Medicine and Health Sciences Commons^™

Perspectives From Community-Based Doulas And Mothers: Neighborhood Context And Pregnancy, Dara D. Mendez, Jessica Burke, Jennifer Jones, Cynthia Salter

Journal of Health Disparities Research and Practice

Objectives: Limited research explores the potential pathways by which neighborhoods influence pregnancy or how community members conceptualize and interpret how neighborhood contexts and living environments influence pregnancy and birth.

Study Design: We applied participatory Concept Mapping and a series of focused discussions with community-based doulas and mothers.

Methods: We collaborated with a community-based doula program to investigate how mothers and community doulas perceived the neighborhood to influence reproductive health. We conducted a series of focused discussions including ‘Brainstorming’ to uncover key themes related to how neighborhood context influenced pregnancy, ‘Sorting and Rating’ of key themes in association with pregnancy and …

Pharmacists On The Front Lines Of Community Health: The Pneumonia Prevention Project, Joseph Fulginiti, Jason Schafer Pharmd, Mph, Marie-Monique Marthol-Clark, Lynn Fields Harris Mpa, Joseph Desimone Jr, Md, Laura T. Pizzi Pharmd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Erratum (For “In Adult Smokers Unwilling Or Unable To Quit, Does Changing From Tobacco Cigarettes To Electronic Cigarettes Decrease The Incidence Of Negative Health Effects Associated With Smoking Tobacco? A Clin-Iq”)

Journal of Patient-Centered Research and Reviews

In Volume 1, Issue 2, the article “In Adult Smokers Unwilling or Unable to Quit, Does Changing From Tobacco Cigarettes to Electronic Cigarettes Decrease the Incidence of Negative Health Effects Associated With Smoking Tobacco? A Clin-IQ” (J Patient-Centered Res Rev. 2014;1:99-101) mistakenly reported the delivery agent in e-cigarettes as diethylene glycol instead of propylene glycol. Propylene glycol is a relatively benign substance commonly used in concert smoke machines. Diethylene glycol, a highly toxic substance, was reportedly found in only one e-cigarette cartridge studied in the literature, which may have been due to use of a nonpharmaceutical grade propylene …

Discordant Documentation Of Obesity Body Mass Index And Obesity Diagnosis In Electronic Medical Records, Jennifer T. Fink, George L. Morris Iii, Maharaj Singh, David A. Nelson, Renee E. Walker, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: This study examined concordance between presence of obesity body mass index (BMI), defined as BMI ≥ 30, in the patient’s electronic medical record (EMR) and a documented diagnosis of obesity.

Methods: We conducted a retrospective review of the EMR in a large health care system for a 1-year period (2012). A total of 397,313 patients met the study criteria of having at least one physician visit, being at least 18 years of age, and not being pregnant. Of those, 158,327 (40%) had a recorded BMI ≥ 30. We examined the EMR of these obese patients to determine whether a …

Assessing Technologies For Information-Seeking On Prostate Cancer Screening By Low-Income Men, Susan W. Mcroy, Emily M. Cramer, Hayeon Song

Journal of Patient-Centered Research and Reviews

Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older.

Methods: The study comprised: 1) a survey assessing current use of the Internet, mobile phones and texting; 2) a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3) a formative field study in which subjects interacted with a health department nurse using text messages.

Results: Survey results suggest the target population has greater access to, …

The Politics Of Hpv Vaccination Advocacy: Effects Of Source Expertise On Effectiveness Of A Pro-Vaccine Message, Roger Gans

Proceedings of the New York State Communication Association

The Politics of HPV Vaccination Advocacy:

Effects of Source Expertise on Effectiveness of a Pro-Vaccine Message

Persistent public resistance to an apparently safe, effective and life-saving public health practice such as HPV vaccination illustrates a significant issue in the communication of behavioral recommendations based on evidence-based scientific data and consensus views of scientific and medical experts. This study examines the influence of source expertise on pro-HPV-vaccine advocacy messaging effectiveness among audiences of differing political ideologies. The findings support prior research indicating greater resistance to HPV vaccination among political conservatives. Subjects who self-identified politically as Centrists and Conservatives were significantly less …

