Community Health and Preventive Medicine Commons^™

Hospital Variation In Costs – A Challenge To The Value Proposition, Aaron B. Caughey, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Mini Commentary on 2017-OG-19978R1: Hospital Variation in Cost of Childbirth and Contributing Factors: A Cross-Sectional Study. To view this article visit https://doi.org/10.1111/1471-0528.15007.

Planning And Designing The Improving Addiction Care Team (Impact) For Hospitalized Adults With Substance Use Disorder, Honora Englander, Melissa B. Weimer, Rachel Solotaroff, Christina Nicolaidis, Benjamin Chan, Christine M. Velez, Alison Noice, Tim Hartnett, Ed Blackburn, Pen Barnes, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

People with substance use disorders (SUD) have high rates of hospitalization and readmission, long lengths of stay, and skyrocketing healthcare costs. Yet, models for improving care are extremely limited. We performed a needs assessment and then convened academic and community partners, including a hospital, community SUD organizations, and Medicaid accountable care organizations, to design a care model for medically complex hospitalized patients with SUD. Needs assessment showed that 58% to 67% of participants who reported active substance use said they were interested in cutting back or quitting. Many reported interest in medication for addiction treatment (MAT). Participants had high rates …

Prevalence, Age Profile, And Associated Risk Factors For Hymenolepis Nana Infection In A Large Population-Based Study In Northern Peru, Percy M. Vilchez Barreto, Ricardo Gamboa, Saul Santivañez, Seth E. O'Neal, Claudio Muro, Andrés G. Lescano, Luz M. Moyano, Guillermo Gonzálvez, Hector H. García

OHSU-PSU School of Public Health Faculty Publications and Presentations

Hymenolepis nana, the dwarf tapeworm, is a common intestinal infection of children worldwide. We evaluated infection and risk factor data that were previously collected from 14,761 children aged 2-15 years during a large-scale program in northern Peru. We found that 1,124 of 14,761 children (7.61%) had H. nana infection, a likely underestimate given that only a single stool sample was examined by microscopy for diagnosis. The strongest association with infection was lack of adequate water (adjusted prevalence ratio [aPR] 2.22, 95% confidence interval [CI] 1.82-2.48) and sanitation infrastructure in the house (aPR 1.94, 95% CI 1.64-2.29). One quarter of …

C-Safe: A Computer-Delivered Sexual Health Promotion Program For Latinas, Charles H. Klein, Tamara Kuhn, Midori Altamirano, Carmela Lomonaco

Anthropology Faculty Publications and Presentations

This article describes the development and evaluation of C-SAFE (Sexual Awareness for Everyone), a computer-delivered sexual health promotion program for Latinas. We first describe the process of adapting an evidence-based, group-level intervention into an individually administered computer-delivered program. We then present the methods and results of a randomized control trial with 321 Latinas in California and Florida to test C-SAFE's preliminary efficacy in reducing sexual health risk. We found no statistically significant differences between the two conditions at a six-month follow-up in terms of sexual behaviors or attitudes toward sexually transmitted infections and condoms, although C-SAFE women reported fewer days …

Brief Report: Medication Sharing Is Rare Among African Hiv-1 Serodiscordant Couples Enrolled In An Efficacy Trial Of Oral Pre-Exposure Prophylaxis (Prep) For Hiv-1 Prevention, Kerry A. Thomson, Jessica Haberer, Mark A. Marzinke, Andrew Mujugira, Craig Hendrix, Connie Celum, Patrick Ndase, Alan Ronald, David Bangsberg, Jared Baeten

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sharing of pre-exposure prophylaxis (PrEP) medications is a concern for PrEP implementation. For HIV-1 serodiscordant couples, sharing may undermine the HIV-1 prevention benefit and also cause antiretroviral resistance if taken by HIV-1 infected partners. Within a PrEP efficacy trial among HIV-1 serodiscordant couples, we assessed the occurrence of PrEP sharing by self-report and plasma tenofovir concentrations in HIV-1 infected partners. PrEP sharing was self-reported at < 0.01% of visits, and 0% -1.6% of randomly selected and 0% of purposively selected specimens from HIV-1 infected participants had detectable tenofovir concentrations (median: 66.5 ng/mL, range: 1.3-292 ng/mL). PrEP sharing within HIV-1 serodiscordant couples was extremely rare.

Evaluating Knowledge Of Developmental Disabilities Among Wic Participants, Carolina Regalado Murillo, Katharine Zuckerman, Alison Chavez, Julie A. Reeder

Student Research Symposium

Background: Children in racial/ethnic minority and low-income families are more likely to experience low rates of early developmental disability (DD) diagnosis. Racial/ethnic and language differences in parent information about DDs could contribute to diagnostic delays, but little is known about differences in parent DD familiarity.

Objectives: To assess DD knowledge and information in a sample of low-income families.

