Digital Commons Network^™

Adolescent Girls Empowerment Programme: Research And Evaluation Baseline Technical Report, Paul C. Hewett, Karen Austrian, Erica Soler-Hampejsek, Jere R. Behrman, Christine A. Kelly, Dela Kusi-Appouh, Fiammetta Bozzani, Barbara Mensch, Minyoi Maimbolwa

Poverty, Gender, and Youth

The theory of change behind the Adolescent Girls Empowerment Program (AGEP) posits that adolescent girls are empowered by acquiring social, health, and economic assets. Girls can draw on these assets to reduce vulnerabilities and expand opportunities, thereby increasing their likelihood of completing school, delaying sexual debut, and reducing the risk of early marriage, unintended pregnancy, acquisition of HIV, and so on. AGEP serves vulnerable adolescent girls in Zambia aged 10–19 in two age cohorts: 10–14-year-olds and 15–19-year-olds. AGEP operates in ten “master sites,” five urban and five rural, in four provinces of Zambia. The three core components of AGEP in …

Urbanization And Land-Use Change In Puerto Maldonado, Peru: Categorizing The Landscape Using High-Resolution Satellite Imagery For Potential Use In Public Health Research, Laura Brianna Gast

All ETDs from UAB

Environmental change, especially rapid urbanization, has measurable effects on human health. Over 70 percent of the global population is expected to live in urban areas by 2025, and at least 1 in 3 of these individuals will live in extreme poverty. Living in a slum or shantytown exposes individuals to health and safety risks including inadequate sanitation, lack of access to clean water, air pollution, violence, over-crowding and risk of infectious disease. Remote sensing technologies are an effective tool for detection and prediction of areas with significant land use change, which enables identification of populations with the highest risk of …

The Increasing Weight Of Regulation: Countries Combat The Global Obesity Epidemic, Allyn L. Taylor, Emily W. Parento, Laura A. Schmidt

Georgetown Law Faculty Publications and Other Works

Obesity is a global epidemic, exacting an enormous human and economic toll. In the absence of a comprehensive global governance strategy, states have increasingly employed a wide array of legal strategies targeting the drivers of obesity. This article identifies recent global trends in obesity-related legislation and makes the normative case for an updated global governance strategy.

National governments have responded to the epidemic both by strengthening traditional interventions and by developing novel legislative strategies. This response consists of nine important trends: (1) strengthened and tailored tax measures; (2) broader use of counter-advertising and health campaigns; (3) expanded food labeling; (4) …

Evaluation Of The Impact Of The Voucher Program For Improving Maternal Health Behavior And Status In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Syed Abu Jafar Md. Musa, Ashish Bajracharya, Kaji Tamanna Keya, Forhana Rahman Noor, Eshita Jahan, Md. Irfan Hossain, Jyotirmoy Saha, Benjamin Bellows

Reproductive Health

Vouchers, a demand-side financing (DSF) instrument for health-care services, were introduced in Bangladesh in 2006. The DSF program grants vouchers to pregnant women to receive free antenatal, delivery, and postpartum care services as well as free medicine, and financial assistance is provided for transportation. Deliveries with skilled service providers are financially incentivized and providers are reimbursed for their services from a special fund. After piloting DSF initially in 21 subdistricts (upazilas), the government expanded it to another 12 upazilas in 2007 (the second phase), and in its third phase in 2010 the program was expanded to another 11 upazilas. To …

Assessing The Potential Market For A Progesterone Contraceptive Vaginal Ring (Pcvr) As A New Contraceptive Option In Sub-Saharan Africa Using Needs-Based Market Segmentation, Francis Obare, Deepa Rajamani, Saumya Ramarao

Reproductive Health

Developing countries, especially in sub-Saharan Africa, have disproportionately high unmet contraceptive needs compared to other regions, and especially high levels of unmet need for spacing pregnancies. To address some of sub-Saharan Africa’s barriers to effective contraception, there is renewed focus on new methods that offer greater ease of use. New methods under investigation would not require daily action, their use would be controlled by women themselves, and they would require no medical providers or significant health-system infrastructure for service delivery. Contraceptive vaginal rings hold great potential by offering not only ease of use but a safe and effective FP solution. …

Facilitator's Guide For Training On Monitoring And Evaluation Of Social And Behavior Change Communication Health Programs, Praween Kumar Agrawal, Kumudha Aruldas, M.E. Khan, Subrato Mondal

