Digital Commons Network^™

A Community Conversation On Adolescent Pregnancy And Parenting Services: Networks Of Support, Gatekeepers To Care, And Non-Compulsory Fathering In A Black Urban Community, Tamara Leech, Elizabeth A. Adams, Marci Littlefield

Department of Public Health Scholarship and Creative Works

This study employed Community-Based Participatory Research (CBPR) methods to document needs and capacity around adolescent pregnancy and parenting in one predominately Black, low-income urban community. Using an iterative focus group method, we engaged 60 participants in a two-day community conversation. Quantitative data from an enrollment questionnaire and qualitative transcripts of the discussions are analyzed. Our results indicate that the community’s greatest capacity lies in a network of women. Men tend to participate in parenting more holistically once formal paternity is established. Neighborhood women typically introduce adolescents to prenatal care, so delays in revealing the pregnancy to them serve as a …

Improving Public Health Safety Nets After An Economic Recession, Sanjay Basu

Center for Policy Research

When we say ‘here’s what’s going on with our nation’s health,’ how do we know the answer? Where is the data coming from? How can we best evaluate our public health system? We’re talking about it every day on CNN given the Ebola scare. What do we mean by our ‘public health system’? I would argue that we should expand our definition to mean something more than hospitals and clinics, or doctors and nurses. In particular, I’ll argue that some of our non-health programs that we have as part of the safety net actually make a bigger health impact than …

Health Advocacy Intervention For Youth : A Case Study Of Metro Youth Advocates., Tiffany Monyhan, Sasha Belenky, Kristi Mcclary King

Faculty and Staff Scholarship

No abstract provided.

Conceptualization Of Autism In The Latino Community And Its Relationship With Early Diagnosis, Katharine E. Zuckerman, Brianna Sinche, Martiza Cobian, Marlene Cervantes, Angie Mejia, Thomas Becker, Christina Nicolaidis

School of Social Work Faculty Publications and Presentations

Objective—Early identification of autism spectrum disorders (ASD) has been linked to improved long-term developmental outcomes. However, Latino children are diagnosed later than white non- Latino children. We aimed to qualitatively assess the understanding and conceptualization of ASD in the Latino community in order to understand potential community barriers to early diagnosis.

Method—We conducted 5 focus groups and 4 qualitative interviews with 30 parents of typicallydeveloping Latino children in Oregon. Participants were asked structured questions concerning video vignettes that follow a Latina mother from the time she begins to worry about her 3-year-old son's behaviors to the time he receives an …

Agency Of The South Sudanese: Compensating For Health Care In Mungula Refugee Settlement, Lauren Schmidt

Independent Study Project (ISP) Collection

In reaction to the endemic violence, which has forced many South Sudanese to flee their homes and seek refuge within Uganda’s borders, the researcher spent the practicum interning with the Uganda Red Cross Society (URCS) in Mungula refugee settlement, under academic advisor Steven Mawa. As the organization is the leading health provider in the settlement, the researcher gained insight into the provision of social services to the population, which allowed an extensive study on the ability of the South Sudanese to compensate for shortages in care and various complications associated with doing so.

The researcher sought to entertain these inquiries …

Antecedents Of Regular Exercise Among Women Who Do And Do Not Achieve Weight Loss Over Six Months, Heather Vartanian

Dissertations (1934 -)

In the United States, 35.5% of adult women are classified as obese, defined as a body mass index (BMI) of > 30 kg/m2. The health risks associated with obesity can be mitigated through losing even 5-10% of initial body weight. Evidence shows that reductions in caloric intake alone without increases in caloric expenditure leads to a decline in resting metabolic rate, thereby impeding attainment or maintenance of weight loss. The purpose of this cross-sectional, mixed-methods study was to explore the antecedents of regular exercise among women with obesity who did and did not achieve weight loss over six months. The antecedents …

International Occupational Health Research On An "Invisible" Workforce, Martin D. Slade, Rafael Lefkowitz

