Social Work Commons^™

Higher Native Peruvian Genetic Ancestry Proportion Is Associated With Tuberculosis Progression Risk, Samira Asgari, Yang Luo, Chuan-Chin Huang, Zibiao Zhang, Roger Calderon, Carmen Contreras, Jerome T. Galea, Leonid Lecca, David Jones, D. Branch Moody, Megan B. Murray, Soumya Raychaudhuri

Social Work Faculty Publications

No abstract provided.

Impact Of Prolonged Isolation On Adolescents With Drug-Susceptible Tuberculosis In Lima, Peru: A Qualitative Study, Victoria Elena Rapoport, Elmer Altamirano, Liz Senador, Milagros Wong, Catherine B. Beckhorn, Julia Coit, Stephanie D. Roche, Leonid Lecca, Jerome T. Galea, Silvia S. Chiang

Social Work Faculty Publications

Objectives Patients with tuberculosis (TB) generally are instructed to isolate at the beginning of treatment in order to prevent disease transmission. The duration of isolation varies and may be prolonged (ie, lasting 1 month or more). Few studies have examined the impact of isolation during TB treatment on adolescents, who may be more vulnerable to its negative effects.

Methods This study took place from 2018 through 2019 in Lima, Peru, where the Ministry of Health mandates the exclusion of patients with TB from educational institutions for at least 2 months. Using semi-structured guides, we conducted individual in-depth interviews with adolescents …

Considerations For Partnering With Ryan White Case Managers To Create Equitable Opportunities For People With Hiv To Participate In Research, Elizabeth Lockhart, Deanne Turner, Jerome T. Galea, Stephanie L. Marhefka

Social Work Faculty Publications

Many research studies focus on recruitment from one or few HIV clinics or internet-engaged populations, but this may result in inequitable representation of people with HIV (PWH), across the rural/urban/suburban continuum. Ryan White Case Managers (RWCM) meet regularly with PWH, potentially positioning them as partners in gathering research-related data from diverse groups of low-income, marginalized, PWH. Yet, data collection in partnership with RWCM, particularly over large geographic areas, has been under-explored. We partnered with RWCM and their organizations throughout Florida to administer a 10-item technology use and willingness survey to clients living with HIV; RWCMs provided process-oriented feedback. Among 382 …

A Role For Community-Level Socioeconomic Indicators In Targeting Tuberculosis Screening Interventions, Meredith B. Brooks, Helen E. Jenkins, Daniela Puma, Christine Tzelios, Ana Karina Millones, Judith Jimenez, Jerome T. Galea, Leonid Lecca, Mercedes C. Becerra, Salmaan Keshavjee, Courtney M. Yuen

Social Work Faculty Publications

Tuberculosis screening programs commonly target areas with high case notification rates. However, this may exacerbate disparities by excluding areas that already face barriers to accessing diagnostic services. We compared historic case notification rates, demographic, and socioeconomic indicators as predictors of neighborhood-level tuberculosis screening yield during a mobile screening program in 74 neighborhoods in Lima, Peru. We used logistic regression and Classification and Regression Tree (CART) analysis to identify predictors of screening yield. During February 7, 2019–February 6, 2020, the program screened 29,619 people and diagnosed 147 tuberculosis cases. Historic case notification rate was not associated with screening yield in any …

Patient And Provider Perceptions Of A Community-Based Accompaniment Intervention For Adolescents Transitioning To Adult Hiv Care In Urban Peru: A Qualitative Analysis, Jerome T. Galea, Milagros Wong, Brennan Ninesling, Alicia Ramos, Liz Senador, Hugo Sanchez, Lenka Kolevic, Eduardo Matos, Eduardo Sanchez, Renato A. Errea, Andrew Lindeborg, Carlos Benites, Leonid Lecca, Sonya Shin, Molly F. Franke

Social Work Faculty Publications

Introduction: Adolescents living with HIV (ALWH) experience higher mortality rates compared to other age groups, exacerbated by the suboptimal transition from paediatric to adult HIV care, during which decreased adherence to antiretroviral therapy (ART) and unsuppressed viremia are frequent. Care transition—a process lasting months or years—ideally prepares ALWH for adult care and can be improved by interventions that are youth-friendly and address psychosocial issues affecting ART adherence; however, such interventions are infrequently operationalized. Community-based accompaniment (CBA), in which laypeople provide individualized support and health system navigation, can improve health outcomes among adults with HIV. Here, we describe patient and provider …

