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An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Determining The Barriers To Prenatal Care Entry Within The First Trimester By Evaluation Of Prenatal Care Surveys And Questionnaires, Joycelyn Akamune

Master of Public Health Program Student Publications

Background: Prenatal care (PNC) within the first trimester is associated with improved fetal and maternal health outcomes. Improved PNC is necessary to prevent negative birth outcomes such as low birth weight and infant mortality, which have significant impact on birth outcome rates. Improving access to PNC in the first trimester involves removing barriers to care. A brief survey distributed to expectant mothers is a simple way to define these barriers. Many small community health centers do not use surveys to gather patient information. By reaching this population, barriers to PNC can be better understood and mitigated using community resources decreasing …

Metabolic Obesity Phenotypes And Risk Of Colorectal Cancer In Postmenopausal Women., G. C. Kabat, M. Y. Kim, M. Stefanick, G. Y. F. Ho, D. S. Lane, A. O. Odegaard, M. S. Simon, J. W. Bea, J. Luo, T. E. Wassertheil-Smoller

Journal Articles

Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-

Teens As Teachers In The Garden: Cultivating A Sustainable Model For Teaching Healthy Living, Virginia Bolshakova, John Gieng, C. Sheena Sidhu, Mary Vollinger, Lorena Gimeno, Jessica Guild

Faculty Publications

School gardens are an ideal space to deliver a healthy living curriculum, such as nutrition and physical activity education, to elementary school youth. However, public schools often lack the resources and support to establish sustainable garden-based programming. We created the Healthy Living Ambassador program, a collaborative after-school garden program in low-income communities that brought together resources from schools, community programs, and University of California Cooperative Extension. This school garden program featured culturally competent teens as teachers to serve as near-peer educators and mentors to elementary school youth. The program development model incorporated lessons from sustainable community-based health program interventions and …

Community Health Worker Interventions To Promote Psychosocial Outcomes Among People Living With Hiv—A Systematic Review, H Han, K Kim, Jeanne Murphy, J Cudjoe, P Wilson, P Sharps, J Farley

Nursing Faculty Publications

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the …

Fusion, 2018, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Relative Roles Of Race Versus Socioeconomic Position In Studies Of Health Inequalities: A Matter Of Interpretation, Amani Nuru-Jeter, Elizabeth Michaels, Marilyn D. Thomas, Alexis Reeves, Roland Thorpe, Thomas A. Laveist

Health Policy and Management Faculty Publications

An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common …

Canada: Obesity, Marissa Olson

Global Public Health

Canada is a country with a relatively healthy population of approximately 37 million people. Canada has few major public health problems; however, Canada has experienced a rise of obesity in its population with a higher rise in the adult population than childhood. The male population is at a greater risk of becoming obese than the female population, and people 35 years old and over than below 35 years old. This brief discusses the effects of obesity, Canada’s interventions to obesity such as surgery, drugs, and healthier school lunches, and a possible new method of health counseling or more convenient healthier …

Bhutan: Human Trafficking, Cindy Osagie

Global Public Health

Human trafficking has been present in Bhutan for many years but has continued to increase along Bhutan’s borders. The reason for this increase can be contributed to the rise of vulnerable citizens. In particular, women and children are extremely susceptible to forced labor and sex trafficking. This brief further details the challenges, political structure, epidemiology, and also the intervention and identification of human trafficking in Bhutan. The increase of human trafficking can also be correlated to the rise in HIV/AIDS in Bhutan. The challenges that has stopped any progress in reducing human trafficking, is the government of Bhutan’s continuous denial …

The Gambia : Tuberculosis, Amen Belayneh

Global Public Health

Tuberculosis in the Gambia

This brief consists of some general information about Gambia, demographic information, the effects of tuberculosis in the country including the challenges brought forth by the disease, and some personal suggestions on the matter. From the general information on Gambia, we learn the location, political structure as well as major internal and external challenges faced by the country. Tuberculosis is one of the country’s major internal challenges in addition to its environmental and economic issues. Under the demographic information we get a broader idea of the Gambia people by looking at population demographic such as birth and …