Methods: We conducted a self-administered survey on 539 parents attending their child’s appointment at the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in six Oregon counties. Survey items assessed familiarity with early signs of DDs, self-reported knowledge about DDs, …

Mujeres Fuertes Y Corazones Saludables: Adaptation Of The Strongwomen—Healthy Hearts (Swhh) Program For Rural Latinas Using An Intervention Mapping Approach, Christie L. Jackson, Cynthia K. Perry, Jean Mccalmont, Emma Solanki, Rebecca Seguin, Judy P. Ward, Hannah-Dulya K. Menelas

Student Research Symposium

Objectives: To adapt Strong Women, Healthy Hearts (SWHH), an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas.

Methods: Using a community-based participatory approach and an intervention mapping process, we partnered with a community advisory board of rural Latinas to identify and adapt a nutrition and physical activity program. A needs assessment and a logic model determined which program best aligned with community objectives and most fit for adaptation. SWHH was adapted; using feedback from the community advisory board to reflect the community’s culture, resources, and needs. We collaborated with one of developers of SWHH in …

Clinician-Parent Discussions About Influenza Vaccination Of Children And Their Association With Vaccine Acceptance, Annika M. Hofstetter, Jeffrey D. Robinson, Katherine Lepere, Morgan Cunningham, Nicole Etsekson, Douglas J. Opel

Communication Faculty Publications and Presentations

Objective: To examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making.

Study Design: We performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011-2012 and 2013-2014 influenza seasons, included children ≥ 6 months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance …

Association Of Depressive Symptomology And Psychological Trauma With Diabetes Control Among Older American Indian Women: Does Social Support Matter?, R. Turner Goins, Carolyn Noonan, Kelly Gonzales, Blythe Winchester, Vickie L. Bradley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Aims—Among older American Indian women with type 2 diabetes (T2DM), we examined the association between mental health and T2DM control and if social support modifies the association.

Methods—Survey data were linked to T2DM medical record information. Mental health measures were the Center for Epidemiologic Studies – Depression Scale and the National Anxiety Disorders Screening Day instrument. T2DM control was all HbA1c values taken post mental health measures.

Results—There was not a significant association between depressive symptomatology and higher HbA1c although increased depressive symptomatology was associated with higher HbA1c values among participants with low social support. There was a significant association …

Factors Associated With Sexual Dysfunction In Taiwanese Females With Rheumatoid Arthritis, Miao-Chiu Lin, Ming-Chi Lu, Hanoch Livneh, Ning-Sheng Lai, How-Ran Guo, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Patients with rheumatoid arthritis (RA) may experience sexual dysfunction because of symptoms or adverse effects from treatments. Data on female sexual dysfunction (FSD) in Asian females with RA issue are limited. This study investigated the prevalence and factors associated with FSD in Taiwanese patients with RA.

Methods: This cross-sectional study used a purposive sampling method to recruit 195 females with RA from a single hospital in southern Taiwan. Demographic and clinical characteristics were obtained by review of medical records and a structured questionnaire. The Chinese version of the Female Sexual Function Index and the Taiwanese Depression Questionnaire were …

North Douglas County Community Needs Health Assessment (Phase 2), Callie H. Lambarth, Diane Reid, Beth L. Green

Early Childhood

Beginning in August 2016, Phase 2 of the North Douglas County (NDC) Community Health Needs Assessment (CHNA) built on work completed in the Phase 1 planning process, and engaged the communities of Drain, Elkton, and Yoncalla, Oregon in the development and administration of a regional health services survey. The purpose of the survey was to learn from families with children ages 0-8 in the NDC region in order to:

• Identify service needs across a range of health service types, e.g., dental care, immunizations, prenatal care, well-child care, primary care, and mental health;
• Identify barriers to access;
• Prioritize the programs and …

Associations Between Prescribed Chinese Herbal Medicine And Risk Of Hepatocellular Carcinoma In Patients With Chronic Hepatitis B: A Nationwide Population-Based Cohort Study, Tzung-Yi Tsai, Hanoch Livneh, Tsung-Hsing Hung, I-Hsin Lin, Ming-Chi Lu, Chia-Chou Yeh

Counselor Education Faculty Publications and Presentations

Objective: Patients with chronic hepatitis B (CHB) are reported to exhibit higher risk of subsequent hepatocellular carcinoma (HCC). However, it remains unclear if Chinese herbal medicine (CHM), an important category of traditional Chinese medicine (TCM), may lower HCC risk in this population. So this study aimed to investigate the effects of CHM on HCC risk among patients with CHB.

Methods: This cohort study used the Taiwanese National Health Insurance Research Database to identify 21,020 newly diagnosed patients with CHB from 1998 to 2007. Among them, 8640 received CHM products after CHB onset (CHM users), and the remaining 12,380 patients were …