Child Protection Policies And Practices In Mennonite Church Usa Congregations: A Follow-Up Study, Jeanette Harder, Elisabeth Wilder

Social Work Faculty Publications

While congregations have a spiritual mandate to be open and welcoming, they must be aware of the risks involved in ministry and be prepared to protect children from all types of abuse and neglect. In 2010 and again in 2018, Dove’s Nest, a nonprofit organization, conducted an online survey to determine the characteristics, practices, and experiences of Mennonite Church USA congregations with and without written child protection policies. The research questions for this study were: (1) What are the characteristics, practices, and experiences of congregations in regard to child protection, and how have they changed since 2010? (2) What is …

Temporal Trends In Suicidal Ideation And Attempts Among Us Adolescents By Sex And Race/Ethnicity, 1991-2019, Yunyu Xiao, Julie Cerel, J. John Mann

Social Work Faculty Publications

Importance: Disparities by sex and racial/ethnic group in suicide death rates are present in US adolescents. Whether disparities in suicide death extend to groups targeted for suicide prevention efforts, namely, those with suicidal ideation or nonfatal suicide attempts, is unknown.

Objective: To examine differences in temporal trends between suicidal ideation and suicide attempts in US adolescents from 1991 through 2019 by sex and race/ethnicity subgroups.

Design, Setting, and Participants: A cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent US adolescents from 1991 to 2019, included 183 563 US high-school students in grades 9 to 12. Data …

Economic Stress Among Low Income Latino Adolescent Fathers: An Application Of The Vulnerability-Stress-Adaptation Model, Diana Cedeño, Autumn M. Bermea, Heidi Adams Rueda, Michelle L. Toews

Social Work Faculty Publications

Latino youth are more likely to live under the poverty line and to become adolescent parents. Although research exists examining adolescent mothers, less is known about adolescent fathers, particularly Latino adolescent fathers. Much of what does exist uses a deficit lens, as opposed to one of strength and resilience. Although adolescent fathers sometimes do struggle in their transition to fatherhood, it is critical to understand the positive ways in which they adapt. The present study uses in-depth interviews and applies the vulnerability-stress-adaptation (VSA) model to understand parental adaptation processes among a sample of low-income Latino adolescent fathers (N = …

Mental Health And Psychosocial Functioning In Recently Separated U.S. Women Veterans: Trajectories And Bi-Directional Relationships, Karen A. Lawrence, Dawne Vogt, Adam Dugan, Shawn R. Nigam, Emily Slade, Brian N. Smith

Social Work Faculty Publications

Prior research on the relationship between veterans’ mental health and psychosocial functioning has primarily relied on male samples. Here, we investigated prospective longitudinal relationships between mental health and psychosocial functioning in 554 female Iraq and Afghanistan War veterans who were surveyed three times between two- and seven-years following separation from service. Mixed effects modeling revealed that increasing depression and posttraumatic stress disorder (PTSD) severity predicted declines in work functioning. Increasing PTSD severity predicted declining parental functioning and worsening depression predicted a decline in relationship functioning. In turn, decreased work and intimate relationship functioning predicted increased PTSD and depression symptom severity …

Incident Tuberculosis Diagnoses In Children At High Risk For Disease, Milagros Wong, Julia M. Coit, Milagros Mendoza, Silvia S. Chiang, Helen Marin, Jerome T. Galea, Leonid Lecca, Molly F. Franke

Social Work Faculty Publications

We followed 35 children meeting a research definition for unconfirmed tuberculosis (TB) but in whom a pediatric pulmonologist did not diagnose or treat TB. After a median follow-up of 16.4 months, most children were not diagnosed with TB following a comprehensive evaluation. However, 2 were diagnosed with TB, demonstrating high TB risk (6%; exact 95% CI, 1%–19%). In some contexts, researchers may wish to supplement these research definitions with clinical decision data and longitudinal follow-up in order to improve specificity.

