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Factors Influencing Acceptance Of A Worksite Wellness Program In A Major Urban Healthcare System - A Cross-Sectional Analysis, Deborah A. Ballard

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Abstract

Adults spend a significant portion of their lives at their workplace. Thus the workplace provides an important venue for public health interventions aimed at prevention and wellness. Best practices for workplace wellness programs are continually being refined. Ironically, health care workers are often less healthy than other professionals and face significant barriers to participating in workplace wellness programs. This paper analyzes the experience of a large urban health care system as it instituted a workplace wellness program and offers recommendations to increase participation in healthcare workplace wellness program and create an overall healthier work environment for healthcare workers.

Factors …

Are Low Wages Risk Factors For Hypertension?, J. Paul Leigh, Juan Du

Economics Faculty Publications

Objective: Socio-economic status (SES) is strongly correlated with hypertension. But SES has several components, including income and correlations in cross-sectional data need not imply SES is a risk factor. This study investigates whether wages-the largest category within income-are risk factors. Methods: We analysed longitudinal, nationally representative US data from four waves (1999, 2001, 2003 and 2005) of the Panel Study of Income Dynamics. The overall sample was restricted to employed persons age 25-65 years, n = 17 295. Separate subsamples were constructed of persons within two age groups (25-44 and 45-65 years) and genders. Hypertension incidence was self-reported based on …

Improving School Lunches And Environment Through On-Site Gardens, Benjamin J. Spoden

A with Honors Projects

This project is a proposal to illustrate the pros and cons of building a program for school lunches and horticulture education. Building community, knowledge, and health by an on-site gardening program.

Conceptualizing Neighborhood Space: Consistency And Variation Of Associations For Neighborhood Factors And Pregnancy Health Across Multiple Neighborhood Units, Lynne C. Messer, Lisa C. Vinikoor-Imler, Barbara A. Laraia

Community Health Faculty Publications and Presentations

The purpose of this research was to assess the consistency of associations between neighborhood characteristics and pregnancy-related behaviors and outcomes across four nested neighborhood boundaries using race-stratified fixed-slope random-intercept multilevel logistic models. High incivilities was associated with increased smoking, inadequate weight gain and pregnancy-induced hypertension (PIH), while walkability was associated with decreased smoking and PIH for white women across all neighborhood definitions. For African American women, high incivilities was associated with increased smoking and inadequate gestational weight gain, while more walkable neighborhoods appeared protective against smoking and inadequate weight gain in all but the smallest neighborhoods. Associations with neighborhood attributes …

Evaluating Retention In Medical Care And Its Impact On The Health Outcomes Of Individuals Living With Human Inmmunodeficiency Virus, Timothy N. Crawford

Theses and Dissertations--Epidemiology and Biostatistics

In the last few years, engagement in medical care among individuals living with HIV has become a major priority among HIV medical providers and public health researchers. Engagement in medical care is an important concept as it involves the process of linking newly diagnosed individuals into medical care and retaining those individuals in care throughout the course of their infection. Although there have been major advances in the management of HIV, like the advent of Highly Active Antiretroviral Therapy, morbidity and mortality due to HIV cannot be fully reduced if the individual does not optimally retain in care. Retention in …

Effects Of Concentration Peaks On Styrene Neuroxicity In The Fibreglass Reinfoced Plastics Industry. Phase Ii, Adolf Vyskocil, Naïma El Majidi, Ross Thuot, Charles Beaudry, Ginette Charest-Tardif, Robert Tardif, France Gagnon, Bernadette Ska, Alice Turcot, Daniel Drolet, Elmira Aliyeva, Claude Viau

Rapports de recherche scientifique

Cliquez ici pour la version française de ce rapport

D’abord, une analogie

Pour bien expliquer l’objet de ce projet de recherche, nous allons d’abord recourir à une analogie. Supposons deux personnes de même poids qui sont invitées chez des amis. À midi, leur hôte débouche une bouteille de vin et leur offre à boire. La première personne commence à consommer très lentement de sorte qu’à huit heures du soir, elle a bu la moitié de la bouteille. La seconde personne commence à boire à sept heures trente du soir et avale donc aussi une demi-bouteille, mais d’un seul trait. Leur …

