Public Health Education and Promotion Commons^™

A Lesson On Homophobia And Teasing, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

Homophobia and gay-related teasing are already present among young children. This lesson introduces the term “prejudice” and places the concept of homophobia within the context of bullying and teasing with which 8–11-year-olds are already familiar. The lesson builds empathy as children think about and discuss how they have felt when they have been teased or called a name and how they think people in gay or lesbian families would feel. The lesson celebrates the lives of gay and lesbian people as it celebrates diversity among all people and families. Children are encouraged to think about the diversity within their own …

Explaining The Race Difference In Prostate Cancer Stage At Diagnosis, Beth A. Jones, Wen-Liang Liu, Andre B. Araujo, Stanislav V. Kasl, Stephanie A. Navarro Silvera, Hosanna Soler-Vila, Mary G.M. Curnen, Robert Dubrow

Department of Public Health Scholarship and Creative Works

Prostate cancer is the most frequently diagnosed cancer in males in the United States, accounting for an estimated 186,320 new cases in 2008. There are striking racial or ethnic differences in prostate cancer incidence and mortality rates in the United States, with Black males 1.6 times more likely to be diagnosed and 2.4 times more likely to die with prostate cancer than Whites. The stage at diagnosis is a key prognostic factor for prostate cancer survival, with African-Americans generally diagnosed at a more advanced stage. To identify factors that explain the race-stage disparity in prostate cancer, we conducted a population-based …

Food Group Intake And Risk Of Subtypes Of Esophageal And Gastric Cancer, Stephanie A. Navarro Silvera, Susan T. Mayne, Harvey Risch, Marilee D. Gammon, Thomas L. Vaughan, Wong-Ho Chow, Robert Dubrow, Janet B. Schoenberg, Janet L. Stanford, Brian West, Heidrun Rotterdam, William J. Blot, Joseph F. Fraumeni Jr.

Department of Public Health Scholarship and Creative Works

Incidence rates for adenocarcinomas of the esophagus and gastric cardia have been increasing rapidly, while rates for non‐cardia gastric adenocarcinoma and esophageal squamous cell carcinoma have declined. We examined food group intake as a risk factor for subtypes of esophageal and gastric cancers in a multicenter, population‐based case–control study in Connecticut, New Jersey and western Washington state. Associations between food groups and risk were estimated using adjusted odds ratios (OR), based on increasing intake of one serving per day. Total vegetable intake was associated with decreased risk of esophageal adenocarcinoma (OR = 0.85, 95% CI = 0.75, 0.96). Conversely, total …

Introduction Of Quality Of Care And A Gender Perspective In Reproductive Health Service Organizations In Latin America And The Caribbean, Patricia Riveros, Antonieta Martin, Ricardo Vernon

Reproductive Health

In 2005 and with the technical assistance of the Frontiers in Reproductive Health (FRONTIERS) Program, the Integrated Health Coordination Program (PROCOSI), a Bolivian network of 33 nongovernmental organizations, designed and tested a set of four guidelines to help organizations deliver high-quality reproductive health services with a gender perspective. The guidelines were: 1) to present a strategy to certify organizations as “gender sensitive” healthcare providers; 2) to present the knowledge staff members should know to be certified; 3) to describe procedures to collect and analyze the data to evaluate implementation of the strategy; and 4) to describe how to assess strategy …

Increasing The Accessibility, Acceptability And Use Of The Iud In Gujarat, India, M.E. Khan, Sitanshu Sekhar Kar, Vikas Kishor Desai, Pratibha Patel, B.P. Itare, Sandhya Barge

Reproductive Health

The USAID-funded FRONTIERS Program of the Population Council, in collaboration with the Department of Health & Family Welfare, Government of Gujarat, and the Center for Operations Research and Training, Vadodara, conducted an operations research study in India to test the hypothesis that by improving the demand for the IUD and simultaneously strengthening the technical competencies and counseling skills of the providers, use of the IUD use would increase. The findings show that demand-generation activities and provision of good-quality IUD services, together with a supportive programmatic environment, when carried out simultaneously showed increased acceptance of the IUD. The intervention could be …

Regional Workshop To Use The Findings From Operations Research To Increase The Access, Quality And Integration Of Contraceptive Services In Latin America And The Caribbean, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

In October 2007, the Frontiers in Reproductive Health (FRONTIERS) program held a three-day regional workshop in La Antigua, Guatemala, to disseminate results of its operations research projects. During the workshop, participants received contraceptive technology updates, and learned about effective strategies tested by FRONTIERS to increase access to the IUD and vasectomy; and about integration of family planning with postpartum, postabortion, and PMTCT. Researchers discussed study results, program managers explained how they were used, and practitioners talked about implementing the interventions—a combination of perspectives that successfully transmitted the message that the interventions were not difficult to apply, could have a great …

