Medicine and Health Sciences Commons^™

Perspective: Food Environment Research Priorities For Africa-Lessons From The Africa Food Environment Research Network, Amos K. Laar, Phyllis Addo, Richmond Aryeetey, Charles Agyemang, Francis Zotor, Gershim Asiki, Krystal K. Ramapalli, Gideon S. Anevinya, Akua Tandoh, Silver Nanema, Akosua Pokua Adjei, Matlida E. Laar, Kobby Mensah, Dennis Laryea, Daniel Sellen, Stefanie Vandevijvere, Christopher Turner, Hibbah Osei-Kwasi, Mark Spires, Christine E. Blake, Dominic Rowland, Suneetha Kadiyala, Isabel Madzorera, Adama Diouf, Namukolo Covic, Isaac M. Dzudzor, Reginald Annan, Peiman Milani, John Nortey, Nicholas Bricas, Sukati Mphumuzi, Kenneth Yongabi Anchang, Ali Jafri, Meenal Dhall, Amanda Kee, Sally Mckay, Samuel O. Oti, Karen Hofman, Edward A. Frongillo Jr. Ph.D., Michelle Holdsworth

Faculty Publications

Over the last 2 decades, many African countries have undergone dietary and nutrition transitions fueled by globalization, rapid urbanization, and development. These changes have altered African food environments and, subsequently, dietary behaviors, including food acquisition and consumption. Dietary patterns associated with the nutrition transition have contributed to Africa's complex burden of malnutrition—obesity and other diet-related noncommunicable diseases (DR-NCDs)—along with persistent food insecurity and undernutrition. Available evidence links unhealthy or obesogenic food environments (including those that market and offer energy-dense, nutrient-poor foods and beverages) with suboptimal diets and associated adverse health outcomes. Elsewhere, governments have responded with policies to improve food …

Mindfulness, Psychological Distress, And Somatic Symptoms Among Women Engaged In Sex Work In China, Cheuk Chi Tam, Yuejiao Zhao, Shan Qiao, Xiaoming Li, Zhiyong Shen

Faculty Publications

Women engaged in sex work (WSW) in China encounter numerous disadvantages (e.g., exposure to violence) and have substantial risk for psychological distress and somatic symptoms. Intervention literature has attended to mindfulness, which is a protective factor for psychological outcomes, and its influences can further improve physical health. However, mindfulness has not been well studied in WSW. We aimed to examine the association among mindfulness, psychological distress, and somatic symptoms among Chinese WSW. Data were collected from 410 WSW in Guangxi, China, using an anonymous, self-administered survey evaluating demographics, mindfulness, psychological distress (i.e., depression, loneliness, and perceived stress), and somatic symptoms …

The Effect Of Social Exclusion On Trust Among Youth Orphaned By Hiv/Aids: Evidence From An Event-Related Potentials Study, Jiaojiao Wan, Qi Zhao, Yafei Zhang, Lili Ji, Junfeng Zhao, Shan Qiao Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Grounded in a follow-up study among children who lost one or both parents to HIV in central China in the early 2000s, we conducted an event-related potentials (ERPs) experiment to explore the effect of social exclusion on trust and the corresponding neurophysiological mechanism among youth orphaned by HIV/AIDS (“AIDS orphans”). A sample of 31 AIDS orphans (26.16 ± 3.34 years old; 15 female) and 32 age and development status matched controls (25.02 ± 3.45 years old; 14 female) participated in the study. They were all assigned to play Cyberball, a virtual ball-tossing game that reliably induced social exclusion (15 orphans, …

Three Dimensions Of Covid-19 Risk Perceptions And Their Socioeconomic Correlates In The United States: A Social Media Analysis, Shan Qiao Ph.D., Zhenlong Li Ph.D., Chen Liang Ph.D., Xiaoming Li Ph.D., Caroline Rudisill Ph.D.

