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Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council

Poverty, Gender, and Youth

When a migrant girl is successful, she creates a ripple effect through generations: families and future children will be better off because of her ability to finish school, get a job, and stay healthy. Despite the positive potential of migration for adolescent girls, migrant girls are largely ignored in policy and programs designed to reach migrants and adolescents. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. If these girls arrive at their destination and settle in safely, their diligence can enable them to capitalize on new opportunities and become productive, contributing …

The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that compromise their healthy development into young women, and lack the social, health, and economic assets to mitigate these risks. The issues that girls are confronted with include high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, and lack of agency and participation. The Adolescent Girls Empowerment Program (AGEP) has three major components: safe spaces groups in which girls meet once a week over the course of two years for training …

A Descriptive Study Of The Leadership Role Of Community Health Ambassadors On Diabetes-Related Health Behaviors, Barbara Pullen-Smith

Dissertations

Diabetes is a chronic disease that bears a disproportionate burden among African American populations. The lack of access to affordable, culturally appropriate health care is a key barrier to effective diabetes prevention or disease management for racial/ethnic minority populations. Living in public housing communities, with concentrated poverty, exacerbates the burden of diabetes and reduces access to screening and early detection services to prevent the onset of diabetes. The purpose of the study was to describe the leadership role of lay health advisors, known as Community Health Ambassadors (CHAs), on diabetes-related health behaviors of African Americans living in a public housing …

Association Between Breastfeeding And Infant Growth: A Probable Reverse Causality, Shraddha Vyas

Theses and Dissertations

Background: Much conflicting results exist in the association between breastfeeding and infant growth. One of these confusions is related to the temporal sequence between breastfeeding practice and infant growth.

Objective: This study aimed at examining the association and investigating a possible reverse causality between breastfeeding and infant growth.

Method: Infant Feeding Practices Survey II, a national longitudinal database with repeated measurements, following women prenatally and until one year postpartum (N=2914) was used. Mixed linear model assessed the impact of breastfeeding from the 2nd, 4th, 6th and 9th months on infant growth at the 3rd, 5th, 7th and 12th months, respectively. …

Fishing And Fish Consumption Patterns In The Gullah/Geechee Sea Island Population, Jamelle Heyward Ellis

Theses and Dissertations

The Gullah/Geechee (G/G) people are descendants of West African slaves who remained in seclusion on the Sea Islands of South Carolina, North Carolina, Georgia, and Florida until the end of the Civil War in 1865. In addition to retaining their unique cultural language, they also remain largely a fishing subsistence population. Decades of urban development have reduced the G/G population's access to traditional fishing locations and have increased exposures to environmental contaminants in some bodies of water that are frequently fished by the G/G. Approximately 98.4% of SC rivers and streams and 77.6% of lakes have been assessed for aquatic …

Associations Between The Perceived And Built Food Environment, Timothy L. Barnes

Theses and Dissertations

Neighborhood food environments have been associated with dietary intake and obesity. Measures of the food environment have typically been characterized with geographic information systems (GIS)-based measures, however, the use of perception-based measures of the food environment have increased in frequency. Few studies have fully examined the relationship between perceptions and GIS-based measures of the food environment, especially considering the congruency between perceived and GIS-based presence of specific retail food outlets, nor the relationship between food outlets and perceived availability of healthy foods or fast food opportunities.

Telephone survey data from 705 residents in an eight-county region of South Carolina were …

Food Environment And Birth Outcomes In South Carolina, Xiaoguang Ma

Theses and Dissertations

An increasing number of studies examined the association between neighborhood characteristics and birth outcomes. However, the results can be difficult to compare because of the variety of indicators used to characterize the neighborhood. As an important neighborhood characteristic, the food environment is associated with residents' nutrition status, diet quality, and related health outcomes. In addition, the food environment has been found to influence women's diet quality during pregnancy, which is a key factor in predicting birth outcomes. However to date, studies on food environment and birth outcomes are extremely limited.

