Medicine and Health Sciences Commons^™

Association Between Depression And Aggression In Rural Women, Laetitia Meyrueix, Gabriel Durham, Jasmine Miller, K. Bryant Smalley Phd, Psyd, Jacob C. Warren Phd

Journal of Health Disparities Research and Practice

Rural women represent approximately 20% of women living in the United States, yet research on the specific mental health needs of rural women is limited. Given the well-recognized gender-linked disparity in depression, its correlated symptoms in women still need much investigation. While emerging notions of depression in men embrace potential symptoms related to irritability and aggression, less research has focused on the potential role of aggression in depressed women. This connection may be particularly relevant for rural women who face unique mental health stressors in comparison to their urban counterparts. The purpose of this study was to examine if aggression …

Hawai‘I’S Caring Communities Initiative: Mobilizing Rural And Ethnic Minority Communities For Youth Suicide Prevention, Jane J. Chung-Do, Deborah A. Goebert, Kris Bifulco, Tasha Tydingco, Antonia Alvarez, Davis Rehuher, Jeanelle Sugimoto-Matsuda, Bridget Arume, Pohai Wilcox

Journal of Health Disparities Research and Practice

Youth suicide is a serious, yet preventable, public health concern for ethnic minorities and rural communities. This paper describes the youth leadership model utilized by Hawai‘i’s Caring Communities Initiative (HCCI) and provides reflections on the important factors for success in implementing a youth and community advocacy project for youth suicide prevention. HCCI partnered with six youth and community organizations who serve ethnic minority and rural communities across the State of Hawai‘i to train youth leaders and community members in suicide prevention, in order to develop community awareness activities that are grounded in each community’s strengths and needs. The work of …

Epidemiology Of Hiv Among American Indians And Alaska Natives – United States, 2008-2011, Frances J. Walker, Jane M. Kelly, Mona Doshani, Neeraja Saduvala, Joseph Prejean

Journal of Health Disparities Research and Practice

American Indians/Alaska Natives (AI/AN) diagnosed with HIV infection have poorer survivorship and a higher percentage of Stage 3 (AIDS] diagnoses within one year of HIV diagnosis, compared to most race/ethnicity groups. National HIV surveillance data for 2008-2011 were used to determine diagnosis rates of HIV infection, persons living with HIV, and persons with a late diagnosis (Stage 3 within three months of HIV diagnosis) by selected characteristics for AI/AN and a combined other race/ethnicity group. The highest percentages of 862 AI/AN diagnosed with HIV infection were among males (75.7%), AI/AN aged 25-34 years (32.9%), persons living in large metropolitan areas …

"There’S More To Us Than This:" A Qualitative Study Of Black Young Adults’ Perceptions Of Media Portrayals Of Hiv, Maya Corneille, Anna Lee, Roseina Britton, Judith C. Barker

Journal of Health Disparities Research and Practice

The extent to which the targeted group attends to and is engaged by HIV/STI prevention messages is one component of effective health communication. Through an empirical examination of the cumulative perceptions of HIV/STI prevention media messages targeted to Black youth and young adults, this qualitative study privileges the voices of Black/ African American young adults as a group that is frequently targeted in HIV prevention campaigns. Semi-structured interviews with 23 Black/African American young adults yielded key themes that suggest barriers to effective health communication. Traditionally, health promotion has advocated for targeted messages as a means to increase risk perception and …

Community Based Participatory Research: The Application And Lessons Learned From A Study With Lgb College Students, Caitlin M. Stover

Journal of Health Disparities Research and Practice

Lesbian, gay, and bisexual (LGB) individuals are members of a vulnerable group where health disparities have been identified. To gain a better understanding of the LGB college student healthcare experience and its contribution to the healthcare disparities found in LGB population, a community based participatory research (CBPR) approach was used to fill the gap. This paper will outline the CBPR process with an emphasis on how the principle investigator applied the tenets of CBPR when working with a local LGB college community. Several lessons learned from the research process are also shared in this paper.

The Role Of Trauma In Disparities For Cancer-Related Health: A Call To Action, Megan Bair-Merritt

Journal of Health Disparities Research and Practice

Cancer is the second leading cause of death in the United States. In this brief report, we describe the current literature on interpersonal trauma (i.e., sexual abuse and intimate partner violence) and cancer. Concordant with the general population, between 20% and 50% of cancer patients have experienced interpersonal trauma. Experiences with interpersonal trauma not only appear to increase risk for developing cancer, but may also act as a roadblock to accessing appropriate preventive testing and to receiving adequate support during cancer care. Healthcare providers can play an important role in making cancer-related care more trauma-informed.