Reproductive Health

Social and behavior change communication (SBCC) interventions are now incorporated within state project implementation plans and increasing resources are being allocated for SBCC activities. A close monitoring of SBCC activities and an evaluation in terms of reach and effectiveness among intended audiences is thus necessary. This calls for a serious effort to build the capacity of monitoring and evaluation (M&E) personnel to monitor and evaluate performance of SBCC activities. FHI 360’s Improving Healthy Behaviors Program, funded by USAID, aims to provide technical assistance to strengthen the capacities of public program managers at the national, state, and district level to monitor …

Maternal Health Commodity Landscaping Exercise: A Snapshot Of The Bangladesh Program, Sharif M.I. Hossain, Saumya Ramarao, Ismat Ara Hena, Ubaidur Rob

Reproductive Health

Despite consistent efforts of the government and national stakeholders, every year in Bangladesh over 5,000 mothers and thousands of children die. Most of these deaths would be preventable with increased access to quality services including existing medicines and other health commodities. The United Nation’s Commission on Life-Saving Commodities for Women and Children suggests that an important cause of these deaths is lack of access and appropriate use of 13 life-saving commodities. This document describes an effort by the Population Council to assess the country’s policies, guidelines, and availability for these 13 life-saving commodities as well as engaging with key stakeholders …

Reaching The Unreached Through Community Mobilization In An Innovative And Sustainable Way, Arupendra Mozumdar, M.E. Khan, Subrato Mondal

Reproductive Health

This study shows the potential of Self Help Groups (SHGs) to deliver health messages that increase women’s knowledge. The intervention for this operations research (OR) study included a day-long training for Swasth Sakhis in the experimental area. A total of 11 trainings were organized, all conducted by Population Council staff. Before the intervention, at baseline, 803 women from eligible households were interviewed for the quantitative assessment. At endline, 470 women were followed up. Additionally, 16 in-depth interviews with women, Swasth Sakhis, and Rajiv Gandhi Mahila Vikas Pariyojana staff were conducted in the experimental area to understand how the intervention was …

Sexual And Reproductive Health Of Women Living With Hiv In Egypt: Unmet Needs And Unfulfilled Dreams, Doaa Oraby, Nahla G. Abdel-Tawab

Reproductive Health

The gender profile of the HIV/AIDS epidemic has changed since it emerged 30 years ago when infections were concentrated in key populations of men such as injecting drug users and men who have sex with men. In 2012, women accounted for nearly 50 percent of the estimated 35.3 million people living with HIV/AIDS globally. In the Middle East and North Africa, 44 percent of infected adults are women. The past 30 years have also witnessed remarkable improvements in access to high-quality information and medical services, including services for prevention of mother-to-child transmission of the virus. With care and treatment for …

Prevalence Of Unintended Pregnancy And Needs For Family Planning Among Married Adolescent Girls Living In Urban Slums Of Dhaka, Bangladesh, Fauzia Akhter Huda, Sabiha Chowdhuri, Bidhan Krishna Sarker, Noushin Islam, Anisuddin Ahmed

Reproductive Health

This STEP UP research report examined the prevalence and basic underlying factors of unintended pregnancy among married adolescent girls in five urban slums in Dhaka, Bangladesh. The specific objectives of the study were to: 1) document the prevalence of unintended pregnancy among married adolescent girls aged 15–19 years living in urban slums of Dhaka; 2) identify the factors associated with or which contribute to unintended pregnancy among urban married adolescent girls; 3) estimate the proportion of married adolescent girls who have an unmet need for family planning (FP) services; and 4) explore the barriers to access and effective use of …

Unintended Pregnancy And Abortion In India: Country Profile Report, Mary Philip Sebastian, M.E. Khan, Daliya Sebastian

Reproductive Health

A review of literature and analysis of large surveys were carried out with funding from the STEP UP consortium led by Population Council to build a coherent body of robust research-based evidence on the situation in India in the context of unmet need for family planning (FP) and safe abortion services. The study found that there is insufficient training of different cadres of health staff in the public health system on abortion provision, post-abortion care, FP counseling of young couples, emergency contraception, and IUD insertion/removal. Despite service delivery guidelines in India expecting providers to provide FP counseling during antenatal visits, …

Clinical Features, Proximate Causes, And Consequences Of Active Convulsive Epilepsy In Africa, Symon M. Kariuki, William Matuja, Albert Akpalu, Angelina Kakooza-Mwesige, Martin Chabi, Ryan G. Wagner, Myles Connor, Eddie Chengo, Anthony K. Ngugi, Rachael Odhiambo, Christian Bottomley, Steven White, Josemir W. Sander, Brian G. R. Neville, Charles R. J. C. Newton

Internal Medicine, East Africa

Purpose: Epilepsy is common in sub-Saharan Africa (SSA), but the clinical features and consequences are poorly characterized. Most studies are hospital-based, and few studies have compared different ecological sites in SSA. We described active convulsive epilepsy (ACE) identified in cross-sectional community-based surveys in SSA, to understand the proximate causes, features, and consequences.

