …

Enabling Outcomes For Students With Developmental Disabilities Through Collaborative Consultation, Michelle Villeneuve, Nancy L. Hutchinson

The Qualitative Report

Collaborative consultation has been widely adopted in school-based occupational therapy practice; however, limited research has examined how collaboration between educators and occupational therapists contributes to students’ outcomes. The purpose of this study was to describe the nature of collaborative working in two cases of school-based occupational therapy service delivery. This paper reports a cross-case analysis, comparing findings about the nature of a joint effort in each case study to identify workplace practices that facilitated educator-occupational therapist collaboration. Ethnographic case study methods (Stake, 1995; Wolcott, 2008) and socio-cultural activity theory (SCAT; Engeström, 2001) were used to examine multiple perspectives concerning school-based …

Shared Journaling As Peer Support In Teaching Qualitative Research Methods, Aine M. Humble, Elizabeth Sharp

The Qualitative Report

Teaching qualitative research methods (QRM), particularly early on in one’s academic career, can be challenging. This paper describes shared peer journaling as one way in which to cope with challenges such as complex debates in the field and student resistance to interpretive paradigms. Literature on teaching QRM and the pedagogical value of journaling for metacognition are reviewed. The two authors describe key points about their teaching contexts and then demonstrate with journal excerpts how they developed (a) clarity, (b) confidence, and (c) connection through two years of co-creating their journal. The article concludes with recommendations for shared journal writing as …

Women In Transition: A Qualitative Analysis Of Definitions Of Poverty And Success, Crystale M. Marsh-Mcdonald, Sybil Schroeder

The Qualitative Report

A phenomenological approach examined the stories of ten women transitioning from childhood poverty to adult life. Women were chosen from a pool of participants in an Upward Bound program designed to assist low-income and/or first-generation college students in the Midwestern United States. Semi-structured interviews were conducted to retrospectively explore their lived experiences. Recurring themes included facilitators of change, specifically the people, including mental health professionals, family members, romantic partners, and friends who helped make change possible. Another frequent theme found in the research was the impact an education had on the participants. Finally, the participants shared their own insights related …

African American Women: The Face Of Hiv/Aids In Washington, Dc, Ndidiamaka N. Amutah

The Qualitative Report

In 2007, the estimated HIV and AIDS case rates among adult and adolescent African-American females in the United States was 60.6 per 100,000, as compared to 3.3 per 100,000 for adult and adolescent white American females. Women living with HIV or AIDS often face complex social problems that may inhibit them from accessing resources and healthcare services to assist them in coping with the disease. In-depth interviews and direct observations utilizing open-ended note taking were conducted at an HIV service provider’s office to determine the unique needs that develop because of these complex social issues, specifically among HIV positive women …

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

How We Want To Be Treated! What Clark County African American Patients Want Their Health Providers To Know, Charlene A. Day, Joyce Woodson, Erica Archuleta

Nevada Journal of Public Health

Research continues to validate the fact that cultural values and beliefs play a major role in determining the extent to which an individual will engage in healthy behaviors, adhere to medical regimen, and seek care when necessary. A 2000 survey of 950 members of predominately African American churches in Clark County, Nevada (a county which comprises Las Vegas) conducted by the University of Nevada Cooperative Extension found members preferred healthcare providers as a source of information on health-related matters. Yet, research shows that for a variety of reasons, many African Americans do not regularly see a health care professional, and …

Screening For Mental Health Problems Among Incarcerated Youth In Nevada: Practice And Policy, Michelle Chino, Jennifer Personius-Zipoy, Denise Tanata

Nevada Journal of Public Health

Incarcerated youth in Nevada with serious mental health problems are not being effectively identified. The current study examined the utility of simple screening instruments as a mechanism for identifying incarcerated youth who may have a mental health disorder. Adjudicated youth, incarcerated at each of Nevada’s 12 juvenile detention facilities, participated in the study by completing a demographic questionnaire and a standardized mental health screening instrument: the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). Findings indicate a high prevalence of mental health disorders among incarcerated juveniles in Nevada. Identifying youth with mental health problems is complicated by the lack of a systematic …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.