Yale Day of Data

There are many professions in which employees are located in remote locations. International maritime workers make up one such occupation. They are a vulnerable, underserved and neglected population of approximately 1.2 million people with high rates of disease and injury. During their typical nine month deployments, they live in relative isolation with no health care professional on board. To understand the root causes of disease and injury among this remote workforce, strategies to collect information, analyze data, and report results and recommendations have been developed. These strategies, which include gathering of data through an alliance of companies involved in seafaring, …

Understanding Factors Determining Early Termination From A Government Assistance Program For Maternal And Child Health: The Special Supplemental Nutrition Program For Women, Infants And Children (Wic), Anthony Dominic Panzera

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation is to understand why individuals enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) fail to retrieve food vouchers, miss WIC appointments, and become inactive in program components. In Kentucky, mothers who fail to pick up food instruments for 60 days are automatically terminated from the program. The specific research questions that guided this study are: (1) Which segments of enrollees are at greatest and least risks of nonparticipation in the WIC program? (2) How do predisposing, enabling and need characteristics impact WIC nonparticipation among eligible mothers? (3) How do WIC …

The Historic Role Of Boards Of Health In Local Innovation: New York City’S Soda Portion Case, Lawrence O. Gostin, Belinda H. Reeve, Marice Ashe

Georgetown Law Faculty Publications and Other Works

Childhood and adult obesity pose major risks for cancer, diabetes, and cardiovascular disease, with the poor and racial minorities suffering from disproportionately high burdens of obesity and chronic disease. With current policies failing, cities and states have moved forward with creative prevention measures–-with boards of health driving policy innovation in many local jurisdictions. The New York City Board of Board of Health’s (NYCBH) soda portion limit pushed the boundaries of innovation, but was struck down on June 26, 2014 by New York State’s highest court, which held that the Board trespassed on the City Council’s authority.

The Court’s decision ignored …

A Dietary-Wide Association Study (Dwas) Of Environmental Metal Exposure In Us Children And Adults, Matthew A. Davis, Diane Gilbert-Diamond, Margaret R. Karagas, Zhigang Li, Jason H. Moore, Scott M. Williams, H. Robert Frost

Dartmouth Scholarship

Background: A growing body of evidence suggests that exposure to toxic metals occurs through diet but few studies have comprehensively examined dietary sources of exposure in US populations.

Purpose: Our goal was to perform a novel dietary-wide association study (DWAS) to identify specific dietary sources of lead, cadmium, mercury, and arsenic exposure in US children and adults.

Methods: We combined data from the National Health and Nutrition Examination Survey with data from the US Department of Agriculture’s Food Intakes Converted to Retail Commodities Database to examine associations between 49 different foods and environmental metal exposure. Using blood and urinary biomarkers …

Parental Feeding Behavior: Influences On Elementary Children's Health, Cydni Martin, Jennifer Paquin, Helen W. Bland

GS4 Student Scholars Symposium

The purpose of this study was to assess the nutrition and physical activity of children. The hypothesis was that parental feeding styles will influence the healthy eating habits and physical activity among children. Childhood obesity has been called one of the most serious public health challenges of the 21st century (World Health Organization, n.d). In the past 30 years, childhood obesity has more than doubled in children and tripled in adolescents (Centers for Disease Control and Prevention, 2013). The research design used was a quantitative, descriptive, non-experimental, self-reported study in which a 27-question survey measured the parents’ child feeding behavior …

Seasonality Of Birth Outcomes In Rural Sarlahi District, Nepal: A Population-Based Prospective Cohort, Michelle M. Hughes, Joanne Katz, Luke C. Mullany, Subarna K. Khatry, Steven C. Leclerq, Gary L. Darmstadt, James M. Tielsch

Global Health Faculty Publications

Background

While seasonality of birth outcomes has been documented in a variety of settings, data from rural South Asia are lacking. We report a descriptive study of the seasonality of prematurity, low birth weight, small for gestational age, neonatal deaths, and stillbirths in the plains of Nepal.