Methods: We performed a detailed clinical and neurophysiologic description of ACE cases identified from a community survey of 584,586 people using medical history, neurologic examination, and electroencephalography (EEG) data from five sites in Africa: South Africa; Tanzania; Uganda; Kenya; and Ghana. The cases were examined by clinicians to …

The Associations Between Homa-Ir And Muscular Strengthening Activity In Euglycemic U.S. Adults, William Robert Boyer Ii

UNF Graduate Theses and Dissertations

Background: Muscular strengthening activity (MSA) has been shown to be inversely associated with insulin resistance (IR). The associations between quartiles of the homeostatic model assessment of insulin resistance (HOMA-IR) and self-reported MSA in a nationally representative sample of euglycemic U.S. adults were examined.

Methods: Sample included adult participants (≥20 years of age [n=2,543]) from the 1999-2004 National Health and Nutrition Examination Survey (NHANES). HOMA-IR was categorized into quartiles based on every 25^th percentile. No MSA was the dependent variable.

Results: Following adjustment for covariates, those with HOMA-IR values in third (p

Conclusions: Having a higher HOMA-IR value is associated …

The Association Between The Social Context Of Mealtime, Children's Diet, Caregiver's Experiences With Discrimination And Household Food Insecurity, Michael Patrick Burke

Theses and Dissertations

The social context of mealtime---defined as the social interactions and practices during mealtime---plays an important role in children's diet. Household food insecurity disrupts or causes worry about the household food supply, and therefore may negate the positive effect of the social context of meals; however, little research has examined household food security and the social context of mealtime. The purpose of this study was to examine the association between various aspects of the social context of mealtime---dietary modeling, parenting style, eating together, mealtime screen time, and priority and atmosphere of mealtime---and dietary quality among children within food-insecure households. The results …

Preventing Childhood Obesity: A Mixed Methods Study Into The Perceptions Of African Americans In A Rural Community, Dayna S. Alexander

College of Graduate Studies: Theses & Dissertations

Preventing childhood obesity is a global priority due to adverse health risks and financial burdens. With childhood obesity rates stabilizing it is difficult to determine which factors alone (i.e., genetic, environmental, behavioral, or demographic) increase susceptibility to childhood obesity. Parents influence childhood obesity risk factors through their parenting styles and behaviors. Social behavioral theories and public health evidence demonstrate including parents in childhood obesity efforts could assist in reducing childhood obesity rates. The objective of this study was to assess perceptions of childhood obesity among African Americans with children enrolled in a rural elementary school in the Deep South. The …

Maternal And Newborn Health Behaviors In Rural Uttar Pradesh: Findings From Learning Phase Baseline Survey 2013, M.E. Khan, Praween Kumar Agrawal, Avishek Hazra, Anvita Dixit, Isha Bhatnagar, Jaleel Ahmad, D.N. Ahmad

Reproductive Health

The Uttar Pradesh Community Mobilization Project (2011–16) aims to develop and scale up evidence-based interventions to improve reproductive, maternal, neonatal, and child health and nutrition health behaviors by an average of 10 percentage points among marginalized populations in Uttar Pradesh, India. The goal is to reduce neonatal mortality by improving maternal and child health behaviors through developing and scaling up a package of family health interventions and strengthening the management of Behavior Change Communication using self-help groups as the platform. The project is being carried out in two phases—a learning phase covering 10 blocks and a scale-up phase covering 100 …

Posters From The 2014 Michigan Epidemiology Conference, Talat Danish

Michigan Journal of Public Health

Poster session presenters from the annual Michigan Epidemiology Conference were invited to submit their posters for publication in the Michigan Journal of Public Health. Submissions were accepted from two authors on subjects much in health news and very relevant to public health. One poster looks at NHANES data for use of energy drinks with interesting recommendations for future research, and the other poster attempts to predict health care costs associated with hospital acquired Methicillin Resistant Staph. Aureus and Clostridium Difficile infections.

