Medicine and Health Sciences Commons^™

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

Do Mothers Affect Daughter’S Behaviors? Diet, Physical Activity, And Sedentary Behaviors In Kuwaiti Mother–Daughter Dyads, Lemia H. Shaban, Joan A. Vaccaro, Shiryn D. Sukhram, Fatma G. Huffman

Publications and Research

The objective of the study was to evaluate 169 Kuwaiti mother– daughter dyads and their associations with health behaviors for eating healthy, engaging in physical activity, daughters perceived body weight, time spent with computer/video, and time viewing television. Female students aged 10–14 years were selected from private and public schools in the State of Kuwait. Results demonstrated that daughters exhibited similar behaviors to their mothers in their perceived eating behavior, physical activity, computer/ video game use, and TV screen time. Future research is essential to determine the role of mothers in effective health behavior intervention strategies for female Kuwaiti adolescents.

Protocol For Project Impact (Improving Millions Hearts For Provider And Community Transformation): A Quasi-Experimental Evaluation Of An Integrated Electronic Health Record And Community Health Worker Intervention Study To Improve Hypertension Management Among South Asian Patients, Priscilla M. Lopez, Jennifer Zanowiak, Keith Godfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam

Publications and Research

Background: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building …

Doula Services Within A Healthy Start Program: Increasing Access For An Underserved Population, Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Publications and Research

Purpose: Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description: To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Barriers To And Facilitators Of Help-Seeking Behavior Among Men Who Experience Sexual Violence, Martina Delle Donne, Joseph Deluca, Pavel Pleskach, Christopher Bromson, Marcus P. Mosley, Edward T. Perez, Shibin G. Matthews, Rob Stephenson, Victoria Frye

Publications and Research

Research on sexual violence and related support services access has mainly focused on female victims; there is still a remarkable lack of research on men who experience sexual violence. Research demonstrates that people who both self-identify as men and are members of sexual-orientation minority populations are at higher risk of sexual violence. They are also less likely to either report or seek support services related to such experiences. The present study is an exploratory one aimed at filling the gap in the literature and better understanding how men, both straight and gay as well as cisgender and transgender, conceptualize, understand, …

Mode Of Delivery And Child And Adolescent Psychological Well-Being: Evidence From Hong Kong’S “Children Of 1997” Birth Cohort, Cherry Y. Leung, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Mode of delivery (vaginal or cesarean section) is thought to affect gut microbiota, which in turn may affect psychological well-being. As such, mode of delivery is potentially a modifiable factor for psychological well-being. Here we examined the association of mode of delivery with child and adolescent psychological well-being. We used multivariable linear regression in a populationrepresentative Hong Kong Chinese birth cohort, “Children of 1997,” to examine the adjusted associations of mode of delivery with behavioral problems assessed from parent-reported Rutter score at ~7 (n = 6294) and ~11 years (n = 5598), self-esteem assessed from self-reported Culture-Free Self- Esteem Inventory …

A Human-Centered Platform For Hiv Infection Reduction In New York: Development And Usage Analysis Of The Ending The Epidemic (Ete) Dashboard, Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash

Publications and Research

Background: Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment.

Objective: We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York’s progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020.

Methods: The ETE dashboard was adapted from an existing human-centered geovisualization …

Assessing The Public Health Impact Of The Mhealth App Business, Nicholas Freudenberg

Publications and Research

Do mobile health applications (mHealth apps) promise solutions to such pressing public health problems as increasing access to care, reducing inequalities in health, lowering health care costs, and providing people with new tools to reduce risky behavior and manage chronic diseases? To answer this question, public health professionals and researchers need to examine how the more than 259 000 mHealth apps now available in the US market contribute to improved population health now and will in the future.

