Social and Behavioral Sciences Commons^™

Addressing The Persistence Of Tuberculosis Among The Canadian Inuit Population: The Need For A Social Determinants Of Health Framework, Kassandra C. Kulmann Ma Candidate, Chantelle Am Richmond Professor

Chantelle Richmond

Canadian Aboriginal people have poorer levels of health than the general population. A serious issue is the high rate of tuberculosis (TB) among the Inuit population; rates are much higher than those of the general Canadian population. Several social determinants of health (SDOH), including household crowding and poverty, are strongly correlated with TB prevalence. In this paper, we describe the medical and social determinants of TB, and critically examine the TB literature specific to the Inuit population. The majority of studies recommend biomedical interventions for the treatment of TB. Few researchers have employed the social determinants of health theory to …

A Profile Of Community Health Center Patients: Implications For Policy, Peter Shin, Carmen Alvarez, Jessica Sharac, Sara J. Rosenbaum, Amanda Van Vleet, Julia Paradise, Rachel Garfield

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers are a key source of comprehensive primary care in medically underserved communities across the country, and their role is expected to grow as health coverage expands under the Affordable Care Act (ACA). To sharpen understanding of the health center patient population, this brief compares it to the overall low-income population, using data from the Health Center Patient Survey and the National Health Interview Survey,respectively. The pre-ACA profile of health center patients that emerges sets the stage for measuring change following implementation of the reform law and can inform health center policy, planning, and assessment moving forward.

An Analysis Of Employment Policies And Their Effect On Work-Life Balance For Caregiving Parents Of Children With Special Needs, Sara Panella

Muskie School Capstones and Dissertations

This capstone addresses the work-­‐life conflict facing employed caregiver parents with special needs children by 1) identifying what employed parents of children with disabilities need from their employer in order to achieve a work-­‐life balance that improves economic security and emotional well-­‐being, and 2) evaluating how well policies address those needs. An investigation of work-­‐family conflict and stress among parents of special needs children is conducted by examining the current literature and conducting interviews with caregivers to explore their work-­‐life balance needs. Policy recommendations are provided, based on an analysis of public and workplace policies currently in use and policy …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

Risk Factors For Becoming Homeless Among A Cohort Of Veterans Who Served In The Era Of The Iraq And Afghanistan Conflicts, Stephen Metraux, Limin X. Clegg, John D. Daigh, Dennis P. Culhane, Vincent R. Kane

Dennis P. Culhane

Community-Level Characteristics Associated With Variations In Rates Of Homelessness Among Families And Single Adults, Jamison D. Fargo, Ellen A. Munley, Thomas H. Byrne, Ann Elizabeth Montgomery, Dennis P. Culhane

Dennis P. Culhane

Relationship Among Adverse Childhood Experiences, History Of Active Military Service, And Adult Outcomes: Homelessness, Mental Health And Physical Health, Ann Elizabeth Montgomery, J J. Cutuli, Michelle Evans-Chase, Dan Treglia, Dennis P. Culhane

Dennis P. Culhane

Homelessness Research: Shaping Policy And Practice, Now And Into The Future, Dennis P. Culhane, Vince R. Kane, Mark Johnston

Dennis P. Culhane

Universal Screening For Homelessness And Risk For Homelessness In The Veterans Health Administration, Ann Elizabeth Montgomery, Jamison D. Fargo, Thomas H. Byrne, Vincent R. Kane, Dennis P. Culhane

Dennis P. Culhane

Get The Word Out: Utilizing Traditional And Emerging Tools To Disseminate And Measure The Impact Of Your Research, Sally A. Gore

Sally A. Gore

Publishing articles and presenting at conferences are tried and true ways for promoting your research within academic and professional circles, but with changes to scholarly communications and the emergence of many new forms that allow individuals to disseminate information more freely, openly, and quickly, researchers have a host of opportunities to both promote their work to a larger audience and track the impact of their research in a more accurate manner. From article-level metrics (altmetrics) to open access publications to the use of social media, this poster gives an introduction to some of the vehicles available today, how to use …

How Medicaid Expansions And Future Community Health Center Funding Will Shape Capacity To Meet The Nation's Primary Care Needs, Leighton C. Ku, Julia Zur, Emily Jones, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

A new report by Drs. L. Ku, J. Zur, E. Jones, P. Shin and S. Rosenbaum examines the impact of federal and state policy decisions on community health centers and their ability to continue providing primary care to the nation's poorest residents. The report estimates that under a worst-case scenario the nation's health centers would be forced to contract, leaving an estimated 1 million low-income people without access to health care services by 2020.