Internet Use For Health Information Among American Indians: Facilitators And Inhibitors, Melissa K. Filippi, Christina M. Pacheco, Charlotte Mccloskey, Rebecca Jeanne Crosthwait, Justin Begaye, Jb Kinlacheeny, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD^© more than any other …

Association Analysis Of Reported Attitudes And Culturally Competent Behavior Engagement Among Public Health Department Employees, Marla B. Hall Phd, Jeffrey J. Guidry Phd, E. Lisako Mckyer Phd, Corliss Outley Phd, Danny Ballard Phd

Journal of Health Disparities Research and Practice

Objective: The purpose of this research is to analyze the association of attitudes and beliefs on engaging in culturally competent behavior.

Design: Explorational case study of individuals employed within an urban public health department.

Participants: Employees (n=90) from four metropolitan clinical sites of an urban public health department located in the southwest region of the United States were solicited and recruited during a monthly staff meeting. This sample is representative of 84% of the total employees which is comprised of 107 individuals.

Main Outcome Measures: The Cultural Competence Assessment is designed to explore individual knowledge, feelings …

Racial Disparities In Access To Community Water Supply Service In Wake County, North Carolina, Jacqueline Macdonald Gibson, Nicholas Defelice, Daniel Sebastian, Hannah Leker

Frontiers in Public Health Services and Systems Research

Anecdotal evidence suggests that historically African American communities on the fringes of cities and towns in North Carolina have been systematically denied access to municipal drinking water service. This paper presents the first statistical analysis of the role of race in determining water access in these fringe areas, known as extraterritorial jurisdictions. Using publicly available property tax data, we quantified the percentage of residences with municipal water service in each census block in Wake County (the second-largest by population in North Carolina). Using the resulting water service maps plus 2010 U.S. Census data, we employed a logistic regression to assess …

Developing A Tool To Assess Administrative Evidence-Based Practices In Local Health Departments, Rodrigo S. Reis, Kathleen Duggan, Peg Allen, Katherine A. Stamatakis, Paul C. Erwin, Ross C. Brownson

Frontiers in Public Health Services and Systems Research

There is need for assessing the practices undertaken by local health departments in order to improve the implementation of evidence-based actions. This paper describes the development and testing of a survey instrument for assessing Administrative Evidence-Based Practices (A-EBPs) in Local Health Departments. A-EBPs identified through a review of the literature were used to develop a survey composed of nine sections and tested in a sample of local health department practitioners. The resulting tool showed adequate test-retest reliability and internal consistency. Practitioners and researchers may apply this tool in practice-based and evaluation research.

Philadelphia Healthier Generation Summit, Lauren Puzen Msw,Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Medical Reserve Corps: Volunteers Making A Difference, Mary Lou Manning Phd, Crnp, Cic, Faan, Neale Batra Ba

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Herd Immunity And The Necessity Of Vaccinations: Modeling The Effects Of Mmr Vaccinations, Caitlyn Cardetti, Katie Groskreutz, Melissa Zins

Journal of Undergraduate Research at Minnesota State University, Mankato

The MMR vaccination is a two dose vaccine given to children between the ages of 12 – 15 months and the second dose between the ages of 4 – 6 years to prevent measles, mumps, and rubella. The objective was to mathematically model the effects of the MMR vaccinations in a hypothetical school through multiple compartment and spatial models. These models were based on each disease individually with their respective vaccine effectiveness and disease infection rates. These models demonstrated the limits of herd immunity. Herd immunity occurs when a high enough percentage of the population is immune or vaccinated to …

Policy Impact Assessment: The “Reasonable Break Time” Provision Of The Patient Protection And Affordable Care Act, Merritt Juliano

