Digital Commons Network^™

Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress

Reproductive Health

Willingness-to-pay (WTP) surveys are increasingly used in reproductive health programs to predict the impact of price changes on revenues, utilization, and client profile. The FRONTIERS program worked with the Clinical Services Improvement (CSI) project and the Cairo Demographic Center to carry out a WTP survey in six CSI clinics in Egypt. The survey found that most clients would be willing to pay higher prices for CSI services, and WTP did not vary much by client economic status. However, predictive validity was low when all reasons for client discontinuation were included. WTP surveys have the potential to be useful tools for …

An Assessment Of Trends In The Use Of The Iud In Ghana: National Results Dissemination And Utilization, Ivy Osei, John Gyapong, Monica Wanjiru, Ian Askew

Reproductive Health

The overall aim of this study was to inform the Ghana Health Service, USAID, and other partners involved in providing family planning services in Ghana about future directions that could be taken to reinvigorate the IUD within the context of a family planning service based on the principles of free and informed choice. The Health Research Unit conducted the study, with technical assistance from FRONTIERS and funding from USAID. The findings showed that the declining interest in and use of the IUD as a family planning method could be attributed to several factors, including negative perceptions and false beliefs about …

Improving The Ghanaian Safe Motherhood Programme, Ivy Osei, Bertha Garshong, Gertrude Banahene, John Gyapong, Placide Tapsoba, Ian Askew, Clement Ahiadeke, Richard Killian, Edward Bonku, Perle Combary, William Sampson

Reproductive Health

Prior to the Ghana Ministry of Health scaling up the country’s Safe Motherhood program, they requested support from the Population Council’s USAID-funded Frontiers in Reproductive Health program to undertake an operations research study to evaluate and compare the cost-effectiveness of two training approaches and other performance improvement interventions. The study measured and compared changes in provider knowledge and skills and the costs of implementing a three-week residential vs. self-paced learning (SPL) approach. The SPL approach costs more per trainer than the traditional residential approach, both in financial costs alone and when opportunity costs are added, however, a cost-effectiveness analysis showed …

Improving Access To Long-Term Contraceptives In Rural Guatemala Through The Ministry Of Health, Edwin Montufar, Carlos Morales, Ricardo Vernon, Carlos Brambila, Jorge Solorzano

Reproductive Health

The purpose of this study was to test a model to train nurse auxiliaries at health centers and posts in Guatemala and to determine whether these providers could deliver adequate, cost-effective services. The training model consisted of: a) selection of nurse auxiliaries; b) two-day group training; c) on-the-job training, including work with actual clients at the trainees’ work centers; and d) certification of trainees who had conducted at least five quality insertions under supervision. This study has shown that nonprofessional health providers can effectively provide quality IUD services in Guatemala. The main recommendation derived from the project is to scale …

Expanding Access To Vasectomy Services In The Ministry Of Health Of Guatemala, Blanca De Rodriguez, Ricardo Vernon, Jorge Solorzano

Reproductive Health

This project tested the effectiveness of a systemic model for introducing vasectomy in service delivery units of the Guatemalan Ministry of Health (MOH), which has four basic components: a) the self-selection of health units according to their response to an invitation to participate in the project; b) the development of a counseling and information model for potential clients; c) training and sensitizing of health teams; and d) on-site training of surgeons. The report concludes that the introduction model for vasectomy in the MOH centers was successful. A high proportion of hospitals that identified vasectomy candidates finished the process, and the …

Systematic Screening As A Strategy To Increase Services Integration And Revenues In Honduras, Ricardo Vernon, James R. Foreit, Fiorella Mancini, Suyapa Pavon, Jheisy Torres

Reproductive Health

This operations research study, undertaken by the Honduras Family Planning Association (Asociación Hondureña de Planificación de Familia—ASHONPLAFA), tested the effectiveness of systematic screening to increase the number of services and revenue per visit in a reproductive health program. Despite monitoring plans, provider compliance with the intervention was low; the overall proportion of clients screened was less than 11 percent, and the frequency of screening varied greatly by clinic contact point. Although the study did not show an increase in the mean number of services per client, the negative results could reasonably be attributed to lack of implementation of the intervention. …

