Medicine and Health Sciences Commons^™

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

Establishing Trust In Hiv/Hcv Research Among People Who Inject Drugs (Pwid): Insights From Empirical Research, Roberto Abadie, Shira Goldenberg, Melissa Welch-Lazoritz, Celia B. Fisher

Department of Sociology: Faculty Publications

Background — The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico.

Methods — Qualitative research was nested within a multi-year Social Network and …

Octo- And Nonagenarians' Outlook On Life And Death When Living With An Implantable Cardioverter Defibrillator: A Cross-Sectional Survey, Ingela Thylén, Debra K. Moser, Anna Strömberg

Nursing Faculty Publications

Background: Elderly individuals are increasingly represented among patients with implantable cardioverter defibrillators (ICD), but data describing life with an ICD are scarse among octo- and nonagenarians. Moreover, few studies have reported those elderly patients’ perspective on timly discussions concerning what shock deactivation involves, preferences on battery replacement, and their attitudes about turning off the ICD nearing end-of-life. Consequently, the aim of the study was to describe outlooks on life and death in octo- and nonagenarian ICD-recipients.

Methods: Participants were identified via the Swedish Pacemaker- and ICD-registry, with 229 octo- and nonagenarians (82.0 ± 2.2 years, 12% female) completing the survey …

Trust, Access, And Adaptation To Needs: The Role Of Community-Based Promoters In Health Insurance Delivery In Gujarat, India, Lauryn Stafford

Independent Study Project (ISP) Collection

The research question this study addresses is: How do community-based promoters contribute to the delivery and utilization of health insurance among marginalized populations in India? To address this question, the successes and difficulties experienced by VimoSEWA community-based insurance promoters, called aagewans, were investigated through field visits and personal interviews in Ahmedabad and nearby rural districts in Gujarat. VimoSEWA’s insurance delivery model is an appropriate topic of investigation for this study because its beneficiaries are self-employed women with limited prior access to financial protection. Both aagewans and insurance members were interviewed during this study to develop a comprehensive understanding of the …

The Challenges Of India’S Rising Breast Cancer Epidemic, Brigette Stickney

Independent Study Project (ISP) Collection

India is currently undergoing rapid urbanization, which is greatly impacting Indian citizens’ health. One of the rising concerns due to the drastic lifestyle and environmental changes that are results of urbanization is the issue of breast cancer. Breast cancer diagnosis rates are rising exponentially, and breast cancer has moved its way up to be the most common cancer in India. Breast cancer mortality rates in India are also some of the worst in the world. This paper analyses the social, mental, economic, geographic, and physical challenges that are present for women diagnosed with cancer in India. It assesses how they …

Boys’ Sex Education In Rural Maharashtra: Context, Community, And Trust, Sierra Bradshaw-Kreimer

Independent Study Project (ISP) Collection

The primary research question of this study is: do alumni of CRHP’s Adolescent Boy’s Program (ABP) and parents of alumni of the ABP report that the boys have changed after completing the program, and if yes, in what ways? Beyond that, the study is also concerned with examining potential reasons behind the results of the primary research question. The researcher conducted interviews with 3 ABP alumni and 3 parents of ABP alumni, in addition to attending information sessions and observing the workings of CRHP. The primary findings were that yes, the respondents reported a change. The change was described as …

Las Perspectivas De Los Trabajadores Sobre La Accesibilidad A Los Recursos Públicos Para El Tratamiento De Depresión Y Ansiedad En La Actualidad En El Área Metropolitana De Buenos Aires: Estudio Cualitativo De Tipo Exploratorio-Descriptivo. / Perspectives Of Workers On The Accessibility Of Public Resources For The Treatment Of Depression And Anxiety In The Metropolitan Area Of Buenos Aires: Qualitative Exploratory-Descriptive Study., Ellen Broaddus

Independent Study Project (ISP) Collection

En los últimos años, el tema de la salud mental se ha convertido en un elemento fundamental para la salud y el bienestar. Con la ley nacional 26.657 de 2010, Argentina declaró que todos tendrían servicios de salud mental gratuitos y accesibles y que no serían discriminados por sus trastornos. Sin embargo, los trastornos mentales, especialmente la depresión y la ansiedad, siguen siendo muy frecuentes, y en realidad muchos de los recursos públicos prometidos no son en realidad accesibles. Para investigar el estado actual de la salud mental pública, esta investigación buscó en los profesionales del campo para explorar sus …