Understanding How Components Of Black Racial Identity And Racial Realities May Impact Healthcare Utilization: A Randomized Study, Alexander M. Chaitoff, Thomas Wickizer, Ismail White

Journal of Health Disparities Research and Practice

Purpose: Studies have suggested that even when minority groups have potential access to healthcare, they may have inadequate utilization (realized access). This study explores the application of a theory from the social psychology and political science literatures concerning how racial centrality and racial realities, specifically amongst Blacks, may influence patients’ healthcare utilization preferences.

Methods: We created a survey with two (pseudo) randomized, controlled experimental treatments designed to assess whether racialized hospital and physician characteristics elicited a preference from Black or White respondents, as well as questions aimed at understanding participants’ different beliefs and levels of knowledge about past and current …

Social Determinants Of Late Stage Hiv Diagnosis And Its Distributions Among African Americans And Latinos: A Critical Literature Review, Alison M. Chopel, Meredith Minkler, Amani Nuru-Jeter, Megan Dunbar

Journal of Health Disparities Research and Practice

ABSTRACT

This critical literature review was conducted to identify both individual- and environmental-level social determinants of health using an ecological framework as a way to contextualize risk for, and distributions of, late HIV diagnosis among African Americans and Latinos in the United States.

Background: Late diagnosis, defined as a diagnosis of AIDS simultaneously with or within one year of an initial HIV diagnosis,¹ disproportionately affects African American and Latino communities;^2,3 disparities in this health problem thus represent a preventable inequity. Such disparities affect not only late diagnosed individuals but also population levels of HIV incidence, as transmission is …

Results Of A Community Randomized Study Of A Faith-Based Education Program To Improve Clinical Trial Participation Among African Americans, Paula M. Frew, Jay T. Schamel, Kelli A. O'Connell, Laura A. Randall, Sahithi Boggavarapu

Environmental & Occupational Health Faculty Publications

This is a report of a cluster randomized clinical trial evaluating the effectiveness of a church-based educational intervention aimed at improving African Americans’ (AA) participation in clinical trials. Two hundred and twenty-one AA subjects ages ≥50 years from six predominantly AA churches were randomized to intervention or control condition. The intervention included three educational sessions about clinical trials and health disparities; control participants completed questionnaires. Primary endpoints of the study were differences in individual subjects' intentions to obtain clinical trial information and intention to join a clinical trial, as determined by 10 point scale items at baseline, three and six …

A Comparison Of Beliefs And Attitudes About Body Image, Eating And Weight Between Incarcerated And Non-~Incarcerated Females, Anne R. Lindsay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract

Incarceration and substance abuse are two of the largest public health issues in America. While the U.S. makes up only 5% of the world’s population, it accounts for 25% of its prisoners. Incarceration affects more than 2.2 million individuals who will eventually return to their families and communities with ongoing family, social and health issues. Women in prison are a particularly vulnerable and underserved population, generally of low education and socio-economic status and although they account for a small percent of the prison population, many are mothers of young children who are likely to become incarcerated themselves. Substance abuse …

Adapting And Piloting An Evidence-~Based Hiv/Aids And Teen Pregnancy Prevention Intervention For Native American Teens, Murlynn Crystal Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Native American youth are at disproportionate risk for HIV infection. Native Americans represent about 1.7% of the U.S. population, yet they rank fifth in HIV/AIDS diagnosis nationwide (U.S. Census, 2012; CDCd 2013). Native Americans with HIV/AIDS are more likely to be younger than non-Native Americans with the disease. There are limited evidence-based HIV/AIDS and teen pregnancy prevention interventions that have been developed, adapted, and/or evaluated for Native American teens. The purpose of this study was to adapt an existing evidence-based HIV/AIDS and teen pregnancy prevention intervention into a culturally responsive intervention curriculum for Native teens. Methods: There were three …

Health Impact Assessment Of Proposed Rental Housing Policy Within Clark County, Nevada, Usa, Erika Raquel Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Homes serve as a central function of our everyday lives, they are where most Americans spend a significant amount of time and money. The quality of our homes can impact our health. Poor housing can cause and contribute to preventable diseases and injuries, such as the development or exacerbation of asthma, neurological deficits, cardiovascular diseases, and cancer. According to the American Housing Survey (2013) approximately 5.8 million homes, of 132 million homes in the United States, are in moderate to severe physical disrepair, with rental housing being at a disproportionate burden. According to 2013 U.S. Census, Clark County, Nevada has …

Television Consumption And Child Obesity: Linking Children's Contemporary Television Use, Physical Activity, And Advertising To Putnam's Displacement Hypothesis, Brittany L. Altamirano

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study observed the relationship between television consumption and child obesity through the theoretical construct of Putnam’s displacement hypothesis. It did so by updating the previous research through the investigation of the displacement of both physical activity and advertisements on contemporary television platforms. The inclusion of Putnam’s displacement hypothesis was to provide a foundational framework, not found in previous literature, to study two important paradigms that were represented in previous research: 1) the displacement of physical activity; and 2) the displacement of traditional advertisement exposure.