Complexities In The Diagnosis And Treatment Of Thyroid Cancer: Discussions, Observations, Research And Public Policy, Hannah V. Gordon

CMC Senior Theses

The impact of the increasing incidence of thyroid cancer presents an interesting case study in public health policy and resource allocation. During the last three decades, thyroid cancer cases have increased by more than 400%. As an illness that affects the lives of hundreds of thousands each year, the human and economic costs will be magnified in the next decade. It is estimated that approximately 13-67% of people will have thyroid nodules during their life of which approximately 5% will be malignant. The standard treatment, a thyroidectomy frequently followed by radioactive 131 iodine treatment, accordingly would seem to be a …

The Relationship Between Religiosity & Selected Health Behaviors Of African Americans Of The Pentecostal Faith, Caprice Jones-Agunbiade

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess the relationship between religiosity and selected health behaviors of African Americans in the Pentecostal faith. A 43 question printed survey was administered to 300 adult attendees from selected Pentecostal churches. The purposive sample was obtained from the Holy Christian Church of Mankato, Brooklyn Park, and St. Paul. The printed survey focused on information about demographics such as age, gender, ethnicity, marital status, education, fellowship, membership, and also health behaviors, perceived weight, weight goals, health classes desired, utilization of a community health educator and religiosity. The findings of the study indicated that high …

The Impact Of Water Supply And Sanitation On Child Health: Evidence From Egypt, Rania Roushdy, Maia Sieverding, Hanan Radwan

Poverty, Gender, and Youth

Using a combination of qualitative and quantitative data, this working paper investigates whether access to improved sources of water and sanitation is an effective “treatment” for the incidence of diarrhea among children under five years of age in Egypt. Both components of the study indicate that widespread access to improved sources of drinking water and toilet facilities exists across Egypt; however, service quality remains a significant problem in many areas. In particular, cuts in water supply—and the resulting practice of storing water—are quite common; a sizable percentage of flush toilet facilities are not connected to the public sewer system; and …

La Santé Des Adolescentes Vulnérables : Un Investissement Stratégique Doublement Rentable, Jennifer Catino

Poverty, Gender, and Youth

Le monde compte aujourd’hui 1,2 milliard d’adolescents âgés de 10 à 19 ans. Près de 90% d’entre eux vivent dans les pays en développement et environ 600 millions sont de sexe féminin. L’adolescence représente normalement une période de santé florissante bien que sujette à de nombreux changements socio-développementaux dont les implications affectent, tout particulièrement, la santé des filles. La plupart des centaines de millions de filles et jeunes femmes du monde en développement vivent dans des conditions et des circonstances qui les rendent vulnérables aux risques de santé et sociaux. Ces adolescentes sont souvent pauvres, déscolarisées, mariées, migrantes, membres de …

Providing Maternal And Newborn Health Services: Experiences Of Auxiliary Nurse Midwives In Rajasthan, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

To better understand the experiences of auxiliary nurse-midwives (ANMs) in providing maternal and newborn health services and to obtain their perspectives on Janani Suraksha Yojana (JSY), the Population Council undertook an exploratory study of ANMs in two districts of the north-western state of Rajasthan, India. Findings show that the vast majority of the ANMs were aware of best practices related to the immediate care of the newborn. Nevertheless, the findings also suggested a number of priority areas for action, including increased investment in training, encouraging provision of services on a more regular basis, making special efforts to enable ANMs to …

Family Planning Programs For The 21st Century: Rationale And Design, John Bongaarts, John C. Cleland, John Townsend, Jane T. Bertrand, Monica Das Gupta

Reproductive Health

Family planning improves health, reduces poverty, and empowers women. Yet, today, more than 200 million women in the developing world want to avoid pregnancy but are not using a modern method of contraception. They face many obstacles, including lack of access to information and health-care services, opposition from their husbands and communities, misperceptions about side effects, and cost. Family planning programs are among the most successful development interventions of the past 50 years. They are unique in their range of potential benefits, encompassing economic development, maternal and child health, educational advances, and women’s empowerment. Research shows that with high-quality voluntary …

Policy Brief: Designing And Implementing High-Quality Voluntary Family Planning Programs, Population Council