Tonga: Chronic Diseases, Muhammad Taimoor

Global Public Health

Tonga is an Archipelago in the south Pacific Ocean, south of Samoa. The public health brief project is on chronic diseases in Tonga. The total population of Tonga was 107,122 in 2010. The Free Wesleyan Church of Tonga is the established religion in Tonga. Tongan’s make up the majority of the population but there are other ethnicities such as Euromericans and Europeans too. The major challenges faced by Tonga are decaying infrastructure, low economy, and political corruption. The widespread of non-communicable diseases such as cancer is a major health issue in Tonga. 74% of all adults in Tonga are the …

Seychelles: Diabetes, Camille Myers

Global Public Health

One of the major health problems in Seychelles, a cluster of islands off the coast of Eastern Africa, is diabetes. There are many different types of diabetes, but the most common type to this region is Type 2 diabetes. At this time Seychelles, and many other countries in Africa, have about half of the adult population diagnosed with Type 2 diabetes. Along with the diagnosis of diabetes being a problem, people in Seychelles often go undiagnosed for a while because they are ignorant to the risks and the symptoms of the disease. Only about 50% of the population with pre-diabetic …

Qatar: Diabetes, Diangelo Gonzalez

Global Public Health

The State of Qatar is a developed nation that is located in the Middle East and borders the Persian Gulf and Saudi Arabia. The nation is a constitutional monarchy and is currently led by Amir Tamim bin Hamad Al Thani. The 2,300,000+ people of Qatar face many major challenges. Although it is one of the wealthiest nations in the Middle East, Qatar faces issues of human trafficking, migrants willing to work in poor conditions, and Middle Eastern Respiratory Syndrome (MERS). The most critical issue that plagues this county is diabetes, both I and II. Diabetes is a disease that is …

Palau: Obesity, Tavia Weis

Global Public Health

Located in the heart of the Western Pacific Ocean is a large group of small islands that make up the country of Palau. Known for its growing tourism, beautiful landscapes, and cultural beliefs. Although the country is developing, the current health issue of obesity is a growing concern. With almost half of the population obese and the other half in jeopardy, the rising concerns of the obesity epidemic have taken global news and brought the attention of major countries to try and fix these rising issues. This public health brief will discuss the problems of obesity in Palau and the …

Infant Mortality: Sub-Saharan Africa, Danielle Rae Steffen

Global Issues in Public Health

Like much of the third world, the countries found in Sub-Saharan Africa have a distressingly high infant mortality rate compared to those recorded in places such as the United States and Europe. While there are many factors that play a role in the increased number of infant deaths in this region, lack of access to adequate healthcare for infants and their families is one of the main overarching causes. Although infant mortality rates remain high, there has been significant improvement in infant survival over the last several years which is largely due to the implementation of the Millennium Development Goals …

Obesity, Noah Rhodes

Global Issues in Public Health

Obesity is a worldwide issue that can be defined as a non-communicable condition which means that it is non-infectious and non-transmissible and it is defined as having a BMI over 30 even though BMI doesn’t account for the person’s muscle mass which causes some athletes to be considered obese just because they weigh a lot for their height. Diagnosing obesity can be a long process which includes a health history being taken, a general physical exam, calculation of BMI, and measuring waist circumference. Diagnosis of obesity also involves checking for problems such as high blood pressure, variation of cholesterol levels …

Childhood Obesity: United States, Jessica Nguyen

Global Issues in Public Health

Childhood obesity, a noncommunicable disease usually caused by consuming more energy in meals than your body needs, is often due to hereditary causes and the structure of their communities. With the average weight of American children increasing in the past thirty years, parents should be more informed on how to improve their offspring’s development and reduce the likelihood of chronic diseases. The Body Mass Index is the scale used to determine whether or not the child is considered overweight for their height and age, based off of their extra body fat. After comparing the child to the CDC growth charts, …

Type 2 Diabetes, Aj Mimlitz

Global Issues in Public Health

The purpose of this two page educational document is to inform not only educators, but also students about the description of type two diabetes and what populations are affected, the epidemiology of type 2 diabetes, including how get diagnosed and how that diagnosis will affect specific outcomes, and the solutions to how we can prevent or begin to cure type 2 diabetes. This brief project shows plenty of statistics revolving around these main points. Research shows that “type 2 diabetes already causes 5 million deaths per year, expecting to become the 7th cause of death globally by 2030” (Alidrisi & …