Posters included:

The MDCH SHARP MRSA?CDI Prevention Initiative: A Cost Analysis

Noreen Mollon, MS, Bryan Buckley, MPH, Gail Denkins, …

Coverage And Quality Of Antenatal Care Provided At Primary Health Care Facilities In The ‘Punjab’ Province Of ‘Pakistan’, Muhammad Ashraf Majrooh, Seema Hasnain, Javaid Akram, Arif Siddiqui,, Zahid Memon

Centre of Excellence in Women and Child Health

Background: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In ‘Pakistan’ antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to ‘Divisions’ and ‘Districts’. By population ‘Punjab’ is the largest province of Pakistan having …

Certified Personal Trainers And Physicians: An Evaluation Of Consumer Preference, Influence, And Decision Making On Intent To Use A Weight-Loss Medication, Linda Lemgruber Lobb

Electronic Theses and Dissertations

In health-related behavioral decision-making, the Theory of Planned Behavior (TPB) posits that attitudes toward a behavior are the function of three metrics: beliefs and strengths of beliefs toward the behavior, subjective norms around the behavior and locus of control for the individual (Ajzen, 1988). The purpose of this research was to identify the extent to which consumers would accept the recommendation of taking weight-loss medications, based on the source of the recommendation. Research shows that the source of knowledge for information plays a significant role in health-related decision-making of consumers (Pornpitakpan, 2004). In comparison to traditional weight-loss methods such as …

Massachusetts Healthy Aging Data Report: Community Profiles, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Stacey Mann

Gerontology Institute Publications

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation.

In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, …

Humidity And Gravimetric Equivalency Adjustments For Nephelometer-Based Particulate Matter Measurements Of Emissions From Solid Biomass Fuel In Cookstoves, Sutyajeet Soneja, Chen Chen, James M. Tielsch, Joanne Katz, Scott L. Zeger, William Checkley, Frank C. Curriero, Patrick L. Breysse

Global Health Faculty Publications

Great uncertainty exists around indoor biomass burning exposure-disease relationships due to lack of detailed exposure data in large health outcome studies. Passive nephelometers can be used to estimate high particulate matter (PM) concentrations during cooking in low resource environments. Since passive nephelometers do not have a collection filter they are not subject to sampler overload. Nephelometric concentration readings can be biased due to particle growth in high humid environments and differences in compositional and size dependent aerosol characteristics. This paper explores relative humidity (RH) and gravimetric equivalency adjustment approaches to be used for the

pDR-1000 used to assess indoor PM …

Correlates Of Asthma Among The Minority Population In South Bronx,New York, Veronica Chibumma Uwanaka

Walden Dissertations and Doctoral Studies

Asthma among children has become an inherent problem in many communities in the United States, especially among the minority population. The South Bronx has a large minority population and a high prevalence of asthma. However, no study to date has explored the factors associated with this high prevalence rates in this population. Drawing from theories of social ecology and environmental health, the objective of this quantitative cross-sectional study is to investigate the correlates of asthma among children in the South Bronx by studying the sociodemographic and environmental risk factors, including parental occupation; neighborhood and housing characteristics, air quality, and poverty. …

Translating Reference Doses Into Allergen Management Practice: Challenges For Stakeholders, René W. R. Crevel, Joseph Baumert, Stefano Luccioli, Athanasia Baka, Sue Hattersley, Jonathan O.B. Hourihane, Stefan Ronsmans, Frans Timmermans, Rachel Ward, Yong-Joo Chung

Department of Food Science and Technology: Faculty Publications

Risk assessment describes the impact of a particular hazard as a function of dose and exposure. It forms the foundation of risk management and contributes to the overall decision-making process, but is not its endpoint. This paper outlines a risk analysis framework to underpin decision-making in the area of allergen cross-contact. Specifically, it identifies challenges relevant to each component of the risk analysis: risk assessment (data gaps and output interpretation); risk management (clear and realistic objectives); and risk communication (clear articulation of risk and benefit). Translation of the outputs from risk assessment models into risk management measures must be informed …

Using Quantitative Disease Dynamics As A Tool For Guiding Response To Avian Influenza In Poultry In The United States Of America, K. M. Pepin, E. Spackman, J. D. Brown, K. L. Pabilonia, Lindsey P. Garber, J. Todd Weaver, D. A. Kennedy, Kelly A. Patyk, K. P. Huyvaert, Ryan S. Miller, Alan B. Franklin, Kerri Pedersen, T. L. Bogich, P. Rohani, Susan A. Shriner, Colleen T. Webb, S. Riley