Introduction Of Emergency Contraceptive Pills In The Public Health System Of Pakistan: A South-To-South Collaboration, M.E. Khan, Gul Rashida, Sharif M.I. Hossain, Ali M. Mir, Ubaidur Rob

Reproductive Health

This report describes a south-to-south collaboration to assist the Ministry of Health of Pakistan to introduce emergency contraception (EC) into its family planning program, supported by the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) program. The collaboration consisted of a three-day visit by senior managers from the Pakistani health authorities to Bangladesh to familiarize them with the EC program in that country, followed by a two-day consultative meeting in Islamabad to draw up concrete plans for introduction of the method into the Pakistan system. Participants at the consultation developed plans to introduce EC into both community-based distribution and clinical …

Feasibility, Acceptability, Effectiveness And Cost Of Models Of Integrating Hiv Prevention And Counseling And Testing For Hiv Within Family Planning Services In North West Province, South Africa, Saiqa Mullick, Mantshi Menziwa, Nzwakie Mosery, Doctor Khoza, Edwin Maroga

Reproductive Health

The Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program, in collaboration with the National Department of Health and the North West Provincial Department of Health and with support from PEPFAR, initiated a two-phased operations research study to test the acceptability, feasibility, and cost of two different models of integration of counseling and testing for HIV into family planning services in South Africa and to evaluate their effectiveness against standard practice. Based on the studies findings, the report concludes that the integration of HIV prevention activities, including education about prevention, dual protection, and counseling and testing within FP services in …

Consentimiento Informado En Ensayos De Prevención Del Vih: Aspectos Destacados De Un Taller Internacional, Population Council

HIV and AIDS

Resumen adaptado del informe del taller organizado conjuntamente por el Population Council y Family Health International en mayo de 2005. El resumen se centra específicamente en las herramientas y estrategias presentadas en el taller que se están usando en ensayos de prevención del VIH para facilitar el consentimiento informado, explicar conceptos difíciles, y evaluar la comprensión entre los participantes del ensayo. Se destacan ejemplos ilustrativos de ensayos concluidos y en curso. Este resumen será útil para una audiencia de investigadores locales, defensores y personal de ensayos clínicos.

--

Brief adapted from the report of the workshop co-hosted by the Population …

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

--

Brief adapted from the report of the workshop co-hosted …

Consentimento Informado Nos Ensaios De Prevenção Do Hiv: Pontos Altos Dum Workshop Internacional, Population Council

HIV and AIDS

Resumo adaptado do relatório do workshop organizado pelo Population Council e Family Health International em maio de 2005. O resumo se concentra especificamente nas ferramentas e estratégias apresentadas no workshop que estão sendo usadas em testes de prevenção do HIV para facilitar o consentimento informado, explicar conceitos difíceis e avaliar a compreensão entre os participantes do estudo. Exemplos ilustrativos de ensaios concluídos e em andamento são destacados. Este resumo será útil para um público de investigadores locais, advogados e equipe de ensaios clínicos.

--

Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health …

Promoting Healthy Timing And Spacing Of Births In India Through A Community-Based Approach, M.E. Khan, Mary Philip Sebastian, Usha Sharma, Rukma Idnani, Kaushal Kumari, Bharati Maheshwari, Shahid Ashraf

Reproductive Health

The Indian Family Welfare Program, though successful in increasing contraceptive use among couples who have achieved their desired family size, has failed in educating people about the importance and need of using contraceptive methods for spacing births. With its Indian collaborators, the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program undertook a study to test a model to increase use of postpartum contraception among young pregnant women with a parity of 0 or 1. The study showed that the Behavior Change Communication (BCC) model developed to promote Healthy Timing and Spacing of Pregnancy (HTSP) was effective in promoting the lactational …

Development Of A Quality Assurance Procedure For Reproductive Health Services For District Public Health Systems: Implementation And Scale-Up In The State Of Gujarat, M.E. Khan, Anurag Mishra, Vivek Sharma, Leila Caleb-Varkey

Reproductive Health

This project was carried out in India, in two districts each in Gujarat and Maharashtra states. It confirmed that quality assurance (QA) checklists and an implementation manual, developed by the USAID-funded Frontiers in Reproductive Health (FRONTIERS) Program of the Population Council in collaboration with UNFPA/India, are useful and effective tools that the Ministry of Health and Social Welfare (MOHFW) can use to monitor the quality of services provided by health facilities. It also demonstrated that this QA mechanism can be easily institutionalized at the district level management. One key lesson has been the critical role that the commitment of state …