Faculty Publications

Social media analysis provides an alternate approach to monitoring and understanding risk perceptions regarding COVID-19 over time. Our current understandings of risk perceptions regarding COVID-19 do not disentangle the three dimensions of risk perceptions (perceived susceptibility, perceived severity, and negative emotion) as the pandemic has evolved. Data are also limited regarding the impact of social determinants of health (SDOH) on COVID-19-related risk perceptions over time. To address these knowledge gaps, we extracted tweets regarding COVID-19-related risk perceptions and developed indicators for the three dimensions of risk perceptions based on over502 million geotagged tweets posted by over 4.9 million Twitter users …

Three Dimensions Of Covid-19 Risk Perceptions And Their Socioeconomic Correlates In The United States: A Social Media Analysis, Shan Qiao, Zhenlong Li, Caroline Rudsill

Faculty Publications

Social media analysis provides an alternate approach to monitoring and understanding risk perceptions regarding COVID-19 over time. Our current understandings of risk perceptions regarding COVID-19 do not disentangle the three dimensions of risk perceptions (perceived susceptibility, perceived severity, and negative emotion) as the pandemic has evolved. Data are also limited regarding the impact of social determinants of health (SDOH) on COVID-19-related risk perceptions over time. To address these knowledge gaps, we extracted tweets regarding COVID-19-related risk perceptions and developed indicators for the three dimensions of risk perceptions based on over 502 million geotagged tweets posted by over 4.9 million Twitter …

“Where The Truth Really Lies”: Listening To Voices From African American Communities In The Southern States About Covid-19 Vaccine Information And Communication, Ran Zhang, Shan Qiao, Brooke Mckeever, Bankole Olatosi, Xiaoming Li

Faculty Publications

The high uptake of COVID-19 vaccines is one of the most promising measures to control the pandemic. However, some African American (AA) communities exhibit vaccination hesitancy due to mis- or disinformation. It is important to understand the challenges in accessing reliable COVID-19 vaccine information and to develop feasible health communication interventions based on voices from AA communities. We conducted 2 focus group discussions (FGDs) among 18 community stakeholders recruited from 3 counties in South Carolina on 8 October and 29 October 2021. The FGDs were conducted online via Zoom meetings. The FGD data were managed and thematically analyzed using NVivo …

How Different Pre-Existing Mental Disorders And Their Co-Occurrence Affects Covid-19 Clinical Outcomes? A Real-World Data Study In The Southern United States, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Shujie Chen, Bankole Olatosi Ph.D., Suzanne Hardeman, Meera Narasimhan, Larisa Bruner, Abdoulaye Diedhiou, Cheryl Scott, Ali Mansaray, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Background: Although a psychiatric history might be an independent risk factor for COVID-19 infection and mortality, no studies have systematically investigated how different clusters of pre-existing mental disorders may affect COVID-19 clinical outcomes or showed how the coexistence of mental disorder clusters is related to COVID-19 clinical outcomes.

Methods: Using a retrospective cohort study design, a total of 476,775 adult patients with lab-confirmed and probable COVID-19 between March 06, 2020 and April 14, 2021 in South Carolina, United States were included in the current study. The electronic health record data of COVID-19 patients were linked to all payer-based claims data …

Multilevel Determinants Of Racial/Ethnic Disparities In Severe Maternal Morbidity And Mortality In The Context Of The Covid-19 Pandemic In The Usa: Protocol For A Concurrent Triangulation, Mixed-Methods Study, Jihong Liu, Peiyin Hung Ph.D, Chen Liang Ph.D., Jiajia Zhang Ph.D., Shan Qiao Ph.D., Berry A. Campbell, Bankole Olatosi Ph.D., Myriam E. Torres Ph. D., Neset Hikmet, Xiaoming Li Ph.D.

Faculty Publications

Introduction The COVID-19 pandemic has affected communities of colour the hardest. Non-Hispanic black and Hispanic pregnant women appear to have disproportionate SARS-CoV-2 infection and death rates.

Methods and analysis We will use the socioecological framework and employ a concurrent triangulation, mixed-methods study design to achieve three specific aims: (1) examine the impacts of the COVID-19 pandemic on racial/ethnic disparities in severe maternal morbidity and mortality (SMMM); (2) explore how social contexts (eg, racial/ethnic residential segregation) have contributed to the widening of racial/ethnic disparities in SMMM during the pandemic and identify distinct mediating pathways through maternity care and mental health; and …

Examining Social Determinants Of Health During A Pandemic: Clinical Application Of Z Codes Before And During Covid-19, Xueying Yang Ph.D., Brooks Yelton, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Shan Qiao Ph.D., Xiaoming Li Ph.D., Daniela B. Friedman Ph.D.

