Medicine and Health Sciences Commons^™

Levels, Trends And Determinants Of Contraceptive Use Among Adolescent Girls In Kenya, Francis Obare, Harriet Birungi, Chi-Chi Undie, Monica Wanjiru, Wilson Liambila, Ian Askew

Reproductive Health

In Kenya, recent trends in contraceptive use among currently married women aged 15–49 years show that after experiencing a stall between 1998 and 2003, the contraceptive prevalence rate (CPR) increased between 2003 and 2008–2009. Although the increase in CPR after 2003 is encouraging, there is limited understanding of how these changes affected adolescents, especially girls, given the unique sexual and reproductive health challenges that they face. This report is based on a secondary analysis of the Kenya Demographic and Health Surveys (KDHS) data to understand the trends, differentials, and determinants of contraceptive use among adolescent girls aged 15–19 years in …

Integrating Tuberculosis Case Finding And Treatment Into Postnatal Care, Charity Ndwiga, Harriet Birungi, Chi-Chi Undie, Shiphrah Kuria, Joseph Sitienei, Sam Ochola

Reproductive Health

Under the USAID funded FRONTIERS program, the Population Council conducted a study in six health facilities in Western Kenya that demonstrated that screening for TB within an antenatal care (ANC) setting is feasible and acceptable among the service providers. However, a major challenge remains: although TB detection is encouraged among ANC clients within the maternal and child health clinics in the country, providers in these settings fail to appreciate the need for a continuum of care from pregnancy through to the postnatal period. In order to address this gap, the APHIA II Operations Research Project developed and tested an intervention …

Making Hiv Services More Responsive To Young Children And Infants In Nyanza, Monica Wanjiru

Reproductive Health

Health workers in Kenya often miss opportunities to discuss pediatric HIV with clients and to track exposed children in order to initiate treatment. To address this problem, the Population Council’s APHIA II Operations Research Project collaborated with the Christian Health Association of Kenya, Catholic Relief Services, and the Kendu Adventist Hospital to improve HIV testing and treatment services for children at the hospital. The project recommended that pediatric HIV services be strengthened and included as an essential service at all levels of healthcare facilities in order to reach more children, including as one of the roles of the community health …

Operationalizing And Scaling Up Hiv/Rh Referrals In Kenya: The Way Forward, Aphia Ii Or Project In Kenya

Reproductive Health

This policy brief describes the APHIA II Operations Research Project through which the Population Council and Kenya’s Ministry of Health (MOH) developed and tested an approach to systematically link HIV-positive family planning (FP) clients to treatment and care services. Key activities included provider training and testing of a referral package which showed how, where, when, and who is to make and receive referrals. This referral package consisted of a directory listing all facilities in the vicinity available for services including HIV counseling and testing, FP, STIs, tuberculosis, and well-child checks; and referral forms directing clients to appropriate receiving clinics. The …

Service Improvements And Community Education Lead To Increase In Uptake Of Hiv Services For Infants And Young Children, Population Council

Reproductive Health

The Population Council’s APHIA II Operations Research Project in Kenya collaborated with Kendu Adventist Hospital and the Christian Health Association to launch a study to examine the effect of improved services and awareness-creation on the uptake of HIV testing and treatment services for children and infants exposed to HIV. The study showed that community education and improvements in individual case tracking can increase the proportion of infants exposed to HIV who are tested for HIV and put on appropriate treatment. The policy brief recommends that health facilities streamline services to ensure that as many exposed infants as possible are identified …

Sexual And Reproductive Health Needs Of Adolescents Living With Hiv In Kenya, Harriet Birungi, Francis Obare, Jane Harriet Namwebya, Ibrahim Mohammed, Margaret Gitau, Margaret Makumi

Reproductive Health

The objective of this study was to assess the sexual and reproductive health needs of adolescents living with HIV in Kenya with a view to identifying and developing interventions that integrate these needs within the existing HIV/AIDS treatment, care, and support programs in the country. The study was a result of collaboration between Population Council, APHIA II Rift Valley and Coast (Family Health International), the National AIDS and STI Control Programme, and APHIA II Nairobi and Central (Pathfinder International). Major findings indicate that many of the adolescents living with HIV are vulnerable, and that programmatic gaps exist in addressing the …

