Digital Commons Network^™

Unconditional Cash Transfers For Reducing Poverty And Vulnerabilities: Effect On Use Of Health Services And Health Outcomes In Low-And Middle-Income Countries, Frank Pega, Sze Yan Liu, Stefan Walter, Roman Pabayo, Ruhi Saith, S L. Lhachimi

Sze Yan Liu

Background

Unconditional cash transfers (UCTs; provided without obligation) for reducing poverty and vulnerabilities (e.g. orphanhood, old age or HIV infection) are a type of social protection intervention that addresses a key social determinant of health (income) in low‐ and middle‐income countries (LMICs). The relative effectiveness of UCTs compared with conditional cash transfers (CCTs; provided so long as the recipient engages in prescribed behaviours such as using a health service or attending school) is unknown.

Objectives

To assess the effects of UCTs for improving health services use and health outcomes in vulnerable children and adults in LMICs. Secondary objectives are to …

The Association Between Blood Pressure And Years Of Schooling Versus Educational Credentials: Test Of The Sheepskin Effect, Sze Yan Liu, Stephen L. Buka, Crystal D. Linkletter, Ichiro Kawachi, Laura Kubzansky, Eric B. Loucks

Sze Yan Liu

Purpose

Attaining a degree may offer greater opportunities for health than years of schooling alone. This study examines whether there is a degree, or “sheepskin”, effect on the association between education and blood pressure.

Methods

Multivariable-adjusted ordinal and linear regression models assessed associations of years of schooling and degree attainment with systolic and diastolic blood pressure in a sample of 552 adults aged 38–47 years.

Results

Years of schooling was inversely associated with systolic blood pressure adjusting for age, gender and race (β=−0.4, 95% CL:−0.7,−0.1 mmHg systolic blood pressure/year of schooling). Additional adjustment for mother’s education, childhood verbal intelligence quotient, …

The Role Of Place In Explaining Racial Heterogeneity In Cognitive Outcomes Among Older Adults, Sze Yan Liu, M Maria Glymou, Laura B. Zahodne, Christopher Weiss, Jennifer J. Manly

Sze Yan Liu

Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We …

Structural Racism And Severe Maternal Morbidity In New York State, Sze Yan Liu, Christina Fiorentini, Zinzi Bailey, Mary Huynh, Katherine Mcveigh, Deborah Kaplan

Sze Yan Liu

ABSTRACT

Objective: We examined the association between county-level structural racism indicators and the odds of severe maternal morbidity (SMM) in New York State.

Design: We merged individual-level hospitalization data from the New York State Department of Health Statewide Planning and Research Cooperative System (SPARCS) with county-level data from the American Community Survey and the Vera Institute of Justice from 2011 to 2013 (n = 244 854). Structural racism in each county included in our sample was constructed as the racial inequity (ratio of black to white population) in female educational attainment, female employment, and incarceration.ReSulT S: Multilevel logistic regression analysis …

Self-Reported And Measured Hypertension Among Older Us- And Foreign-Born Adults, Kellee White, Mauricio Avedano, J Robin Moon, Benjamin Capistrant, Sze Yan Liu, M Maria Glymour

Sze Yan Liu

Self-reported hypertension is frequently used for health surveillance. However, little is known about the validity of self-reported hypertension among older Americans by nativity status. This study compared self-reported and measured hypertension among older black, white, and Hispanic Americans by nativity using the 2006 and 2008 Health and Retirement Study (n = 13,451). Sensitivity and specificity of self-reported hypertension were calculated using the Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure definition. Sensitivity was high among older blacks (88.9%), whites (82.8%), and Hispanics (84.0%), and both foreign-born (83.2%) and US-born (84.0%). Specificity …

Hospital Readmissions For Childhood Asthma: The Role Of Individual And Neighborhood Factors., Sze Yan Liu, Deborah Pearlman

Sze Yan Liu

Objectives

This study used a Cox proportional hazards model to determine whether neighborhood characteristics are associated with risk of readmission for childhood asthma independently of individual characteristics.

Methods

Rhode Island Hospital Discharge Data from 2001 to 2005 were used to identify children younger than 19 years of age at the time of the index (i.e., first) asthma admission, defined as a primary diagnosis of asthma or a primary diagnosis of respiratory illness with a secondary or tertiary diagnosis of asthma (n=2,919). Hazard ratios of repeat hospitalizations for childhood asthma from 2001 to 2005 were estimated, controlling for individual- …

Historical Differences In School Term Length And Measured Blood Pressure: Contributions To Persistent Racial Disparities Among Us-Born Adults, Sze Yan Liu, Jennifer M. Manly, Benjamin Capistrant, M Maria Glymour

Sze Yan Liu

Abstract

Introduction

Legally mandated segregation policies dictated significant differences in the educational experiences of black and white Americans through the first half of the 20^th century, with markedly lower quality in schools attended by black children. We determined whether school term length, a common marker of school quality, was associated with blood pressure and hypertension among a cohort of older Americans who attended school during the de jure segregation era.