Faculty Publications

Recognition of the impact of social determinants of health (SDoH) on healthcare outcomes, healthcare service utilization, and population health has prompted a global shift in focus to patient social needs and lived experiences in assessment and treatment. The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) provides a list of non-billable “Z codes” specific to SDoH for use in electronic health records. Using population-level analysis, this study aims to examine clinical application of Z codes in South Carolina before and during the COVID-19 pandemic. The study population consists of South Carolina residents who had a healthcare visit and had …

Social Capital, Urbanization Level, And Covid-19 Vaccination Uptake In The United States: A National Level Analysis, Shan Qiao, Zhenlong Li, Jiajia Zhang, Xiaowen Sun, Camryn Garrett, Xiaoming Li

Faculty Publications

Vaccination remains the most promising mitigation strategy for the COVID-19 pandemic. However, existing literature shows significant disparities in vaccination uptake in the United States. Using publicly available national-level data, we aimed to explore if county-level social capital can further explain disparities in vaccination uptake rates when adjusting for demographic and social determinants of health (SDOH) variables, and if association between social capital and vaccination uptake may vary by urbanization level. Bivariate analyses and a hierarchical multivariable quasi-binomial regression analysis were conducted, where the regression analysis was stratified by urban–rural status. The current study suggests that social capital contributes significantly to …

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

The Relationship Of Hair Glucocorticoid Levels To Immunological And Virological Outcomes In A Large Cohort Of Combination Antiretroviral Therapy Treated People Living With Hiv, Quan Zhang, Xiaoming Li Ph.D., Shan Qiao Ph.D., Shuaifeng Liu, Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Background

Existing literature mostly investigated the relationship of acute or short-term glucocorticoid exposure to HIV disease progression using cortisol levels in serum, saliva, or urine. Data are limited on the relationship of long-term glucocorticoid exposure to HIV disease progression. This study examined whether hair glucocorticoid levels, novel retrospective indicators of long-term glucocorticoid exposure, are associated with two common indicators of HIV disease progression (CD4 count and HIV viral load) among a large cohort of combination antiretroviral therapy treated Chinese people living with HIV (PLHIV).

Methods

A total of 1198 treated PLHIV provided hair samples for glucocorticoid (cortisol and cortisone) assay …

Evaluation Of A Community-Based Performance Arts Programme For People Who Have Experienced Stroke In The Uk: Protocol For The Shaper-Stroke Odysseys Study, Carolina Estevao, Maria Baldellou Lopez, Rachel E. Davis, Lucinda Jarret, Tayana Soukup, Ioannis Bakolis, Andy Healey, Jean Harrington, Anthony Woods, Nikki Crane, Fiona Jones, Carmine Pariante, Daisy Fancourt, Nick Sevdalis

Faculty Publications

INTRODUCTION: Stroke survivors, once in the community, face challenges with their long-term rehabilitation care and present higher levels of loneliness, depression and anxiety than the rest of the population. A community-based performance arts programme, Stroke Odysseys (SO), has been devised to tackle the challenges of living with stroke in the UK. In this study, we aim to evaluate the implementation, impact and experiences of SO for stroke survivors. METHODS AND ANALYSIS: Scaling-up Health Arts Programmes: Implementation and Effectiveness Research (SHAPER)-SO aims to scale-up SO to 75 participants and 47 stakeholders, while simultaneously evaluating the effectiveness and implementation of the programme. …

Specificity Matters: Unpacking Impact Pathways Of Individual Interventions Within Bundled Packages Helps Interpret The Limited Impacts Of A Maternal Nutrition Intervention In India, Shivani Kachwaha, Phuong H. Nguyen, Lan Mai Tran, Rasmi Avula, Melissa F. Young, Sebanti Ghosh, Thomas Forissier, Jessica Escobar-Alegria, Praveen Kumar Sharma, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

