Public Health Commons^™

The Use Of Mobile Apps To Increase Physical Activity Level: A Systematic Review, Dziyana Nazaruk, Kelli Rouser

Department of Health Policy and Community Health Faculty Publications

Background: About 82% of the U.S. adult population owns a smartphone. More than half of that population downloaded a fitness or health app to increase the physical activity level. The current review included studies that have utilized mobile apps in conjunction with other intervention strategies to increase physical activity levels. Methods: The search was conducted in five electronic databases. Studies were included if they were randomized controlled trials, utilized mobile apps, physical activity was the primary outcome, written in English, and conducted between the years of 2007 and 2019. Results: Thirteen studies were included in the final review. Results indicated …

Disparities In Hiv Clinical Stages Progression Of Patients At Outpatient Clinics In Democratic Republic Of Congo, Raimi Ewetola, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Astrid Mulenga, Apolinaire Kilundu

Department of Health Policy and Community Health Faculty Publications

Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients’ clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research evidence explaining factors associated with patients’ clinical stages is needed. Objectives: The primary objective of this study was to produce such scientific evidence by analyzing the most recent data for patients at outpatient clinics in the provinces of Kinshasa and Haut-Katanga and to examine the patient characteristics associated with WHO stages of disease progression. Methods: Using a …

Risk Factors For Tb/Hiv Coinfection And Consequences For Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Cong, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, Lievain Maluantesa, Kristie C. Waterfield, Elodie Engetele, Apolinaire Kilundu

Department of Health Policy and Community Health Faculty Publications

(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from …

Public Health Employees’ Perceptions About The Impact Of Emerging Public Health Trends On Their Day-To-Day Work: Effects Of Organizational Climate And Culture, Kristie Cason Waterfield, Gulzar H. Shah, Linda Kimsey, William A. Mase, Jingjing Yin

Department of Health Policy and Community Health Faculty Publications

Objective: The purpose of this research was to assess the workforce characteristics associated with public health employees’ perceived impact of emerging trends in public health on their day-to-day work. Methods: Multinomial logistic regression was performed to analyze data from the 2017 PH WINS, a cross-sectional survey utilizing a nationally representative sample of the United States public health workforce. Results: More than 55% of the public health workforce perceived that their day-to-day work was impacted by the emerging public health trends. Workplace environment was significantly associated with the perception of their day-to-day work being impacted by emerging public health trends such …

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Department of Health Policy and Community Health Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Retention And Predictors Of Attrition Among Children Living With Hiv On Antiretroviral Therapy (Art) In Côte D’Ivoire Between 2012 And 2016, F. Traore-Toure, Gina D. Etheredge, Gulzar H. Shah, C. Brennan

Department of Health Policy and Community Health Faculty Publications

Background: In Côte d’Ivoire a retrospective national-level cohort study conducted in 2009 indicated that 77%, 72% and 75% of children living with HIV (CLHIV) remained in care at 12, 36, and 48 months after starting ART, respectively. The CDC-sponsored Improving HIV Surveillance and Program Evaluation in Côte d’Ivoire project assessed retention progress since that study.

Methods and materials: A retrospective review of medical records was conducted using 2-stage cluster sampling. HIV care and treatment centers (CTC) were sampled based on patient caseload, then records of patients under 15 years of age who initiated ART between 2012–2016 were randomly …

Tb/Hiv Coinfection And Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Congo, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, L. Maluantesa, Kristie C. Waterfield, L.-K. Lukusa

Department of Health Policy and Community Health Faculty Publications

Background: To provide efficient, equitable, patient-centered, and evidence-based services to people living with HIV/AIDS (PLWH), it is critical for the intervention programs to understand the nature of barriers to effective treatment and additional risks faced by PLWH with tuberculosis (TB) coinfection. This study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes such as death, loss to follow up, and higher viral load among PLWH with TB coinfection compared to those without such coinfection.