Methods

National Health and Nutrition Examination Survey I and II data were linked to state level historical information on school term length. We used race and gender-stratified linear regression …

Genetic Vulnerability To Diabetes And Obesity: Does Education Offset The Risk?, Sze Yan Liu, Stefan Walter, Jessica Daniel, David H. Rehkopf, Laura E. Kubzansky, M Maria Glymour

Sze Yan Liu

The prevalence of type 2 diabetes (T2D) and obesity has recently increased dramatically. These common diseases are likely to arise from the interaction of multiple genetic, socio-demographic and environmental risk factors. While previous research has found genetic risk and education to be strong predictors of these diseases, few studies to date have examined their joint effects. This study investigates whether education modifies the association between genetic background and risk for type 2 diabetes (T2D) and obesity. Using data from non-Hispanic Whites in the Health and Retirement Study (HRS, n = 8398), we tested whether education modifies genetic risk for obesity …

Discrimination And Telomere Length Among Older Adults In The United States, Sze Yan Liu, Ichiro Kawachi

Sze Yan Liu

Abstract

Objectives:

Chronic stress from experiencing discrimination can lead to long-term changes in psychological and physiologic responses, including shorter leukocyte telomere length. We examined the association between leukocyte telomere length and variations in the association by race or type of discrimination.

Methods:

Our study consisted of 3868 US-born non-Hispanic black (hereinafter, black) and non-Hispanic white (hereinafter, white) adult participants from the 2008 Health and Retirement Study biomarker sample with complete sociodemographic and discrimination information. We examined major lifetime unfair treatment and everyday discrimination. Coarsened exact matching matched exposed and unexposed participants on several sociodemographic factors. Coarsened exact matching creates analytic …

Breast And Cervical Cancer Screening Practices Among Disabled Women Aged 40–75: Does Quality Of The Experience Matter?, Sze Yan Liu, Melissa A. Clark

Sze Yan Liu

Background

Women with disabilities (WWD) face significant barriers accessing healthcare, which may affect rates of routine preventive services. We examined the relationship between disability status and routine breast and cervical cancer screening among middle-aged and older unmarried women and the differences in reported quality of the screening experience.

Methods

Data were from a 2003–2005 cross-sectional survey of 630 unmarried women in Rhode Island, 40–75 years of age, stratified by marital status (previously vs. never married) and partner gender (women who partner with men exclusively [WPM] vs. women who partner with women exclusively or with both women and men [WPW]).

Results …

Detecting, Preventing, And Treating Sexually Transmitted Diseases Among Adolescent Arrestees: An Unmet Public Health Need, Christopher Salvatore, Steven Belenko, Richard Dembo, Matthew Rollie, Kristina Childs

Christopher Salvatore

Studies of detained and incarcerated adolescent offenders in the United States indicate that these juveniles have an elevated risk of sexually transmitted diseases (STDs). However, many more arrestees enter the “front end” of the juvenile justice system that is detained or incarcerated, and research into the STD risk profiles and service needs of this larger group is lacking. An expansion of STD testing (including of asymptomatic youths), prevention, and treatment is needed, as is improved knowledge about gender- and race-specific services. A pilot program in Florida has shown that juvenile justice and public health systems can collaborate to implement STD …

Cues To Cervical Cancer Screening Among U.S.-Hispanic Women, Arelis Moore De Peralta, Bonnie Holaday, Ida Mikisa Hadoto

Arelis Moore de Peralta

Introduction: Hispanic women’s cervical cancer rates are disproportionately high. Cues to cervical cancer screening (Cues to Action) are strategies to activate the decision-making process to get screened for cervical cancer. This study used the health belief model to examine which cues prompt Hispanic women to undergo cervical cancer screening and how perceptions could be potentiated by cues to cervical cancer screening.

Method: A cross-sectional survey was conducted among Hispanic women 18 to 65 years old (n = 220). Generalized linear modeling was used.