Prediction Tool To Identify Children At Highest Risk Of Tuberculosis Disease Progression Among Those Exposed At Home, Meredith B. Brooks, Leonid Lecca, Carmen Contreras, Roger Calderon, Rosa Yataco, Jerome Galea, Chuan-Chin Huang, Megan B. Murray, Mercedes C. Becerra

Social Work Faculty Publications

Background: There is a dearth of research to understand which children, among those who are exposed at home to tuberculosis (TB), are at the highest risk of TB disease, to tailor care. We sought to identify predictors of TB progression in children.

Methods: We conducted a prospective cohort study of children living with adults with pulmonary TB in Lima, Peru (2009–2012). We applied classification and regression tree analysis to examine potential predictors of incident TB disease during 12 months in 3 age groups (0–4, 5–9, and 10–14 years). We calculated the relative risk (RR) for top predictors in each age …

Evaluating The Impact Of Incentives On Clinical Trial Participation: Protocol For A Mixed Methods, Community-Engaged Study, Jerome T. Galea, Karah Y. Greene, Brandon Nguyen, Andrea N. Polonijo, Karine Dubé, Jeff Taylor, Christopher Christensen, Zhiwei Zhang, Brandon Brown

Social Work Faculty Publications

Background: Monetary incentives in research are frequently used to support participant recruitment and retention. However, there are scant empirical data regarding how researchers decide upon the type and amount of incentives offered. Likewise, there is little guidance to assist study investigators and institutional review boards (IRBs) in their decision-making on incentives. Monetary incentives, in addition to other factors such as the risk of harm or other intangible benefits, guide individuals’ decisions to enroll in research studies. These factors emphasize the need for evidence-informed guidance for study investigators and IRBs when determining the type and amount of incentives to provide to …

Closing Delivery Gaps In The Treatment Of Tuberculosis Infection: Lessons From Implementation Research In Peru, Courtney M. Yuen, Ana Karina Millones, Daniela Puma, Judith Jimenez, Jerome T. Galea, Roger Calderon, Gabriela S. Pages, Meredith B. Brooks, Leonid Lecca, Tom Nicholson, Mercedes C. Becerra, Salmaan Keshavjee

Social Work Faculty Publications

Background: Targeted testing and treatment of TB infection to prevent disease is a pillar of TB elimination. Despite recent global commitments to greatly expand access to preventive treatment for TB infection, there remains a lack of research on how best to expand preventive treatment programs in settings with high TB burdens.

Methods: We conducted implementation research in Lima, Peru, around a multifaceted intervention to deliver TB preventive treatment to close contacts of all ages, health care workers, and people in congregate settings. Key interventions included use of the interferon gamma release assay (IGRA), specialist support for generalist physicians at primary-level …

Toward Patient-Centered Tuberculosis Preventive Treatment: Preferences For Regimens And Formulations In Lima, Peru, Courtney M. Yuen, Ana K. Millones, Jerome T. Galea, Daniela Puma, Judith Jimenez, Leonid Lecca, Mercedes C. Becerra, Salmaan Keshavjee

Social Work Faculty Publications

Background: To ensure patient-centered tuberculosis preventive treatment, it is important to consider factors that make it easier for patients to complete treatment. However, there is little published literature about patient preferences for different preventive treatment regimen options, particularly from countries with high tuberculosis burdens.

Methods: We conducted a qualitative research study using a framework analysis approach to understand tuberculosis preventive treatment preferences among household contacts. We conducted three focus group discussions with 16 members of families affected by tuberculosis in Lima, Peru. Participants were asked to vote for preferred preventive treatment regimens and discuss the reasons behind their choices. Coding …

Adapting Problem Management Plus For Implementation: Lessons Learned From Public Sector Settings Across Rwanda, Peru, Mexico And Malawi, Sarah F. Coleman, Hildegarde Mukasakindi, Alexandra L. Rose, Jerome T. Galea, Beatha Nyirandagijimana, Janvier Hakizimana, Robert Bienvenue, Priya Kundu, Eugenie Uwimana, Anathalie Uwamwezi, Carmen Contreras, Fátima G. Rodriguez-Cuevas, Jimena Maza, Todd Ruderman, Emilia Connolly, Mark Chalamanda, Waste Kayira, Kingsley Kazoole, Ksakrad K. Kelly, Jesse H. Wilson, Amruta A. Houde, Elizabeth B. Magill, Giuseppe J. Raviola, Stephanie L. Smith