United States Department of Agriculture Wildlife Services: Staff Publications

Wild birds are the primary source of genetic diversity for influenza A viruses that eventually emerge in poultry and humans. Much progress has been made in the descriptive ecology of avian influenza viruses (AIVs), but contributions are less evident from quantitative studies (e.g., those including disease dynamic models). Transmission between host species, individuals and flocks has not been measured with sufficient accuracy to allow robust quantitative evaluation of alternate control protocols. We focused on the United States of America (USA) as a case study for determining the state of our quantitative knowledge of potential AIV emergence processes from wild hosts …

Results From Ireland's 2014 Report Card On Physical Activity In Children And Youth, Deirdre M. Harrington, Sarahjane Belton, Tara Coppinger, Muireann Cullen, Alan Donnelly, Kieran Dowd, Teresa Keating, Richard Layte, Marie Murphy, Niamh Murphy, Elaine Murtagh, Catherine Woods

Publications

Background: Physical activity (PA) levels are a key performance indicator for policy documents in Ireland. The first Ireland Report Card on Physical Activity in Children and Youth aims to set a robust baseline for future surveillance of indicators related to PA in children and youth. Methods: Data collected between 2003-2010 on more than 35,000 7- to 18-year-old children and youth were used and graded using a standardized grading system for 10 indicators. Results: Grades assigned for the indicators were as follows: overall physical activity levels, D-; sedentary behavior (TV viewing), C-; organized sport participation, C-: physical education, D-; active play, …

Factors Influencing U.S Army Personnel Meeting Body Mass Index Standards, Salma Theus

Walden Dissertations and Doctoral Studies

Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards

by

Salma Theus

MS, California State University, Dominguez Hills, 2008

BA, La Sierra University, 2005

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

September 2014

U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness …

Physician As Teacher: Promoting Health And Wellness Among Elementary School Students, Jill E. Stefaniak, Victoria C. Lucia

STEMPS Faculty Publications

BACKGROUND: Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children.

METHODS: As a required component of a …

Promoting Worksite Stair Use By Launching The "Stepping Up" Campaign, Lynne A. Obiaka

All ETDs from UAB

Background: Obesity and overweight contribute to worksite absenteeism and decreased productivity. Encouraging employees to frequent the stairs is one approach towards increasing worksite physical activity. Methods: An explanatory, mixed methods research design was used to explore the impact of a health communications campaign entitled "Stepping Up" on worksite stair use in health department employees. The campaign included octagonal shaped posters similar to traffic signs, email prompts and printed materials. A pretest and posttest were administered before and after the intervention to assess stair use frequencies and identify predictors. A Wilcoxon signed-rank test for related samples, Spearman correlations and multiple rank …

The Effect Of Medicaid Dental Coverage On Dental Care Utilization Among Older Americans, Ahyuda Oh

All ETDs from UAB

This dissertation examines the impact of Medicaid dental coverage on dental care utilization and oral health outcome of low-income elderly and non-elderly adults, using a fixed-effects model with longitudinal data of all states and multiple years from the Behavioral Risk Factors Surveillance System (BRFSS). By exploiting within-state variation over time in adult Medicaid dental coverage, the study estimates the effects of Medicaid dental coverage on dental care utilization (i.e., dental visits and dental cleanings) and oral health outcome (i.e., tooth loss). The study evaluates the effects of Medicaid dental benefits with preventive dental services on each of the three dental …

Interaction Between A Low-Iron Diet And Early-Life Methylmercury Exposure In Daphnia Pulex, Sherri Hudson

All ETDs from UAB

Methylmercury (MeHg) is a known neurotoxicant and bioaccumulates in fish, with exposure to humans in utero being of highest concern. Iron deficiency (ID) accounts for approximately 50% of anemia cases. Anemia is estimated to affect 1.62 billion people worldwide, and is particularly problematic during pregnancy and early life. Previous studies have shown that ID exacerbates toxicity associated with exposure to metals, including lead, manganese, and cadmium. The overall purpose of this thesis research is to investigate the interaction between a low-iron (Fe) diet and early-life exposure to MeHg in Daphnia pulex. I hypothesized when D. pulex are fed a low-Fe …