In this issue of AJPH, Grundy et al. (p. 1783) provide evidence that may temper the often uncritically enthusiastic response to …

First Trimester Medication Abortion Practice In The United States And Canada, Heidi E. Jones, Katharine O'Connell White, Wendy V. Norman, Edith Guilbert, E. Steve Lichtenberg, Maureen Paul

Publications and Research

We conducted a cross-sectional survey of abortion facilities from professional networks in the United States (US, n = 703) and Canada (n = 94) to estimate the prevalence of medication abortion practices in these settings and to look at regional differences. Administrators responded to questions on gestational limits, while up to five clinicians per facility reported on 2012 medication abortion practice. At the time of fielding, mifepristone was not approved in Canada. 383 (54.5%) US and 78 (83.0%) Canadian facilities participated. In the US, 95.3% offered first trimester medication abortion compared to 25.6% in Canada. While 100% of providers were …

Association Of Body Shape Index (Absi) With Cardio-Metabolic Risk Factors: A Crosssectional Study Of 6081 Caucasian Adults, Simona Bertoli, Alessandro Leone, Nir Y. Krakauer, Giorgio Bedogni, Angelo Vanzulli, Valentino Ippocrates Redaelli, Ramona De Amicis, Laila Vignati, Jesse C. Krakauer, Alberto Battezzati

Publications and Research

A Body Shape Index (ABSI) was specifically developed as a transformation of waist circumference (WC), statistically independent of BMI to better evaluate the relative contribution of WC to central obesity and clinical outcomes. Previous studies have found ABSI is associated with total mortality and cardiovascular events. However, no study has specifically evaluated the joint contribution of ABSI and BMI to cardio-metabolic outcomes (high triglycerides, low HDL, high fasting glucose and high blood pressure). With this aim, we performed a retrospective study on 6081 Caucasian adults. Subjects underwent a medical interview, anthropometric measurements, blood sampling, measurement of blood pressure, and measurement …

Trends In Hpv Vaccine Initiation And Completion Among Girls In Texas: Behavioral Risk Factor Surveillance System Data, 2008–2010, Tatjana Gazibara, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objective: The objective of this study was to evaluate the trend of HPV vaccine initiation and completion among girls in Texas from 2008 to 2010.

Methods: Data were obtained from the Behavioral Risk Factors Surveillance System (BRFSS) over 3 years (2008–2010). The information regarding HPV vaccination was gathered from the parents of 9- to 17-year-old daughters (choosing only 1 per household) in randomly selected households in the sample area.

Results: The highest prevalence of vaccine initiation and completion were detected in 2010 (20.9% and 9.7%, respectively). Over the study period, HPV vaccine initiation statistically significantly increased (2008, 14.9%; 2009, 20.7%; …

Thyroid Function And Ischemic Heart Disease: A Mendelian Randomization Study, Jie V. Zhao, C. Mary Schooling

Publications and Research

To clarify the role of thyroid function in ischemic heart disease (IHD) we assessed IHD risk and risk factors according to genetically predicted thyroid stimulating hormone (TSH), free thyroxine (FT4) and thyroid peroxidase antibody (TPOAb) positivity. Separate-sample instrumental variable analysis with genetic instruments (Mendelian randomization) was used in an extensively genotyped case (n = 64,374)-control (n = 130,681) study, CARDIoGRAMplusC4D. Associations with lipids, diabetes and adiposity were assessed using the Global Lipids Genetics Consortium Results (n = 196,475), the DIAbetes Genetics Replication And Meta-analysis case (n = 34,380)-control (n = 114,981) study, and the Genetic Investigation of ANthropometric Traits (body …

Differences In Neighborhood Social Cohesion And Aerobic Physical Activity By Latino Subgroup, Rosenda Murillo, Sandra Echeverria, Elizabeth Vasquez

Publications and Research

Previous research has examined the role of neighborhood social cohesion in physical activity outcomes; however, less is known about this relationship across Latino subgroups. The purpose of our study was to examine the association between neighborhood social cohesion and aerobic leisure-time physical activity (LTPA) among Latino adults and to determine whether these associations differ by Latino subgroup. We used cross-sectional 2013–2014 National Health Interview Survey (NHIS) data on Latinos originating from 5 countries/regions (i.e., Latinos of Puerto Rican, Mexican/Mexican-American, Cuban/Cuban-American, Dominican and Central or South American origin) aged ≥18 years (n=11,126). Multivariable logistic regression models were used to estimate associations …

Blogs As Channels For Disseminating Health Technology Innovations, Ashish Joshi, Rinzin Wangmo, Chioma Amadi

Publications and Research

Objectives: The objective of this study was to describe the features of health informatics blogs on the Internet.