Food Insecurity: United States, Courtney Handzel

Global Issues in Public Health

Food insecurity is a global issue and has caused struggles to millions of people, specifically in the United States. This environmental issue involves not having the resources to obtain adequate food supply. The economic and social influences that affect food insecurity leave vulnerable populations, such as low-income families and minority races, at a greater disadvantage. This issue causes serious health complications to arise too, the most common being diabetes. The increased risk of diabetes due to food insecurity has been studied on several occasions and the results all show the correlation, lack of food security increases the risk of diabetes. …

Waking Up Every Day In A Body That Is Not Yours: A Qualitative Research Inquiry Into The Intersection Between Eating Disorders And Pregnancy, Elizabeth A. Claydon, Danielle M. Davidov, Keith J. Zullig, Christa L. Lilly, Lesley Cattrell, Stephanie C. Zerwas

Faculty & Staff Scholarship

Background: Women with eating disorders are more likely to negatively react to finding out they are pregnant, although this difference in attitudes between women with eating disorders and controls disappears at 18-weeks’ gestation. Those with anorexia also are twice as likely to have an unplanned pregnancy and those with bulimia have a 30-fold increased chance compared with healthy controls. Therefore, due to these considerations, pregnancy and the transition to motherhood can be an extremely challenging time for these women both psychologically and physically. The purpose of this qualitative descriptive study was to understand the intersection between eating disorders and pregnancy …

Rubella Immunity And Serum Perfluoroalkyl Substances: Sex And Analytic Strategy, Courtney S. Pilkerton, Gerald R. Hobbs, Christa Lilly, Sarah S. Knox

Faculty & Staff Scholarship

Background

Perfluoroalkyl substances (PFASs) have been associated with decreased immunity to child- hood tetanus and diphtheria immunizations. If these vaccinations are vulnerable to influence from PFASs, questions arise about associations with other common inoculations.

Objective

To examine whether serum PFASs were associated with reduced immunity to rubella immu- nization, and whether interactions with sex or ethnicity warranted analytic stratification. Usually, toxicology analyses are calculated controlling for race and sex. However, sex differ- ences in immune function have been reported and a reduction of immunity to rubella in women could pose risks such miscarriage.

Methods

We analyzed a nationally representative sample …

Food Choice Priorities Change Over Time And Predict Dietary Intake At The End Of The First Year Of College Among Students In The U.S., Melissa J. Vilaro, Sarah E. Colby, Kristin Riggsbee, Wenjun Zhou, Carol Byrd-Bredbenner, Melissa D. Olfert, Tracey E. Barnett, Tanya Horacek, Morgan Sowers, Anne E. Matthews

Faculty & Staff Scholarship

This study assessed food choice priorities (FCP) and associations with consumption of fruits and vegetables (FV), fiber, added sugars from non-beverage sources, and sugar-sweetened beverages (SSB) among college students. Freshmen from eight U.S. universities (N = 1149) completed the Food Choice Priorities Survey, designed for college students to provide a way to determine the factors of greatest importance regarding food choices, and the NCI Dietary Screener Questionnaire. Changes in FCP and dietary intake from fall 2015 to spring 2016 were assessed. Multiple regression models examined associations between FCP and log-transformed dietary intake, controlling for sex, age, race, and BMI. Participant …

The Complementary Health Approaches For Pain Survey (Chaps): Validity Testing And Characteristics Of A Rural Population With Pain, Termeh Feinberg, Dina L. Jones, Christa Lilly, Amna Umer, Kim Innes

Faculty & Staff Scholarship

Objectives

Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS).

Design

Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to com- plete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Trans- theoretical Model (TTM) underpinning to …

Perceived Benefits And Barriers Of A Community-Based Diabetes Prevention And Management Program, Samantha Shawley-Brzoska, Ranjita Misra

Faculty & Staff Scholarship

This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants’ perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% …

Vegetarian Diet And Cardiometabolic Risk Among Asian Indians In The United States, Ranjita Misra, Padmini Balagopal, Sudha Raj, Thakor G. Patel

Faculty & Staff Scholarship

Research studies have shown that plant-based diets confer cardiovascular and metabolic health benefits. Asian Indians (AIs) in the US (who have often followed plant-based diets) have elevated risk for chronic diseases such as diabetes, metabolic syndrome, and obesity suggesting ethnic vulnerability that imply genetic and/or lifestyle causative links. This study explored the association between this ethnic group and diabetes, obesity, and metabolic syndrome after controlling for demographics, acculturation, family history of diabetes, and lifestyle and clinical risk factors. The sample comprised of 1038 randomly selected adult AIs in seven US sites. Prevalence and metabolic syndrome was estimated, and obesity was …

The Inception Of A Prediabetes Prevention Program In County Government, Gregory R. Grier

Education Dissertations and Projects

With the increasing prevalence and high cost of treatment, diabetes places an enormous demand on economic resources. To combat this issue and rising health care costs,Cleveland County Government took a proactive approach and partnered with its local YMCA. The YMCA was contracted to provide Prediabetes Prevention and Diabetes Control program classes to County employees. The programs were designed to (a) decrease the A1c level of program participants, (b) lower health care costs for the County, and (c) provide education about prevention and maintenance.