Methods

Using data collected prospectively during a randomized controlled trial of neonatal skin and umbilical cord cleansing with chlorhexidine, we analyzed a cohort of 23,662 babies born between September 2002 and January 2006. Project workers collected data on birth outcomes at the infant’s household. Supplemental data from other studies conducted at the same …

Racial And Ethnic Disparities In Time To Cure Of Incontinence Present At Nursing Home Admission, Donna Z. Bliss, Olga Gurvich, Kay Savik, Lynn Eberly, Susan Harms, Jean F. Wyman

Journal of Health Disparities Research and Practice

Abstract

As many as half of older people that are admitted to nursing homes (NHs) are incontinent of urine and/or feces. Not much is known about the rate of cure of incontinence present at NH admission, but available reports suggest the rate is low. There have been racial and ethnic disparities in incontinence treatment, but the role of disparities in the cure of incontinence is understudied. Using the Peters-Belson method and multilevel predictors, our findings showed that there were disparities in the time to cure of incontinence for Hispanic NH admissions. A significantly smaller proportion of older Hispanic admissions were …

Internet Use For Health Information Among American Indians: Facilitators And Inhibitors, Melissa K. Filippi, Christina M. Pacheco, Charlotte Mccloskey, Rebecca Jeanne Crosthwait, Justin Begaye, Jb Kinlacheeny, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD^© more than any other …

Community Health Centers: A 2012 Profile And Spotlight On Implications Of State Medicaid Expansion Decisions, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2012 nearly 1,200 federally funded community health centers were providing access to care for a predominantly low-income population in medically underserved areas across the country. As health insurance coverage expands under the Affordable Care Act (ACA) and the demand for primary care increases, the role of health centers is likely to increase, and the ACA’s large investment in the health center program provides new resources to help meet growing needs.

This brief provides a pre-ACA snapshot of health centers that can help in understanding the impact of state decisions about the ACA Medicaid expansion on health centers as health …

Prevalence And Determinants Of Unintended Childbirth In Ethiopia, Yibeltal Tebekaw, Bezuhan Aemro, Charles Teller

Global Health Faculty Publications

Background

Ethiopia’s population policy specifically aims to reduce TFR from 7.7 to 4.0 and to increase contraceptive use from 4.0% to 44.0% between 1990 and 2015. In 2011, the use of contraceptive methods increased seven-fold from 4.0% to 27%; and the TFR declined by 38% to 4.8. The use of modern contraceptives is, however, much higher in the capital Addis Ababa (56%) and other urban areas but very low in rural areas (23%) far below the national average (27%). In 2011, one in four Ethiopian women had an unmet need for contraception. The main aim of this study was to …

Approaches To Improve Quality Of Care (Qoc) For Women And Newborns: Conclusions, Evidence Gaps And Research Priorities, Zulfiqar Ahmed Bhutta, Rehana A. Salam, Zohra S. Lassi, Anne Austin, Ana Langer

Department of Paediatrics and Child Health

Despite progress in recent years, an estimated 273,500 women died as a result of maternal causes in 2010. The burden of these deaths is disproportionately bourne by women who reside in low income countries or belong to the poorest sectors of the population of middle or high income ones, and it is particularly acute in regions where access to and utilization of facility-based services for childbirth and newborn care is lowest. Evidence has shown that poor quality of facility-based care for these women and newborns is one of the major contributing factors for their elevated rates of morbidity and mortality. …

Pattern Of Household Drug Storage, Retno Gitawati

Kesmas

Household storage of pharmaceutical is world-widely practice, including in Indonesia. The purpose of this study was to obtain the pattern of medicine storage, the sources and reasons of medicine kept in households. Acrosssectional survey was conducted on October 2011, involving 250 adult household respondents, randomly selected from three subdistricts in North Jakarta, and have approved the written consents, and interviewed with structured questionnaire. Data were performed in univariate and bivariate analysis with chi square test. The majority of household (82%) stored drugs at home; analgesic-antipyretic nonsteroidal anti-inflammatory was the type of drugs kept by mostly (76.1%) of household. Out of …

Family Role Towards Smoking Behaviour Among Children In Jakarta, Wahyu Septiono, Dan Wolf Meyrowitsch