Social Work Faculty Publications

Problem Management Plus (PM+) is a low-intensity psychological intervention developed by the World Health Organization that can be delivered by nonspecialists to address common mental health conditions in people affected by adversity. Emerging evidence demonstrates the efficacy of PM+ across a range of settings. However, the published literature rarely documents the adaptation processes for psychological interventions to context or culture, including curriculum or implementation adaptations. Practical guidance for adapting PM+ to context while maintaining fidelity to core psychological elements is essential for mental health implementers to enable replication and scale. This paper describes the process of contextually adapting PM+ for …

A Non-Specialist Depression Care Pathway For Adolescents Living With Hiv And Transitioning Into Adult Care In Peru: A Nested, Proof Of Concept Pilot Study, Jerome T. Galea, Carmen Contreras, Milagros Wong, Karen Ramos, Valentina Vargas, Hugo Sánchez, Renato A. Errea, Leonid Lecca, Molly F. Franke

Social Work Faculty Publications

Background: Adolescents living with HIV (ALWH) are disproportionally impacted by depression, experiencing worse HIV outcomes. Integrated depression and HIV care may support antiretroviral adherence. This study pilot tested for proof of concept a basic depression care pathway for ALWH to inform depression care integration with HIV services in Peru.

Methods: ALWH were screened for depression with the Patient Health Questionnaire-9 (PHQ-9). Participants with PHQ-9 scores of ⩾10 or suicidal ideation (SI) were eligible for Psychological First Aid (PFA) delivered by non-mental health specialists. Participants with PHQ-9 re-assessments of ⩾20 or SI were referred to specialized services.

Results: Twenty-eight (11 female, …

Identifying Barriers And Facilitators To Implementation Of Community-Based Tuberculosis Active Case Finding With Mobile X-Ray Units In Lima, Peru: A Re-Aim Evaluation, Courtney M. Yuen, Daniela Puma, Ana Karina Millones, Jerome T. Galea, Christine Tzelios, Roger I. Calderon, Meredith B. Brooks, Judith Jimenez, Carmen Contreras, Tim C. Nichols, Tom Nicholson, Leonid Lecca, Mercedes C. Becerra, Salmaan Keshavjee

Social Work Faculty Publications

Objectives: Identify barriers and facilitators to integrating community tuberculosis screening with mobile X-ray units into a health system.

Methods: Reach, effectiveness, adoption, implementation and maintenance evaluation.

Setting: 3-district region of Lima, Peru.

Participants: 63 899 people attended the mobile units from 7 February 2019 to 6 February 2020.

Interventions: Participants were screened by chest radiography, which was scored for abnormality by computer-aided detection. People with abnormal X-rays were evaluated clinically and by GeneXpert MTB/RIF (Xpert) sputum testing. People diagnosed with tuberculosis at the mobile unit were accompanied to health facilities for treatment initiation.

Primary and secondary outcome measures: Reach was …

Impact Of The Sars-Cov-2 Pandemic On Adolescents Living With Hiv In Lima, Peru, Renato A. Errea, Milagros Wong, Liz Senador, Alicia Ramos, Karen Ramos, Jerome T. Galea, Leonid Lecca, Hugo Sánchez, Carlos Benites, Molly F. Franke

Social Work Faculty Publications

Adolescents living with HIV (ALWH) have lower rates of virologic suppression and higher rates of immunologic decline compared to their older counterparts, potentially placing them at high-risk for developing severe SARS-CoV-2 disease. ALWH who are transitioning to adult care face additional challenges to remaining in care and adhering to treatment. In this special section we report the experiences of ALWH in the process of transitioning to adult HIV services during the COVID-19 pandemic. In first place, the government-mandated stay-at-home order has substantially limited access to full HIV care by restricting public transportation, HIV medication stock-outs, and the suspension of routine …

A Review Investigating The Relationship Between Cannabis Use And Adolescent Cognitive Functioning, Elena Cyrus, Makella S. Coudray, Sandra Kiplagat, Yandra Mariano, Ines Noel, Jerome T. Galea, Dexter Hadley, Jessy G. Dévieux, Eric Wagner

Social Work Faculty Publications

No abstract provided.