Systematic Screening To Integrate Reproductive Health Services In India, N.P. Das, Urvi Shah, Varsha Chitania, Pratibha Patel, M.E. Khan, Anurag Mishra, James R. Foreit

Reproductive Health

This study, conducted in large public clinics and small health posts in the city of Vadodara, India, tested the effectiveness of a systematic screening technique in integrating reproductive health services at the provider level. The objective was to determine if women screened during clinic visits received more services, appointments, and referrals per visit than women who were not screened. Results show that in experimental group clinics the number of services per visit increased while control clinics experienced a slight decrease; the effect of systematic screening was smaller in health posts than in clinics. In experimental posts, services per visit increased …

Nursing Staff Dynamics And Implications For Maternal Health Provision In Public Health Facilities In The Context Of Hiv/Aids, Loveday Penn-Kekana, Duane Blaauw, Khin San Tint, Desiree Monareng, Jane Chege

Reproductive Health

This study, carried out in Limpopo, KwaZulu-Natal, and Mpumalanga provinces in South Africa, aimed to document nursing staff dynamics in maternal health services, and to explore the factors associated with these dynamics. The study found that a high percentage of nursing staff working in public facilities were demotivated, burnt out, and were considering leaving the facility where they were working. A range of factors, both financial and nonfinancial, were associated with nurses considering going overseas: inadequate pay, poor promotion, feeling unsupported by management, and having bad relationships at work were all associated with lack of organizational commitment. As a result …

Feasibility Of Introducing A Comprehensive Package Of Antenatal Care Services In Rural Public Clinics In South Africa, Jane Chege, Ian Askew, Nzwakie Mosery, Mbali Ndube-Nxumalo, Busi Kunene, Mags Beksinska, Janet Dalton, Ester Snyman, Wilem Sturm, Preshny Moodley

Reproductive Health

The Maternal, Child and Women’s Health Unit, in collaboration with the Population Council’s FRONTIERS in Reproductive Health (FRONTIERS) program, the Reproductive Health Research Unit of the University of Witwatersrand, and the Department of Medical Microbiology and Infectious Diseases of the Nelson Mandela School of Medicine, University of Natal, developed and then pilot-tested this revised model in KwaZulu-Natal, South Africa. The project’s objective was to develop and test an improved and integrated antenatal care program for public-sector clinics that would increase the range and quality of services received by pregnant women and improve their reproductive health behavior and status. Various problems, …

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …

Evaluating Awareness Of Community Health And Human Services By The Hispanic Population In Lexington, Kentucky, Pilar Corbellini

MPA/MPP/MPFM Capstone Projects

Over the past 10 years, Hispanics, predominately Mexicans, have become a notable component of immigration in Kentucky. At the same time, the city of Lexington has striven to increase and stimulate community efforts to help and support people in need. Over 2000 non-profit organizations exist in the city and surrounding areas that unite community support to assist people seeking help.

Among non-profit agencies, particularly the United Way of the Bluegrass, there is a perceived idea that people in need and seeking help are overwhelmed with information about available community human and health services. Notwithstanding this perception, a different reality seems …

The Relationship Between Future Orientation And Street Substance Use Among Texas Alternative School Students, R J Peters, Susan R Tortolero, Regina Jones Johnson, Robert C Addy, Christine M Markham, S Liliana Escobar-Chaves, Holly Lewis, George S Yacoubian

Faculty, Staff and Student Publications

Self-reported substance use data were collected from 963 alternative school students in grades 7-12 who were surveyed through the Safer Choices 2 study in Houston, Texas. Data were collected between October 2000 and March 2001. Logistic regression analyses indicated that lower levels of future orientation was significantly associated (OR = 0.88, 95% CI = 0.81-0.97) with thirty-day substance use after controlling for age and gender. In addition, lower levels of future orientation was found to have a significant association with students' lifetime substance use (OR = 0.93, 95% CI = 0.87-.99) after controlling for age, race, and gender. While the …

Population Variables And Self-Reported Barriers That Influence Receipt Of Dental Care By Arizona's Children., Carol H. Danielson

All ETDs from UAB

No abstract provided.

Predictors Of Family-Related Indirect Costs For Asthma In Low -Income African American Children: Morbidity, Adherence, And Psychosocial Risk Factors., Chanda Nicole Mobley

All ETDs from UAB

No abstract provided.