Local Tobacco Control: Application Of The Essential Public Health Services Model In A County Health Department’S Efforts To Put It Out Rockland, Lisa D. Lieberman, Una Diffley, Sandy King, Shelley Chanler, Maryanne Ferrera, Oscar Alleyne, Joan Facelle

Department of Public Health Scholarship and Creative Works

In 2000, Rockland County, a small suburban county north of New York City, dedicated $1 million of its Master Settlement Agreement funds to a comprehensive tobacco control program, Put It Out Rockland. Developed and implemented by the county health department, this program used an essential public health services model and an ongoing financial investment, within the context of strong statewide tobacco control efforts, to lower adult smoking rates to 9.7% and to reduce both smoking among youths and exposure to secondhand smoke over the ensuing decade. By combining state funds and local dollars for a total of $6.75 cost per …

Willow: Reaching Hiv-Positive African-American Women Through A Computer-Delivered Intervention, Charles H. Klein

Anthropology Faculty Publications and Presentations

This study evaluates the efficacy of Multimedia WiLLOW in enhancing HIV-protective sexual behaviors and psychosocial outcomes among HIV-positive African American women, including condom use for vaginal and anal sex, and psychosocial mediators associated with risk reduction practices. Using a community-based randomized controlled design, 168 participants completed a baseline and follow-up assessment as well as an exit satisfaction survey. Intervention participants reported significantly higher proportions of condom protected sex acts in the past 30 days (p=.002), with both HIV-negative (p=.040) and HIV-positive (p=.003) partners. They were also more likely to report 100% condom use (OR = .10; p=.030); a lower adjusted …

The 2013 Annual Homelessness Assessment Report (Ahar) To Congress: Part 1, Point-In-Time Estimates Of Homelessness, Meghan Henry, Alvaro Cortes, Sean Morris, Jill Khadduri, Dennis P. Culhane

Dennis P. Culhane

The Population Health Revolution, Drew Harris Dpm, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Short- And Long-Term Associations Between Widowhood And Mortality In The United States: Longitudinal Analyses, J. Robin Moon, M. Maria Glamour, Anusha M. Vable, Sze Yan Liu, S.V. Subramanian

Department of Public Health Scholarship and Creative Works

Background

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time.

Methods

Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

Results

Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio …

Frontiers Of The New Social Marketing, R. Craig Lefebvre

GW Health Communication and Marketing Symposium Series

No abstract provided.

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: A Nationwide And State-By-State Analysis, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In this brief, we estimate the number of uninsured community health center (CHC) patients who would gain coverage under the Affordable Care Act using data from the 2009 HRSA Survey of CHC patients and 2011 Uniform Data System. We find that were all states to implement the Affordable Care Act Medicaid expansion, an estimated 5 million uninsured health center patients – or two-thirds of all uninsured patients served by CHCs nationally – would be eligible for coverage. However, over one million uninsured patients – 72% of whom live in southern states – who would have been eligible for coverage will …

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Occupational Health Faculty Publications

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

Los Determinantes De La Diferencia En La Tasa De Fecundidad Adolescente Entre Comunidades Pobres Y Ricas En Buenos Aires, Emily Turner

Independent Study Project (ISP) Collection

The city of Buenos Aires has some of the lowest rates of teenage fertility in Argentina (Gogna, Binstock, Fernández, Ibarlucía, & Zamberlin, 2008). However, this aggregated number obscures the huge variance within the city. In the most current available data (2010/2012) from the government of the city of Buenos Aires (GCBA) broken down by comunas (areas) highest fertility rate for 15-19 year olds was 81.6 births (per 1000) versus the lowest fertility rate which was only 6.2 (D. d. e. d. GCBA). This discrepancy is huge and reflects the incredible economic disparity in Buenos Aires. The comunas with the three …

The Association Between Insurance Status And Cervical Cancer Screening In Community Health Centers: Exploring The Potential Of Electronic Health Records For Population-Level Surveillance, 2008-2010, Stuart Cowburn, Matthew J. Carlson, Jodi A. Lapidus, Jennifer E. Devoe

