Public Health Education and Promotion Commons^™

Filter Presence And Tipping Paper Color Influence Consumer Perceptions Of Cigarettes, Richard J. O’Connor, Maansi Bansal-Travers, K. Michael Cummings, David Hammond, Jim Thrasher, Cindy Tworek

Faculty Publications

Background: Cigarettes are marketed in a wide array of packaging and product configurations, and these may impact consumers’ perceptions of product health effects and attractiveness. Filtered cigarettes are typically perceived as less hazardous and white tipping paper (as opposed to cork) often conveys ‘lightness’.

Methods: This study examined cigarette-related perceptions among 1220 young adult (age 18-35) current, ever, and never smokers recruited from three eastern U.S. cities (Buffalo NY, Columbia SC, Morgantown WV). Participants rated three cigarette sticks: two filtered cigarettes 85 mm in length, differing only in tipping paper color (cork versus white), and an unfiltered 70 mm cigarette. …

A Qualitative Study Of The Massage Therapy Foundation's Best Practices Symposium: Clarifying Definitions And Creating A Framework For Practice, Ann Blair Kennedy

Theses and Dissertations

Large numbers of individuals seek massage therapy for wellness/disease prevention purposes and research supports consumer reported benefits including physical and psychological improvements. However, challenges within the profession may be hindering the advancement of the field. To better understand the process and outcomes and ultimately develop best practices for massage therapy as well as better inform education, policy and research, it is necessary to investigate how massage and/or massage therapy are defined and operationalized in practice. This study entailed qualitative analysis of cross-sectional data using a grounded theory approach to examine the data gathered from a two-day symposium held in 2010 …

Framing Risk, Responsibility, And Resolution: A Mixed-Methods Study Exploring Traditional And Social Media Coverage Of The 2014 Elk River Chemical Spill, Tracey Thomas

Theses and Dissertations

Background: The 2014 Elk River Chemical Spill raised policy questions concerning chemical safety and revealed an immediate need for improved emergency communication. This two-phase study explored how media presented causes of and longterm solutions to the spill through an examination of media frames. The study also explored how health risks were communicated through traditional and social media. The specific aims of Phase I were to examine media coverage in the days following the spill and compare coverage across media channels. The specific aims of Phase II were to understand how public health stakeholders perceived coverage of the spill and how …

Support For Comprehensive Sexuality Education And Adolescent Access To Condoms And Contraceptions In South Carolina, Sarah H. Kershner

Theses and Dissertations

A statewide random-digit dialed telephone survey was administered to residents of a historically conservative southern state to 1) assess the level of support for comprehensive sexuality education (CSE) in public schools, 2) assess the support for availability to condoms and contraception as an effective strategy for reducing unintended pregnancies and sexually transmitted (STIs) among adolescents and 3) assess the perceived view of reproductive health as a moral or public health issue. Survey data were obtained from 841 South Carolina residents May through June 2013. Findings from the study revealed that the majority (90%) of South Carolina residents support CSE in …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

Refinement And Pilot Testing Social Networks For Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social Pod) Study, Sarah B. Hales

Theses and Dissertations

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the …

Human Immunodeficiency Virus, Syphilis And Hepatitis C Virus Prevalence Trends Among Cross-Border Migrant Vietnamese Female Sex Workers In Guangxi, China, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhenzhu Tang, Zhiyong Shen

Faculty Publications

Background: Global literature indicates the burden of human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) has disproportionately affected cross-border migrant female sex workers (FSW). However, few studies reported the HIV risk among Vietnamese FSW at borderline areas in China. We examined five consecutive years of HIV, syphilis, and HCV prevalence and corresponding risk factors among this group in Guangxi Province of China in the current study. Method: Demographic and behavioral data as well as test results of blood samples for HIV/syphilis/HCV testing were collected from the annual National Sentinel Surveillance (NSS) from the year of 2010 to 2014. …

Successive 1-Month Weight Increments In Infancy Can Be Used To Screen For Faltering Linear Growth, Adelheid W. Onyango, Elaine Borghi, Mercedes De Onis, Edward A. Frongillo Jr., Cesar G. Victora, Kathryn G. Dewey, Anna Lartey, Nita Bhandari, Anne Baerug, Cutberto Garza

Faculty Publications

Background: Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention.