Several trends became apparent within previous literature. Previous literature did not include an explicitly stated …

Differences In Disease Reporting: An Analysis Of State Reportable Conditions And Their Relationship To The Nationally Notifiable Conditions List, Brian Labus

UNLV Theses, Dissertations, Professional Papers, and Capstones

The basis of public health surveillance is the reporting of diseases and conditions to the health department by clinicians and laboratories. In the United States, over eighty diseases and conditions of national importance (e.g., tuberculosis, syphilis, and cancer) are included on the list of Nationally Notifiable Conditions (NNC) for submission to the Centers for Disease Control and Prevention (CDC) by the states. The legal basis for disease reporting is found at the state level, where inconsistent laws may differ in terms of which conditions are reportable and their reporting process. The process by which states require the reporting of NNCs …

Factors Associated With Colorectal Cancer Screening Among Younger African American Men: A Systematic Review, Charles R. Rogers, Patricia Goodson, Margaret Foster

Journal of Health Disparities Research and Practice

Of cancers affecting both men and women, colorectal cancer (CRC) is the second leading cancer killer among African Americans in the U.S. Compared to White men, African American men have incidence and mortality rates 25% and 50% higher from CRC. Despite the benefits of early detection and the availability of effective screening, most adults over age 50 have not undergone testing, and disparities in colorectal cancer screening (CRCS) persist. Owing to CRC’s high incidence and younger age at presentation among African American men, CRCS is warranted at age 45 rather than 50. However, the factors influencing young adult (i.e., age < 50) African American men’s intention to screen and/or their CRCS behaviors has not been systematically assessed. To assess whether the factors influencing young adult African American men’s screening intentions and behaviors are changeable through structured health education interventions, we conducted a systematic review, with the two-fold purpose of: (1) synthesizing studies examining African American men's knowledge, beliefs, and behaviors regarding CRCS; and (2) assessing these studies’ methodological quality. Utilizing Garrard’s Matrix Method, a total of 28 manuscripts met our inclusion/exclusion criteria: 20 studies followed a non-experimental research design, 4 comprised a quasi-experimental design, and 4, an experimental design. Studies were published between 2002 and 2012; the majority, between 2007 and 2011. The factors most frequently assessed were behaviors (79%), beliefs (68%), and knowledge (61%) of CRC and CRCS. Six factors associated with CRC and CRCS emerged: previous CRCS, CRC test preference, perceived benefits, perceived barriers, CRC/CRCS knowledge, and physician support/recommendation. Studies were assigned a methodological quality score (MQS – ranging from 0 to 21). The mean MQS of 10.9 indicated these studies were, overall, of medium quality and suffered from specific flaws. Alongside a call for more rigorous research, this review provides important suggestions for practice and culturally relevant interventions.

Experiences With The Streptococcus Mutans In Lakota Sioux (Smiles) Study: Risk Factors For Caries In American Indian Children 0-3 Years, David R. Drake, Deborah Dawson, Katherine Kramer, Amy Schumacher, John Warren, Teresa Marshall, Delores Starr, Kathy Phipps

Journal of Health Disparities Research and Practice

Severe Early Childhood Caries (S-ECC) is a terribly aggressive and devastating disease that is all too common in lower socio-economic children, but none more so that what is encountered in American Indian Tribes. Nationwide, approximately 27% of 2-5 year olds have decay while 62% percent of American Indian/Alaska Native children in the same age group have a history of decay (IHS 2010, NHANES 1999-2002). We have conducted a study of children from birth to 36 months of age on Pine Reservation to gain a better understanding of the variables that come into play in the development of this disease, from …

Hispanic Ethnicity Is Associated With Increased Hospital Charges After Radical Cystectomy In The United States, Mark D. Tyson, Erik P. Castle

Journal of Health Disparities Research and Practice

Objective: To examine the impact of race and ethnicity on financial charges associated with radical cystectomy (RC).