Methods: A search was conducted in August, 2016 using the search engine, Google, and key words: ‘mobile health blog,’ ‘telehealth/telemedicine blog,’ ‘Electronic Health Record blog,’ ‘personalized health record blog,’ ‘population health decision support system blog,’ and ‘public/population health dashboard blog.’ The first 24 blogs resulting from each key word search were recorded, generating 144 blogs. A total of 109 unique blogs resulted after removing duplicates and non-functional sites.

Results: Blogs with ‘.com’ extensions were most prevalent (72%, n = 79). More than …

Maternal Choline Supplementation Alters Fetal Growth Patterns In A Mouse Model Of Placental Insufficiency, Julia H. King, Sze Ting (Cecilia) Kwan, Jian Yan, Kevin C. Klatt, Xinyin Jiang, Mark S. Roberson, Marie A. Caudill

Publications and Research

Impairments in placental development can adversely affect pregnancy outcomes. The bioactive nutrient choline may mitigate some of these impairments, as suggested by data in humans, animals, and human trophoblasts. Herein, we investigated the effects of maternal choline supplementation (MCS) on parameters of fetal growth in a Dlx3+/− (distal-less homeobox 3) mouse model of placental insufficiency. Dlx3+/− female mice were assigned to 1X (control), 2X, or 4X choline intake levels during gestation. Dams were sacrificed at embryonic days E10.5, 12.5, 15.5, and 18.5. At E10.5, placental weight, embryo weight, and placental efficiency were higher in 4X versus 1X choline. Higher concentrations …

Effects Of A Multidisciplinary Weight Loss Intervention In Overweight And Obese Children And Adolescents: 11 Years Of Experience, Chiara Mameli, Jesse C. Krakauer, Nir Y. Krakauer, Alessandra Bosetti, Chiara Matilde Ferrari, Laura Schneider, Barbara Borsani, Sara Arrigoni, Erica Pendezza, Gian Vincenzo Zuccotti

Publications and Research

Aims To evaluate the effects of an outpatient multidisciplinary weight loss intervention in reducing body mass index (BMI) in children and adolescents suffering overweight and obesity, changes in A Body Shape Index (ABSI, waist circumference normalized to height and weight) and Hip Index (HI, normalized hip circumference) during treatment and correlation between the ABSI and HI with change in BMI z score.

Methods We analyze anthropometric data from pediatric patients affected by overweight and obesity aged 2 to 18 years old who entered our multidisciplinary weight loss intervention, which included medical, psychological and nutritional sessions, from January 1st 2006 to …

Divergent Secular Trends In Blood Pressure And Body Mass Index In Children And Adolescents In Hong Kong, Man Ki Kwok, Gabriel M. Leung, Thomas H.W. Chung, Karen K.Y. Lee, C. Mary Schooling

Publications and Research

Secular trends in blood pressure (BP) and body mass index (BMI) during childhood and adolescence are sentinels for the future population cardiovascular disease burden. We examined trends in BP z-score (ages 9-18 years from 1999 to 2014) and BMI z-score (ages 6-18 years from 1996 to 2014) in Hong Kong, China. Overall, BP z-score fell, systolic BP from 0.08 to -0.01 in girls and from 0.31 to 0.25 in boys. However, the trends were not consistent, for both sexes, systolic BP z-score was stable from 1999, decreased slightly from 2002 to 2005 and increased slightly to 2014, diastolic BP z-score …