21st Century Social Justice

Breastfeeding continues to be the most optimal source of nutrition for infants under 6 months of age, and has been associated with a wide variety of infant and maternal health benefits, including protection against certain illnesses and diseases. Most health organizations recommend exclusive breastfeeding for at least the first 6 months post-birth. Despite these recommendations, breastfeeding women, especially those in lower socioeconomic groups face many challenges in our society. Moreover, maternal employment stands as a significant barrier to successful breastfeeding durations. To counter these problems, Section 4207 of the Patient Protection and Affordable Care Act [ACA] was enacted to offer …

Black Is Decidedly Not Just Black: A Case Study On Hiv Among African-Born Populations Living In Massachusetts, Chioma Nnaji, Nzinga Metzger

Trotter Review

Black or African American is a racial category that includes the descendants of enslaved Africans as well as members of foreign-born black communities who migrated to the United States from places abroad, such as Africa, the Caribbean, and Latin America. Grouping native-born and foreign-born blacks into a single homogeneous racial category may make it easier to track disease and health outcomes; however, it masks the different cultural experiences, histories, languages, social and moral values, and expectations that influence health beliefs, attitudes, practices, and behaviors. It also ignores such factors as migration, which forces foreign-born populations to examine both their traditional …

The Association Between Health Literacy And Diet Adherence Among Primary Care Patients With Hypertension, Jenny A. Hutchison Ms., Jan Warren-Findlow Dr., Michael Dulin Dr., Hazel Tapp Dr., Lindsay Kuhn

Journal of Health Disparities Research and Practice

This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between …

Developing An Action Learning Community Advocacy/Leadership Training Program For Community Health Workers And Their Agencies To Reduce Health Disparities In Arizona Border Communities, Kenneth A. Schachter Md, Mba, Maia Ingram Mph, Laurel Jacobs Drph, Mph, Hannah Hafter Mph, Jill Guernsey De Zapien Ba, Scott Carvajal Phd, Mph

Journal of Health Disparities Research and Practice

Community health workers (CHWs) make unique and important contributions to society. They serve as patient advocates, educators, and navigators in our health care system and a growing body of research indicates that they play an important role in the effective delivery of prevention and treatment services in underserved communities. CHWs also serve as informal community leaders and advocates for organizational and community change, providing valuable insiders' insights about health promotion and the interrelatedness of individuals, their community, its institutions, and the surrounding environment. Accion Para La Salud or Action for Health (Accion) is a CDC-funded community based participatory research (CBPR) …

Prevalence And Correlates Of Hiv-Risk Behaviors Among Homeless Adults In A Southern City, Kristen R. Morrell, Latrice C. Pichon, Theresa Chapple-Mcgruder, Jennifer M. Kmet, Amanda Chandler, Marvell L. Terry Ii

Journal of Health Disparities Research and Practice

This paper aims to describe the prevalence and correlates of HIV-risk behaviors among adults receiving transitional and emergency housing services in Memphis, Tennessee. A cross-sectional, interviewer-administered survey was conducted with a convenience-based sample (N=116) of homeless adults. Sex without a condom, sex while on drugs or drunk, and sex with an unknown person emerged as the three most prevalent HIV-risk behaviors. Sex while drunk or high on drugs was also assessed as a significant predictor for sex without a condom and sex with an unknown person. Multivariate logistic regressions revealed that mental health status, duration of homelessness, incarceration history, and …

Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice To Describe The Assets And Barriers To Sexual And Reproductive Health Among Latinos In North Carolina, Barbara Baquero, Shira Goldman, Florence Siman, Sadiya Muqueeth, Laura Villa-Torres, Eugenia Eng, Scott D. Rhodes

Journal of Health Disparities Research and Practice

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a …

Social Determinants Of Late Presentation To Hiv Care, Connie Leeper, Michael Mugavero, James Willig, Eric Chamot, Shatomi Kerbawy, Anne Zinski

Journal of Health Disparities Research and Practice

Background: In recent years, increased attention has shifted toward evaluating social determinants of health, and understanding how community, environment, and system factors affect health outcomes. HIV policies and guidelines emphasize the importance of earlier HIV diagnosis and presentation for care. This study evaluated the role of individual and community-level factors in late presentation to HIV care.