Data Sources/Study Setting: The Nationwide Inpatient Sample was used to identify patients who underwent RC for bladder cancer between 1998 and 2010.

Study Design: The primary outcome was total hospital charges adjusted for inflation. Multivariate analysis was performed using a generalized linear model on the logarithmically transformed outcome variable (total hospital charges) after adjusting for age, sex, race, Elixhauser comorbidities, surgical approach, year, primary payer, hospital and surgeon annual RC volume, hospital characteristics, and postoperative complications.

Principle findings: A total of 14,873 patients …

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

Caregivers Of Underserved Minority Populations: Views And Opinions Of The Role Of Schools In Bmi Screening, Education And Communication, Lori Keough Phd, M.Ed, Fnp-Bc

Journal of Health Disparities Research and Practice

A pilot study exploring caregiver views of the role of schools in students’ health.

Abstract

To date, 20 states in theUnited Statesrequire school-based body mass index (BMI) screening for school-aged populations and for some the requirements include caregiver notification of the findings. Few studies have provided empirical data indicating whether or not caregivers accept or act on BMI communication from schools. Therefore, an exploratory pilot study was conducted in a culturally diverse urban school district to determine how a required (BMI) screening and notification were viewed by caregivers. Most caregivers reported that they felt schools did not have a role …

Implementation And Feasibility Of An Auricular Acupuncture Intervention For Smoking Cessation In A Residential Spiritual Recovery Program: A Pilot Study, Cynthia Johnson, Payam Sheikhattari, Lixing Lao, Yvonne Bronner, Fernando Wagner

Journal of Health Disparities Research and Practice

Abstract

This study examined the feasibility of recruiting of participants and retention to an auricular acupuncture intervention for smoking cessation at a residential spiritual recovery program for a chemically dependent population in the mid-Atlantic region. The association between beliefs about acupuncture and smoking cessation were also assessed. This was an intervention study guided by the principles of Community Based Participatory Research (CBPR).

The National Acupuncture Detoxification Association (NADA) protocol was used as part of the smoking cessation intervention (participants received auricular acupuncture for 40 minutes, 3 times per week for 1 month). Smoking cessation, adherence rate to the treatment plan, …

The Complexities Of Childhood Obesity: A Qualitative Study Among Mexican American Mothers, Erica T. Sosa, E. Lisako Mckyer, Buzz Pruitt, Patricia Goodson, Linda Castillo

Journal of Health Disparities Research and Practice

Introduction: Mothers play an important role in preventing childhood obesity; however, might differ in how they define healthy weight and the associated consequences. Due to the lack of research investigating how Mexican American mothers perceive childhood obesity, the purpose of this paper is to qualitatively assess Mexican-American mothers’ perceptions regarding childhood obesity, its causes and consequences.

Methods: Three focus groups, two in Spanish and one in English, were conducted with 23 mothers in Bryan, TX. Thematic analysis was performed by three researchers independently using sentences as the unit of meaning.

Findings: Mexican American mothers believed that a …

Educators’ Perspectives Associated With School Garden Programs In Clark County, Nevada: Practices, Resources, Benefits And Barriers., Tomomi Murakami

UNLV Theses, Dissertations, Professional Papers, and Capstones

School garden programs have been utilized in the U.S. since their introduction at the end of the 19th century. The use of school gardens and the teaching style implemented in them are dependent on individual schools and teachers. Educators’ attitudes, knowledge, and motivation for a school-based gardening program are crucial to implementing comprehensive school garden programs. To move toward an expansion of garden education, it is necessary to determine the concerns, resources, benefits or barriers that educators identify regarding the utilization of gardens to teach their students. The purpose of this pilot study was to determine principals’ and teachers’ perceived …

The Presence Of Clostridium Difficile On Environmental Surfaces In Healthcare Facilities Pre- And Post-Decontamination Of Patient Rooms, Theresa Trice

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections (HAIs) are infections related to receiving medical care. HAIs are responsible for an excess of morbidity and mortality among hospitalized patients. Though most HAIs rates are on the decline, Clostridium difficile infection rates are at an all-time high, primarily due to the persistence of C. difficile spores in the environment. In the United States, Clostridium difficile-related mortality rates per million have increased from 5.7 in 1999 to 23.7 in 2004, with an estimated 26,642 deaths due to Clostridium difficile infections (CDIs). Clostridium difficile is transmitted via the fecal-oral route or aerosolized endospores, but it can also be transmitted …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Journal of Health Disparities Research and Practice

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Factors Influencing Hpv Vaccine Use Among Racially Diverse Female College Students, Timmerie F. Cohen, Jeffrey Legg

Journal of Health Disparities Research and Practice

Abstract

Objective. This study describes Human Papillomavirus (HPV) vaccination rates and possible factors influencing vaccination utilization rates in a diverse population of college women 18-26 years old.