Results: Spanish media and reminders by mother and doctors were relevant cues. Generalized linear modeling showed …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Aurora Family Medicine Residents

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

It’S All About Trust And Respect: Cultural Competence And Cultural Humility In Mobile Health Clinic Services For Underserved Minority Populations, Arelis Moore De Peralta, Melinda Gillispie, Catherine Mobley, Lynette M. Gibson

Arelis Moore de Peralta

To explore participants' perceptions of cultural competence and cultural humility in mobile health clinic (MHC) service delivery, using the Cultural Competence Model (CCM) as an organizing framework. Methods. We conducted five focus groups with an ethnically diverse group of English-and Spanish-speaking men and women, ages 20–67, residing in five underserved neighborhoods in a Southeastern U.S. city. Data analysis followed a thematic approach and iterative qualitative content analysis. Results. Participants expressed a desire for well-trained and caring staff who practice cultural humility. Conclusions. By applying the CCM's five-pronged constellation of cultural abilities, health care personnel could ultimately be more responsive to …

Realmente Tenemos La Capacidad: Engaging Youth To Explore Health In The Dominican Republic Through Photovoice, Catalina Tang Yan, Arelis Moore De Peralta, Edmond P. Bowers, Linda Sprague Martinez

Arelis Moore de Peralta

Youth are often at risk for physical and psychosocial illnesses, and yet their input is rarely included in health assessments and interventions. Two U.S.-based universities partnered with community stakeholders and youth in Las Malvinas II, Dominican Republic to explore factors that promote and/or hinder the health of youth in Las Malvinas II. Youth (n=8) conducted a photovoice, and identified six key health priorities: (1) good nutrition, (2) depression and poverty, (3) violence, (4) sports and neighborhood association, (5) education, and (6) sanitation and community infrastructure. Findings revealed youth’s exploration of complex multi-level determinants of health. This study suggests youth have …

Liberty Without Capacity: Why States Should Ban Adolescent Driving, Vivian E. Hamilton

Vivian E. Hamilton

No abstract provided.

Using The Theory Of Planned Behavior As A Predictor Of Radiologic Technologists' Use Of Patient Radiation Protection Best Practices: A Regional Study, Brenda L. Boyd

Brenda Boyd, PhD

Problem. A growing concern exists that patients are receiving an increase in radiation exposure while undergoing medical imaging exams. According to a March 2009 report by the National Council on Radiation Protection and Measurements (NCRP), the U.S. population's total exposure to ionizing radiation has nearly doubled over the past two decades. With the introduction of new digital radiology equipment, patient dose is on the rise. Possible reasons for a radiologic technologist's behavior include: influence by availability or lack of equipment, policies, social pressure, attitudes, and a safety culture. Little research has been done in this area, specifically with applying a …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Glenda Sundberg, FNP-CS, APNP

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Jessica Kram, MPH

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Recommendations For The Evaluation Of Cross-System Care Coordination From The Va State-Of-The-Art Working Group On Va/Non-Va Care, Kristin M. Mattocks, Kristin Cunningham, A. Rani Elwy, Erin P. Finley, Clinton Greenstone, Michelle A. Mengeling, Steven D. Pizer, Megan E. Vanneman, Michael Weiner, Lori A. Bastian

Kristin M. Mattocks

In response to widespread concerns regarding Veterans' access to VA care, Congress enacted the Veterans Access, Choice and Accountability Act of 2014, which required VA to establish the Veterans Choice Program (VCP). Since the inception of VCP, more than two million Veterans have received care from community providers, representing approximately 25% of Veterans enrolled in VA care. However, expanded access to non-VA care has created challenges in care coordination between VA and community health systems. In March 2018, the VA Health Services Research and Development Service hosted a VA State of the Art conference (SOTA) focused on care coordination. The …

Segmental Distribution Of Hepatocellular Carcinoma Correlates With Microvascular Invasion In Liver Explants Undergoing Transplantation, Yasir Al-Azzawai, Eva Rouanet, Ryan J. Hendrix, Lidia Spaho, Hesham Malik, Deepika Devuni, Gyongyi Szabo, Graham Barnard

Gyongyi Szabo

Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) patients is a poor prognostic factor after liver transplantation and/or resection. Any correlation between MVI and segmental location of HCC has yet to be studied. Our aim is to evaluate the segmental location of HCC and any correlation with the presence of MVI, portal vein thrombosis (PVT) in explanted livers, and the recurrence of HCC after transplantation. Another objective of the study is to assess the treatment history (ablation or transarterial chemoembolization (TACE)) and size of the tumor with respect to the risk of MVI.

Methods: A single center, retrospective chart review, …

Predictors Of Neonatal Abstinence Syndrome In Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?, Darshan Shah, Stacy Brown, Nick Hagemeier, Shimin Zheng, Amy Kyle, Jason Pryor, Nilesh Dankhara, Piyuesh Singh

Stacy D. Brown

Background

Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.