Kesmas

In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified factors related to smoking behaviour among 8 – 12 years old children in Jakarta, Indonesia using a questionnaire based cross sectional survey to obtain smoking status and possible predictors towards smoking habit. The total sample size was 1,097 students among 3rd - 7th grade students from schools in Jakarta. Self-reported smoking status was defined as whether the …

Asupan Karbohidrat Sebagai Faktor Dominan Yang Berhubungan Dengan Kadar Gula Darah Puasa, Aprilya Roza Werdani, Triyanti Triyanti

Kesmas

Peningkatan kadar gula darah memicu peningkatan produksi hormon insulin yang erat hubungannya dengan diabetes melitus. Berdasarkan data Riskesdas, prevalensi diabetes melitus di Indonesia meningkat dari 1,1% (2007) menjadi 2,1% (2013). Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kadar gula darah puasa pegawai pemberdayaan masyarakat & keluarga dan pegawai sekretariat daerah Kota Depok. Desain penelitian yang digunakan adalah potong lintang dan melibatkan 105 sampel. Variabel independen penelitian meliputi karakteristik individu, asupan zat gizi, hipertensi, aktivitas fisik, status gizi dan pengetahuan gizi. Analisis data yang dilakukan adalah analisis univariat, analisis bivariat menggunakan uji korelasi dan uji beda dua mean, …

Asupan Vitamin D Rendah Dan Keparahan Demam Berdarah Dengue Pada Anak Usia 1-14 Tahun, Nur Siyam, Siswanto Agus Wilopo, Mohammad Hakimi

Kesmas

Demam berdarah dengue (DBD) menimbulkan syok dan kematian. Penderita DBD di Yogyakarta sebagian besar usia 1 - 12 tahun dengan DBD parah. Asupan vitamin D rendah diasumsikan penyebab DBD parah. Asumsi ini perlu dibuktikan dengan menganalisis pengaruh asupan Vitamin D dan keparahan DBD. Rancangan penelitian adalah studi kasus kontrol. Penelitian di bangsal rawat inap anak dan instalasi catatan medik RS Jogja dan RSUP Dr. Sardjito. Kasus adalah anak usia 1 - 14 tahun dengan DBD grade III & IV, kontrolnya DBD grade I & II. Data asupan vitamin D diambil dengan food frequency questionnaire (FFQ). Variabel luar adalah indeks massa …

Optimalisasi Sistem Pelayanan Kesehatan Berjenjang Pada Program Kartu Jakarta Sehat, Fachmi Idris

Kesmas

Peningkatan jumlah kunjungan pasien ke rumah sakit pada awal masa pemberlakuan program Kartu Jakarta Sehat (KJS) disebabkan belum optimalnya sistem pelayanan kesehatan berjenjang. PT Asuransi Kesehatan (PT Askes) bersama Dinas Kesehatan DKI Jakarta melakukan berbagai upaya dalam bentuk paket intervensi untuk mengoptimalkan sistem tersebut. Penelitian ini bertujuan untuk mengevaluasi efektivitas paket intervensi PT Askes dan Dinas Kesehatan DKI Jakarta dalam meningkatkan optimilisasi sistem rujukan pelayanan kesehatan. Penelitian ini menggunakan survei potong lintang dengan metode pengambilan sampel acak pada puskesmas di DKI Jakarta terhadap hasil intervensi PT Askes. Hasil intervensi diukur melalui wawancara pada kepala puskesmas atau petugas yang mewakili. Data …

Penelitian Genom Dan Implikasinya Dalam Kesehatan Masyarakat Di Indonesia, Doni Hikmat Ramdhan

Kesmas

Penelitian genom yang mengkaji kaitan antara setiap gen dengan suatu penyakit sekaligus mekanismenya untuk mendapatkan pengetahuan yang menyeluruh dalam pengobatan, telah membawa perubahan besar dunia kedokteran dalam mengobati berbagai penyakit. Namun demikian, penelitian genom seharusnya tidak hanya dimanfaatkan untuk pengobatan tetapi juga untuk pencegahan penyakit. Artikel ini membahas masalah kesehatan masyarakat dan peluang pemanfaatan penelitian genom dalam pencegahan penyakit. Penelitian genom yang dapat dimanfaatkan pada bidang kesehatan masyarakat adalah toksikogenomik dan nutrigenomik. Penelitian toksikogenomik mengkaji respons gen akibat pajanan toksikan yang berdampak pada kesehatan manusia. Penelitian nutrigenomik mengkaji respons gen terhadap makanan yang berdampak pada kesehatan manusia. Penelitian toksikogenomik dan …