BACKGROUND: To address gaps in coverage and quality of nutrition services, Alive & Thrive (A&T) strengthened the delivery of maternal nutrition interventions through government antenatal care (ANC) services in Uttar Pradesh, India. The impact evaluation of the A&T interventions compared intensive ANC (I-ANC) with standard ANC (S-ANC) areas and found modest impacts on micronutrient supplementation, dietary diversity, and weight-gain monitoring. OBJECTIVES: This study examined intervention-specific program impact pathways (PIPs) and identified reasons for limited impacts of the A&T maternal nutrition intervention package. METHODS: We used mixed methods: frontline worker (FLW) surveys (n = ∼500), counseling observations (n = 407), and …

Study Protocol: Randomised Controlled Hybrid Type 2 Trial Evaluating The Scale-Up Of Two Arts Interventions For Postnatal Depression And Parkinson’S Disease, Tayana Soukup, Rachel Davis, Maria Baldellou Lopez, Andy Healey, Carolina Estevao, Daisy Fancourt, Paola Dazzan, Carmine Pariante, Hannah Dye, Tim Osborn, Rebecca Bind, Kristi Sawyer, Lavinia Rebecchini, Katie Hazelgrove, Alexandra Burton, Manonmani Manoharan, Rosie Perkins, Aleksandra Podlewska, Ray Chaudhuri, Fleur Derbyshire-Fox, Alison Hartley, Anthony Woods, Nikki Crane

Faculty Publications

INTRODUCTION: Research on the benefits of 'arts' interventions to improve individuals' physical, social and psychological well-being is growing, but evidence on implementation and scale-up into health and social care systems is lacking. This protocol reports the SHAPER-Implement programme (Scale-up of Health-Arts Programmes Effectiveness-Implementation Research), aimed at studying the impact, implementation and scale-up of: Melodies for Mums (M4M), a singing intervention for postnatal depression; and Dance for Parkinson's (PD-Ballet) a dance intervention for Parkinson's disease. We examine how they could be embedded in clinical pathways to ensure their longer-term sustainability. METHODS AND ANALYSIS: A randomised two-arm effectiveness-implementation hybrid type 2 trial …

Social Determinants Of Health And Depression Among African American Adults: A Scoping Review Of Current Research, Brooks Yelton, Daniela B. Friedman, Samuel Noblet, Matthew C. Lohman, Mark M. Macauda, Mayank Sakhuja, Katherine H. Leith

Faculty Publications

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for …

The Mediating Effect Of Depression On The Relation Between Interpersonal Needs And Suicidal Ideation Among Chinese Transgender Women, Ruijie Chang, Chengbo Zeng, Shan Qiao Ph.D., Huwen Wang, Chen Xu, Xiaoyue Yu, Tiecheng Ma, Ying Wang, Xiaoming Li Ph.D., Yong Cai

Faculty Publications

Background: Transgender women are at high risk of depression and suicidal ideation. The interpersonal theory of suicide proposes that suicidal ideation could be a consequence of high interpersonal needs (thwarted belongingness and perceived burdensomeness). The current study tests this theory and investigates whether depression could mediate the relationship between interpersonal needs and suicidal ideation among transgender women in Shenyang, China.

Methods: A total of 198 transgender women were recruited by snowball sampling. A cross-sectional study was conducted through a structured questionnaire. Suicidal ideation, depression, and interpersonal needs were assessed. Path analysis was used to carry out the research goals and …

Challenges For Estimating The Global Prevalence Of Micronutrient Deficiencies And Related Disease Burden: A Case Study Of The Global Burden Of Disease Study, Sonja Y. Hess, Alexander C. Mclain, Edward A. Frongillo Jr., Ashkan Afshin, Nicholas J. Kassebaum, Saskia J. Osendarp, Reed Atkin, Rahul Rawat, Kenneth H. Brown