Ten Years Of The Kenya Adolescent Reproductive Health Project: What Has Happened?, Humphres Evelia, Monica Wanjiru, Francis Obare, Harriet Birungi

Reproductive Health

This evaluation by the Population Council’s APHIA II Operations Research Project sought to find out whether the adolescent sexual and reproductive health (ASRH) and HIV/AIDS activities in Kenya had been sustained over a 10-year period when the project was replicated and scaled up to cover seven provinces in the country. The evaluation had three main objectives: 1) to determine the extent to which activities of the Kenya Adolescent Reproductive Health Program (KARHP) have continued at national, provincial, and district levels; 2) to determine whether desired sexual and reproductive health outcomes (knowledge, behavior, and practices) have been sustained among in- and …

Increasing Access To Family Planning (Fp) And Reproductive Health (Rh) Services Through Task-Sharing Between Community Health Workers (Chws) And Community Mid-Level Professionals In Large-Scale Public-Sector Programs: A Literature Review To Help Guide Case Studies, James R. Foreit, Sarah Raifman

Reproductive Health

This literature review covers case studies related to community-based distribution of family planning programs, and community health worker (CHW) programs that included family planning and other reproductive health services. It offers essential processes and implications for additional operations research which look at constraints and factors critical to introducing new program procedures or strengthening existing ones.

Integrating Alcohol Risk Reduction Into Htc Services, Population Council

Reproductive Health

This brief describes how screening for alcohol abuse and hosting long-term support groups through HIV testing and counseling centers (HTC) is one way to decrease high-risk sexual and alcohol behaviors among people who have tested for HIV. Findings from program activities funded by Population Council, Liverpool VCT and Support for Addiction Prevention and Treatment in Africa Center (SAPTA) found that screening HTC clients for alcohol abuse and referral to active support and counseling services is feasible. Follow up using SMS is also recommended. However, the lack of a control group in this study may hinder drawing direct causality between the …

Informe Años Dos Movil.Com: Evaluación De La Línea Final Resumen De Hallazgos Principales, Annik Sorhaindo, Xipatl Contreras, Kate S. Wilson, Sandra G. Garcia

Reproductive Health

This report highlights the findings of the endline evaluation of a two-year leadership project aimed at indigenous youth in Oaxaca, Mexico: Movil.com. Movil.com is a community project headed by peers and built on elements of other models. It is similar to a cascaded peer education and training model, in which nuclear leaders are trained who, in turn, train facilitators of larger groups. The Population Council office in Mexico evaluated the project at the request of the social organization that implements it, the Rosales Castellanos Women's Study Group, an NGO that has worked for more than 30 years with indigenous communities …

Memory And Language: Evidence Of Relationships From Three Studies Of School-Age Children, Michele A. Anderson

Dissertations

The purpose of this three-paper dissertation was to explore the relationship between performance on verbal memory and language assessment tasks in school-age children. Study one used data from whole-class administration of three language assessment tasks to 2nd, 4th, 6th, and 9th graders (N= 187). Studies two and three used data from individualized administration of language assessment and verbal memory tasks to comparable samples of children between the ages of 6 and 18 years with typical language (TL) and language impairment (LI) (n = 37 per group).

The first study addressed practical and theoretical questions regarding memory and language demands of …

Living With Bipolar Disorder: A Qualitative Investigation, Richard P. Freedberg

Dissertations

The specific aims of this study were to gain a broader understanding of the lived experience of adults with bipolar disorder and to explore how people diagnosed with bipolar disorder used cognitively, affectively, and spiritually oriented strategies to cope with life stressors and circumstances. The cognitive domain in this investigation was defined as those activities related to how one knows, thinks, or perceives phenomena in a way distinct from emotion. The affective domain referred to the feelings and emotions associated with phenomena that are distinct from cognitive reasoning or knowledge. The spiritual domain was defined as values, attitudes, and beliefs …

Should Pseudoephedrine (Pse) Be Moved From Behind The Counter To Prescription-Only? An Analysis Of Pse As An Otc Medication And A Precursor For Methamphetamine Production, Jerry Dillon

MPA/MPP/MPFM Capstone Projects

Kentucky State Senator Tom Jensen recently sponsored Senate Bill 45, which would change pseudoephedrine (PSE) from an over-the-counter to a schedule V prescription-only drug. The bill failed, but the debate continues as to whether Kentucky should make PSE, a precursor required to manufacture illicit methamphetamine, a controlled drug that is available by prescription only.