This study examined the association between food environment (evaluated by …

Emerging Technologies: Webcams And Crowd-Sourcing To Identify Active Transportation, J. Aaron Hipp, Deepti Adlakha, Bill Chang, Amy A. Eyler, Robert B. Pless

Brown School Faculty Publications

Over 25% of adults in the US are obese, contributing to 300,000 deaths and costing the US healthcare system $147 billion annually. Federal governments to local non-profit agencies have instituted policy and built environment (BE) changes in effort to reduce obesity and increase physical activity (PA). A challenge in evaluating the success of policy and BE change is the capacity to capture a priori PA behaviors and the ability to eliminate researcher and respondent bias in assessing post-change environments. A novel transdisciplinary collaboration between public health and computer science is presented here with the goal of automatically analyzing existing public …

Ciclovía Initiatives: Engaging Communities, Partners, And Policy Makers Along The Route To Success, Susan G. Zieff Phd, J. Aaron Hipp, Amy A. Eyler, Mi-Sook Kim Phd

Brown School Faculty Publications

Recent efforts to increase physical activity through changes to the built environment have led to strategies and programs that use existing public space, including bicycle lanes, temporary parks, and the ciclovia initiative (scheduled events in which streets are closed to motorized vehicles and opened for recreational activities) popularized in South America. Objective: This article describes and compares the processes and structures involved in developing and implementing a ciclovia-type program in 2 US urban contexts: San Francisco, California, and St Louis, Missouri. Considering the current growth of and interest in ciclovia initiatives, important outcomes, lessons learned are offered for application in …

Physical Activity Surveillance And Emerging Technologies, J. Aaron Hipp

Brown School Faculty Publications

No abstract provided.

Is The Reporting Timeliness Gap For Avian Flu And H1n1 Outbreaks In Global Health Surveillance Systems Associated With Country Transparency?, Feng-Jen Tsai, Eva Tseng, Chang-Chuan Chan, Hiko Tamashiro, Sandrine Motamed, André C Rougemont

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: This study aims to evaluate the length of time elapsed between reports of the same incidents related to avian flu and H1N1 outbreaks published by the WHO and ProMED-mail, the two major global health surveillance systems, before and after the amendment of the International Health Regulations in 2005 (IHR 2005) and to explore the association between country transparency and this timeliness gap.

METHODS: We recorded the initial release dates of each report related to avian flu or H1N1 listed on the WHO Disease Outbreak News site and the matching outbreak report from ProMED-mail, a non-governmental program for monitoring emerging …

Adolescents, Obesity, And Motivational Interviewing, Betty J. Cheney

Master of Public Health Program Student Publications

The United States has seen higher rates of obesity (18.4%) in adolescents in recent years. The impact of obesity can be felt at all levels of public health because of the co-morbidities that correlate to obesity, especially in adolescents. Health outcomes for these future adults are dampened by health behavior decisions made today. Motivational interviewing has demonstrated promising evidence but mixed results when addressing health-related behaviors in adolescents. It is unclear what intervention characteristics are most successful, so more research is required to determine the intervention most appropriate for adolescents to improve health-related behaviors and ultimately improve health outcomes associated …

Smoking Status, Demographic Predictors And Birth Weight Outcomes In Mothers Participating In The Ohio Wic Program, 2012, Gracie Hemphill

Master of Public Health Program Student Publications

The purpose of this study was to describe the relationship between age and smoking status of household members to maternal smoking status during pregnancy and describe the relationship of maternal smoking during pregnancy to low birth weight outcomes in Ohio women enrolled in WIC. This project used data from the 2012 Pregnancy Nutrition Surveillance Survey (PNSS) and only the records from the initial visit women made to Ohio WIC clinics in 2012 (n=64,573). One in five women smoked during pregnancy. Younger mothers where most likely to report smoking (20.3%) than women 35 or more years old (17.9%). Of women 24 …

The Impact Of Telephonic Health Coaching On Physical Activity, Healthy Eating, And Cholesterol Levels, Jill Marie Hansen