Faculty Publications

Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators …

Shaper-Pnd Trial: Clinical Effectiveness Protocol Of A Community Singing Intervention For Postnatal Depression, Carolina Estevao, Rebecca Bind, Daisy Fancourt, Kristi Sawyer, Paola Dazzan, Nick Sevdalis, Anthony Woods, Nikki Crane, Lavinia Rebecchini, Katie Hazelgrove, Manonmani Manoharan, Alexandra Burton, Hannah Dye, Tim Osborn, Rachel E. Davis, Tayana Soukup, Jorge Arias De La Torre, Ioannis Bakolis, Andy Healey, Rosie Perkins, Carmine Pariante

Faculty Publications

INTRODUCTION: Postnatal depression (PND) affects approximately 13% of new mothers. Community-based activities are sought after by many mothers, especially mothers that prefer not to access pharmacological or psychological interventions. Singing has shown positive effects in maternal mood and mother-child bonding. The Scaling-Up Health-Arts Programmes: Implementation and Effectiveness Research-Postnatal Depression study will analyse the clinical and implementation effectiveness of 10-week singing sessions for PND in new mothers. This protocol paper will focus on the clinical effectiveness of this trial. METHODS AND ANALYSIS: A total of 400 mothers with PND (with a score of at least 10 on the Edinburgh Postnatal Depression …

The Individual Water Insecurity Experiences (Iwise) Scale: Reliability, Equivalence And Validity Of An Individual-Level Measure Of Water Security, Sera L. Young, Hilary J. Bethancourt, Zacchary R. Ritter, Edward A. Frongillo Jr.

Faculty Publications

Objective: The lack of a validated and cross-culturally equivalent scale for measuring individual-level water insecurity has prevented identification of those most vulnerable to it. Therefore, we developed the 12-item Individual Water InSecurity Experiences (IWISE) Scale to comparably measure individual experiences with access, use, and stability (reliability) of water. Here, we examine the reliability, cross-country equivalence, and cross-country and within-country validity of the scale in a cross-sectional sample.

Methods: IWISE items were implemented by the Gallup World Poll among nationally representative samples of 43 970 adults (15 y) in 31 low-income and middle-income countries (LMICs). Internal consistency was assessed …

Prolonged Time From Diagnosis To Breast-Conserving Surgery Is Associated With Upstaging In Hormone Receptor-Positive Invasive Ductal Breast Carcinoma, Natalie Hills, Macall Leslie, Rachel Davis, Marielle Crowell, Hiroyasu Kameyama, Hallgeir Rui, Inna Chervoneva, William Dooley, Takemi Tanaka

Faculty Publications

BACKGROUND: Time to surgery (TTS) has been suggested to have an association with mortality in early-stage breast cancer. OBJECTIVE: This study aims to determine the association between TTS and preoperative disease progression in tumor size or nodal status among women diagnosed with clinical T1N0M0 ductal breast cancer. METHODS: Women diagnosed with clinical T1N0M0 ductal breast cancer who had breast-conserving surgery as their first definitive treatment between 2010 and 2016 (n = 90,405) were analyzed using the National Cancer Database. Separate multivariable logistic regression models for hormone receptor (HR)-positive and HR-negative patients, adjusted for clinical and demographic variables, were used to …

The Assessment Of An Extended Set Of Socio-Economic Determinants To Explain Anxiety And Uncertainty, Insufficient Quality And Food Intake Of Afghan Refugees, Mohammad Reza Pakravan-Charvadeh, Hassan Vatanparast, Edward A. Frongillo Jr., Mahasti Khakpour, Cornelia Flora

Faculty Publications

OBJECTIVES:

In this study, socio-economic factors associated with Afghan refugee households' food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined.

DESIGN:

Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors.

SETTING:

The study was carried out in urban areas of Tehran province in Iran. PARTICIPANTS: To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a …

Advancing Use Of Nutrition Knowledge To Improve Practice By Policy And Program Communities In India During A Political Transition, Edward A. Frongillo Jr., Jessica L. Escobar-Alegria

Faculty Publications

Models are needed for how to advance use of knowledge by programs and policy officials to make evidence-based decisions about nutrition. How to advance use of nutrition knowledge in India from 2011 to 2015 during a political transition was investigated through studying a knowledge initiative led by the International Food Policy Research Institute. Semistructured interviews were conducted with 37 diverse participants, and 1091 news articles, 318 Twitter and 175 Facebook posts, 12 YouTube events, 65 knowledge products, and 130 engaging events were assessed. Open-axial coding, content and themes analysis, triangulation, and process tracing were used. The knowledge initiative analyzed the …