Oral Health Needs And Parental Attitudes, Behavior, And Knowledge Of Lower Ses Children, Mildred Mcclain, Clifford R. Mcclain, Anthony Paventy

Nevada Journal of Public Health

Despite the declining prevalence of dental caries over recent decades, caries remain the most common chronic childhood disease, especially in high-risk (low socio-economic status) populations. This appears to be true even when parents are aware of good oral health habits. The purpose of this study was to gather oral hygiene data on high-risk children in Nevada and to assess parental attitudes and education concerning their children’s oral health. Using visual examinations and a dmft (decayed, missing, filled, teeth) severity index, 235 lower SES children were screened and given treatment recommendations. The screenings showed larger than expected prevalence in both caries …

Interrelated Processes Toward Quality Of Life In Survivors Of Childhood Cancer: A Grounded Theory, Miranda Tsonis, Janette Mcdougall, Angela Mandich, Jennifer Irwin

The Qualitative Report

Past research has not adequately addressed the quality of life (QOL) of survivors of childhood cancer. The purpose of this study was to understand how QOL is experienced for individuals who have survived childhood cancer. Specific research questions included: (a) How do childhood cancer survivors define the concept of QOL and (b) What processes do childhood cancer survivors go through regarding their QOL? Researchers used grounded theory to analyze in-depth interviews conducted with eight survivors. Survivors use a process of specific action strategies and intervening conditions to manage impacts and effects, resulting in life enjoyment, or good QOL. The identification …

Fostering Change In Organizational Culture Using A Critical Ethnographic Approach, Rosemary A. Brander, Margo Patterson, Yolande E. Chan

The Qualitative Report

Healthcare organizations are striving to meet legislated and public expectations to include patients as equal partners in their care, and research is needed to guide successful implementation and outcomes. The current research examined the meaning of customer service as related to the culture of care relationships within a Canadian hospital in southeastern Ontario. The goals were to better understand these expectations, develop shared meanings and influence cultural change from the perspective of the organization’s employees about their interactions with patients, families and work colleagues, and to generate ideas and groundswell for change. An ethnographic approach within the critical research paradigm …

Adverse Maternal Outcomes For Women With Different Health Insurance Statuses In Nevada, Jay J. Shen, Hong Wei

Nevada Journal of Public Health

Objective. Nevada women with unfavorable health insurance status may face greater barriers than women in the rest of the nation, since the development of healthcare infrastructure in Nevada is running behind population growth. This study examines the relationship between health insurance status and adverse maternal outcomes in Nevada.

Methods. Hospital discharge information of 33,149 women aged 13 or older who delivered in 2004 was abstracted from the 2004 State Inpatient Data for Nevada. A total of 13 measures of complications associated with pregnancy were identified, including preterm labor, hypertensive disorders of pregnancy, gestational diabetes, ante-partum hemorrhage, membrane disorders, cesarean section, …

The Administrative Prevalence Of Autism Spectrum Disorders In Nevada School Districts: A Pooled Time Series Analysis, 1996-2004, John P. Tuman, Sheniz Moonie, Danielle Roth-Johnson

Nevada Journal of Public Health

Objective: To examine the administrative prevalence of Autism Spectrum Disorders (ASD) in all seventeen school districts in Nevada during the period of 1996 to 2004.