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to understand the role of telephonic health coaching in reducing the risk behaviors of physical inactivity and imprudent dietary behaviors and improving cholesterol levels from Year 1 to Year 2. Data related to 45,410 employees was drawn from seven employer groups from January 1, 2009 to December 12, 2012. Descriptive statistics, independent sample t-tests, one sample t-tests, and Pearson's product-moment correlational analyses were used to describe the employees in data set and test the hypotheses of this study. Health coaching participants were significantly more likely to be females than males. Participants in health coaching …

Effect Of Small Monetary Incentive And Demographic Characteristics On Response Rate Of Self-Administered Questionnaire Mailed To Rural Women, Lacey A. Mccormack

Health and Nutritional Sciences Faculty Publications

Objectives: The National Children’s Study (NCS) is a longitudinal observational study that will examine the effects of genetics and environment on the health and development of children in the United States. The NCS is in a Vanguard, or pilot phase, so it is important to determine the feasibility, acceptability and cost of different data collection methods. The purpose of this study was to determine whether demographic characteristics differed in self-administered questionnaire (SAQ) completion rates, and to examine response rates when a $2 incentive was included with the mailed questionnaire. Methods: Subjects for the study (~500) were being followed by a …

Assessment Of Neck And Shoulder Muscle Coactivations And The Effect On The Musculoskeletal System, Regina Derria Pope-Ford

Dissertations

Musculoskeletal disorders (MSDs) constitute one of the most important occupational health issues in healthcare workers who are susceptible to upper extremity disorders. Yet MSDs in the healthcare professions have not been studied extensively beyond the lower back. The focus population for this research is the field of dentistry where neck and shoulder disorders have been documented to have a high prevalence. Though quantitative data has been collected, many prior studies have focused on self-reported information. The goal of this research is to provide insight into the inter-relationship of muscles in the upper extremities. One way to accomplish this is to …

Disparate Health Implications Stemming From The Propensity Of Elderly And Medically Fragile Populations To Shelter In Place During Severe Storm Events, Joshua G. Behr, Rafael Diaz

VMASC Publications

Chronic conditions, disability limitations (mobility, cognitive, and sensory), and the need for assistance with activities of daily living are characteristics of elderly and medically fragile populations. Theory suggests that households with these vulnerability attributes are more likely to suffer storm-induced adverse and prolonged health consequences and, therefore, ought to evidence an increased propensity to evacuate prior to a severe storm event. Yet despite being more sensitive to storm disruption, the elderly and medically fragile populations are only slightly more likely to evacuate in the face of impending storms. This suggests, for these groups, there may be other factors such as …

Vitamin D And Biomarkers Of Sex Steroid Hormones Are Non-Linearly And Inversely Related To All-Cause Mortality: Results From Nhanes Iii, Hind A. Beydoun, Shaker M. Eid, Hueiwang Anna Jeng, Alan B. Zonderman, May A. Beydoun

Community & Environmental Health Faculty Publications

Background: In men, hypovitaminosis D as well as high and low testosterone levels have been linked to adverse events, including death. A biological interaction has been previously suggested between vitamin D and androgens. In a cohort study using Third National Health and Nutrition Examination Survey data, we simultaneously investigated circulating vitamin D and biomarkers of sex steroid hormones as predictors of all-cause mortality.

Methods: Age-adjusted and fully-adjusted Cox regression models were constructed to estimate hazard ratios (HR) and their 95% confidence intervals (CI). Whereas the vitamin D sufficient group (25(OH)D3 ≥30 ng/ml) was selected as a referent, biomarkers of sex …

Identifying Environmental Health Priorities In Underserved Populations: A Study Of Rural Versus Urban Communities, M. C. Bernhard, M. B. Evans, S. T. Kent, E. Johnson, S. L. Threadgill, S. M. Becker

Community & Environmental Health Faculty Publications

Objectives- Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members' concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities: defined the term environment; their perceptions of environmental exposures as affecting their health; specific priorities in their communities; and differences in urban versus rural populations.