Methods: HIV-infected patients newly initiating outpatient HIV medical care at an academic medical center between 2005-2010 were included. Patients' self-reported addresses at their first clinic visit were geocoded using geographic information systems software to the appropriate United States census block group. Using …

Bedbugs Biting Back? A Multifactorial Consideration Of Bedbug Resurgence, Vanessa L. Abejuela-Matt

Journal of Patient-Centered Research and Reviews

Bedbugs, previously thought to be eradicated during the mid-20th century, have reemerged in the new millennium with unforeseen furor. Affected patients and families frequently present in primary care settings, not only with complaints of pruritus or rash, but with anxiety and shame regarding the condition. Changes in eradication techniques and resistance, as well as lack of reporting – from both patients and lodging institutions – have hindered control. The increased mobility of goods and the human population has provided further avenues for bedbug spread. While current literature thoroughly describes the clinical presentation of bedbugs and the increasingly problematic effects on …

The Effects Of The Changes In Section 317 Rules For Administration Of Federally Purchased Vaccines, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

Section 317 of the Public Health Services Act is a federal program that provides funds for the purchase of vaccines. These annual Congressional allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2013, Section 317 rules redefined the population eligible for immunization with Section 317 purchased vaccines. In Tennessee, the response was a policy change …

The Effects Of The State Of Tennessee Immunization Policy Change Of 2011 - 2012 On Vaccination Uptake In East Tennessee, Margaret A. Knight, Anne D. Kershenbaum, Martha Buchanan, Janet Ridley, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

In the United States, funding for the purchase of vaccines depend on annual Congressional allocations. These allocations fluctuate from year to year as Congress responds to changes in national needs for immunizations. The Affordable Care Act requires first dollar coverage of immunizations and other preventive care, allowing a reduction in federal funding for vaccine purchase and a reallocation of funds to other uses such as infrastructure development. In fiscal year 2012, the loss of funds allocated from the American Recovery and Reinvestment Act required action by states to ensure appropriate use of remaining funds. In Tennessee, the response was a …

Alteration Of Host Cell Ubiquitination By The Intracellular Bacterial Pathogen Coxiella Burnetii, Lindsay Pritchett, Daniel E. Voth

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

The intracellular bacterial agent of Q fever, Coxiella burnetii, replicates within a phagolysosomelike parasitophorous vacuole (PV) in human macrophages and delivers effector proteins to the host cytosol via a Dot/Icm type IV secretion system (T4SS). The T4SS effectors are critical for PV formation and prevention of host cell death that allows sufficient time for bacterial replication. Recruitment of ubiquitin-related components to the C. burnetii PV is also predicted to be involved in PV formation and bacterial replication and is likely controlled by effector proteins. In this study, we assessed the role of the Dot/Icm T4SS in regulating ubiquitination by comparing …

Presence Of Antibiotic Resistance Genes From Wastewater Treatment Plant Effluent In Northwest Arkansas, Ryan Macleod, Mary Savin

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Antibiotic resistance genes (ARGs) among bacterial populations are causing increasing concern with medical and agricultural implications. While the effluent of wastewater treatment plants (WWTPs) is treated with a variety of antimicrobial methods, bacteria and the genetic material that is able to pass on antibiotic resistance to environmental populations are not completely destroyed. Ampicillin (amp), tetracycline (tet), and sulfonamide (sul) antibiotics have been detected in Northwest Arkansas (NWA) streams, and IncP plasmids—which are especially notorious for containing antibiotic resistance genes and have been detected after disinfection in NWA WWTPs—are known to carry ARGs for those antibiotics. The objective of this inquiry …