Medicine and Health Sciences Commons^™

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li, Yu Liu, Shan Qiao, Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Patient Organizations And Primary Care Development: Reflections By Patients With Chronic Diseases, Britta E. Berglund, Irene Westerlund

Patient Experience Journal

To explore how patients with chronic diseases, as well as members of patient organizations, perceive primary care and how they think about how to participate in primary care development. Focus group interviews with 28 patients in three regions in Sweden were conducted. We identified four themes: Availability of care, How to be met by professionals, Information needs and Continuity and prevention in care. Important was to meet the same doctor at every visit and to be met with empathy and knowledge about your disease. Suggestions about better use of technical information services, introduction of a coordinator in the waiting room …

Late Newborn Hearing Screening, Late Follow-Up, And Multiple Follow-Ups Increase The Risk Of Incomplete Audiologic Diagnosis Evaluation, Tri Tran, Ian Ng, Thiravat Choojitarom, Jeanette Webb, Wendy Jumonville, Mary Jo Smith, Terri Ibieta, Melinda Peat, Susan Berry

Journal of Early Hearing Detection and Intervention

This study aimed to determine whether the following factors were associated with an incomplete audiologic diagnosis evaluation (IAD): age at newborn screening, length of time between newborn screening and first follow-up, and total number of follow-ups. 2011-2013 linked Louisiana Early Hearing Detection and Intervention data and birth records were analyzed. Logistic regression models were used to evaluate different effects of the predictors on IAD among birth weight groups. In very low birth weight newborns, there were no statistical associations of IAD with age at NHS or length of time between NHS and first follow-up, but there was with the number …

Progress In Standardization Of Reporting And Analysis Of Data From Early Hearing Detection And Intervention (Ehdi) Programs, Suhana Alam, Ashley Satterfield, Xidong Deng, Craig A. Mason

Journal of Early Hearing Detection and Intervention

Congenital hearing loss affects one to three of every 1,000 live born infants. If left undetected, it may negatively impact children through delayed speech and language development. To help avoid developmental delays and ensure that deaf or hard of hearing (DHH) infants are identified and receiving services as early as possible, complete and accurate data are crucial. Despite substantial progress made over the years, some children are still delayed in identification and/or lost to the early hearing detection and intervention (EHDI) surveillance and tracking systems. Lack of standardization in data reporting contributes to this issue. This article discusses reasons for …

Predictive Mapping Of Mycobacterium Tuberculosis At The County Level In The State Of Florida, Ali Moradi

USF Tampa Graduate Theses and Dissertations

Introduction: One of the major barriers to developing an accurate tuberculosis (TB) surveillance program for Florida is the design and implementation of a sampling system that will adequately monitor and predict varying sizes and characteristics of county-level vulnerable endemic sub-populations and their explanatory covariates (e.g., living or working in a residential care facility). The aim of this research study is to envision an endemic, tuberculosis-related web-based interface for use by public health officials in the State of Florida which includes generating essential information such as a real-time syndrome-based reporting to regulate automated and immediate 'Alerts' to public health officials, doctors, …

Perceptions Of And Preferences For A Mobile Health Clinic For Underserved Populations, Melinda Gillispie, Catherine Mobley, Lynette M. Gibson, Arelis Moore De Peralta

Publications

Background: Research has established that members of particular demographic groups are inordinately burdened by differential healthcare access. Mobile health clinics (MHCs) are emerging across health systems to improve access to care of marginalized populations. This study explored the perceptions and concerns of community residents living in underserved neighborhoods toward MHC services.

Methods: This study used a qualitative descriptive design with 5 focus group meetings. Purposive sampling was used to recruit ethnically diverse, English- and Spanish-speaking men and women ages 20–67 residing in 5 underserved neighborhoods in Greenville County, SC.