Methamphetamine abuse has been increasing in Kentucky as well as in the rest of the country, despite efforts to control the sale of PSE through federal and state legislation. The Combat Methamphetamine Epidemic Act (CMEA) of 2006 and Kentucky’s initiative to electronically monitor the sales of …

The Incidence Of Hip Fracture Associated With Proton Pump Inhibitor (Ppi) And/Or H2 Receptor Antagonist (H2ra) Use In The Kentucky Medicaid Population, Timothy C. Umeh

MPA/MPP/MPFM Capstone Projects

No executive summary.

Family Systems And Mental Health Issues: A Resilience Approach, Lynne Cohen, Catherine Ferguson, Craig Harms, Julie Ann Pooley, Stuart Tomlinson

Research outputs 2011

In many cases the consumers of mental health information and support are the families of mental health sufferers. The aim of the project was to understand resilience in people who live with or support a family member with a diagnosed or undiagnosed mental illness. Participants were 15 carers (one male, 14 female). Semi-structured interviews were transcribed and analysed using content analysis. Eight recurring themes emerged which indicated the challenges the carers faced and provided indications of the positive and negative personal, family and social factors that impacted on their lives. These themes were 'Getting to CLAN WA', 'Accessing help including …

Review Of Indigenous Offender Health [Journal Article], Jocelyn Grace, Ineke Krom, Caitlin Maling, Tony Butler, Richard Midford

Research outputs 2011

This review provides an overview of health issues facing the Indigenous offender population, including some of the social and historical factors relevant to Indigenous health and incarceration. In doing so, it is important to first understand how Indigenous people conceptualise health. Health as it is understood in western society is a fairly discrete category, which differs from the traditional Indigenous perspective of health as holistic [1]. This is made explicit in the 1989 National Aboriginal health strategy that states 'health to Aboriginal peoples is a matter of determining all aspects of their life, including control over their physical environment, of …

Linking Hiv-Positive Family Planning Clients To Treatment And Care Services In Kenya, Wilson Liambila, Francis Obare, Harriet Birungi, Ruth Wayua Muia, Joyce Wanderi Maina, Mary N. Maina, Christine Awuor, Ibrahim Mohammed

Reproductive Health

A project from the Population Council’s USAID-funded FRONTIERS program found that integrating HIV counseling and testing into family planning (FP) services was feasible and acceptable to clients and providers, and led to significant improvement in the quality of care provided. However, a major limitation was that FP clients who tested HIV-positive were not actively linked to care and treatment services, including antiretroviral treatment, and screening and management of sexually transmitted infections. A new initiative aimed to design and test a referral framework for linking HIV-positive FP clients to treatment and care in selected health facilities; assess the acceptability of the …

Using Youth-Friendly Communication Approaches To Communicate Hiv/Aids With Young People Is Feasible And Acceptable, Population Council

Reproductive Health

HIV remains a major concern in Kenya among all segments of the population, including adolescents. New ways of delivering HIV information and services are therefore needed, especially to reach young people and encourage them to take up counselling and testing to know their sero-status. The APHIA II Operations Research Project collaborated with the Ministry of Education, Well Told Story, and the National AIDS and STD Control Programme to implement a project to enhance communication in schools about HIV and create demand for early counseling and testing. The project also sought to create a supportive environment in schools for young people …

Identifying Opportunities And Challenges To Strengthen Union Level Facility For Providing Normal Delivery And Newborn Care Services: Findings From Policy Advocacy Activities, Md. Noorunnabi Talukder, Ubaidur Rob, A.K.M. Zafar Ullah Khan