Reproductive Health

Voluntary high-quality family planning programs reduce poverty and improve women’s and children’s health by speeding fertility declines. They are one of the most cost-effective health and development investments available to governments. But, today, more than 200 million women worldwide lack access to modern contraception. If this unmet need for family planning could be met, 54 million unintended pregnancies, 26 million abortions, more than 79,000 maternal deaths, and 1.1 million infant deaths could be prevented each year. This policy brief states that global interest in family planning is growing as the benefits of family planning programs are becoming increasingly evident. However, …

Incentivizing Providers To Improve Maternal, Newborn And Child Health Services In Bangladesh: Pay-For-Performance Model Refinement And Advocacy (P4p Mra) Final Report, Md. Noorunnabi Talukder, Ubaidur Rob, Laila Rahman, A.K.M. Zafar Ullah Khan, Riad Mahmud, Azizul Alim, Ismat Ara Hena, Farhana Akter, Anup Kumar Dey

Reproductive Health

An operations research project by the Directorate General of Health Services (DGHS) of the Ministry of Health and Family Welfare, Government of Bangladesh tested the feasibility of a pay-for-performance (P4P) approach, which offered financial incentives to reward service providers for meeting and exceeding specified performance targets for maternal, newborn, and child health services. In response to the encouraging findings, the DGHS implemented a follow-up project, with technical assistance from Population Council and UNICEF, to utilize the experiences and findings of the P4P OR project. Despite it short duration, implementation of the revised P4P scheme induced improvements in service volume and …

Assessment Of Management Information System [Mis] Of National Program For Family Planning And Primary Health Care [Lhw Program], Arshad Mahmood, Syeda Saman Naz

Reproductive Health

This assessment by the Population Council is based on a random sample of 154 Lady Health Workers (LHWs) from three provinces of Pakistan. The aim is to strengthen the routine LHW-MIS (management information system) in the districts so that it can contribute to the improvement of the district health system by providing reliable evidence. Further, based on the findings of the current assessment, the districts managers/decisionmakers should be able to continuously improve the LHW-MIS through applying a problem-solving approach. The report details recommendations for program management, including: 1) providing all necessary MIS tools to each LHW; 2) providing basic equipment …

Increasing Access To Family Planning And Reproductive Health Services Through Community Work: A Case Study Of A Dual Cadre Model In India, Jaleel Ahmad, Isha Bhatnagar, M.E. Khan

Reproductive Health

Before the introduction of Accredited Social Health Activists (ASHAs) in India, mid-level auxiliary nurse midwives (ANMs) were responsible for community health education and services such as antenatal care, delivery, IUCD insertion, and sterilization referrals. The Population Council studied how community extension work and some primary care responsibilities have been shifted to ASHAs, who are tasked with identifying pregnant women; facilitating ANC check-ups; motivating women for institutional deliveries during ANC checkups; and organizing child immunization. Establishing dual worker cadres in India by shifting community extension tasks from ANMs to local ASHAs has been well conceived. Task shifting has allowed ANMs, as …

Situation Analysis Of Behavior Change Communication Activities In Bihar: A Step Towards Developing A Comprehensive Bcc Strategy, M.E. Khan, Isha Bhatnagar, Avishek Hazra, Mukesh Kumar

Reproductive Health

A situation analysis undertaken by the Population Council in Bihar, India assessed a number of contributing factors to a behavior change communication (BCC) strategy. Social norms and practices can be changed if appropriate messages are delivered through a combination of communication channels including mass, mid-, and other media, coupled with improved interactions between frontline healthcare workers and target populations at family and community levels. The analysis notes that effective BCC strategy should be measured in terms of actual behavior change. Impact of BCC activities can be measured by immediate outputs and intermediate and final outcomes depending on implementation duration. The …

Repositioning Community-Based Family Planning In Ghana: A Case Study Of Community-Based Health Planning And Services (Chps), Stephen Ntsua, Placide Tapsoba, Gloria Quansah Asare, Frank K. Nyonator

Reproductive Health

The Population Council conducted a diagnostic appraisal of delivering family planning services using the community-based health planning and services (CHPS model) in Ghana. This study’s results indicate that the CHPS program is well appreciated by rural communities where it is operational. However, the study identified several developments with implications for service delivery: increased community health officer (CHO) workloads and concomitant reductions in outreach services and home visits by community health visitors (CHVs) have weakened the CHO-CHV working relationship, leaving both cadres working in isolation. CHPS has significantly improved health indices but its contribution to increasing family planning is limited and …