Results: Participants (N = 35) felt positive about obtaining personalized health …

Risk For Type 2 Diabetes Among Snap Participants With Prediabetes, Diana L. Malkin-Washeim, Phd, Mph, R.D., Cde, Shirley Gerrior, Phd, R.D.

Journal of Social, Behavioral, and Health Sciences

This study explored food security status among Supplemental Nutrition Assistance Program (SNAP) participants with prediabetes in relation to food choice decisions over a 30-day benefit cycle that potentially increases the risk of Type 2 diabetes. A cross-sectional, quantitative design based on food choice process model constructs was used. SNAP participants (n = 36) with prediabetes, aged 21–70 years, were recruited as outpatients from Bronx Lebanon Hospital Center and completed self-reported questionnaires on demographics and health, food security, and food frequency over time. Descriptive statistics, Pearson chi square tests, and regression analysis were performed using SPSS. Two post-hoc tests, the …

Chemical Reactions: Marijuana, Opioids, And Our Families, Denise A. Hines Ph.D, Staci Gruber Ph.D, John F. Kelly Ph.D, Kathleen M. Palm Reed, Hilary Smith Connery M.D., Ph.D.

Mosakowski Institute for Public Enterprise

Chemical Reactions: Marijuana, Opioids, and Our Families is the seventh Massachusetts Family Impact Seminar. This seminar was designed to emphasize a family perspective in policymaking on issues related to the legalization of marijuana and managing the opioid abuse crisis in the Commonwealth. In general, Family Impact Seminars analyze the consequences an issue, policy, or program may have for families.

Patient Portals In Pharmacist-Run Ambulatory Care Clinics: Is There “Meaningful Use”?, H. Paige Erdeljac, Melissa J. Snider, Kelly Bartsch, Raul Weiss

Excerpts in Pharmacy Research Journal

Objective

The purpose of this study is to describe patient portal utilization within pharmacist-managed clinics at an academic medical center from the perspectives of the institution, healthcare team, and patient. This study measures the progress toward meeting requirements for meaningful use per the Centers for Medicare and Medicaid Services (CMS).

Methods

The study included patients in pharmacist-managed clinics and consisted of a retrospective chart review and patient survey. Primary endpoints consisted of: 1) report progress toward meeting CMS criteria for meaningful use in subset of patients seen in the pharmacy-managed clinics, 2) describe utilization of patient portal across the healthcare …

Impacts On Breastfeeding Practices Of At Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, And Community Mobilization: Results Of Cluster Randomized Program Evaluations In Bangladesh And Viet Nam, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact …

Exposure To Large-Scale Social And Behavior Change Communication Interventions Is Associated With Improvements In Infant And Young Child Feeding Practices In Ethiopia, Sunny S. Kim, Rahul Rawat, Edina M. Mwangi, Roman Tesfaye, Yewelsew Abebe, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and …

Civic Engagement Among Orphans And Non-Orphans In Five Low- And Middle-Income Countries, Christine L. Gray, Brian W. Pence, Lynne C. Messer, Jan Ostermann, Rachel A. Whetten, Nathan M. Thielman, Karen O’Donnell, Kathryn Whetten

Faculty Publications

Background: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development.

Methods: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and …

Assessing Feasibility And Readiness To Address Obesity Through Policy In American Indian Reservations, Valarie Blue Bird Jernigan, Gail Boe, Carolyn Noonan, Leslie Carroll, Dedra Buchwald

Journal of Health Disparities Research and Practice

The Institute of Medicine and Centers for Disease Control and Prevention (CDC) have identified policy and environmental strategies as critical to the prevention and control of obesity. However such strategies are rare in American Indian communities despite significant obesity-related disparities. Tribal policymaking processes differ by tribal nation and are often poorly understood by researchers and public health practitioners, hindering the dissemination, implementation, and successful scale-up of evidence-base obesity strategies in tribal communities. To address these gaps in knowledge we surveyed 138 diverse stakeholders in two American Indian reservations to assess the feasibility of and readiness to implement CDC-recommended obesity policy …