Gender In The Time Of Covid-19: Evaluating National Leadership And Covid-19 Fatalities, Leah C. Windsor, Gina Yannitell Reinhardt, Alistair J. Windsor, Robert Ostergard, Susan Allen, Courtney Burns, Jarod Giger, Reed Wood

Social Work Faculty Publications

In this paper we explore whether countries led by women have fared better during the COVID-19 pandemic than those led by men. Media and public health officials have lauded the perceived gender-related influence on policies and strategies for reducing the deleterious effects of the pandemic. We examine this proposition by analyzing COVID-19-related deaths globally across countries led by men and women. While we find some limited support for lower reported fatality rates in countries led by women, they are not statistically significant. Country cultural values offer more substantive explanation for COVID-19 outcomes. We offer several potential explanations for the pervasive …

Technical Reviewing For The Family First Prevention Services Act: Strategies And Recommendations, Antonio R. Garcia, Peter J. Pecora, Audrey H. Schnell, Cynthia Burnson, Elizabeth Harris, Allison Finseth

Social Work Faculty Publications

The Family First Prevention Services Act (FFPSA) has compelled states to expand their priorities to implement evidence-based practices (EBPs) as a means to prevent foster care placement. While the states may opt to include EBPs already approved by the Administration for Children and Families (ACF), some state leaders are opting to commission an independent technical review for the EBP they would prefer to implement as part of their FFPSA plan. While the goal is for ACF to approve their plan and issue a temporary license, little guidance is provided on how to conduct technical reviews. Relying upon the expectations that …

Two Clinical Prediction Tools To Improve Tuberculosis Contact Investigation, Ruoran Li, Francesco Nordio, Chuan-Chin Huang, Carmen Contreras, Roger Calderon, Rosa Yataco, Jerome Galea, Zibiao Zhang, Mercedes C. Becerra, Leonid Lecca, Megan B. Murray

Social Work Faculty Publications

Background: Efficient contact investigation strategies are needed for the early diagnosis of TB disease and treatment of latent TB infections.

Methods: Between September 2009 and August 2012, we conducted a prospective cohort study in Lima, Peru in which we enrolled and followed 14,044 household contacts of adult pulmonary TB patients. We used information from a subset of this cohort to derive two clinical prediction tools that identify contacts of TB patients at elevated risk of progressing to active disease by training multivariable models that predict (1) co-prevalent TB among all household contacts and (2) one-year incident TB among adult contacts. …

Witnessing Intimate Partner Violence Across Contexts: Mental Health, Delinquency, And Dating Violence Outcomes Among Mexican Heritage Youth, Lela Rankin Williams, Heidi Adams Rueda

Social Work Faculty Publications

Immigrant Mexican American (MA) youth are at greater risk for violence exposure due to risk factors associated with migration–postmigration processes and as they settle into urban U.S. communities marked by crime and poverty. Less is known about the contexts of this exposure. Specifically, what are the ecological contexts in which youth witness intimate partner violence (IPV), how do these experiences differ by immigration generational status, and what is the impact on youth’s externalizing and internalizing behaviors? MA adolescents (N = 279; 15–17 years, M = 16.17, SD = 0.81) from the Southwest United States participated in an online survey. …

Risk And Protective Factors Of Dementia Among Adults With Post-Traumatic Stress Disorder: A Systematic Review Protocol, Karen A. Lawrence, Theresia M. Pachner, Molly M. Long, Stephanie Henderson, Donna L. Schuman, Brenda L. Plassman

Social Work Faculty Publications

INTRODUCTION: Post-traumatic stress disorder (PTSD) is associated with an increased risk of dementia. Individual epidemiological studies have controlled for several confounders of the relationship between PTSD and increased dementia risk, yet particular risk factors underlying this relationship have not been determined. This systematic review protocol aims to identify risk and protective factors of dementia among adults with PTSD.