A Structural Study Of The Cytoplasmic Chaperone Effect Of 14-3-3 Proteins On Ataxin-1, Seppe Leysen, Rebecca Jane Burnley, Elizabeth Rodriguez, Lech-Gustav Milroy, Lorenzo Soini, Carolyn J. Adamski, Larissa Nitschke, Rachel Davis, Tomas Obsil, Lucas Brunsveld, Tom Crabbe, Huda Yahya Zoghbi, Christian Ottmann, Jeremy Martin Davis

Faculty Publications

Expansion of the polyglutamine tract in the N terminus of Ataxin-1 is the main cause of the neurodegenerative disease, spinocerebellar ataxia type 1 (SCA1). However, the C-terminal part of the protein - including its AXH domain and a phosphorylation on residue serine 776 - also plays a crucial role in disease development. This phosphorylation event is known to be crucial for the interaction of Ataxin-1 with the 14-3-3 adaptor proteins and has been shown to indirectly contribute to Ataxin-1 stability. Here we show that 14-3-3 also has a direct anti-aggregation or "chaperone" effect on Ataxin-1. Furthermore, we provide structural and …

Maternal Resources For Care Are Associated With Child Growth And Early Childhood Development In Bangladesh And Vietnam, Sulochana Basnet, Edward A. Frongillo Jr., Phuong Hong Nguyen, Spencer Moore, Mandana Arabi

Faculty Publications

BACKGROUND:

Suboptimal child growth and development are significant problems in low- and middle-income countries. Maternal resources for care may help to improve growth and development. This study examined the association of maternal resources for care on child length, motor development and language development of children 12-23.9 months old.

METHODS:

We used baseline data from the Alive & Thrive household surveys collected in Bangladesh (n = 803) and Vietnam (n = 635). Resources for care were represented by maternal education, knowledge, height, well-nourishment, mental well-being, decision-making, employment, support in chores and perceived support. The regression analyses were adjusted for household wealth …

Relationship Between Food Insecurity And Smoking Status Among Women Living With And At Risk For Hiv In The Usa: A Cohort Study, Lila A. Sheira, Edward A. Frongillo Jr., Judith Hahn, Kartika Palar, Elise D. Riley, Tracey E. Wilson, Adebola Adedimeji, Daniel Merenstein, Mardge Cohen, Eryka L. Wentz, Adaora A. Adimora, Ighovwerha Ofotokun, Lisa Metsch, Janet M. Turan, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

Objectives People living with HIV (PLHIV) in the USA, particularly women, have a higher prevalence of food insecurity than the general population. Cigarette smoking among PLHIV is common (42%), and PLHIV are 6–13 times more likely to die from lung cancer than AIDS related causes. This study sought to investigate the associations between food security status and smoking status and severity among a cohort of predominantly low-income women of colour living with and without HIV in the USA.

Design Women enrolled in an ongoing longitudinal cohort study from 2013 to 2015.

Setting Nine participating sites across the USA.

Participants 2553 …

Adaptation Of The Agency For Healthcare Research And Quality’S ‘Hospital Survey On Patient Safety Culture’ To The Bosnia And Herzegovina Context, Šehad Draganović, Guido Offermanns, Rachel E. Davis

Faculty Publications

OBJECTIVES: Measuring staff perspectives on patient safety culture (PSC) can identify areas of concern that, if addressed, could lead to improvements in healthcare. To date, there is no validated measure to assess PSC that has been tested and adapted for use in Bosnia and Herzegovina (BiH). This research addresses the gap in the evidence through the psychometric assessment of the Agency for Healthcare Research and Quality's: 'Hospital Survey on Patient Safety Culture' (HSOPSC), to determine its suitability for the health system in BiH. SETTING: Nine hospitals. PARTICIPANTS: Healthcare professionals (n=1429); nurse (n=823), doctors (n=328), other clinical personnel (n=111), non-clinical personnel …