Brighter Sights: Using Photovoice For A Process Evaluation Of A Food Co-Op Style Nutrition Intervention, Margaret P. Raber, Kimberly Kay Lopez, Mike Pomeroy, Avni Mody, Christine Markham, Shreela V. Sharma

Journal of Health Disparities Research and Practice

Access to healthy food is a critical factor impacting childhood obesity. Brighter Bites is a school-based program that addresses the issue of fresh food access among low-income families living in food deserts using a food co-op model. The aim of this study is to evaluate initial parent participant reactions to the ongoing Brighter Bites program using Photovoice. A predominately Hispanic, economically disadvantaged, urban school was chosen as the site for the Photovoice project. A total of seven Brighter Bites parent participants were enrolled and six completed the study. The participants developed research questions, took documentary photographs, completed a group analysis …

Feasibility Of A Community-Based Sickle Cell Trait Testing And Counseling Program, Ashley Housten, Regina Abel, Terianne Lindsey, Allison King

Journal of Health Disparities Research and Practice

Background: Sickle cell trait (SCT) screening is required at birth in the United States; however, adults rarely know their SCT status prior to having children.

Purpose: Assess feasibility of a community-based SCT education and testing intervention.

Methods: Participants were recruited from eight community sites to complete an educational program and offered a hemoglobin analysis. A genetic counselor met individually with participants to discuss lab results.

Results: Between July 14, 2010 and May 31, 2012, 637 participants completed the educational program. Five hundred seventy (89.5%) provided a blood sample, and 61 (10.9%) had SCT or other hemoglobinopathies. The genetic counselor met …

Peer Victimization And Depressive Symptoms Among Rural-To-Urban Migrant Children In China: The Protective Role Of Resilience, Zhi Ye, Lihua Chen, Sayward Harrison, Haiying Guo, Xiaoming Li, Danhua Lin

Faculty Publications

Peer victimization can have a profound effect on children’s wellbeing and is a known risk factor for depression in childhood. Migrant children experience peer victimization at higher rates than non-migrant peers; however, limited research has examined psychological factors that may serve to reduce depression risk for this group. In particular, no studies have yet investigated whether resilience, including personal characteristics, and a strong social support network, may moderate the relationship between peer victimization and depressive symptoms for migrant children. This study utilized a latent interaction model to examine the effect of resilience on the relationship between peer victimization and depressive …

Breast Is Best: Determinants Of Breastfeeding In Bali, Leah Hardenbergh

Independent Study Project (ISP) Collection

Breastfeeding greatly benefits the health of newborns, providing them with needed antibodies and protection from numerous diseases, including some of the leading causes of infant mortality. This paper explores breastfeeding practices in Bali, and the wide array of factors that have led to these practices. After discussing how breastfeeding fits into the larger context of maternal and newborn health, I explain factors in Bali that affect a woman’s decision to breastfeed and experience while breastfeeding. Determinants include those related to health, financial position, and social status. I explore the history of formula companies and formula as an alternative to breastmilk, …

Design And Feasibility Of A Text Messaging Intervention To Prevent Indoor Tanning Among Young Adult Women: A Pilot Study, William Douglas Evans, Darren Mays

Prevention and Community Health Faculty Publications

Background: Although skin cancer is largely preventable, it affects nearly 1 of 5 US adults. There is a need for research on how to optimally design persuasive public health indoor tanning prevention messages.

Objective: The objective of our study was to examine whether framed messages on indoor tanning behavioral intentions delivered through short message service (SMS) text messaging would produce (1) positive responses to the messages, including message receptivity and emotional response; (2) indoor tanning efficacy beliefs, including response efficacy and self-efficacy; and (3) indoor tanning risk beliefs.