Public Health Research Priorities To Address Us Human Trafficking, Emily F. Rothman, Hanni Stoklosa, Susie B. Baldwin, Makini Chisolm-Straker, Rumi Kato Price, Holly G. Atkinson

Publications and Research

In this Perspective, HEAL Trafficking, the nation's leading public health anti-trafficking organization maps out a national research agenda to tackle the problem of human trafficking. Given the paucity of research on trafficking, HEAL Trafficking engaged its membership in a consensus development process throughout 2016 to develop its national research agenda. HEAL Trafficking proposes five priorities that public health researchers should focus on in the decade ahead to make meaningful progress on preventing and responding to human trafficking in the Unites States.

Self-Reported Racial/Ethnic Discrimination And Bronchodilator Response In African American Youth With Asthma, Sonia Carlson, Luisa N. Borrell, Celeste Eng, Myngoc Nguyen, Shannon Thyne, Michael A. Lenoir, Nadine Burke-Harris, Esteban G. Burchard, Neeta Thakur

Publications and Research

Importance Asthma is a multifactorial disease composed of endotypes with varying risk profiles and outcomes. African Americans experience a high burden of asthma and of psychosocial stress, including racial discrimination. It is unknown which endotypes of asthma are vulnerable to racial/ethnic discrimination.

Objective We examined the association between self-reported racial/ethnic discrimination and bronchodilator response (BDR) among African American youth with asthma ages 8 to 21 years (n = 576) and whether this association varies with tumor necrosis factor alpha (TNF-α) level.

Materials and methods Self-reported racial/ethnic discrimination was assessed by a modified Experiences of Discrimination questionnaire as none or any. …

How Much Are Ecuadorians Willing To Pay To Reduce Maternal Mortality? Results From A Pilot Study On Contingent Valuation, Maria-Isabel Roldos, Phaedra Corso, Justin Engel

Publications and Research

Context:

There is an established association between the provision of health care services and maternal mortality. In Ecuador, little is known if the societal value is greater than the resources expended in preventive medicine.

Aims:

The purpose of this research is to investigate Ecuadorians’ willingness to pay to prevent maternal death and disabilities due to complications of care during childbirth in the context of universal coverage.

Methods and Materials:

The study elicited a “contingent” market on morbidity and mortality outcomes, specific to Ecuador’s epidemiologic profiles between a hypothetical market that included a 50% reduction in the risk of maternal mortality …

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without …

Zika Virus-Like Particle (Vlp) Based Vaccine, Héléne Boigard, Alexandra Alimova, George R. Martin, Al Katz, Paul Gottlieb, Jose M. Galarza

Publications and Research

The newly emerged mosquito-borne Zika virus poses a major public challenge due to its ability to cause significant birth defects and neurological disorders. The impact of sexual transmission is unclear but raises further concerns about virus dissemination. No specific treatment or vaccine is currently available, thus the development of a safe and effective vaccine is paramount. Here we describe a novel strategy to assemble Zika virus-like particles (VLPs) by co-expressing the structural (CprME) and non-structural (NS2B/NS3) proteins, and demonstrate their effectiveness as vaccines. VLPs are produced in a suspension culture of mammalian cells and self-assembled into particles closely resembling Zika …

How Income And Food Prices Influence Global Dietary Intakes By Age And Sex: Evidence From 164 Countries, Andrew Muhammad, Anna D'Souza, Birgit Meade, Renata Micha, Dariush Mozaffarian

Publications and Research

Background While income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.