Water Insecurity Is Associated With Lack Of Viral Suppression And Greater Odds Of Aids-Defining Illnesses Among Adults With Hiv In Western Kenya, Jason M. Nagata, Joshua D. Miller, Craig R. Cohen, Edward A. Frongillo Jr., Elly Weke, Rachel Burger, Pauline Wekesa, Lila A. Sheira, A Rain Mocello, Phelgona Otieno, Lisa M. Butler, Elizabeth A. Bukusi, Sheri D. Weiser, Sera L. Young

Faculty Publications

Reliable access to safe and acceptable water in sufficient quantities (i.e., water security) is important for medication adherence and limiting pathogen exposure, yet prior studies have only considered the role of food security as a social determinant of HIV-related health. Therefore, the objective of this analysis was to assess the relationships between household water insecurity and HIV-related outcomes among adults living with HIV in western Kenya (N = 716). We conducted a cross-sectional analysis of baseline data from Shamba Maisha (NCT02815579), a cluster randomized controlled trial of a multisectoral agricultural and asset loan intervention. Baseline data were collected from June …

Covid-19 Disrupted Provision And Utilization Of Health And Nutrition Services In Uttar Pradesh, India: Insights From Service Providers, Household Phone Surveys, And Administrative Data, Phuong H. Nguyen, Shivani Kachwaha, Anjali Pant, Lan M. Tran, Monika Walia, Sebanti Ghosh, Praveen K. Sharma, Jessica Escobar-Alegria, Edward A. Frongillo Jr., Purnima Menon, Rasmi Avula

Faculty Publications

BACKGROUND: The coronavirus (COVID-19) pandemic may substantially affect health systems, but little primary evidence is available on disruption of health and nutrition services. OBJECTIVES: This study aimed to 1) determine the extent of disruption in provision and utilization of health and nutrition services induced by the pandemic in Uttar Pradesh, India; and 2) identify how adaptations were made to restore service provision in response to the pandemic. METHODS: We conducted longitudinal surveys with frontline workers (FLWs, n = 313) and mothers of children < 2 y old (n = 659) in December 2019 (in-person) and July 2020 (by phone). We also interviewed block-level managers and obtained administrative data. We examined changes in service provision and utilization using Wilcoxon matched-pairs signed-rank tests. RESULTS: Compared with prepandemic, service provision reduced substantially during lockdown (83-98 percentage points, pp), except for home visits and take-home rations (∼ 30%). Most FLWs (68%-90%) restored service provision in July 2020, except for immunization and hot cooked meals (< 10%). Administrative data showed similar patterns of disruption and restoration. FLW fears, increased workload, inadequate personal protective equipment (PPE), and manpower shortages challenged service provision. Key adaptations made to provide services were delivering services to beneficiary homes (∼ 40%-90%), social distancing (80%), and using PPE (40%-50%) and telephones for communication (∼ 20%). On the demand side, service utilization reduced substantially (40-80 pp) during the lockdown, but about half of mothers received home visits and food supplementation. Utilization for most services did not improve after the lockdown, bearing the challenges of limited travel (30%), nonavailability of services (26%), and fear of catching the virus when leaving the house (22%) or meeting service providers (14%). CONCLUSIONS: COVID-19 disrupted the provision and use of health and nutrition services in Uttar Pradesh, India, despite adaptations to restore services. Strengthening logistical support, capacity enhancement, performance management, and demand creation are needed to improve service provision and utilization during and post-COVID-19.

Perspective: The Importance Of Water Security For Ensuring Food Security, Good Nutrition, And Well-Being, Sera L. Young, Edward A. Frongillo Jr., Zeina Jamaluddine, Hugo Melgar-Quinonez, Rafael Perez-Escamilla, Claudia Ringler, Asher Y. Rosinger

Faculty Publications

Water security is a powerful concept that is still in its early days in the field of nutrition. Given the prevalence and severity of water issues and the many interconnections between water and nutrition, we argue that water security deserves attention commensurate with its importance to human nutrition and health. To this end, we first give a brief introduction to water insecurity and discuss its conceptualization in terms of availability, access, use, and stability. We then lay out the empirical grounding for its assessment. Parallels to the food-security literature are drawn throughout, both because the concepts are analogous and food …