Methods: We conducted a pilot study of indoor tanning prevention messages delivered …

Hiv/Aids Prevention: Educating Future Generations, Carmella Williams

All Student Theses

The purpose of this study was to discover if implementing more educational interventions on HIV/AIDS would lead to lower incidents of HIV/AIDS among youth. A quantitative research design was used to determine the level of knowledge, perceptions, and attitudes of high school students in regard to HIV/AIDS. The targeted population were youth ages 14-18 years old, which are generally high school students who are at risk of contracting HIV/AIDS. Participants in this study were students from Human Resources Development Institute’s Teen Pregnancy Prevention Program at Harper High School in Chicago, Illinois. The researcher administered questionnaires to the students at Harper …

Infant Formula Feeding At Birth Is Common And Inversely Associated With Subsequent Breastfeeding Behavior In Vietnam, Tuan T. Nguyen, Mellissa Withers, Nemat Hajeebhoy, Edward A. Frongillo

Faculty Publications

BACKGROUND: The association between infant formula feeding at birth and subsequent feeding patterns in a low- or middle-income context is not clear. OBJECTIVE: We examined the association of infant formula feeding during the first 3 d after birth with subsequent infant formula feeding and early breastfeeding cessation in Vietnam. METHODS: In a cross-sectional survey, we interviewed 10,681 mothers with children aged 0-23 mo (mean age: 8.2 mo; 52% boys) about their feeding practices during the first 3 d after birth and on the previous day. We used stratified analysis, multiple logistic regression, propensity score-matching analysis, and structural equation modeling to …

Combining Intensive Counseling By Frontline Workers With A Nationwide Mass Media Campaign Has Large Differential Impacts On Complementary Feeding Practices But Not On Child Growth: Results Of A Cluster-Randomized Program Evaluation In Bangladesh, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Tina Sanghvi, Jean Baker, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background: Complementary feeding (CF) contributes to child growth and development, but few CF programs are delivered at scale. Alive & Thrive addressed this in Bangladesh through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM).

Objective: The objective was to evaluate the impact of providing IPC + MM + CM (intensive) compared with standard nutrition counseling + less intensive MM + CM (nonintensive) on CF practices and anthropometric measurements.

Methods: We used a cluster-randomized, nonblinded evaluation with cross-sectional surveys [n = ∼600 and 1090 children 6-23.9 mo and 24-47.9 mo/group, respectively, at baseline (2010) and n = ∼500 …

Access Is Not Enough: Family Planning In Dar Es Salaam, Claire Burrus

Independent Study Project (ISP) Collection

Population growth is a large problem, both globally and at local levels. The global population is growing at an unsustainable rate, particularly in developing nations. Tanzania, as a developing nation, is one of the fastest growing countries in the world, and as a result, faces many hardships related to high population. The Tanzanian government, non-governmental organizations, and private institutions have made attempts to address these concerns by encouraging family planning. Even so, the national population continues to rise. Many social and cultural factors have contributed to this phenomenon. This study was performed in the Women’s Clinic at Sanitas Hospital in …

Solid Waste Management Of Disposable Diaper Sanitation And The Connection To Environmental Awareness For Women In Zanzibar, Micalea Leaska

Independent Study Project (ISP) Collection

This project examined the solid waste management of disposable diapers in three locations, Stone Town, Mangapwani and Vikokotoni, within Zanzibar, Tanzania. Its methods included field observations of the solid waste disposal system in Zanzibar and interviews with women about their rationales for buying and using disposable diapers. For one of the first times, the data collected during this project will further assist to educate women about the benefits of cloth diapers and the negative effects disposable diapers create for Zanzibari families and the environment. This study has observed one of the most growing concerns regarding excess solid waste contributing to …

Sugar And Spice, Not Everything's Nice: Changing Dietary Habits In Bali, Harry Teplow