Hearing Sensitivity Among Anniston Army Depot Workers., Melissa W. Norman

All ETDs from UAB

No abstract provided.

The Association Between Eating Habits And Hypertension Among African American Women Compared To Other Women, Anike N. Clark

Theses and Dissertations

Background: Hypertension is a major public health concern for African American women. Many studies have shown a greater prevalence of hypertension, as well as physical inactivity, excess weight, and diabetes, in African Americans. Objective: To determine if differences in eating patterns, as measured by Healthy Eating Index (HEI) scores, between African American women and other women in the United States are associated with hypertension. Methods: Data were extracted from the Third National Health and Nutrition Examination Survey (NHANESIII). The sample included 31,189,534 women aged 45 years or greater after survey weights were applied. The majority was White (86.1 %); minority …

Predictors Of Induced Abortion Among Female Youth Center Users In Port-Au-Prince, Haiti, Rachel Barker

Theses and Dissertations

Objective: Induced abortions occur in every country in the world. However sixty percent of the world's women live in countries where abortion is illegal. 19 million pregnancies end in unsafe and/or illegal abortions. Annually, 68,000 women die from unsafe abortions. Legal or not, unsafe abortion is one of the great neglected problems of health care in developing countries like Haiti and is a serious concern to women during their reproductive lives. Methods: The data for this study was collected from youth centers (ages 15-24) and used to estimate percentage distributions of abortion ratios by selected characteristics of women, particularly age …

A Descriptive Study Of Ethical Procedures That Maintain Cultural Security When Conducting Health Research With Aboriginal And Torres Strait Islander School Children In Western Australia, Dionne Paki

Theses : Honours

Cultural security is the maintenance of values and beliefs and the celebration of diversity unique to different cultures. This honours thesis developed a proposed framework to guide collaborative ethics procedures that demonstrate the Aboriginal values relevant to health research for use in Western Australia (WA). These values of reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity have been identified in the National Health and Medical Research Council's Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Ethical procedures for maintaining cultural security when conducting health research among Aboriginal people throughout Australia …

Healthcare Practitioners' Perspectives On The Use Of E-Health Applications To Support Overweight And Obese Adolescents, Rachel J. Mahncke

Theses : Honours

The aim of this research was to investigate, from an Australian healthcare practitioners' perspective, whether online and e-health applications could provide support for and be beneficial to overweight and obese adolescents. This research has investigated whether diet and exercise related environmental causes of obesity could be positively affected by using e-health applications to re-educate adolescents about healthy eating and exercise behaviours the research identified what online and electronic resources healthcare practitioners' recommended to their patients, in order to understand how information systems· solutions could better assist these patients in achieving healthier lifestyle outcomes. Additionally, the research investigated what content, features …

The Relationship Between Breastfeeding And The Development Of Asthma In Early Childhood, River Anne Pugsley

Theses and Dissertations

Purpose: Asthma can have significant adverse effects on the health and quality of life of children, and the prevalence of this condition continues to rise. Breastfeeding may protect against asthma, but some uncertainty remains. The purpose of this study was to further examine the relationship between breastfeeding and the risk of developing asthma in early childhood. Methods: Data were collected from the State and Local Area Integrated Telephone Survey: National Survey of Children's Health, 2003. The study population consisted of 33,315 children ages 0 to 5 years. Prevalence rates of asthma and breastfeeding ,were calculated, as were crude and Mantel-Haenszel …

The Search For An Effective International Regime For The Long-Term Safety And Security Of High Level Radioactive Waste: Pangea And Beyond, Vincent Cusack

Theses: Doctorates and Masters

This thesis is a study of public policy issues relating to multinational geological repositories for high-level radioactive waste disposal (HLW). Nuclear states have attempted for decades to implement effective radioactive waste policies, though with limited success. The safe disposal of HLW has proven particularly troublesome and, thus far, a solution has eluded all states. A review of radioactive waste policy in the UK, the US and Switzerland reveals some of the underlying themes behind community opposition to repository siting and the reasons for a broader global search. The failure to achieve HLW repositories at a national level has led to …

Development Of Dose Conversion Coefficients For Radionuclides Produced In Spallation Neutron Sources: Quarterly Progress Report 9/1/04 – 12/31/04, Phillip W. Patton, Mark Rudin

Transmutation Sciences Physics (TRP)

The research consortium comprised of representatives from several universities and national laboratories has successfully generated internal and external dose conversion coefficients for twenty radionuclides produced in spallation neutron sources. In addition, the group has identified twenty radionuclide that are missing electron capture files and eighteen additional radionuclides missing substantial physical data.