Methods We used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income …

Encouraging Medicare Advantage Enrollees To Switch To Higher Quality Plans: Assessing The Effectiveness Of A ‘‘Nudge’’ Letter, Benjamin L. Howell, Partha Deb, Sai Ma, Rachel O. Reid, Jesse Levy, Gerald F. Riley, Patrick H. Conway, William H. Shrank

Publications and Research

There are considerable quality differences across private Medicare Advantage insurance plans, so it is important that beneficiaries make informed choices. During open enrollment for the 2013 coverage year, the Centers for Medicare & Medicaid Services sent letters to beneficiaries enrolled in low-quality Medicare Advantage plans (i.e., plans rated less than 3 stars for at least 3 consecutive years by Medicare) explaining the stars and encouraging them to reexamine their choices. To understand the effectiveness of these low-cost, behavioral ‘‘nudge’’ letters, we used a beneficiary-level national retrospective cohort and performed multivariate regression analysis of plan selection during the 2013 open enrollment …

Legal Mapping Analysis Of State Telehealth Reimbursement Policies, Kate E. Trout, Sankeerth Rampa, Fernando A. Wilson, Jim P. Stimpson

Publications and Research

Background: There exists rapid growth and inconsistency in the telehealth policy environment, which makes it difficult to quantitatively evaluate the impact of telehealth reimbursement and other policies without the availability of a legal mapping database. Introduction: We describe the creation of a legal mapping database of state-level policies related to telehealth reimbursement of healthcare services. Trends and characteristics of these policies are presented.

Materials and Methods: Information provided by the Center for Connected Health Policy was used to identify state-wide laws and regulations regarding telehealth reimbursement. Other information was retrieved using: (1) LexisNexis database, (2) Westlaw database, and (3) retrieval …

Impact Of Health Policy Changes On Emergency Medicine In Maryland Stratified By Socioeconomic Status, Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barreuto, Jon M. Hirshon

Publications and Research

Introduction: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.

Methods: We collected monthly mean data including patient volume, hospitalization percentages, …

Development And Validation Of Measures To Evaluate Adolescents' Knowledge About Human Papillomavirus (Hpv), Involvement In Hpv Vaccine Decision-Making, Self-Efficacy To Receive The Vaccine And Fear And Anxiety, A. S. Forster, K. A. Mcbride, C. Davies, T. Stoney, H. Marshall, K. Mcgeechan, Spring C. Cooper, S. R. Skinner

Publications and Research

Objectives: We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). Study design: Literature search, cognitive interviews and cross-sectional survey.

Methods: A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and …

Identifying Inequities In Maternal And Child Health Through Risk Stratification To Inform Health Systems Strengthening In Northern Togo, Katharine J. Mccarthy, Sandra Braganza, Kevin Fiori, Christophe Gbeleou, Vivien Kpakpo, Andrew Lopez, Jennifer Schechter, Alicia Singham Goodwin, Heidi E. Jones

Publications and Research

Objective
In Togo, substantial progress in maternal and child health is needed to reach global development goals. To better inform clinic and community-based health services, this study identifies factors associated with maternal and child health care utilization in the Kara region of Northern Togo.

Methods
We conducted a population-representative household survey of four health clinic catchment areas of 1,075 women of reproductive age in 2015. Multivariable logistic regression was used to model individual and structural factors associated with utilization of four maternal and child health services. Key outcomes were: facility-based delivery, maternal postnatal health check by a health professional within …

Longitudinal Associations Between Body Mass Index, Physical Activity, And Healthy Dietary Behaviors In Adults: A Parallel Latent Growth Curve Modeling Approach, Youngdeok Kim, Jung-Min Lee, Jungyoon Kim, Emily Dhurandhar, Ghada Soliman, Nizar K. Wehbi, James Canedy

Publications and Research

Background Physical activity (PA) and healthy dietary behaviors (HDB) are two well-documented lifestyle factors influencing body mass index (BMI). This study examined 7-year longitudinal associations between changes in PA, HDB, and BMI among adults using a parallel latent growth curve modeling (LGCM).

Methods We used prospective cohort data collected by a private company (SimplyWell LLC, Omaha, NE, USA) implementing a workplace health screening program. Data from a total of 2,579 adults who provided valid BMI, PA, and HDB information for at least 5 out of 7 follow-up years from the time they entered the program were analyzed. PA and HDB …