The ultimate goal of the program was to assist county administration and staff in their efforts to …

Novel Caries Loci In Children And Adults Implicated By Genome-Wide Analysis Of Families, Manika Govil, Nandita Mukhopadhyay, Daniel E. Weeks, Eleanor Feingold, John R. Shaffer, Steven M. Levy, Alexandre R. Vieira, Rebecca L. Slayton, Daniel W. Mcneil, Robert J. Weyant, Richard J. Crout, Mary L. Marazita

Faculty & Staff Scholarship

Background: Dental caries is a common chronic disease among children and adults alike, posing a substantial health burden. Caries is affected by multiple genetic and environmental factors, and prior studies have found that a substantial proportion of caries susceptibility is genetically inherited.

Methods: To identify such genetic factors, we conducted a genome-wide linkage scan in 464 extended families with 2616 individuals from Iowa, Pennsylvania and West Virginia for three dental caries phenotypes: (1) PRIM: dichotomized as zero versus one or more affected primary teeth, (2) QTOT1: age-adjusted quantitative caries measure for both primary and permanent dentitions including pre-cavitated lesions, and …

Parent Perspectives On Health And Functioning Of School-Aged Adolescents With Disabilities, Gavin Colquit Edd, Cape, Cscs, Ashley D. Walker Phd, Ches, Moya L. Alfonso Phd, Msph, Maria Olivas Mph, Bethrand Ugwu Mph, Theophile Dipita Dr, Ph

United States Food and Drug Administration: Publications

BACKGROUND: Youth living with disabilities are at risk of experiencing poor health outcomes. Coordinated school health programs have an opportunity to help youth with disabilities and their families through health education, health services, and community engagement. The World Health Organization developed the International Classification of Functioning, Disability, and Health (ICF) as a framework to analyze factors related to health conditions. We used the ICF to examine parental perceptions of health and function among students with disabilities living in rural and urban areas.

METHODS: We surveyed parents (N = 71) using the parent-report versions of the Pediatric Outcomes Data Collection Instrument …

Mental Health Problems And Onset Of Tobacco Use Among 12- To 24-Year-Olds In The Path Study, Victoria R. Green Mhs, Kevin P. Conway Phd, Ches, Marushka L. Silveira Bds, Mph, Phd, Karin A. Kasza Ma, Amy Cohn Phd, K. Michael Cummings Phd, Mph, Cassandra A. Stanton Phd, Priscilla Callahan-Lyon Md, Wendy Slavit Mph, Ches, James D. Sargent Md, Nahla Hilmi Mph, Raymond S. Niaura Phd, Chad J. Reissig Phd, Elizabeth Lambert Ma, Izabella Zandberg Phd, Mary F. Brunette Md, Susanne E. Tanski Md, Nicolette Borek Phd, Andrew J. Hyland Phd, Wilson M. Compton Md, Mpe

United States Food and Drug Administration: Publications

Objective: To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults.

Method: This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2.

Results:In multivariable …

Etiology Of Teen Dating Violence Among Adolescent Children Of Alcoholics, Jennifer A. Livingston, Rina D. Eiden, Jared Lessard, Meghan Casey, James Henrie, Kenneth E. Leonard

United States Food and Drug Administration: Publications

Family processes in early life have been impli- cated in adolescent involvement in teen dating violence, yet the developmental pathways through which this occurs are not well understood. In this study, etiological pathways from parental psychopathology and marital conflict in infancy to involvement in dating violence in late adoles- cence were examined in a sample of children at high-risk due to parental alcohol problems. Families (N = 227) recruited when the child was 12 months of age were assessed at 12-, 24-, 36-months, kindergarten, 6th, 8th, and 12th grades. Slightly more than half of the children were female (51%) and …