Public Health Abstracts 2004

Florida Public Health Review

No abstract provided.

Public Health Nursing Acceptance Of The 5 A’S Protocol For Prenatal Smoking Cessation, Jihong Liu

Faculty Publications

Oregon’s efforts in tobacco cessation have historically focused on the general population and have depended on quit line services as the primary intervention. The Oregon Smoke Free Mothers and Babies Program (SFMB) was developed in 2002 to focus on public health nurses and prenatal care providers who work with high risk pregnant women. It seeks to increase smoking cessation among low income and other high risk pregnant women by disseminating the U.S. Public Health Service best practices, the 5 A’s (Ask, Advise, Assess, Assist, Arrange) tobacco brief intervention protocol, to public health nurses and prenatal care providers. Interventions included teaching …

Comparison Of Two Approaches To Structured Physical Activity Surveys Of Adolescents, Robert G. Mcmurray, Kimberly B. Ring, Margarita S. Treuth, Gregory J. Welk, Russell R. Pate, Kathryn H. Schmitz, Julie L. Pickrel, Vivian Gonzalez, Maria João C. A. Almeida, Deborah Rohm Young, James F. Sallis

Faculty Publications

Purpose - To compare the test-retest reliability, convergent validity, and overall feasibility/usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents.

Methods - Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph^® accelerometer for the same period.

Results - The TB instrument took about 3 min longer to complete (P=0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r=0.676 and 0.667), but the girls …

Diagnosing Crohn's Disease: An Economic Analysis Comparing Wireless Capsule Endoscopy With Traditional Diagnostic Procedures, Neil I. Goldfarb, Laura T. Pizzi, Joseph P. Fuhr Jr., Christopher Salvador, Vanja Sikirica, Asher Kornbluth, Blair Lewis

College of Population Health Faculty Papers

The purpose of this study was to review economic considerations related to establishing a diagnosis of Crohn's disease, and to compare the costs of a diagnostic algorithm incorporating wireless capsule endoscopy (WCE) with the current algorithm for diagnosing Crohn's disease suspected in the small bowel. Published literature, clinical trial data on WCE in comparison to other diagnostic tools, and input from clinical experts were used as data sources for (1) identifying contributors to the costs of diagnosing Crohn's disease; (2) exploring where WCE should be placed within the diagnostic algorithm for Crohn's; and (3) constructing decision tree models with sensitivity …

Promotion Of Jump Rope In An Elementary School

Florida Public Health Review

No abstract provided.

Prevention Conference Vii - Obesity, A Worldwide Epidemic Related To Heart Disease And Stroke: Executive Summary, Robert H. Eckel, David A. York, Stephan Rössner, Van Hubbard, Ian Caterson, Sachiko T. St. Jeor, Laura L. Hayman, Rebecca M. Mullis, Steven N. Blair

Faculty Publications

No abstract provided.

Clinical Implications Of Obesity With Specific Focus On Cardiovascular Disease: A Statement For Professionals From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism, Samuel Klein, Lora E. Burke, George A. Bray, Steven N. Blair, David B. Allison, Xavier Pi-Sunyer, Yuling Hong, Robert H. Eckel

Faculty Publications

Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides …

Aging In Place At Harbor Point: Outreach Follow-Up Of Older Adults Living In Independent Mixed-Income Apartments, Judith M. Conahan, Nina M. Silverstein, Kelly Fitzgerald

Gerontology Institute Publications

Most older people, despite functional impairments, plan to stay in their homes and/or communities as long as possible. According to an AARP survey, 82% of adults 65+ reported that they believe that they are “very likely” or “somewhat likely” to stay in their current homes or apartments for the rest of their lives. With increasing age, housing and community characteristics and services gain importance in meeting the challenges of “aging in place.” Staying in their homes maximizes elder’s independence, sustains their social connections, and reaffirms their identity and value.