Methods and materials: This quantitative study used …

Hiv Clinical Stage Progression Of Patients At 241 Outpatient Clinics In Democratic Republic Of Congo: Disparities By Gender, Tb Status And Rurality, Gina D. Etheredge, Raimi Ewetola, Gulzar H. Shah, L. Maluantesa, Kristie C. Waterfield, A. Mulenga, A. Kilundu

Department of Health Policy and Community Health Faculty Publications

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO's four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services.

Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda Kimsey, Charles Owens, Samuel T. Opoku, Angela Peden, William Mase

Department of Health Policy and Community Health Faculty Publications

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

Blood Transfusion: Knowledge, Perspectives, And Experiences Of Individuals With Sickle Cell Disease, Raymona H. Lawrence, Ashley Singleton, Jane Branscomb

Department of Health Policy and Community Health Faculty Publications

Patient voice and perspective were needed to inform effective, comprehensive strategies for reducing preventable transfusion-associated complications. This report presents the results of interviews with sickle cell disease (SCD) patients and implications for strategies to reduce transfusion complications in this population. Twenty-two participants were recruited from 2 comprehensive SCD treatment centers in Georgia and interviewed regarding knowledge about transfusions and potential complications, attitudes about data storage and sharing, and the transfusion experience. Participants had general knowledge of physiology, blood products, and blood transfusions, including knowing the risk of complications, but varied in comprehension of complex health information and level of misinformation. …

Publication Of Data Collection Forms From Nhlbi Funded Sickle Cell Disease Implementation Consortium (Scdic) Registry, Jeffrey Glassberg, Elizabeth A. Linton, Katrina Burson, Tabitha Hendershot, Joseph Telfair, Julie Kanter, Victor R. Gordeuk, Allison A. King, Cathy L. Melvin, Nirmish Shah, Jane S. Hankins, Axel Yannick Epié, Lynne D. Richardson

Department of Health Policy and Community Health Faculty Publications

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline …

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Department of Health Policy and Community Health Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Engagement Of Community Stakeholders To Develop A Framework To Guide Research Dissemination To Communities, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Yolanda Vaughn, Jim Hawk, Mike Helms, Claudia Barajas, Yvonne Joosten

Department of Health Policy and Community Health Faculty Publications

Background: Dissemination of research findings to past study participants and the community-at-large is important. Yet, a standardized process for research dissemination is needed to report results to the community. Objective: We developed a framework and strategies to guide community-academic partnerships in community-targeted, dissemination efforts.

Methods: From 2017 to 2019, a community-academic partnership was formed in Nashville, Tennessee, and iteratively developed a framework and strategies for research dissemination using cognitive interviews. A deductive, constant comparative analysis was conducted on interview responses to examine framework and strategy content. Feedback was used to finalize the framework and strategies for the evaluation. …

Effect Of Influenza Vaccination On Mortality And Risk Of Hospitalization In Elderly Individuals With And Without Disabilities: A Nationwide, Population-Based Cohort Study, Yu-Chia Chang, Ho-Jui Tung, Yu-Tung Huang, Chin-Te Lu, Ernawaty Ernawaty, Szu-Yuan Wu

Department of Health Policy and Community Health Faculty Publications

Purpose: The effects of influenza vaccines are unclear for elderly individuals with disabilities. We use a population-based cohort study to estimate the effects of influenza vaccines in elderly individuals with and without disabilities. Methods: Data were taken from the National Health Insurance Research Database and Disabled Population Profile of Taiwan. A total of 2,741,403 adults aged 65 or older were identified and 394,490 were people with a disability. These two groups were further divided into those who had or had not received an influenza vaccine. Generalized estimating equations (GEE) were used to compare the relative risks (RRs) of …

A Scoping Review Of Theoretical Models And Conceptual Frameworks Used In Public Health Services And Systems Research (Phssr) Literature, Zahra Shahin, Anna Messick, Jenna Harris, Kristie C. Waterfield, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

Objectives

Theoretical models and conceptual frameworks are often used to design research methods. This study aims to provide an overview of the application of theoretical models and conceptual frameworks in Public Health Services and Systems Research (PHSSR). We also examine how the integration of such terms in research can improve intervention designs and support the decision-making process within the field of public health practice.