Sociology Faculty Publications and Presentations

Introduction: Cervical cancer incidence and mortality rates in the United States have decreased 67% over the past 3 decades, a reduction mainly attributed to widespread use of the Papanicolaou (Pap) test for cervical cancer screening. In the general population, receipt of cervical cancer screening is positively associated with having health insurance. Less is known about the role insurance plays among women seeking care in community health centers, where screening services are available regardless of insurance status. The objective of our study was to assess the association between cervical cancer screening and insurance status in Oregon and California community health centers …

Association Of Dietary Intake Patterns With Emotion Regulation, Megan Holt

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Western dietary patterns, characterized by high intakes of trans fatty acids (TFA’s), are associated with numerous preventable chronic diseases. Conversely, a Mediterranean dietary pattern is known to be favorably associated with health. Recent findings suggest a correlation between Mediterranean dietary patterns and positive affect, and an inverse correlation with negative affect. Trans fatty acid intake is also associated with negative affect. Further, affect disturbances are associated with emotion dysregulation. We have yet to understand the association of diet with emotion regulation after taking affect disturbances into consideration. The purpose of this study was to examine effects of Mediterranean diet …

Social Ecological Constraints To Park Use In Communities With Proximate Park Access, J. Aaron Hipp, Deepti Adlakha, Ravikumar Chockalingam

Brown School Faculty Publications

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, but with proximate access to underutilized parks. The authors used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed …

A Comparison Of Malnutrition Causes And Treatments: A Case Of Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala District And Nakifuma Government Health Unit, Mukono District, Berkley Singer

Independent Study Project (ISP) Collection

In beginning of the investigation process, the researcher set out to study malnutrition in Uganda. She wanted to study an urban region in comparison to a rural region and so based her research out of both Kampala and the Mukono region. The researcher set out to learn more about the causes of the condition and why children become malnourished. She also was interested in the differences that exist between the two different locations and why they exist. Finally, the researcher was eager to learn what malnutrition meant to each community and how health care professionals go about treating the condition …

I Don't Want To Save Second Base, Chelsea E. Broe

SURGE

Tomorrow kicks off Breast Cancer Awareness Month, and I have one request: This October, let’s not save second base.

I know, I know, you probably think this month is a good thing. If not for all of those T-shirts demanding every female-bodied person to feel their boobies, or the bracelets simply proclaiming “I love boobies,” people with breasts might forget that they even have them, or at the very least might start to think that their breasts are their own business. But the female body seems to be an object owned by the public, so we must always be reminded …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and …

Assessing The Burden Of Crime And The Criminal Sanction: A Public Health Perspective On Critical Issues In Criminal Justice, Jeremy Travis

Publications and Research

No abstract provided.

The 2012 Annual Homelessness Assessment Report (Ahar) To Congress: Volume 2, Estimates Of Homelessness In The United States, Claudia Solari, Alvaro Cortes, Scott Brown, Jill Khadduri, Dennis P. Culhane

Dennis P. Culhane

Risk Factors For Diabetes Mellitus: A Comparative Analysis Of Subpopulation Differences In A Large Canadian Sample, Michael James Taylor

Electronic Thesis and Dissertation Repository

Objectives: Certain Canadian subpopulations observe numerous modifiable and non-modifiable risk factors for diabetes. This study compares immigrants and Aboriginals (First Nations, Inuit, and Métis) with Canada-born individuals at higher risks for diabetes, and deciphers the determinant differences between them.

Methods: Pooled Canadian Community Health Survey data (2001-2010) were used. Time trends for diabetes within each subsample were calculated using individual survey year prevalence rates; diabetes diagnoses were self-reported (N=33,565). Various risk factors were also examined using logistic regression.

Results: Diabetes prevalence rates significantly increased from 2001 to 2010 for each subpopulation, as well as the total sample: Canada-Born individuals (3.9% …

Barriers To Depression Treatment Among Low-Income, Latino Emergency Department Patients, Anjanette A. Wells, Isabel T. Lagomasino M.D., Lawrence A. Palinkas, Jennifer Green, Diana Gonzalez Msw

Brown School Faculty Publications

Objectives. Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. Methods. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79% female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Results. Although most patients acknowledged signs of depression, there …