Study design- A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities.

Methods- A total of eight …

2013 Children’S Legislative Briefing Book, Nevada Institute For Children’S Research And Policy, Children’S Advocacy Alliance, Denise Tanata Ashby, Tara Phebus

Nevada Institute for Children's Research and Policy Reports

The purpose of this Legislative Briefing Book is to provide a quick snapshot of some of the most pressing issues facing Nevada’s children in order to provide advocates and policymakers with a stepping stone in creating positive changes to improve the lives of Nevada’s children. While this book will not cover every issue facing our children, it is intended to highlight some of those where state policy may have an impact, covering issues in education, health, safety and security, and the juvenile justice system. Diligent efforts need to be made during the 2013 Legislative Session to improve policies, procedures and …

Adherence To Physical Activity Among Individuals With Or Without Cardiovascular Disease, Zyad T. Saleh

Theses and Dissertations--Nursing

Cardiovascular disease (CVD) is a major public health problem and a primary cause of morbidity and mortality in the United States. Regular physical activity is recommended for prevention and management of CVD. Despite the cardiovascular health benefits of physical activity most adults are physically inactive. Therefore, the aim of this dissertation was to examine the factors associated with adherence to physical activity among individuals with or without CVD.

The first paper is a report of a study conducted to examine which baseline demographic (age, gender, marital status, socioeconomic status, and place of residency), psychosocial (social support, depression, anxiety, and fatalism), …

Infant Mortality In American Indians And Alaska Natives 1995–1999 And 2000–2004, Patrik Johansson, Weston Williams, Ayman El-Mohandes

Publications and Research

Objectives. (1) To determine the infant mortality rate (IMR) in American Indians/ Alaska Natives (AI/AN) and Whites between 1995–1999 and 2000–2004. (2) To compare the leading causes of infant mortality in AI/AN and Whites. (3) To examine differences in neonatal vs. postneonatal causes of death in Whites and AI/AN.

Methods. Using the 1995–99 and 2000–04 Centers for Disease Control and Prevention’s National Center for Health Statistics national linked birth/infant death data, we examined neonatal and postneonatal IMR among AI/AN and Whites.

Results. AI/AN experienced significantly greater overall IMR in 1995–1999 and 2000–2004 than Whites. While the reduction in …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Rwanda 2010, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Rwanda 2010” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

The Ishraq Program For Out-Of-School Girls: From Pilot To Scale-Up, Mona Selim, Nahla G. Abdel-Tawab, Khaled El Sayed, Asmaa Elbadawy, Heba El Kalaawy

Poverty, Gender, and Youth

In response to the needs of adolescent girls in Egypt for improved schooling, health, and livelihood prospects, Ishraq (sunrise)—a multidimensional program for 12–15-year-old out-of-school girls—was launched in 2001 by the Population Council in collaboration with CEDPA, Save the Children, Caritas, and local nongovernmental organizations. The program combined traditional tested program elements (literacy, life skills, nutrition) with more innovative ones (sports, financial education). It focused on building a multilayered platform to support and institutionalize the program by educating and mobilizing communities around issues of importance to adolescent girls; forging partnerships between international NGOs, government institutions, and local NGOs; and building capacities …

Shaping Demand And Practices To Improve Family Health Outcomes: Findings From A Quantitative Survey, Volume 3: Bihar, M.E. Khan, France Donnay, Usha Kiran Tarigopula, Kumudha Aruldas

Reproductive Health

This report provides findings of a study undertaken to generate comprehensive information on eight target behaviors that have direct bearing on family health in rural Bihar. Behaviors include: 1) Increasing the proportion of deliveries that occur in a facility and mothers who have access to basic emergency obstetric care; 2) Increasing the proportion of safe deliveries at home; 3) Increasing the uptake of preventive postnatal-care services for newborns and mothers; 4) Increasing the practice of skin-to-skin care/Kangaroo Mother Care for newborns; 5) Increasing the practice of early and exclusive breastfeeding of infants during the first six months of life; 6) …