Discutiendo Desde El Interior: La Marginación De Los Hombres Trans Dentro Del Movimiento Por El Aborto Legal En Argentina / Arguing From Within: The Marginalization Of Trans Men Within The Movement For Legal Abortion In Argentina, Olivia Nichols

Independent Study Project (ISP) Collection

En la actualidad, el color verde lleva con ello una asociación casi indudable al movimiento por el aborto legal en Argentina. A pesar de este alto perfil del movimiento conocido como la marea verde, una recorrida por la historia del movimiento revela una gran brecha en el diálogo en relación con la inclusión de personas que no son mujeres cis, como los hombres trans que también abortan.

Informada por entrevistas con activistas trans argentinos y la observación de un encuentro de la Campaña Nacional por el Derecho al Aborto Legal, Seguro y Gratuito, esta investigación considera la inclusión (o falta …

Family Experiences In Engaging In Employment: How Do We Improve Outcomes?, John Kramer, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Session 018: Abolishing Exploitive Labour Practices Room: Freedom H

Sponsors: Disability Youth, Aging, and the Life Course

Organizer, Presider &

Discussant: Katherine Caldwell, University of Illinois at Chicago

Papers:

“Differences in Earnings among Persons with and without Disabilities,” Alexandra Krause, Florida State University

“Family Experiences in Engaging in Employment: How Do We Improve Outcomes?” John Kramer, University of Massachusetts Boston

“Shifting the Paradigm through Entrepreneurship,” Katherine Caldwell, University of Illinois at Chicago

Families And Employment Of People With Intellectual And Developmental Disabilities: Results From A Scoping Study, John Kramer, Jennifer Bose, Jean Winsor, Thinkwork! At The Institute For Community Inclusion At Umass Boston

ThinkWork! Publications

Purpose: Recent policy changes expanding community employment for people with intellectual/developmental disabilities (IDD) and awareness of the important role of family members as facilitators of these opportunities motivated this scoping review of the literature on family engagement with the IDD service system.

Methods: Researchers used Arksey and O’Malley’s six-stage scoping review methodology (2005) to map a wide range of literature to discover the resources and strategies available to families supporting people with IDD to find employment; the resources and strategies to support people with IDD and families to develop a vision of employment; and the resources and strategies to support …

Injection Partners, Hcv, And Hiv Status Among Rural Persons Who Inject Drugs In Puerto Rico, Patrick Habecker, Roberto Abadie, Melissa L. Welch-Lazoritz, Juan Carlos Reyes, Bilal Khan, Kirk Dombrowski

Department of Sociology: Faculty Publications

Background—The prevalence of hepatitis C (HCV) and HIV among persons who inject drugs (PWID) and the ability of these diseases to spread through injection networks are well documented in urban areas. However, less is known about injection behaviors in rural areas.

Objectives—This study focuses on the association between the number of self-reported injection partners with the PWID’s self-reported HCV and HIV status. Injection networks provide paths for infection and information to flow, and are important to consider when developing prevention and intervention strategies.

Methods—Respondent driven sampling was used to conduct 315 interviews with PWID in rural Puerto Rico during 2015. …

Ptsd And Dysfunctional Parenting: Emotional And Biological Mechanisms, Molly Franz

Department of Psychology: Dissertations, Theses, and Student Research

Women are disproportionately at risk for developing PTSD following exposure to trauma. Among its many harmful effects, PTSD is associated with a range of negative family outcomes, including impairments in parenting behaviors. Despite the prevalence of PTSD and its impact on parenting, little is known about the mechanisms responsible for this association. The present project addressed this gap by examining the impact of PTSD on dysfunctional parenting behaviors in a lab setting. Based on prior theory and empirical evidence, I expected that a diagnosis of PTSD would be associated with more dysfunctional parenting (i.e., harsh/overreactive and lax/permissive behaviors) during routine …