METHODS AND ANALYSIS: We will conduct an electronic search of the databases: PubMed, CINAHL, PsychINFO, The Cochrane Library, Scopus and ProQuest Dissertation and Theses Global. After screening the studies, quantitative synthesis will be performed, if possible. Otherwise, a narrative synthesis will be …

Staff Perspectives Regarding The Influence Of Trauma On The Intimate Partnering Experiences Of Adolescent Mothers In Residential Foster Care, Autumn M. Bermea, Heidi Adams Rueda, Kwynn M. Gonzalez-Pons

Social Work Faculty Publications

Adolescent girls in foster care are disproportionately vulnerable to pregnancy and parenthood. These experiences of motherhood might be partially attributable to experiences of trauma, including sexual trauma. Trauma, particularly related to domestic violence and sexual abuse, have been linked to subsequent struggles in intimate relationships, such as dating violence or engagement in unsafe sexual behaviors. Although some research has begun to investigate experiences of trauma on relationships, there has been a lack of focus on intimate relationships in general and how they have been influenced by past and/or current traumatic experiences. The present study draws on 12 interviews with program …

A Look At Empathy, University Belonging, And Intersectionality: How To Support A Diverse Student Body Amid The Covid-19 Crisis, Shantalea Johns, Stephanie Hawkes

Social Work Faculty Publications

The present short essay discusses the impact COVID-19 has had on college students. As universities work to build supportive learning environments during these unprecedented times, it is important for practitioners to consider how mental health and student identity impact student success. The framework proposes that empathy, university belonging, and an intersectional approach to academic support can contribute to a student's mental health, identity, and emotional well-being as they transition back to academic life.

Spatial Analyses Of Temporary Assistance For Needy Families: Its Responsiveness To Labor Market Performance And Policies During The 2008 Recession, Vicky Albert, Jaewon Lim

Social Work Faculty Publications

The major economic downturn of the Great Recession led many families with children to depend on cash assistance from the Temporary Assistance for Needy Families (TANF) program. In order to capture TANF caseload growth rates relative to their labor market performance, we developed a responsiveness index which revealed that many of the western and midwestern states were quite responsive to the recession. Using Exploratory Spatial Data Analysis (ESDA) tools, we found the presence of strong spatial clusters in unemployment rate and in TANF maximum aid. Several states in the western region were surrounded by neighboring states with higher growth in …

Health-Related Quality Of Life And Health Literacy Among Mexican American And Black American Youth In A Southern Border State, Steven Hoffman, Heidi Adams Rueda, Lauren Beasley

Social Work Faculty Publications

Among adults, health literacy and health-related quality of life are highly correlated constructs that are associated with tangible health outcomes. While the connection between these concepts and health outcomes among youth is still unclear, studying these factors among at-risk adolescent populations can provide researchers, policy-creators, and educators a quantifiable summary of the challenge they face in their efforts to reduce health disparities. The purpose of this study was to better understand the health of minority youth living in a Southern state near the US-Mexico border. Specifically, we sought to describe their health literacy and health-related quality of life, and identify …

An Assessment Of Mental Wellbeing And Health-Related Quality Of Life Among Youth Living In Central Mexico, Steven Hoffman, Heidi Adams Rueda, Stefan Chase

Social Work Faculty Publications

The current state of adolescent mental health and wellbeing in Mexico constitutes a serious public health concern. In an effort to better understand the potential impact this crisis is having on youth in Central Mexico, we designed a study to assess the connection between Mental Wellbeing and Health-related Quality of Life among a sample of children in junior high school. Descriptive statistics suggest that 22.5% of our sample was “at-risk” of poor health-related quality of life, with 19.8% at risk within the physical subscale and 24.3% at risk within the psychosocial subscale. Regression analyses showed that mental wellbeing scores significantly …

Human Behavior And The Social Environment: Fall 2020 Syllabus, Rigaud Joseph

Social Work Faculty Publications

Syllabus for graduate course on Human Behavior and the Social Environment. (Critical examination and application of biological, psychological, and social aspects of human development from infancy through old age. Major theories, risk and protective factors.)