Assessment Of The Availability And Use Of Maternal Health Supplies In The Primary Health Care System In Amhara Region, Ethiopia, Sarah Raifman, Sisay Mellese, Kelemua Hailemariam, Ian Askew, Annabel Erulkar

Reproductive Health

Maternal mortality in Ethiopia remains among the highest in the world. A UN Commission Report in 2012 identified 13 life-saving commodities—defined as medicines, medical devices, and health supplies—that effectively address avoidable causes of death during pregnancy and childbirth that, if more widely accessed and properly used, could significantly reduce preventable deaths among women. This assessment, conducted by the Population Council, evaluates the availability of these life-saving commodities that are essential for basic emergency obstetric and neonatal care, and safe and clean delivery services within primary health care in Ethiopia. The report concludes that Ethiopia’s pharmaceutical procurement and supply system is …

Effectiveness Of A Comprehensive Sexual And Gender-Based Violence Prevention Project For In-School Girls In Swaziland, Swaziland Action Group Against Abuse (Swagaa)

Reproductive Health

Swaziland is one of the sub-Saharan African countries affected by sexual and gender-based violence (SGBV) and HIV and AIDS, with women facing greater risk compared to men. In response to increasing reports of violence against women and children in the country, the Swaziland Action Group Against Abuse launched a Girls’ Empowerment Clubs (GEC) program in primary and secondary schools in order prevent SGBV cases. Due to limitations of the program (such as being led by teachers and reliance on volunteers), an intervention study was carried out by the Population Council to test the effectiveness of an enhanced version, “GEC-Plus,” that …

Scaling Up Advocacy For Gender-Based Violence And Child Sexual Abuse In The East, Central And Southern Africa Region: Technical Exchange And Meeting, East Central And Southern African Health Community

Reproductive Health

The East, Central and Southern Africa (ECSA) Health Community, which prioritizes gender-based violence and child sexual abuse as regional health concerns, partnered with the Population Council to convene a pre-conference Expert Committee meeting of the Research, Information and Advocacy Programme. The conference marked a major milestone in the ECSA Health Community’s commitment to promote and support region-wide sharing and utilization of health research and policy information among its member states. This report summarizes the deliberations of the two-day workshop and the recommendations for implementing an advocacy plan to address this important facet of the region’s development agenda.

Comprendre Les Grossesses Non Désirées Au Sénégal: Rapport Du Profil Pays, Kaila Clarke, Mohamadou Sall, Babacar Mane, Nafissatou Diop, Bocar Mamadou Daff

Reproductive Health

Un profil pays a été préparé pour le Sénégal pour compiler et synthétiser les informations disponibles sur la santé de la reproduction, en particulier les grossesses non désirées et par conséquent les besoins non satisfaits en matière de planification familiale. D’importants efforts ont été consentis par l’Etat sénégalais, mais de nombreux obstacles continuent de freiner les progrès réalisés. Un programme national plus cohérent et ciblé est donc nécessaire pour réduire ces obstacles. Dans le même temps, les acteurs non-gouvernementaux devraient poursuivre leurs efforts pour renforcer leur programmation pour produire des effets plus immédiats, tout en assurant une meilleure coordination entre …

Understanding Unintended Pregnancy In Bangladesh: Country Profile Report, Fauzia Akhter Huda, Sabiha Chowdhuri, Yolande Robertson, Noushin Islam, Bidhan Krishna Sarker, Ashrafi Jahan Azmi, Laura Reichenbach

Reproductive Health

The objective of this report is to identify the determinants of unintended pregnancy and unmet need for family planning in Bangladesh and therefore provide a strong body of evidence that will contribute to issue identification, evidence generation, and communication for use of evidence in policy and programming. The evidence generated can be used to find ways to reduce the rate of unintended pregnancy and hence reduce the risk of abortion-related morbidity and mortality; ultimately this will aid Bangladeshi couples in reaching their fertility goals. Results demonstrate that Bangladesh has shown progress and promise in several areas of family planning and …