The Contributing Factors To Adolescent Depression, Josie H. Lee

Independent Study Project (ISP) Collection

Objective: This paper reviews individual, familial, peer, and societal factors influencing adolescent depression in developed countries. Background: Depression usually onsets at adolescence and contributes to high DALYs. Since depression is treatable, efforts should be made to reduce its prevalence and effect. Methods: The research consisted of looking at literature relevant to the topic and age group and conducting interviews with experts who know about and have worked with adolescent depression. Discussion: Adolescents begins at the onset of puberty, allowing different biological factors such as genetics, stress of puberty, and cognitive changes to increase vulnerability to depression. Adolescents who had substance …

Partidarios De La Vida: Resiliencia En Los Afectados Directos De La Dictadura En Arica, Chile / Supporters Of Life: Resilience In The Direct Victims Of The Dictatorship In Arica, Chile, Danielle Levinson

Independent Study Project (ISP) Collection

The present study is a qualitative analysis of resilience mechanisms in inhabitants of the city of Arica, Chile who participated actively in the resistance against the Pinochet dictatorship. Through one-on-one interviews with members of this population and the coordinator/social assistant of the Arican branch of the Chilean government’s reparation program (PRAIS), this project was able to corroborate the existence of the following four categories of resilience mechanisms, which are identified in a technical standard published by the Chilean Under-Secretariat of Health: individual, family, social network, and values and ideology. However, it was revealed that this model should be adapted to …

Rural And Urban Injection Drug Use In Puerto Rico: Network Implications For Human Immunodeficiency Virus And Hepatitis C Virus Infection, Courtney Thrash, Melissa L. Welch-Lazoritz, G. Robin Gauthier, Bilal Khan, Roberto Abadie, Kirk Dombrowski, Sandra Miranda De Leon, Yadira Rolon Colon

Department of Sociology: Faculty Publications

Understanding the short- and long-term transmission dynamics of blood-borne illnesses in network contexts represents an important public health priority for people who inject drugs and the general population that surrounds them. The purpose of this article is to compare the risk networks of urban and rural people who inject drugs in Puerto Rico. In the current study, network characteristics are drawn from the sampling “trees” used to recruit participants to the study. We found that injection frequency is the only factor significantly related to clustering behavior among both urban and rural people who inject drugs.

What To Expect When You’Re Expecting: The Impacts China’S Maternal And Child Health Care Law Has Had On Tibetan Birthing Practices In The Diqing Tibetan Autonomous Prefecture, Hannah Mishriky

Independent Study Project (ISP) Collection

While childbirth is universal, it is undeniable that class, culture, ethnicity, and the scientific and political state of medicine all influence how women experienced it. The Tibetan ethnic minority of the People’s Republic of China (PRC) is a culture that exemplifies the uniqueness of each birth. Due to both their distinctive childbirth beliefs and practices, as well as the swift changes China has undergone, Tibetan birthing experiences are asking to be explored.

This study will focus on two major factors influencing Tibetan women's birthing experiences. To begin, research will be done to understand the Buddhist influences surrounding pregnancy and childbirth, …

Ontology Of Personhood In Ayurveda From The Perspective Of Patients And Physicians In Palampur, Himachal Pradesh: An Independent Study, Denise Defelice

Independent Study Project (ISP) Collection

Scholars in western biomedicine describe the body as a physical entity distinct from mind and soul. However, the human body in Indian systems of medicine integrates the multiple natures of personhood and is both deeply physical and spiritual. This study demonstrates the unique view of personhood, being, health, and illness in Ayurveda through literature research and interviews with practitioners and patients. This study extends past a search for the ontology of personhood in Ayurveda and discusses the implications of this ontology on the way one views oneself and the world around him or her. Through this integrative approach, this study …

Perceptions Of Complementary And Alternative Medicine In Western Society: A Focus Study On Switzerland, Sandra B. Saldana

Independent Study Project (ISP) Collection

The demand for complementary, alternative, and traditional medicine, or CAM, has been a topic of debate in Western countries like Switzerland in the past decades due to the limited evidence-based research on its effectiveness. However, countries like Switzerland have been implementing CAM in their national health insurance as a response to the pressure of demand from the people. Thus, understanding the motivations for CAM use may help medical and government institutions address the shift towards a new way of managing health and disease. The purpose of this study was to evaluate the psychosocial factors involved in influencing the patients’ perception …

“Arica Tiene Vih, ¿Y Tú?” El Rol Del Test Rápido De Vih En El Diagnóstico Oportuno Para Jóvenes De La Comuna De Arica, Chile / "Arica Has Hiv, And You?" The Role Of The Rapid Hiv Test In The Timely Diagnosis For Young People In The District Of Arica, Chile, Julia Zigman

Independent Study Project (ISP) Collection

Research question: How is the rapid HIV test useful in assuring access to timely diagnosis of HIV for young adults in the city of Arica, Chile?