Objective: This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life.

Methods: By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for …

Experiences With Food Insecurity And Risky Sex Among Low-Income People Living With Hiv/Aids In A Resource-Rich Setting, Henry J. Whittle, Kartika Palar, Tessa Napoles, Lee Lemus Hufstedler, Irene Ching, Frederick M. Hecht, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Background: Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM).

Methods: Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted …

Comparison Of Tobacco And Alcohol Use In Films Produced In Europe, Latin America, And The United States, Inti Barrientos-Gutierrez, Christy Kollath-Cattano, Raul Mejía, Edna Arillo-Santillán, Reiner Hanewinkel, Matthis Morgenstern, James D. Sargent, Jim Thrasher

Faculty Publications

Background: Studies that have evaluated tobacco and alcohol portrayals in films have mainly focused on US films. Our aim is to describe tobacco and alcohol portrayals in nationally produced films from six European and two Latin American countries, and compare them with US produced films.

Methods: A sample of 337 nationally produced and 502 US produced films, consisting of top grossing films from 2004 to 2009 in each country, was content coded for presence of tobacco or alcohol and seconds of tobacco or alcohol use. Logistic and linear regression models were estimated for all films and youth-rated films (Ages 0–14) …

Using Height-For-Age Differences (Had) Instead Of Height-For-Age Z-Scores (Haz) For The Meaningful Measurement Of Population-Level Catch-Up In Linear Growth In Children Less Than 5 Years Of Age, Jef L. Leroy, Marie Ruel, Jean-Pierre Habicht, Edward A. Frongillo Jr.

Faculty Publications

Background: Evidence from studies conducted in nutritionally deprived children in low- and middle-income countries (LIMC) in past decades showed little or no population-level catch-up in linear growth (mostly defined as reductions in the absolute height deficit) after 2 years of age. Recent studies, however, have reported population-level catch-up growth in children, defined as positive changes in mean height-for-age z-scores (HAZ). The aim of this paper was to assess whether population-level catch-up in linear growth is found when height-for-age difference (HAD: child’s height compared to standard, expressed in centimeters) is used instead of HAZ. Our premise is that HAZ is inappropriate …

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

Provider Behavior Under Global Budgeting And Policy Responses: An Observational Study On Eye Care Services In Taiwan, Chao-Kai Chang, Sudha Xirasagar, Brian Chen, James R. Hussey, I-Jong Wang, Jen-Chieh Chen, Ie-Bin Lian

Faculty Publications

Third-party payer systems are consistently associated with health care cost escalation. Taiwan’s single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists’ response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior …

Eliciting Preferences For Waterpipe Tobacco Smoking Using A Discrete Choice Experiment: Implications For Product Regulation, Ramzi G. Salloum, Wasim Maziak, David Hammond, Rima Nakkash, Farahnaz Islam, Xi Cheng, Jim Thrasher

Faculty Publications

Objectives Waterpipe smoking is highly prevalent among university students, and has been increasing in popularity despite mounting evidence showing it is harmful to health. The aim of this study was to measure preferences for waterpipe smoking and determine which product characteristics are most important to smokers.

Setting A large university in the Southeastern USA.

Participants Adult waterpipe smokers attending the university (N=367).

Design Participants completed an Internet-based discrete choice experiment to reveal their preferences for, and trade-offs between, the attributes of hypothetical waterpipe smoking sessions. Participants were presented with waterpipe lounge menus, each with three fruit-flavoured options and one tobacco …

Individual Attitudes Toward Innovation, Occupational Stress And Social Support For Work Among Hiv Health Care Providers In Southwest China, Shan Qiao Ph.D., Xiaoming Li Ph.D., Bonita Stanton, Yuejiao Zhou, Zhiyong Shen, Zhenzhu Tang

Faculty Publications

No abstract provided.