Improving Communication Between Parents And Adolescents On Reproductive Health And Hiv/Aids, Nafissatou J. Diop, Alioune Diagne

Reproductive Health

Cette recherche opérationnelle avait pour but d’évaluer la fonctionnalité et l’efficacité d’un modèle d’intervention destiné à prendre en charge les besoins d’informations des adolescent(e)s en matière de santé de la reproduction et cela à travers le renforcement et l’amélioration de la communication entre les parents et les enfants/adolescent(e)s. Les résultats ont montré la faisabilité de mettre en place un programme qui est spécifiquement destiné à améliorer le niveau et la qualité de la communication entre les parents/tuteurs et les adolescent(e)s sur les questions de SR/VIH/SIDA et cela malgré le caractère encore sensible de cette question dans le contexte socioculturel sénégalais. …

Enhancing Utilization Of The Findings From The Youth Reproductive Health Project In Senegal, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

This operations research (OR) study focused on providing information appropriate to the cultural context of Senegalese adolescents on a variety of reproductive health issues including: knowledge of the human body; puberty; sexuality; gender roles; different cultural, familial, and peer values regarding sexual and reproductive behavior; contraception; responsible parenthood; STIs and AIDS; and sources of help and services. The study was undertaken in three urban communities in northern Senegal and had an overall positive result on young people's reproductive health knowledge, enhanced community understanding of youth reproductive health needs, and showed that a multisectoral approach is vital to supporting young people’s …

Highlighting Marital Hiv Risk And Promoting Premarital Vct In Nyanza Province, Kenya, Ben Ochieng, Annabel Erulkar

Reproductive Health

This report describes a project undertaken in Kenya by the Population Council, in collaboration with PATH and Kendu Adventist Hospital, whose objectives were: 1) to design and implement educational strategies to raise awareness of the risks of HIV and early marriage; 2) to promote voluntary counseling and testing (VCT) for couples; and 3) to support and empower newly married girls through community-based clubs. The report notes that the strong technical support and leadership provided by the partners led to successful implementation of most project activities. The partnership enabled scarce resources to be shared, and has ensured that the comparative advantages …

Taller Regional De Utilización De Resultados De Investigación Operativa Para Incrementar El Acceso, La Calidad E Integración De Los Servicios Anticonceptivos En América Latina Y El Caribe, M. Estela Rivero-Fuentes, Antonieta Martin

Reproductive Health

En octubre de 2007, el programa Fronteras de la Salud Reproductiva (FRONTERAS) realizó un taller regional de tres días en La Antigua, Guatemala, para difundir los resultados de sus proyectos de investigación operativa. Durante el taller, los participantes escucharon los avances en la metodología anticonceptiva y escucharon las estrategias efectivas que probó FRONTERAS para incrementar el acceso al DIU y la vasectomía; la integración de la planificación familiar con los servicios posparto, postaborto y PTMI. Los investigadores habloaron sobre los resultados de los estudios, los gerentes de los programas explicaron cómo se usaban los instrumentos y se habló de la …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In Haiti, M. Estela Rivero-Fuentes, Ricardo Vernon, Michaelle Boulos, Louis-Marie Boulos

Reproductive Health

This report presents the results of a situation analysis of the provision and use of contraception in postpartum, postabortion, and Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in Haiti. FRONTIERS provided the Centre d’Évaluation et de Recherche Appliqueé (Center for Evaluation and Applied Research or CERA) with technical assistance for the data collection, cleaning, and entry processes. The study found that there is a substantial unmet need for family planning services among postpartum women and many missed opportunities to provide these services during the pregnancy-extended postpartum period continuum. Most outpatient services have adequately implemented HIV counseling for pregnant women, …

Creating The Conditions For Scale-Up Of The Men In Maternity Intervention In India, Leila Caleb-Varkey, Anurag Mishra, M.E. Khan

Reproductive Health

The Frontiers in Reproductive Health (FRONTIERS) program conducted an operations research study, called the Men in Maternity (MiM) study, in collaboration with the Employees' State Insurance Corporation of India (ESIC), aimed at involving men in the antenatal and postpartum care of their partners to raise knowledge and use of postpartum contraception and preventive practices against sexually transmitted infections, as well as improving pregnancy outcomes. This report details the MiM scale-up process, which worked well in terms of ESIC assuming ownership of the training component of the program and being able to build capacity for training. However, to further scale up …