Pengaruh Pendekatan Child Healthcare Modeldan Transtheoretical Model Terhadap Asupan Makan Anak Overweight Dan Obesitas, Kadek Ayu Erika, Elly Nurachmah

Kesmas

Overweight dan obesitas pada anak merupakan suatu masalah yang kompleks disebabkan multifaktor, yaitu interaksi genetik dan lingkungan. Gaya hidup perkotaan dipicu oleh asupan makanan yang berlebih pada anak overweight dan obesitas. Strategi untuk menurunkan asupan makan berlebih pada anak adalah dengan pendekatan child healthcare model dan transtheoretical model sehingga dapat mengendalikan gaya hidup anak. Penelitian ini bertujuan membuktikan pengaruh pendekatan child healthcare dan transtheoretical model terhadap asupan karbohidrat anak overweight dan obesitas. Penelitian ini dilaksanakan di wilayah kecamatan Biringkanaya dan Tamalanrea, Makassar, pada bulan Agustus 2013 sampai Maret 2014. Desain yang digunakan adalah quasy experiment yaitu pretest and posttest with …

Tingkat Pengetahuan Dan Persepsi Terhadap Shisha Pada Mahasiswa, Dhimas Nirwana Yudha, Yayi Suryo Prabandari, Purwanta Purwanta

Kesmas

Isu yang berkembang terkait pengetahuan dan persepsi seorang calon tenaga kesehatan memengaruhi keberhasilan pelayanan kesehatan dalam menjawab tantangan di masyarakat nantinya. Shisha (rokok dari Timur Tengah) mulai marak di Yogyakarta. Tujuan penelitian ini untuk memperoleh gambaran tentang tingkat pengetahuan dan persepsi terhadap shisha pada mahasiswa reguler tahap akademik Fakultas Kedokteran Universitas Gadjah Mada. Penelitian ini merupakan penelitian deskriptif menggunakan rancangan potong lintang. Sampel penelitian adalah mahasiswa dari tiga program studi yang dilakukan pada bulan September - Oktober 2013. Jumlah responden sebanyak 72 mahasiswa ilmu keperawatan, 74 mahasiswa gizi dan kesehatan dan 258 mahasiswa pendidikan dokter. Pengumpulan data dilakukan dengan kuesioner. …

Diagnosis Dini Tuberkulosis Pada Kontak Serumah Dengan Penderita Tuberkulosis Paru Melalui Deteksi Kadar Ifn-Γ, Sri Andarini Indreswari, Suharyo Suharyo

Kesmas

Tuberkulosis paru masih merupakan masalah dunia. Indonesia menempati peringkat ke tiga di dunia pada tahun 2012. Target nasional Case Detection Rate tahun 2012 adalah 70%, sedangkan pencapaian Jawa Tengah sebesar 58,48%. Penelitian ini bertujuan untuk memperoleh batas kadar interferon (IFN) γ pada orang kontak serumah dengan penderita tuberkulosis paru sebagai dasar diagnosis dini penyakit tuberkulosis. Penelitian dilakukan secara kohort selama dua tahun (2011 - 2013) di Balai Kesehatan Masyarakat Paru Semarang. Pada akhir penelitian, terdapat 12 responden kontak dan 13 tidak kontak serumah. Uji Wilcoxon menunjukkan perbedaan bermakna rerata kadar IFN-γ antara kelompok kontak dengan kelompok tidak kontak serumah (nilai …

Peningkatan Determinan Sosial Dalam Menurunkan Kejadian Tuberkulosis Paru, Dyah Wulan Sumekar Rengganis Wardani