Food Insecurity Reported By Children, But Not By Mothers, Is Associated With Lower Quality Of Diet And Shifts In Foods Consumed, Jennifer Bernal, Edward A. Frongillo Jr., Juan A. Rivera

Faculty Publications

Household food security shows little indication of nutrient inadequacy among children, according to reports made by parents. We examined the associations of food insecurity as reported by children and mothers with children’s consumption of energy, macronutrients such as vitamin A, calcium, iron and zinc, and selected foods, and whether these associations differed by child’s gender. This cross-sectional study had non-probabilistic 128 Venezuelan mother–child pairs. We assessed food insecurity and management strategies in children using 10- and nine-item instruments, respectively. Mothers’ report of food insecurity came from a previously validated 12-item instrument. Nutrient intake of children was assessed with a 67-item …

Federally Qualified Health Centers’ Capacity And Readiness For Research Collaborations: Implications For Clinical-Academic-Community Partnerships, Heather M. Brandt, Vicki M. Young, Dayna A. Campbell, Seul Ki Choi, Jessica S. Seel, Daniela B. Friedman

Faculty Publications

BACKGROUND: Federally qualified health centers (FQHCs) provide a health care safety net for underserved populations and contribute unique expertise to research that could further enhance quality of patient care. The purpose of this research was to assess interest in, readiness to, and capacity for conducting research in FQHCs in South Carolina (SC). METHODS: A Web-based survey was administered to 20 FQHCs across SC. Fourteen representatives of FQHCs completed the 39-item survey that assessed research experience and interest, partnerships and funding, barriers and benefits to research participation, training and technical assistance needs, and research capacity. RESULTS: FQHCs are interested in conducting …

Stages Of Change Of The Readiness To Quit Smoking Among A Random Sample Of Minority Arab-Male Smokers In Israel, Nihaya Daoud, Samah Hayek, Ahmad Sheikh Muhammad, Kathleen Abusaad, Jim Thrasher, Ofra Kalter-Leibovici

Faculty Publications

Background

Despite advanced smoking prevention and cessation policies in many countries, the prevalence of cigarette smoking among indigenous and some ethnic minorities continues to be high. This study examined the stages of change (SOC) of the readiness to quit smoking among Arab men in Israel shortly after new regulations of free-of-charge smoking cessation workshops and subsidized medications were introduced through primary health care clinics.

Methods

We conducted a countrywide study in Israel between 2012–2013. Participants, 735 current smokers; 18–64 years old; were recruited from a stratified random sample and interviewed face-to-face using a structured questionnaire in Arabic. We used ordered …

Evaluating The Validity Of Self-Reported Smoking In Mexican Adolescents, María Del Carmen Valladolid-López, Tonatiuh Barrientos-Gutiérrez, Luz Myriam Reynales-Shigematsu, Jim Thrasher, Ingris Peláez-Ballestas, Eduardo Lazcano-Ponce, Mauricio Hernández-Ávila

Faculty Publications

Objectives We aimed to evaluate the validity of the self-reported smoking indicator used in the Global Youth Tobacco Survey (GYTS).

Setting 43 middle and high-school classrooms from 26 schools were selected from Mexico City and Cuernavaca, Morelos.

Participants A total of 1257 students provided both a questionnaire and a urine sample.

Primary and secondary outcome Sensitivity and specificity of self-reported smoking compared to urinary cotinine. Validity indices were evaluated by subgroups of gender, social acceptability of smoking (ie, smoking parents or friends) and smoking frequency.

Results Sensitivity and specificity for current smoking were 93.2% and 81.7%, respectively. Validity indices remained …

The Impact Of Free Trial Acceptance On Demand For Alternative Nicotine Products: Evidence From Experimental Auctions, Matthew C. Rousu, Richard J. O'Connor, Maans Bansal-Travers, James M. Pitcavage, Jim Thrasher

Faculty Publications

Objectives: This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP).

Methods: An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opportunity to try, but did not have to accept, one of three relatively novel ST products (i.e., snus, dissolvable tobacco, or medicinal nicotine), or they were placed into a control group (i.e., no trial). All the participants then bid on all three of these products, as well as on cigarettes. We assessed interest in using ANP based on …

Colonoscopy Screening Among Us Adults Aged 40 Or Older With A Family History Of Colorectal Cancer, Meng-Han Tsai, Sudha Xirasagar, Yi-Jhen Li, Piet C. De Groen

Faculty Publications

Introduction
Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines.