Reproductive Health

The Population Council/Bangladesh, with assistance from the UK Department for International Development (DFID), organized a series of advocacy meetings and workshops that were carried out as part of a policy and systems research study titled “Strengthening Union Level Facility for Providing Normal Delivery and Newborn Care Services.” The Council held one consultative meeting, one stakeholders’ meeting, two experience-sharing workshops in Jamalpur and Thakurgaon, two local-level advocacy workshops in Kurigram and Habiganj, and two roundtable dialogues with journalists from Bengali and English newspapers. This document includes five reports: Strengthening HFWCs (Health and Family Welfare Centers) for Normal Delivery and Newborn Care …

The Relationship Of Race And Social Integration On The Health Status Of Older Adults In An Urban City, Thomas T. Jordan

Dissertations, Theses, and Capstone Projects

Durkheim argues that an individual is more vulnerable to self-destruction the more s/he is detached from the collective. This dissertation will explore the relative impact of social integration on older adults who have transitioned into their new roles in the social structure in relationship to their physical (obesity) and psychological (stress) health status. Additionally, the dissertation examines how social integration varies in its impact from one racial group to another, and how such variations influence the health status of the older adults who are members of these groups.

This dissertation employs data from the Brookdale Center for Healthy Aging and …

Risk Factors For Driving Cessation Vary By Race And Ethnicity, Elizabeth Dugan, Frank Porell, Chae Man Lee

Gerontology Institute Publications

Driving is related to our identity and independence as well as allowing us to get needed goods, services, and social opportunities that enrich daily life. Yet with increasing age, the risk for developing threats to medical fitness to drive increases. Driving cessation is related to a long list of negative outcomes, such as: depression, social isolation, diminished access to health care, and diminished quality of life. We investigated risks for driving cessation, paying close attention to racial differences. This study used data from the Health and Retirement Study (HRS), 1998-2008. The study included N=46, 528 older people (age 65 and …

Dental Service Utilization In An Academic Setting: An Analysis For Improved Oral Health, Paula R. Sandford

MPA/MPP/MPFM Capstone Projects

The National Oral Health Surveillance System (NOHSS) is the result of a collaborative effort between the Centers for Disease Control and Prevention and the Association of State and Territorial Dental Directors which is designed to monitor aspects of oral health and disease on both a national and state level. The NOHSS ranks Kentucky at or near the bottom in most oral health indicators. The primary message of the Surgeon General’s May 2000 report on Oral Health in America was to emphasize the link between oral health and overall health including the effect on day‐to‐day activities such as work and school …

Best Practice In Working With The Somali Population, Ilhan Duale

All Graduate Theses, Dissertations, and Other Capstone Projects

Since the early 1990s, the state of Minnesota has had an unprecedented increase in refugees from Somalia. These individuals have emigrated from a war-zone country and arrived in the United States with a range of trauma-related injuries and mental health issues. As a result, Somali individuals and families who have migrated to the United States will require physical and mental health support. There is, however, a lack of research on effective interventions with Somali individuals and families. With the stigma that surrounds mental health and negative cultural views of mental health in the Somali population, practitioners at Comunidades Latinas Unidas …

Natural Connections: A Recommendation To Implement An Animal Assisted Therapy (Aat) Program Within The Shakopee Mdewakantonsioux Community, Heidi Simon

All Graduate Theses, Dissertations, and Other Capstone Projects

Currently the Shakopee Mdewakanton Sioux Community does not have an Animal Assisted Therapy (AAT) program. The purpose of this project was to research AAT programs that exist in First Nation Communities. The ultimate goal was to present evidence to support the implementation of a culturally based AAT program into the current mental health model within the Shakopee Mdewakanton Sioux Community. The Animal Assisted Therapeutic Learning (ATTL) program would incorporate traditional beliefs with contemporary ways of life in regard to healing and mental health.