Community Midwifery Services In Kenya: Implementation Guidelines, Kenya Ministry Of Health

Reproductive Health

Community midwifery guidelines by the Kenya Minister for Health have been revised in order to standardize the implementation of community midwifery services as a strategy for improving skilled attendance in the provision of maternal and newborn health care at the community level. The revised guidelines address key policies that are outlined in the Kenya Health Policy regarding the provision of essential packages for health in line with the new constitution, Vision 2030, and the Community Health Strategy. The policy emphasizes a shift of focus to preventive and promotive health care; major strategies include improving access, realizing equity goals, and providing …

Birth Spacing And Family Planning Uptake In Pakistan: Evidence From Falah, Arshad Mahmood

Reproductive Health

The Population Council was the lead implementing agency for the Family Advancement for Life and Health (FALAH) project in Pakistan. The project’s main objectives were to achieve a 10 percent increase in the use of moden contraceptives, to equip 80 service delivery points to provide family planning services, and to ensure birth-spacing understanding and ways to achieve it by three-quarters of the target population. The main conclusion of this research is that a sharp uptake of family planning is possible in a relatively short time, if certain investments are made to ensure better communication and greater access to quality family …

Evaluation Of The Population-Level Impact Of The Maternal Health Voucher Program In Uganda, Reproductive Health Vouchers Evaluation Team

Reproductive Health

This report is based on an evaluation of the population-level impact of the maternal health voucher program in Uganda focusing on targeting of beneficiaries, health service utilization (four or more antenatal care visits, facility delivery, and postnatal care), out-of-pocket expenses, and equity. It further reviews the findings from an independent verification of the program that was conducted by PricewaterhouseCoopers Limited in 2010. The impact of the program on the outcomes considered is determined through a simple comparison of changes in proportions between intervention and comparison groups before and after the program started as well as estimation of multilevel random-intercept logit …

Contraceptive Use Dynamics In Pakistan 2008-09, Arshad Mahmood, Syeda Saman Naz

Reproductive Health

This report looks at contraceptive use dynamics in Pakistan, focusing on contraceptive discontinuation, method failure, and contraceptive switching, as well as the reasons for discontinuation. The study found that almost one-third of discontinuations were due to side effects followed by one-fifth of them by the method failure. Side effects were the most common reason for discontinuing modern methods (IUDs and hormonal methods), while failure was the most common reasons for discontinuing barrier and traditional methods (condom, rhythm, withdrawal). Based on the findings of this study, this report suggests that better training of health providers and better information and counseling of …

The Development Of An Interdisciplinary Research Agenda At Ngala: An Innovative Case Study, E Bennett, Y Hauck, S Bindahneem, Vicki Banham, M Owens, L E Priddis, G Wells, W Sinclair, L Shields

Research outputs 2012

Background Ngala is an early parenting, not-for-profit organisation in Western Australia (WA). Research academics from three universities in Perth had been involved in separate research activities over recent years at Ngala. During 2007, a strategic decision was made to forge formal links and articulate an interdisciplinary research framework to promote a research culture amongst Ngala practitioners. Aim To describe an organisational case study of the development of an interdisciplinary research agenda within Ngala. Methods Collaborative methods were used. An action learning project was undertaken over a two-year period with the involvement of researchers, managers and practitioners across the five disciplines …

Self-Revelation In An Online Health Community: Exploring Issues Around Co-Presence For Vulnerable Members, Leesa Costello, Cynthia Witney, Lelia Green, Vanessa Bradshaw

Research outputs 2012

Problem: This paper addresses the implications of working with vulnerable groups in the context of an online health community when members move from co-presence online to co-presence offline. Theoretical Approach: The case study presented in this paper challenges the expectation that self-revelations are usually more common in online environments because of the anonymity and comfort experienced there. Methodology: Taking as its example the events in a research project designed to investigate the relative features of online communities and social network sites by using a ‘netnographic’ approach, this paper examines the introduction of live chat sessions with a view to building …

Health Insurance Coverage Among Diabetic Adults From Three Major Ethnic Groups In The Us, Linda I. Ekperi, Shamola Greene, Ahmed Dehal, Ana Lopez-De Fede