Kesmas

Upaya pengendalian tuberkulosis paru oleh World Health Organization telah meningkatkan angka kesembuhan dan menyelamatkan banyak jiwa, tetapi kurang berhasil dalam menurunkan insiden tuberkulosis. Oleh karena itu, pengendalian tuberkulosis akan lebih menekankan pada kebijakan determinan sosial karena determinan sosial secara langsung maupun melalui faktor risiko tuberkulosis berpengaruh terhadap tuberkulosis. Di Bandar Lampung, angka notifikasi tuberkulosis dari tahun 2009 – 2010 mengalami peningkatan walaupun angka kesembuhan sudah lebih dari 85%. Bandar Lampung juga merupakan bagian dari salah satu provinsi termiskin di Indonesia. Penelitian ini bertujuan untuk mempelajari pengaruh determinan sosial (yang diukur melalui indikator pendidikan, pendapatan dan kelas sosial) terhadap kejadian tuberkulosis. …

Pertumbuhan Dan Perkembangan Anak Usia 3-24 Bulan Di Daerah Konflik, Hastuti Usman, Hadyana Sukandar, Ma’Mun Sutisna

Kesmas

Lima tahun pertama adalah masa penting dalam proses tumbuh kembang anak. Anak lahir dan tinggal di daerah rawan bencana (bencana alam, perang, atau konflik bersenjata) berisiko mengalami kegagalan pertumbuhan dan keterlambatan perkembangan. Penelitian ini bertujuan mengukur perbedaan pertumbuhan dan perkembangan anak usia 3 - 24 bulan antara yang tinggal di daerah konflik dan bukan konflik dan menganalisis korelasi tempat tinggal daerah konflik dengan pertumbuhan serta perkembangan anak usia 3 - 24 bulan. Metode penelitian secara potong lintang dilakukan di Kabupaten Poso periode Februari - Maret 2014 terhadap 40 anak usia 3 - 24 bulan di daerah konflik dan bukan konflik. …

Malnutrisi Akut Berat Dan Determinannya Pada Balita Di Wilayah Rural Dan Urban, Titih Huriah, Laksono Trisnantoro, Fitri Haryanti, Madarina Julia

Kesmas

Malnutrisi akut berat merupakan malnutrisi yang paling serius yang memengaruhi balita dan merupakan masalah kesehatan utama di negara-negara berkembang. Malnutrisi telah meluas baik di perkotaan maupun perdesaan. Akar permasalahan malnutrisi di negara berkembang salah satunya adalah faktor sosial demografi. Tujuan penelitian untuk melihat perbedaan kejadian malnutrisi dan determinannya di area perkotaan dan pedesaan di Yogyakarta. Penelitian menggunakan desain potong lintang dengan responden adalah semua balita malnutrisi akut berat di Kabupaten Sleman (23 balita) dan Kota Yogyakarta (33 balita). Analisis data menggunakan statistik deskriptif dan inferensial. Penelitian dilaksanakan pada Bulan Desember 2012 - Februari 2013. Prevalensi balita malnutrisi akut lebih banyak …

Pendapatan Daerah, Pembiayaan Kesehatan, Dan Gizi Buruk Pada Balita: Studi Korelasi Tingkat Kabupaten/Kota, Septyana Choirunisa, Asri C. Adisasmita

Kesmas

Pendanaan kesehatan merupakan salah satu faktor penting dalam memengaruhi derajat kesehatan, termasuk salah satu masalah gizi pada balita yang disebut gizi buruk. Oleh karena itu, penelitian ini bertujuan mendeskripsikan pendapatan daerah dan pembiayaan kesehatan serta korelasinya dengan gizi buruk pada balita di tingkat kabupaten/kota di Indonesia tahun 2007. Penelitian ini merupakan studi ekologi/korelasi. Data pendapatan daerah dan pembiayaan kesehatan didapat dari Kementerian Keuangan, sedangkan data gizi buruk menggunakan data Riset Kesehatan Nasional tahun 2007. Sebanyak 250 kabupaten/kota yang diteliti dengan tidak mengikutsertakan kabupaten/kota yang datanya tidak lengkap atau tidak valid. Secara nasional, hanya persentase pendapatan asli daerah (PAD) per total …