Objectives: The primary objective of this study is to evaluate the rapid HIV test as a means of increasing access to timely diagnosis of HIV among those aged 18 – 29 in the community of Arica, which participated in a pilot of the rapid test in early 2018. The study sets out to evaluate the installation of this pilot to situate the role of the rapid test in Chile’s HIV landscape. Further objectives …

Uso De La Medicina Tradicional Y De La Biomedicina Por Migrantes Q’Ero En El Distrito De San Sebastian, Cusco / Use Of Traditional Medicine And Biomedicine By Q'Ero Migrants In The District Of San Sebastian, Cusco, Isabel Blaettler

Independent Study Project (ISP) Collection

An estimated 49% of the indigenous population of Latin America has migrated to cities in the past 50 years. In Peru, over 600,000 native Quechua speakers migrated to cities due solely to the terrorist conflicts of the 1980s. Many of these immigrants came from small towns with little to no infrastructure in terms of roads, schools, and hospitals or access to western biomedicine. In this study, semi-formal qualitative interviews were used to investigate whether migration from a small rural community to a city, specifically among the Queros people of Southern Peru, affected the use of traditional medicine and biomedicine. A …

“Religion Is Religion; My Life Is My Life”: Religious Influences On Family Planning Decisions In Kapchorwa District, Uganda, Sarah Mathys

Independent Study Project (ISP) Collection

This report seeks to understand the influence that religion has on family planning decisions in Kapchorwa District, in eastern Uganda. Increased uptake of family planning has significant impliations for sustainability and development in Uganda as a whole. As a district with a high unmet need for faily planning, Kapchorwa serves as an important case study. Because over 99% of Uganda’s population reports a religious affiliation, and because literature on family planning claims conservative spirituality as a major cause of low uptake, religion is a natural lens through which to study family planning perceptions and utilization.

Through focus groups and key …

Trends Of Parent-Adolescent Drug Talk Styles In Early Adolescence, Youngju Shin, Jonathan Pettigrew, Michelle Miller-Day, Michael L. Hecht, Janice L. Krieger

Communication Faculty Articles and Research

The present study seeks to understand how parents as prevention agents approach substance use prevention messages during the period of early adolescence. Students (N = 410) in a drug prevention trial completed surveys from 7th to 9th grade. Using longitudinal data, a series of latent transition analyses was conducted to identify major trends of parent–adolescent drug talk styles (i.e., never talked, situated direct, ongoing direct, situated indirect, and ongoing indirect) in control and treatment conditions. Findings demonstrate a developmental trend in drug talk styles toward a situated style of talk as youth transitioned from 7th grade to 9th grade. …

Differential Effects Of Parental “Drug Talk” Styles And Family Communication Environments On Adolescent Substance Use, Youngju Shin, Michelle Miller-Day, Michael L. Hecht

Communication Faculty Articles and Research

The current study examines the relationships among adolescent reports of parent–adolescent drug talk styles, family communication environments (e.g., expressiveness, structural traditionalism, and conflict avoidance), and adolescent substance use. ANCOVAs revealed that the 9th grade adolescents (N = 718) engaged in four styles of “drug talks” with parents (e.g., situated direct, ongoing direct, situated indirect, and ongoing indirect style) and these styles differed in their effect on adolescent substance use. Multiple regression analyses showed that expressiveness and structural traditionalism were negatively related to adolescent substance use, whereas conflict avoidance was positively associated with substance use. When controlling for family communication …

Exploring Places Of Street Drug Dealing In A Downtown Area In Brazil: An Analysis Of The Reliability Of Google Street View In International Criminological Research, Elenice De Souza Oliveira, Ko-Hsin Hsu