Publications

Objective: The lack of adequate health insurance may result in a downward spiral of the diabetic condition, imposing an increased financial strain on family and the society as a whole. The objective of our study was to assess the insurance type and coverage among diabetic adults from three major ethnic groups. Design and setting: We used data of two cross-sectional national surveys to estimate insurance coverage among diabetic adults aged 20-64 years, 1988-1994 and 2003-2008. Results: The prevalence of doctor-diagnosed diabetes has increased by 120%, 178% and 135% respectively among non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexicans & other …

Long Term Weight Variability In Adults Of Adventist Health Study 1 And 2, Namgyal Lhawang Kyulo

Loma Linda University Electronic Theses, Dissertations & Projects

Background: The effect of overweight and obesity on the risk of fatal disease tends to attenuate with age. One plausible explanation is that a proportion of elderly people in the ideal weight category (19 to 25 kg/m ) experienced disease-related weight loss - an effect that will attenuate health risk related to overweight and obesity. One potential approach to controlling for this bias would be to examine fluctuations in weight during the adult lifespan by considering multiple measures of weight or recall of body weight during adulthood. Some of these measures are available in the Adventist Health Study cohorts and …

Retrospective Analysis Of Metabolic Syndrome: Prevalence And Distribution In Executive Population In Urban Pakistan., Niloufer Sultan Ali, Ali Khan Khuwaja, Adnan Ur Rahman, Kashmira Nanji

Department of Family Medicine

Background. Metabolic Syndrome (MetS) is a major public health concern.

Objective. The aim of this study was to estimate the frequency of MetS, its components, and factors associated with MetS amongst apparently healthy individuals in Pakistan.

Methods. A retrospective cross-sectional study was conducted at the executive Clinics of Aga Khan Hospital, Pakistan. Medical records of patients aged ≥18 years visiting the clinics from July 2011 to December 2011 were consecutively reviewed. Records in which either MetS components data or 10% of overall data was missing were excluded. A total of 1329 participants’ records was included in final analysis. Data was …

An Analysis Of Laboratory Inspections At The University Of Kentucky, Rachel Eldridge

MPA/MPP/MPFM Capstone Projects

Recent news stories about laboratory accidents in which students were severely injured and killed have brought much-needed attention to lab safety. Creating a positive safety climate on college and university campuses is very important in reducing accidents. At the University of Kentucky, all laboratories are inspected once every year, and the results are recorded in a lab inspection database. These data include the department, building, lab classification, type of violation, room number, and the name of the PI (Principal Investigator). I want to analyze inspections to find out whether department and the lab classification are significant in looking at violations. …

Identifying Risk Factors For Disparities In Breast Cancer Mortality Among African-American And Hispanic Women, Nancy Tian, Pierre Goovaerts, F. Benjamin Zhan, T. Edwin Chow, Jeff Gaines Wilson

School of Earth, Environmental, & Marine Sciences Faculty Publications

Background: This study evaluated the risk factors associated with racial disparities in female breast cancer mortality for African-American and Hispanic women at the census tract level in Texas from 1995 to 2005.

Methods: Data on female breast cancer cases were obtained from the Texas Cancer Registry. Socioeconomic and demographic data were collected from Census 2000. Network distance and driving times to mammography facilities were estimated using Geographic Information System techniques. Demographic, poverty and spatial accessibility factors were constructed using principal component analysis. Logistic regression models were developed to predict the census tracts with significant racial disparities in breast cancer mortality …

Explaining Benefit Utilization Variability In Fmnp In Kentucky: An Application Of Pierre Bourdieu’S Theory, Stephanie M. Holcomb-Kreiner

Theses and Dissertations--Sociology

Research has demonstrated the crucial role fresh fruit and vegetable consumption plays in maintaining good health. However, most Americans do not consume adequate amounts, and low-income Americans consume the lowest quantities of fresh fruits and vegetables. The Farmers’ Market Nutrition Program (FMNP) and Senior Farmers’ Market Nutrition Program (SFMNP) attempts to rectify this situation by providing vouchers to low-income women, children, and elders that can be used only at farmers’ markets for the purchase of locally grown, fresh fruits and vegetables. Unfortunately, FMNP and SFMNP exhibit variable and often low benefit utilization. This variable and often low benefit utilization is …