Methods. The National College Health Assessment survey provided a large diverse sample size (N=67,762) in which to perform descriptive and binary logistic regression analysis. Demographic characteristics were analyzed as potential barriers to HPV vaccination. Additionally, lack of certain health behaviors were explored as potential barriers to HPV vaccination.

Results. In this study, White/non-Hispanic women had a higher HPV vaccination rate when compared to minority women. Binary regression analysis demonstrated that minority …

Modeling Bmi, Dietary Habits, And Physical Activity Among Ethnically Diverse Urban College Students, Hollie Jones, Nicholas Freudenberg, Lorraine Mongiello

Journal of Health Disparities Research and Practice

Objectives The objective of this research study was to examine the relationship between BMI, physical activity, dietary habits, and student demographic factors (age, ethnicity, income, immigration, and sex). Given the association between overweight and obesity and the inequitable burden of chronic health conditions among ethnic minority populations, a deeper understanding of the socioeconomic, gender, age, and racial/ethnic variation in BMI, physical activity, and dietary habits is needed. The shifting demographics of urban college populations make urban college campuses an important setting for addressing the lifetime health needs of ethnically diverse urban populations.

Methods In this cross-sectional non-experimental study, we used …

Addressing Disparities In Access To Information For Hispanic Families Of Children With Special Health Care Needs, Suzanne M. Bronheim, Sandra Soto, Bruno J. Anthony

Journal of Health Disparities Research and Practice

Objectives: Utilizing a diffusion of innovation (DOI) framework, the study seeks to increase access to information for Hispanic families of children with special health care needs (SHCN) by increasing their use of Family-to-family Centers (F2Fs) in their states. Methods: Focus groups were implemented of both English-speaking and Spanish-speaking Hispanic families in two states with a confirming Delphi procedure exploring factors within DOI framework related to using F2Fs and the nature of current family communication networks. Results: Families seeking information at key change points turn to formal sources, although Spanish-speaking families, noted that due to language barriers, they also turned to …

Personal, Family, And Peer Correlates Of General And Sport Physical Activity Among African American, Latino, And White Girls, Susan C. Duncan, Lisa A. Strycker, Nigel R. Chaumeton

Journal of Health Disparities Research and Practice

This study examined associations between personal, family, and peer variables on objectively measured physical activity (PA), and sports participation, of African American, Latino, and white girls. Specific variables included barriers efficacy, parent PA, parent support of PA, the home exercise environment, friends’ PA, and friends’ support of PA. The sample comprised 372 girls (mean age = 12.03 years; SD = 1.81; n = 128 African American, n = 120 Latino, and n = 124 white). Data were analyzed using multiple-sample structural equation models (by ethnicity), controlling for age, household income, body mass index, and physical development. Girls’ moderate to vigorous …

The Self-Reported Sexual Behaviors Of Single Older African Americans, Victoria Foster, Patricia C. Clark, Marcia M. Holstad

Journal of Health Disparities Research and Practice

Abstract

African Americans are disproportionally affected by HIV/AIDS, but little is known about the risky sexual behaviors of older African Americans. This cross-sectional, comparative study, investigated the self-reported sexual behaviors of sexually active older African Americans. The nonrandom sample (N = 78) included single African American men (59%) and women (41%), 50-74 years of age. Participants were recruited from various community sites, and data were collected with a standard sexual history questionnaire. Participants reported practicing risky behaviors such having unprotected oral, anal, and vaginal sex (96.5%), and having multiple sex partners (37.2%). There were several significant gender differences such …

Improving Influenza And Tdap Vaccination During Pregnancy: A Cluster-Randomized Trial Of A Multi-Component Antenatal Vaccine Promotion Package In Late Influenza Season, A. T. Chamberlain, K. Seib, K. A. Ault, E. S. Rosenberg, Paula M. Frew, M. Cortés, E. A. S. Whitney, R. L. Berkelman, W. A. Orenstein, S. B. Omer

Environmental & Occupational Health Faculty Publications

Background Evidence-based interventions to improve influenza vaccine coverage among pregnant women are needed, particularly among those who remain unvaccinated late into the influenza season. Improving rates of antenatal tetanus, diphtheria and acellular pertussis (Tdap) vaccination is also needed.