The Power Of Service Work: Developing A Consumer Volunteer Program For The House Of Hope, Inc., Darcy Wennes

All Graduate Theses, Dissertations, and Other Capstone Projects

House of Hope, Inc. (HOH) is a rural residential chemical dependency treatment center serving adults over the age of 18. HOH is a non-profit non-sectarian agency. Many clients at HOH have a dual diagnosis of chemical dependency and mental illness. Consumers at HOH are encouraged to volunteer, but are given limited support to do so. They have several hours in their day where there is no programming, and many consumers feel bored and unproductive. The literature suggests that there is a relationship between volunteer work carried out by consumers and their personal feelings of empowerment (Cohen, 2009) . Consumers’ feelings …

Effects Of Two Group Approaches On Life Satisfaction And Mood Of Older Females In Nursing Homes, Bede Redpath Ryan

Wayne State University Dissertations

The purpose of this study was to examine the effects of two group counseling therapy interventions on levels of life satisfaction and mood disturbance of older women, age 65+, living in two Detroit-based skilled nursing home facilities. This quasi-experimental, two-treatment group design examined the pretest-posttest data of two group counseling therapy interventions, Group Art Therapy (GAT) and Group Life Stories Narrative Therapy (GLSNT). Seventeen participants completed the bi-weekly, 90-minute sessions, over a four-week period. A univariate ANCOVA with group membership as fixed independent variable was used to compare life satisfaction post scores with pre scores as covariates. Mean scores were …

Chemotherapy For Lung Cancer: Determinants Of Guideline Adherence And Associated Patient Outcomes, Ramzi George Salloum

Wayne State University Dissertations

Evidence-based guidelines recommend chemotherapy for medically fit patients with stage II-IV non-small cell lung cancer (NSCLC). Adherence to chemotherapy guidelines has rarely been studied among large populations, mainly because performance status (PS), a key component in assessing chemotherapy appropriateness, is missing from claims-based datasets. Among a large cohort of patients with known PS, this dissertation describes chemotherapy use relative to guideline recommendations and identifies patient factors and outcomes associated with guideline concordant use. Among these patients 29% do not receive guideline recommended chemotherapy treatment, missing opportunities for cure or receiving chemotherapy with more risk of harm than benefit, thereby likely …

Maternal Exposure To The Holocaust And Health Complaints In Offspring, Janine D. Flory, Linda M. Bierer, Rachel Yehuda

Publications and Research

Although the link between chronic stress and the development of cardiovascular and metabolic diseases of adulthood has been known for some time, there is growing recognition that early environmental influences may result in developmental programming via epigenetic mechanisms, thereby affecting the developmental trajectory of disease progression. Previous studies support the idea that offspring of Holocaust survivors may have been subjected to early developmental programming. We evaluated the relationship between parental exposure to the Holocaust and selfreported health ratings and disorders made by their adult offspring (i.e., second generation Holocaust survivors). A total of 137 subjects were evaluated. Regression analyses demonstrated …

Research Diary: A Tool For Scaffolding, Marion Engin

All Works

Diaries have long been seen as tools for reflection in learning languages, and learning about teaching. Despite this recognition of the importance of narratives in diary writing, little attention has been paid to the role of research diaries in the process of learning about research, and learning how to be a researcher. During the author's own research into the construction of teaching knowledge by pre-service trainees, she became aware that her research diary was scaffolding her own construction of research knowledge. In this article the author discusses the role of a research diary based on a socio-cultural theory of learning. …

The Prevalence Of Evidence-Based Practice By The Certified Therapeutic Recreation Specialist In The Intervention Planning Process For Client Treatment, Linda Mrkic

Online Theses and Dissertations

Currently, there is a paucity of research examining the extent to which Evidence-Based Practice (EBP) is being used by the Certified Therapeutic Recreation Specialist (CTRS). The purpose of this study was to examine the prevalence of EBP used by the CTRS in the National Recreation and Park Association (NRPA) southern district of the United States. This observational study investigated the use of EBP in the intervention planning process for client treatment. A sample of five hundred randomly selected CTRS from the National Council for Therapeutic Recreation Certification (NCTRC) were surveyed, and 102 completed the survey, yielding a 20.4% response rate. …