Methods

Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and …

Public Opinion Report Of Nutrition Education And Nutrition-Related Behaviors, Kristen Hicks-Roof, Robert J. Zeglin, Daniel Manson, Corinne A. Labyak

Kristen Hicks-Roof

Objectives: Sources of obtaining credible evidence-based nutrition knowledge appears to be more and more limited as nutrition information becomes widespread. The purpose of this study was to determine sources of nutrition information and corresponding nutrition-related behaviors among Florida residents. Study Design: A cross-sectional study.

Methods: A telephone survey was conducted using probability sampling with residents of Florida in October 2017.Results: A total of 611 respondents completed the survey from 45 different counties across Florida. A significant relationship was established between age and primary source of obtaining nutrition information. Young, middle age and elderly adults preferred media, registered dietitians and physicians/nurses …

Assessing Community Support For Comprehensive Sexual Health Education In High-Risk Florida Schools, Kimberly K. Walker, Ellen J. Schafer, Karen Maziarz, Michael Binder, Danielle Quichocho

Michael Binder

Fifty percent of middle schools and 35% of high schools in Hillsborough County, Florida, serve students at high-risk for teen birth and sexually transmitted infections. This study assessed the desired type of sexual health education (SHE), content, and support for SHE from residents in the districts. Descriptive and bivariate statistics were used to analyze 314 survey phone interviews with adults, and thematic analysis was used to analyze eight focus groups with 104 youth living in the high-risk school districts. Survey results showed strong community support for comprehensive SHE with human anatomy and reproduction and HIV and sexually transmitted disease as …

Accessibility And Affordability Of Healthy Foods In Food Deserts In Florida: Policy And Practice Implications, Lauri Wright, Palak Gupta, Kumiko Yoshihara

Lauri Wright

Food deserts are areas where people experience limited access to healthy and affordable food. People with limited access to affordable food have been shown to have higher rates of obesity and obesity-related, chronic diseases. The purpose of this study was to assess the availability and affordability of healthy foods in retail outlets of food deserts in Florida. Eighteen food deserts in two large metropolitan areas were assessed using the USDA Food Store Survey Instrument. Overall, stores within food deserts were missing 43.16% of food items and convenience stores were missing food items almost seven times more than supermarkets. Food items …

The Accuracy Of Referral For Portable Lipid Analyzers In An Old Order Mennonite Population, Maria E. Main, M. Susan Jones, Cathy H. Abell

Eve Main

The primary purposes of this study were to: 1) examine the accuracy for referral of two portable lipid analyzers (PLAs) in an old order Mennonite population through a comparison to a national standardized reference laboratory, 2) examine the relationship of total cholesterol values with other known cardiovascular risk factors, and 3) foster the continued participatory model of health care service in this community. The self-selected sample was composed of 42 adult members of an old order Mennonite community residing in south central Kentucky. A descriptive correlational design was used in this study. There were clinically relevant variations in the total …

Impact Belize 2010 Executive Report, Ritchie D. Taylor, Jordan Norris, Molly Calico, Bernie Strenecky, Daniel Carter, Dawn Garrett Wright, Eve Main, Bonny Petty, Molly Kerby, Jill Norris

Eve Main

No abstract provided.

A Colorectal Cancer Screening Project In An Old Order Mennonite Community: Capstone Project Technical Report, Maria Eve Main

Eve Main

The purpose of this project was to determine if colorectal cancer (CRC) screening education and community access to fecal occult blood tests (FOBT) is associated with an increase in the uptake of FOBT in an old order Mennonite community. Utilizing a modified cultural model, an educational offering on CRC screening and access to FOBT in the community was delivered to a self-selected sample of age-eligible participants. Thirty-three age eligible residents completed the CRC screening questionnaires and received education on CRC screening. Twenty-nine of the age-eligible participants were found to be at average risk and twenty-three elected to receive FOBT testing …

Child Weight And Feeding Patterns In An Old Order Mennonite Community, Dawn M. Garrett Wright, Maria E. Main, M. Susan Jones

Eve Main

Feeding practices in some religious communities may decrease childhood obesity. However, there is limited research in these communities to assess maternal perceptions of their children’s weight and feeding patterns. The purpose of this study was to ascertain Old Order Mennonite mothers’ perceptions of their children’s body weight and to examine feeding patterns for their children. Sample: Participants for this descriptive, correlational study were recruited from an Old Order Mennonite community in south central Kentucky. Sampling was achieved using a snowball sampling strategy and the use of a community insider. Methods: Body Mass Index was measured for mothers and child participants, …

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …