Social and Behavioral Sciences Commons^™

Psychological Distress And Change In A Pediatric Obesity Population, Amy Rebecca Beck

Loma Linda University Electronic Theses, Dissertations & Projects

Pediatric overweight and obesity is a growing national epidemic with 15 percent of children ages 6-19 considered obese and at least 22 percent considered overweight. While there is considerable research pointing to contributing factors of obesity, there is a paucity of research which elucidates what contributes to successful intervention. Considering that by the year 2050, nearly 50 million Americans may be obese, understanding the factors delineating success of weight loss and prevention is a necessity. The purpose of this study was to utilize archival data from the LLU Growing Fit Program to evaluate the levels of psychological distress experienced by …

Individuals' Use Of Care While Uninsured: Effects Of Time Since Episode Inception And Episode Length, Carole Gresenz, J. Rogowski, Jose Escarce

Carole Roan Gresenz

No abstract provided.

A Lesson On Homophobia And Teasing, Eva S. 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 …

Is American Health Care Uniquely Inefficient?, Alan M. Garber, Jonathan Skinner

Dartmouth Scholarship

No abstract provided.

The Effectiveness Of Treatment In An Inpatient And Outpatient Psychiatric Facility, Timothy Quan Tran

Loma Linda University Electronic Theses, Dissertations & Projects

The present study is aimed at examining treatment outcome in a large psychiatric facility that provides both inpatient and outpatient services to a broad range of patients. Not only will patient outcomes be assessed at a facility-wide level, but patient outcomes on the various units/programs in the facility will also be assessed and compared. It is expected that, facility wide, patients will show significant improvement on the outcome measure from admission to discharge, but that patient outcomes will differ across the various units/programs in the facility. In sum, the results of the paired-sample t-test and effect size obtained in this …

Positioning Hospice Care Within The Black And Hispanic Communities, Carol Armstrong

Graduate Theses

Nationally, hospice care and the signing of advance directives are underutilized by minority populations. Research on this phenomenon includes cultural differences, access to medical care and language barriers. A retrospective study of 1,817 closed patient charts from a local hospice was conducted to determine significant differences among the White, Black and Hispanic patient populations. The number of White patients admitted to both hospice homecare and to the hospice inpatient was significantly greater than the number of admissions of either the Black or Hispanic patients. There were no significant findings in the total number of services provided to each of the …

Mental Health Services Research & Policy Collection: Arl Collection Initiative, Phyllis Ruscella, Ardis Hanson, John Abresch, Claudia Dold

Ardis Hanson

An ARL-level mental health services research and policy collection will support, not only the international and national goals of improving mental health; it also positions USF (USF) within the renowned health services research community, becoming peers with other major university health services research centers. The further development of the mental health services research and policy collections, with the foci on disaster mental health and vulnerable populations and the improved access to related mental health services research grey literature, directly supports USF’s stated goals. It expands the university’s capacity for world-renowned interdisciplinary research. It supports globally competitive undergraduate, graduate, and professional …

Cultural Beliefs About Health Professionals, Attributions For Mistreatment, And Continuity Of Cancer-Related Care, Jennifer Anne Tucker

Loma Linda University Electronic Theses, Dissertations & Projects

This research examined attributions for health care mistreatment, related emotions, and the role of cultural beliefs about health care professionals as determinants of cancer-related continuity of care among Anglo and Latino women in Southern California. This research was guided by Betancourt’s model of culture adapted for the study of health behavior (Betancourt & Flynn, 2008) and Weiner’s (1996) attribution theory of motivation and emotion. As predicted, higher levels of negative cultural beliefs about health professionals resulted in lower intentions for continuity of care indirectly through mediating psychological perceptions of intentionality for mistreatment, controllability of its causes, and anger toward the …

The Impact Of Being Born With Cleft And Cleft Reparative Surgery On Overall Health And Speech Outcomes, Khatansuudal Evsanaa

Master's Theses

Orofacial cleft is one of the most common and treatable birth defects in the world. If left untreated, orofacial cleft can impair normal speech development, growth, and could lead to a number of health consequences later in life. The main motivation of the study is to measure the impact of being born with cleft and the cleft reparative surgery on overall speech and health cleft for teenagers in India using difference-in-differences approach along with household fixed effects method. An overall health outcome was measured using height, weight, grip strength and BMI, and the speech acceptability was measured using a “Universal …

Designing A Successful Pbrn In Public Health: Key Concepts, Glen P. Mays, Sharla A. Smith

Glen Mays

Successful public health practice-based research networks (PBRNs) will require organizational, financial, and intellectual resources that allow practitioners and researchers to mount relevant studies in real-world public health settings. This brief outlines characteristics likely to be important to the success of public health PBRNs, based on the experience of PBRNs in other practice settings

Productivity Spillovers In Healthcare: Evidence From The Treatment Of Heart Attacks, Amitabh Chandra, Douglas O. Staiger

Dartmouth Scholarship

A large literature in medicine documents variation across areas in the use of surgical treatments that is unrelated to outcomes. Observers of this phenomena have invoked “flat of the curve medicine” to explain these facts, and have advocated for reductions in spending in high-use areas. In contrast, we develop a simple Roy model of patient treatment choice with productivity spillovers that can generate the empirical facts. Our model predicts that high-use areas will have higher returns to surgery, better outcomes among patients most appropriate for surgery, and worse outcomes among patients least appropriate for surgery, while displaying no relationship between …

Finding Order In Complexity: A Typology Of Local Public Health Delivery Systems, Glen Mays

Glen Mays

Public health decision-makers and researchers currently lack an evidence-based framework for describing, classifying, and comparing public health delivery systems based on their organizational components, operational characteristics, and division of responsibility. Related typologies developed in the health services sector have proven extremely valuable for policy and administrative decision-making as well as for ongoing research. Performance assessment, quality improvement, and accreditation activities are now blossoming in public health—adding urgency to the need for classification and comparison frameworks. This brief describes a newly-developed empirical typology for local public health systems and highlights its policy and managerial applications.

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

Lower Adherence To Screening Mammography Guidelines Among Ethnic Minority Women In America: A Meta-Analytic Review, Rebecca J. Purc-Stephenson, Kevin M. Gorey

Social Work Publications

OBJECTIVE: This study investigates the association between ethnic minority status and receiving a screening mammogram within the past 2 years among American women over 50.

METHOD: The findings from 33 studies identified from interdisciplinary research databases (1980 to 2006) were synthesized. Separate pooled analyses compared white non-Hispanics to African Americans (28 outcomes), Hispanics (18 outcomes), and Asian/Pacific Islanders (10 outcomes).

RESULTS: Using the random effects model, results showed that African Americans were screened less than white non-Hispanics at a marginal level (OR 0.87, 95% CI 0.75, 1.00). Larger and significant discrepancies were observed for Hispanics (OR 0.65, 95% CI 0.50, …

Cancer Survival In Ontario, 1986-2003: Evidence Of Equitable Advances Across Most Diverse Urban And Rural Places, Kevin M. Gorey

Social Work Publications

OBJECTIVES: This study examined whether place and socio-economic status had differential effects on the survival of women diagnosed with breast cancer in Ontario during the 1980s and the 1990s.

METHODS: The Ontario Cancer Registry provided 29,934 primary malignant breast cancer cases. Successive historical cohorts (1986-1988 and 1995-1997) were, respectively, followed until 1994 and 2003. Diverse places were compared: the greater metropolitan Toronto area, other cities, ranging in size from 50,000 to a million people, smaller towns and villages, and rural and remote areas. Socio-economic data for each woman's residence at the time of diagnosis were taken from population censuses.

RESULTS: …

A Situation Analysis Of Care And Support For Rape Survivors At First Point Of Contact In India And Bangladesh, M.E. Khan, Aruna Bhattacharya, Ismat Bhuiya, Aditi Aeron

Reproductive Health

A situation analysis of post-rape care services available at the first point of contact was conducted in three cities in India and four cities in Bangladesh. The aim of this investigation was to gather information that could be used in the development of a comprehensive care and support system for the rape survivor. Secondarily, the study field-tested sensitive and practical tools that could be used in the future for large-scale situation analyses of the rape survivor services. The results demonstrated that there is no uniform service provision protocol to follow for managing rape survivors at health facilities in India or …

Creating The Conditions For Scaling Up The Integration Of Reproductive Health Services For Men In Health And Family Welfare Centers In Bangladesh, M.A. Mannan, Jafar Ahmad Hakim, Syeda Tazneen Waris, Ashraf Ali, Akm Nurul Hakim, Abdul Hannan, Sameena Chowdhury, Saria Tasnim, Saiful Islam, Aqm Rezaul Karim, Sharif M.I. Hossain, Ubaidur Rob, M.E. Khan

Reproductive Health

An operations research study, supported by the Population Council’s Frontiers in Reproductive Health (FRONTIERS) program, showed that reproductive health services for men could be feasibly and acceptably integrated within the Health and Family Welfare Centres in Bangladesh, which have been primarily women-centered health facilities. Given these findings, a follow-up study was implemented to create the conditions for scaling up the model through identifying and piloting the operational details to consider when taking the intervention to scale. The findings presented in this report suggest that this model of service delivery and training can be scaled up countrywide, preferably in stages. To …

Situation Analysis Of The Integration Of Family Planning Services In Postpartum, Postabortion And Prevention Of Mother To Child Transmission Programs In The Dominican Republic, Gisela Quiterio, Maritza Molina, Marija Miric, Ricardo Vernon, M. Estela Rivero-Fuentes

Reproductive Health

A diagnostic study of the provision and use of contraception in postpartum, postabortion, and prevention of mother-to-child transmission (PMTCT) programs in the Dominican Republic was conducted with funding from USAID. The objectives of the study were to assess the contraceptive knowledge, attitudes, and behaviors of providers and clients; the degree to which information, counseling, and delivery are implemented in postpartum, postabortion, and PMTCT services; the quality of these services; and the readiness of postpartum, postabortion, and PMTCT services to offer contraceptive services. The report finds that family planning services are linked to antenatal, delivery, and postpartum care in most of …

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.

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

Strengthening Health And Family Planning Services In Low Performing And Hard-To-Reach Areas Of Bangladesh: Workshop Report, Ubaidur Rob, Md. Noorunnabi Talukder

Reproductive Health

Although Bangladesh has established a comprehensive physical infrastructure to deliver health and family planning services with a network of primary health care facilities in rural areas, the impact of this health service network has been much less than expected because services do not reach all regions effectively. Two divisions, Sylhet and Chittagong, remain the most disadvantaged in terms of health and population outcomes and access to services, compounded by poor utilization of facilities in these areas. Moreover, the current health and population sector programs are beset with human resources and infrastructural problems. The Population Council organized a workshop to find …

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 …

Snapshot 2008: Maine Workers With Disabilities, Maine’S Commission On Disability And Employment, Choices Ceo Project

Disability & Aging

No abstract provided.

Technical Assistance To The Interagency Coordination Group Seeking To Reduce Female Genital Mutilation/Cutting, Nafissatou J. Diop

Reproductive Health

This report documents technical assistance provided by FRONTIERS to the Interagency Coordination Group seeking to reduce female genital mutilation/cutting (FGM/C) in sub-Saharan Africa. In particular, staff assisted the group in networking, learning to talk to each other, setting up an operational way of functioning, and influencing key international policy and programmatic documents. Lessons learned through operations research on FGM/C were disseminated widely through the group’s activities and FRONTIERS technical assistance influenced several plans of action and implementation programs. The report notes that in addition to better networking for presenting a common regional vision during the development of policy and programmatic …

Sharing Experiences With Comprehensive Responses To Adolescent Reproductive Health Needs In Africa, Nafissatou J. Diop, Anta Fall Diagne

Reproductive Health

In 1999, the Population Council’s USAID-funded Frontiers in Reproductive Health (FRONTIERS) project, began a three-year collaboration in Senegal on an adolescent reproductive health (ARH) pilot project that showed that a multisectoral, multidisciplinary approach can increase knowledge, enhance attitudes, and foster positive behaviors for reproductive health. Following requests from several neighboring countries, and given the long collaboration with WHO, FRONTIERS initiated efforts in 2007 to enable utilization of these findings in other African countries. The purpose of this report is to promote the utilization of multisectoral approaches for improving ARH programming by governments, donors, and national and international agencies in francophone …

India: Quality Assurance Procedure Monitors And Improves Quality Of Services, Population Council

Reproductive Health

A quality assurance (QA) procedure was pilot-tested and subsequently scaled up throughout the state of Gujarat, India, after demonstrating that a 65-item checklist is an efficient tool for identifying and remedying gaps in service delivery. From 2004–06, FRONTIERS developed and tested a standardized QA procedure. The State Ministry of Health and Family Welfare (MOHFW) used the procedure to assess health-care services in rural clinics in two pilot districts each in the states of Gujarat and Maharashtra. Based on positive results, the State MOHFW expanded the QA procedure in a phased manner throughout all 25 districts of Gujarat. The model is …

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.

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Operations Research For Managers Of Reproductive Health Programs, James R. Foreit, M.E. Khan

Reproductive Health

The course presented in this publication defines operations research (OR) as the study of factors under the control of health program managers and other decision-makers. The purpose of OR is to improve programs and provide information for management decision-making. Successful OR is characterized by a close collaboration between program managers and researchers throughout the study. The course focuses on OR as a branch of the behavioral sciences and deals with formative research and field experiments. It concentrates on improving the research knowledge of managers who have had little or no training in research. The focus of this interactive course is …

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.

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

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.

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