Independent Study Project (ISP) Collection

In this paper, I will explore the ways in which locals interact with new food options on the island of Bali. Specifically, I will explore dietary behaviors surrounding pre-­‐ packaged snacks and ‘fast-­‐food’ chains and determine whether the presence of these food options is affecting the Balinese’s relationship with more traditional cuisine. I will use everyday observations and conversations with locals to analyze dietary habits and the various food items that are being consumed while examining the potential dietary differentiation between two age groups. I will also consider health outcomes in Bali and discuss how changing dietary habits may be …

Aca Implementation In Metro Louisville: Outreach And Enrollment, Susan Buchino, Liza Creel

Susan Buchino

Perceptions Of Fidelity And Adaptation In Evidence-Informed Interventions By Women Of Color Sexuality Health Educators, Sara C. Flowers

Dissertations, Theses, and Capstone Projects

Sexuality health educators (SHEs) adapt interventions to the participants’ needs in the dissemination and implementation of comprehensive sexuality education (CSE) programming. However, there is a lack of understanding of how, why and when SHEs make such adaptations. Success or failure of the transfer of prevention technology to practitioners occurs by determining community capacities and preparedness to adopt/adapt high-impact interventions to effectively manage implementation. Experts argue for evidence-informed interventions (EII), as opposed to evidence-based interventions (EBI), as the best way to incorporate research in applied settings. EBIs are solely guided by recommendations from current evidence, whereas EIIs recognize and incorporate the …

Effect Of A Randomised Exclusive Breastfeeding Counselling Intervention Nested Into The Minimat Prenatal Nutrition Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Hanna Eneroth, Shams El Arifeen, Eva-Charlotte Ekström, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

AIM: It is unknown whether maternal malnutrition reduces the effect of counselling on exclusive breastfeeding. This study evaluated the effect of breastfeeding counselling on the duration of exclusive breastfeeding, and whether the timing of prenatal food and different micronutrient supplements further prolonged this duration. METHODS: Pregnant women in Matlab, Bangladesh, were randomised to receive daily food supplements of 600 kcal at nine weeks of gestation or at the standard 20 weeks. They also were allocated to either 30 mg of iron and 400 μg folic acid, or the standard programme 60 mg of iron and folic acid or multiple micronutrients. …

Test Site Predicts Hiv Care Linkage And Antiretroviral Therapy Initiation: A Prospective 3.5 Year Cohort Study Of Hivpositive Testers In Northern Tanzania, Elizabeth A. Reddy, Chris Bernard Agala, Venance P. Maro, Jan Ostermann, Brian W. Pence, Dafrosa K. Itemba, Donna Safley, Jia Yao, Nathan M. Thielman, Kathryn Whetten

Faculty Publications

Background: Linkage to HIV care is crucial to the success of antiretroviral therapy (ART) programs worldwide, loss to follow up at all stages of the care continuum is frequent, and long-term prospective studies of care linkage are currently lacking.

Methods: Consecutive clients who tested HIV-positive were enrolled from four HIV testing centers (1 health facility and 3 community-based centers) in the Kilimanjaro region of Tanzania as part of the larger Coping with HIV/AIDS in Tanzania (CHAT) prospective observational study. Biannual interviews were conducted over 3.5 years, assessing care linkage, retention, and mental health. Bivariable and multivariate logistic regression analyses were …

‘Because I Don’T Know’: Uncertainty And Ambiguity In Closed-Ended Reports Of Perceived Discrimination In Us Health Care, Chih-Yuan Lee, Amy Irby-Shasanmi

Department of Public Health Scholarship and Creative Works

Objective

Surveys often ask respondents to assess discrimination in health care. Yet, patients’ responses to one type of widely used measure of discrimination (single-item, personally mediated) tend to reveal prevalence rates lower than observational studies would suggest. This study examines the meaning behind respondents’ closed-ended self-reports on this specific type of measure, paying special attention to the frameworks and references used within the medical setting.

Design

Twenty-nine respondents participated in this study. They were asked the widely used question: ‘Within the past 12 months when seeking health care do you feel your experiences were worse than, the same as, or …