Methods

A scoping review was conducted using publications from public health journals to identify relevant articles in the field of PHSSR. The eligibility of studies was determined after performing evaluations through a full-text review of each …

Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella M. Hardwick, Nancy Jeffery, Jalisa Jordan, William Mase

Department of Health Policy and Community Health Faculty Publications

Background

The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and …

Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin

Department of Health Policy and Community Health Faculty Publications

Background

The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.

Methods

A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …

Characteristics Of The Health Information Technology Workforce In Georgia, Imaobong Ekpo, Emmanuel Akowuah, Bettye Apenteng, Samuel T. Opoku

Department of Health Policy and Community Health Faculty Publications

Background: Advancement in medical technology, as well as the Health Information Technology for Economic and Clinical Health Act, has in part influenced the demand for health information technology (HIT) workers. While other sectors have experienced a tremendous increase in the information technology workforce, the health sector lags in this regard. The aim of this study was to describe the characteristics of the HIT workforce in Georgia, relative to surrounding states and the United States.

Methods: The supply of the HIT workforce in Georgia, surrounding states, and the United States was estimated using data from the 2014-2016 American Community Survey (ACS). …

Adapting Medical Guidelines To Be Patient-Centered Using A Patient-Driven Process For Individuals With Sickle Cell Disease And Their Caregivers, Robert M. Cronin, Tilicia Mayo-Gamble, Sarah-Jo Stimpson, Sherif M. Badawy, Lori E. Crosby, Jeannie Byrd, Emmanuel J. Volanakis, Adetola A. Kassim, Jean L. Raphael, Velma Mcbride Murry, Michael Debaun

Department of Health Policy and Community Health Faculty Publications

Background: Evidence-based guidelines for sickle cell disease (SCD) health maintenance and management have been developed for primary health care providers, but not for individuals with SCD. To improve the quality of care delivered to individuals with SCD and their caregivers, the main purposes of this study were to: (1) understand the desire for patient-centered guidelines among the SCD community; and (2) adapt guideline material to be patient-centered using community-engagement strategies involving health care providers, community -based organizations, and individuals with the disease.

Methods: From May–December 2016, a volunteer sample of 107 individuals with SCD and their caregivers gave …

2491: Parental Concerns About Child Participation In S Reflect A Need To Move Beyond Traditional Notions Of Trust And Race, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Consuelo H. Wilkins

Department of Health Policy and Community Health Faculty Publications

OBJECTIVES/SPECIFIC AIMS: The objective of this study was to identify factors influencing parental willingness of adolescent participation in clinical trials. METHODS/STUDY POPULATION: We applied community engaged research principles to conduct a theory-based, cross-sectional study of parental willingness. Parents (N=307) were given a survey from November 2014 to April 2015. Factors influencing parental willingness were identified using binary logistic regression. SPSS version 22.0 was used to perform analyses, and p

2484: Establishment Of The Tennessee-Sickle Cell Disease Network As A Mechanism For Engaging A Rare Disease Population In Patient Centered Outcomes Research, Tilicia Mayo-Gamble, Velma Mcbride Murry, Michael R. Debaun

Department of Health Policy and Community Health Faculty Publications

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in …

Cyberbullying And Self-Perceptions Of Students Associated With Their Academic Performance, Maham Muzamil, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

The aim of this study is to explore the factors influencing students’ academic achievements in secondary school level (grades 09 and 10). Those factors include students’ self-reported psychological and issues (e.g. being bullied through social media) as well as socioeconomic status. Study participants included610 students at senior secondary level (237 male and 363 female) randomly selected from ten different government schools. The schools were randomly selected from the lists provided by their respective Education District Officer (EDO). The data were collected by researchers with the help of teachers. Participants’ were offered as incentives a drawing for a gift certificate. Bivariate …