Department of Justice Studies Faculty Scholarship and Creative Works

This study assesses the reliability of Google Street View (GSV) in auditing environmental features that help create hotbeds of drug dealing in Belo Horizonte, one of Brazil’s largest cities. Based on concepts of “crime generators” and “crime enablers,” a set of 40 items were selected using arrest data related to drug activities for the period between 2007 and 2011. These items served to develop a GSV data collection instrument used to observe features of 135 street segments that were identified as drug dealing hot spots in downtown Belo Horizonte. The study employs an intra-class correlation (ICC) statistics as a measure …

Proposed Metrics To Measure Quality: Overview, Anrudh K. Jain, John Townsend, Saumya Ramarao

Reproductive Health

The first quality-of-care framework in family planning was articulated over 25 years ago and a considerable amount of work has been done since then to measure quality in the context of routine service delivery, yet, we do not have agreed-upon indicators to measure quality that can be applied uniformly across different health systems and social contexts. This paper takes a slightly different approach and uses a common definition of quality from the outset. Indicators of quality are required for describing the nature of family planning services and quality of care offered by a health service delivery program, and for improving …

Accelerating Uptake Of Voluntary, Rights-Based Family Planning In Developing Countries, Kazuyo Machiyama, Francis Obare, Venkatraman Chandra-Mouli, Doris Chou, Mario Festin, Rajat Khosla, James Kiarie, Lale Say, Nandita Thatte

Reproductive Health

This brief summarizes evidence on the benefits of family planning for girls and women, their children, families, and societies. It also provides evidence on the cost-effectiveness of family planning programs; discusses reasons for unmet need for contraception and identifies ways to reduce unmet need and discontinuation; and describes progress in meeting FP2020 and the Sustainable Development Goals (SDGs). To meet the FP2020 and SDGs, significant investments are required by countries and donors in the following priority areas: sustainable financing, reaching all adolescents, expanding availability of services to the poorest and hard-to-reach populations, improving the quality of services, increasing the range …

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance

Reproductive Health

The goal of family planning and reproductive health operations research is to generate evidence that helps policies and programs maximize access to and quality of services for women and their families. Yet the crucial step of ensuring the utilization of that evidence often receives inconsistent or inadequate attention. The goal of this case study is to document an activity of Marie Stopes International (MSI) in Kenya, part of the STEP UP research program consortium, which resulted in successful evidence utilization. STEP UP research on quality of care for medical abortion, particularly on pharmacy provision of medical abortion, has provided the …

Dynamics Of Postpartum Iud Use In India, The Evidence Project

Reproductive Health

Evidence suggests that in India, compared to married women in general, postpartum married women have a much higher need for family planning that remains unmet. India’s postpartum IUD (PPIUD) program aims to help postpartum women space pregnancies and prevent mistimed or unwanted births. The majority of PPIUD users in this study were young, educated, and had one child. Most were involved in making the final decision about which family planning method to use after discussions with the provider, and most had spoken with a frontline health worker at least once about family planning methods in the three months preceding birth …

Dynamics Of Injectable Contraceptive Use In India, The Evidence Project

Reproductive Health

This brief describes a research study by the Population Council, with support from USAID/India, whose purpose is to provide evidence that can be used to strengthen the family planning program and meet the needs of reversible contraceptive users who want to prevent pregnancy in India. Understanding the experiences of the small but growing population of women choosing the injectable is important as the Government of India continues to roll out injectable contraceptive methods in the public sector. The report’s key recommendations include: disseminating messaging about potential side effects of the injectable, institutionalizing quality of care in pre-service trainings for all …

Findings From Post-Intervention Analysis Of Pre-Eclampsia/Eclampsia In Ebonyi State, Salisu Mohammed Ishaku

Reproductive Health

Maternal and newborn deaths due to pre-eclampsia and eclampsia (PE/E) are preventable, yet in Nigeria this is the most significant direct cause of maternal mortality. Following a landscape analysis to better understand the enormity of this problem across seven states in Nigeria, a cross-cutting intervention was implemented in Cross River, Ebonyi, and Kogi states. Researchers worked with primary healthcare (PHC) providers, policymakers, women’s groups, and community members to increase uptake of underutilized interventions and commodities for the prevention and treatment of PE/E in rural Nigeria. This brief presents study findings from Ebonyi State on post-intervention landscape changes in: programmatic and …