Propiciando Cambio Personal Y Social Alrededor Del Género, Sexualidad Y Vih: Evaluación De Impacto De La Estrategia De Comunicación De Puntos De Encuentro En Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

School As A Workplace In Kenya: Evaluation Of The Teachers Matter Hiv/Aids Project, Karusa Kiragu, Caroline Mackenzie, Jennifer Weiss, Murungaru Kimani, Debbie Gachuhi

HIV and AIDS

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of the workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Assessment Of Risk Factors For Hiv Infection Among Men Who Have Sex With Men In The Metropolitan Area Of Campinas City, Brazil, Using Respondent-Driven Sampling, Maeve De Mello, Adriana De Araujo Pinho, Magda Chinaglia, Waimar Tun, Aristides Barbosa Junior, Maria Cristina, F.J. Ilario, Paulo Reis, Regina C.S. Salles, Suzanne Westman, Juan Diaz

HIV and AIDS

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but …

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …

Promoting Gender Equity As A Strategy To Reduce Hiv Risk And Gender-Based Violence Among Young Men In India, Ravi K. Verma, Julie Pulerwitz, Vaishali Sharma Mahendra, Sujata Khandekar, A.K. Singh, S.S. Das, Sunil Mehra, Anita Nura, Gary Barker

HIV and AIDS

The Horizons Program, CORO for Literacy, MAMTA, and Instituto Promundo developed, piloted, and scaled-up a behavior-change intervention in India to examine the effectiveness of interventions to improve young men’s attitudes toward gender roles and sexual relationships, and to reduce HIV risk behaviors and partner violence. The results of this study suggest that young men became less supportive of inequitable gender norms after participating in the interventions. Similarly, there were significant improvements among intervention participants in key outcome indicators, including condom use, partner communication, partner violence, and attitudes toward PLHIV. To maximize the chances of long-term sustainability of these positive changes, …

If You Build It, Will They Come? Kenya Healthy Start Pediatric Hiv Study: A Diagnostic Study Investigating Barriers To Hiv Treatment And Care Among Children, Karusa Kiragu, Katie D. Schenk, Julie Murugi, Avina Sarna

HIV and AIDS

In Kenya the proportion of eligible HIV-positive children receiving ART treatment is only 11 percent. This study explored and documented possible barriers in the community to accessing pediatric HIV testing and treatment, to guide the development of new interventions to encourage uptake. The study identified barriers such as cost, use of traditional healers, low knowledge of treatment options, attitudinal barriers, stigma, unique treatment issues, and dissatisfaction with available services. Additionally, healthcare workers missed opportunities to provide services and cited numerous service-side challenges. The study recommends prioritizing community awareness, mobile clinics, strengthening capacity of healthcare workers, supporting family-based HIV testing, and …

Catalyzing Personal And Social Change Around Gender, Sexuality, And Hiv: Impact Evaluation Of Puntos De Encuentro´S Communication Strategy In Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Caring For Caregivers: An Hiv/Aids Workplace Intervention For Hospital Staff In Zambia—Evaluation Results, Karusa Kiragu, Mutinta Nyumbu, Thabale J. Ngulube, Panganani Njobvu, Chilufya Mwaba, Arthur Kalimbwe, Spike Bradford

HIV and AIDS

The Horizons Program collaborated on a Caring for Caregivers initiative in Zambia whose objective was to develop and test a risk-reduction workplace program for hospital staff. This was motivated by the recognition that hospital workers are often overlooked in HIV programming, and yet many are infected or affected by HIV. It was also motivated by the fact that hospital staff are heterogeneous, with both clinical and non-clinical staff having varying levels of understanding regarding HIV transmission. Caring for Caregivers was a peer education program targeted at hospital staff and implemented in two hospitals in Zambia, with a combined staff of …

Moving Forward: Tackling Stigma In A Tanzanian Community, Laura Nyblade, Kerry Macquarrie, Gideon Kwesigabo, Aparna Jain, Lusajo Kajula, Fausta Philip, William Henerico Tibesigwa, Jessie K. Mbwambo

HIV and AIDS

The International Center for Research on Women, the Muhimbili University College of the Health Sciences, the Population Council, and Family Health International conducted an evaluation of a community-based effort to reduce stigma surrounding HIV infections in a peri-urban community in Tanzania. Results presented a mixed, but hopeful, picture for a way forward in tackling stigma at the community level. Tackling stigma requires that the individuals tasked with doing this undergo personal change. Programs can start by focusing stigma-reduction efforts on a smaller, more manageable geographical area and adding specific anti-stigma components to their portfolio of activities. Engaging community opinion leaders …