Methods
We studied colonoscopy screening rates among the US population reporting a CRC family history …

Ecpat: Development And Testing Of Mobile Technology To Engage Youth In Active Living Policy, Systems, And Environmental Health Promotion Efforts, Gina M. Besenyi

Theses and Dissertations

Modifying the built environment is a promising way to promote youth physical activity and reduce obesity. Parks, in particular, are key intervention venues given their low cost and legislated ubiquity. Creating healthy communities, including better parks, will require the interest and participation of multiple constituencies, including youth. Creation of mobile technology environmental audit tools can provide a more interactive way for youth to engage with communities and facilitate participation in participatory action research (PAR) and health promotion efforts.

The purpose of the first study was to describe the development and validity and reliability testing of an electronic version of the …

By Word Of Mouth: A Qualitative Approach To Understanding The Integration Of Preventive Dental Health In Primary Care Settings, Joni D. Nelson

Theses and Dissertations

Childhood and adolescence are sensitive periods in the lifespan when oral and craniofacial appearances can help determine social interactions and lifetime outcomes. In this respect, oral health can be viewed as more than just brushing or flossing for healthy teeth; children’s oral health can influence their social development and behaviors, impact their academic growth, affect their guardian’s responsibility for healthcare cost and create a potential pathway for negative impacts on quality of life. Access to quality oral healthcare is vital for the prevention of unwanted diseases and to avoid the burden of oral health complications. Oral health disparities may not …

The Role Of Social Relationship In Hiv Healing And Its Implications In Hiv Cure In China, Shan Qiao Ph.D., Jing-Bao Nie, Joseph Tucker, Stuart Rennie, Xiao-Ming Li

Faculty Publications

HIV is both a biomedical disease and a social phenomenon that is constructed in particular cultural contexts. A successful and humane HIV cure requires not only the science of eradicating pathogens, but also the art of healing to restore harmony between mind and body. Healing in the context of HIV cure will be both personal and interpersonal, biological and social, and will involve rebuilding connections between HIV patients and their social environment. Social conceptions of healing have been highlighted in many regions with rich non-biomedical healing traditions, including China. Based on an adapted theoretical model on social relationships and health, …

The Influence Of Self-Reported Degree Of Masculinity/Femininity On Condom Use Among Black Men Who Have Sex With Men In The Deep South, Elizabeth D. Peeler

Theses and Dissertations

In the United States, 50,000 Americans are diagnosed with HIV each year (CDCa, 2014). The HIV/AIDS epidemic has had a particularly devastating impact on the southern U.S., especially the Deep South – Alabama, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina (Reif, Whetten, Wilson, McAllaster, Pence, Legrand, & Gong, 2014). The Deep South, while only composing of 36% of the national population, accounts for 50% of all people living with HIV/AIDS in the nation (Human Rights Watch, 2010). No other population has been hit harder than men who have sex with men (MSM; Prejean, Tang, & hall, 2013). Black MSM …

Statewide Scale-Up Of Group Prenatal Care In South Carolina, Kristin M. Van De Griend

Theses and Dissertations

Background: Poor birth outcomes and racial disparities in birth outcomes in South Carolina are widely recognized problems. To improve maternal and child health outcomes, especially among vulnerable groups, universal access to timely, appropriate, and effective care should remain a priority through increased availability and accessibility. An interagency collaborative in South Carolina expanded CenteringPregnancy (CP) from two to five medical practices throughout the state. CenteringPregnancy is associated with improved birth outcomes and reduced rates of racial disparities in preterm birth throughout the United States. Important questions in the literature remain about strategies and determinants of scaling up sexual and reproductive …

Ethnic Discrimination: Measurement And Associations With Smoking-Related Outcomes Among Arab Male Current And Former Smokers In Israel, Amira Osman

Theses and Dissertations

We evaluated the psychometric properties of two instruments used to assess ethnic discrimination among Arabs in Israel. The “Experiences of Discrimination” (EOD) scale was adapted to assess interpersonal ethnic discrimination (EOD-A) and a new measure was developed to assess perceptions of institutional group discrimination (IGD) against Arabs as an ethnic group. Then, we examined the association between each form of ethnic discrimination (interpersonal and institutional) and smoking outcomes among Arab men from Israel, and whether social support and coping efficacy moderate these associations. Data were analyzed from a cross-sectional study of Arab male current and former smokers, aged 18-64. A …