Methods: Normalized administrative prevalence rates (per 1,000 children ages 6-17) for ASD, Mental Retardation (MR), Learning Disability (LD), and Speech and Language Impairment (SLI) were calculated. Covariates for board certified pediatricians per 1,000 students, Federal special education funding per student, and other measures of school resources were employed. Models were estimated with pooled Ordinary Least Squares (OLS) regression with panel corrected standard errors. A separate analysis compared pooled OLS results to results from Latent Growth …

The Effects Of Television Food Advertising On Childhood Obesity, Aleathia Cezar

Nevada Journal of Public Health

Children’s food choices are influenced by the media, television advertising, focusing directly at infants and toddlers. This literature review presents multiple studies that explain how TV advertising of fast food, sugary cereals and other foods high in calories, fat, sugar, sodium and low in nutrients are contributing to the increase rates of childhood obesity. It is concluded that children are exposed to high amounts of food advertisements which affect young children’s food choices and poor food consumption. Due to the growing numbers of hours that children sit in front of the television, less physical activity and the epidemic of childhood …

Health Care Insurance And Advance Directive Completion: A Population Based Study, Wei Yang, Sally P. Hardwick, Noel Tiano, Clare T. Pettis

Nevada Journal of Public Health

Background: The relationship between advance directive (AD) completion and health insurance status is rarely studied.

Method: AD completion information was collected through the 2008 Nevada Behavior Risk Factor Surveillance System (BRFSS), a statewide cross-sectional telephone survey. Nevada non-institutionalized population over 18 were randomly selected as a population sample. Respondents were divided to “health care plan group” (HCPG) and “no health care plan group” (NHCPG). Demographic and behavior risk factors were also collected. Weighted multiple logistic regressions were utilized to assess the relationships between ADs, healthcare coverage and other factors.

Results: Of 4,461 respondents completing the survey, HCPG were six times …

Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall

Nevada Journal of Public Health

The purpose of this study was to assess the prevalence of plumbism in children one to six years of age in Nevada. During a four-year period from 1992 – 1996, 10,700 children were screened for evidence of blood lead intoxication. The capillary specimens were analyzed by atomic absorption spectrometry. All children with a lead level => 10 ug/L were retested using venous blood. Ninety three percent of the children had blood lead levels < 10 µg/dL

Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian

Nevada Journal of Public Health

Objective. Asthma is a common clinical complication of pregnancy and women with asthma are at greater risk of having complications. This study compared adverse maternal outcomes between women with asthma and women without asthma in Nevada.

Methods. A total of 64,664 hospital discharges of delivery were abstracted from the Nevada 2003-2004 hospital discharges and thirteen adverse maternal outcomes were examined. Logistic regression was applied to compare the maternal outcomes between women with and without asthma.

Results. Women with asthma were more likely to have pre-eclampsia (OR [CI] 1.73 [1.13, 2.65]), transient hypertension of pregnancy (OR [CI] 1.76 [1.11, 2.78]), pregnancy-induced …

The Economic Impact Of The Nevada Clean Indoor Air Act In Clark County, Nevada – Preliminary Findings, Robin Mukalian, Fang Lin, Christopher R. Cochran, Jay J. Shen, Nancy L. York

Nevada Journal of Public Health

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County.

Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and …

Kitchen Stories: A Review, Dan Wulff, Sally St. George, Sandy Harper-Jaques, Lorne Jaques

The Qualitative Report

Using four voices, we created a movie review of Kitchen Stories, a Scandinavian movie ostensibly about a research project, but with layers of meaning extending beyond research into relationships, wider communities, and teaching. As friends and colleagues, our co-authored review/essay allowed each of us room to elaborate numerous themes that can inform and support a variety of researchers and practitioners. This writing also confirmed our belief that contemporary movies can be evocative learning devices for professionals.

Understanding The Culture Of Ahiska Turks In Wheaton, Illinois: A Case Study, Omer Avci

The Qualitative Report

This study focuses on the cultural characteristics of Ahiska Turks in Wheaton, Illinois in the United States. By trying to understand the culture of the participants, I sought to shed light on how the Ahiska Turks managed to cope with the hardship they experienced and yet preserved their ethnic identities. In this multicase study, I interviewed six male Ahiska Turks. As a result of my analyses, eight themes emerged: family, religion (i.e., Islam), language (i.e., Turkish), communal life, endogamy, authoritarianism, oppression against the preservation of culture and identity, and education for upward mobility. The Ahiska Turks’ agrarian way of life, …