Community Health Commons^™

Improving Rhode Island’S Health Care System: Lessons From The Cuban Model, Sarah R. Moffitt

Senior Honors Projects

Improving Rhode Island’s health care system: lessons from the Cuban model

Cuba is world renowned for its health care system. In regards to international health crises, Cuba is a leader in sending workers abroad and training doctors from all over the world. Within its own borders, the Cuban model provides free access to all citizens in which every individual has a primary care provider. Cuba boasts high vaccination rates, a long life expectancy, low infant mortality rate, and a population that is one of the healthiest in the western hemisphere.

The purpose of this research project is to evaluate the …

Processes, Practices And Politics In The Treatment Centers For Addictions And Problematic Consumptions: An Analysis Of The Perspectives And Practices Of The Professionals In A Treatment Center In The Autonomous City Of Buenos Aires, Chiara Lawrence

Independent Study Project (ISP) Collection

Contextual Information: Historically in Argentina, as well as globally, the politics regarding the use of “drugs” have been prohibitionist and treatment centers have implemented these politics with models of abstinence. More recently, the need for both the politics and the treatment to prioritize the rights and health of the drug uses has become more widely recognized in both social and political contexts, as much as among professionals in treatment centers. New laws have been passed proposing the implementation of harm reduction strategies in the treatment of addictions and problematic drug use. In the Autonomous City of Buenos Aires there are …

Dying For A Drink: How The Consumption Of Home Brews Affects Health Within The Kibera Slum Of Nairobi, Kenya, Teaka Jackson

Independent Study Project (ISP) Collection

Home-brewed alcohols are inexpensive, thus they are especially consumed by low-income individuals such as those residing in Kibera. This project investigates three alcohols brewed within this area: muratina (mugasha), busaa and chang’aa. With the help of Philip Ndemwa, a nutrition expert from the Kenya Medical Research Institute, I was able to gain insight regarding the process of these alcohols, as well as the sanitation conditions of the production sites of these home brews and how these factors affect the health of the consumer. Both qualitative and quantitative research methods were utilized in order to fully understand the health repercussions from …

Perceived Barriers To Utilizing Maternal And Neonatal Health Services In Contracted-Out Versus Government-Managed Health Facilities In The Rural Districts Of Pakistan, Atif Riaz, Shehla Zaidi, Asif Raza Khowaja

Community Health Sciences

Background: A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted).

Methods: A community-based qualitative exploratory study was conducted between April to September 2012 at two …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

The Effects Of Environmental Prompts On Stair Usage, Lori Andersen, Tim Bungum, Sheniz Moonie Phd

Nevada Journal of Public Health

Experts have advocated exercise with little success, and have turned to encouraging physical activity by incorporating it into daily activities such as taking the stairs over elevators. Much literature exists suggesting that environmental prompts can encourage the use of stairs and literature has established that some messages may be more effective than others. This study aimed to assess the effects of selected signage prompts on stair usage. Methods: Stair and elevator use were monitored in three, two-story buildings. One building served as a control, while a fitness message was placed in another building, and the final building received a weight …

Environmental Health In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

There are a multitude of environmental factors that influence public health. The purpose of this manuscript is to evaluate the Southern Nevada community with respect to environmental conditions and health, including both positive and negative traits, and develop realistic goals and strategies aimed at improving these conditions. Southern Nevada is located in one of the most arid regions of North America. Since annual rainfall averages less than four inches per year, Southern Nevada depends upon the Colorado River for its water supply. It is predicted that water flow to the area will decrease by 5% to 20% by 2050. As …

Community Health Indicators In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

Community design and access to services are essential components of healthy and sustainable communities. The purpose of this manuscript is to evaluate Southern Nevada with respect to community design and access, including both positive and negative traits, and to suggest realistic changes that could be made to improve these conditions. The region’s network of parks and open space recreation areas is one of its strongest assets. Clark County enjoys over 42 million acres of federal and state lands which offer a large variety of recreational opportunities. The region has an extensive trail system, with a total of 179 miles of …

Effective Smoking Cessation Methods Among Smokers With Diabetes In Nv, Salome Kapella-Mshigeni, Eunice Kimunai, Peter Anderson, Elizabeth Fildes, Tam Villar

Nevada Journal of Public Health

Smoking and diabetes could both be prevented if individuals would abstain from smoking, eat healthy, and exercise regularly. Smokers with diabetes have an increased risk of serious health outcomes, hence effective smoking cessation interventions are critical. The transtheoretical model was used in this quantitative study analyzing secondary data from the state of Nevada Quitline to examine the relationships between smoking cessation method (counseling versus counseling and medication) and quitting smoking for 720 smokers with/without diabetes. Participants were Nevada residents, ages 18+, men and women, English or Spanish speakers. Descriptive statistics, logistic regression, and a test of two proportions were conducted. …

Education And Educational Attainment In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Failure to complete high school has a direct impact on a person’s earning potential and quality of life. Higher levels of education are associated with better health. Because of this association, it is important for children and adults to have access to quality education. The percentage of adults who have successfully pursued higher education in Southern Nevada is lower than the peer Mountain West metropolitan areas and the national average. Nevada high school graduation rates are the lowest in the nation. High school graduation rates and dropout rates vary by race/ethnicity in the Clark County School District. High school graduation …

Building On Social Capital To Improve Health: The Interactional Approach To Community Development, Matthew Charles Tomlin Mr

Student Research – Stevenson Center

Since political scientist, Robert Putnam, (1995) brought the concept of social capital into popular discourse, there has been a surge in debate over its definition, causes, and consequences in a range of social science disciplines. While social capital has been found to support self-rated overall health at the state level (Kawachi et al, 1999), there is still a dearth of data and research on localities in different regions of the country. This study analyzes survey data collected in the United Way of McLean County’s 2014 Community Assessment to better understand the dynamic between social capital and health in one Central …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Photovoice: Engaging School Communities In Wellness Efforts, Hilary J. Overby

Electronic Theses and Dissertations

Introduction: Currently there are no interactive tools that allow school communities to assess their school wellness needs and foster interest in wellness efforts. PhotoVoice is a participatory action research methodology commonly used in public health that utilizes photography to document and showcase community strengths and weaknesses in order to promote change. Purpose: The purpose of this study was to gather perceptions of a school community after using PhotoVoice to document school wellness efforts 1. Participants: High school students (n=103) and school community members (i.e., residents of community, school faculty) (n=188) were recruited across three school districts. Methods: High school students …

Differences In Health Literacy Knowledge And Experiences Among Senior Nursing Students, Sharon S. Williamson, Joanne Chopak-Foss

Community Health: Faculty Publications

Background: Low health literacy has been identified as a significant public health problem. Also, higher expenditures due to longer hospital stays have been reported for persons with low health literacy. Nurses can assist patients with low health literacy to reduce their hospital stays and increase compliance with discharge instructions.

Methods: A quantitative, descriptive research design was employed to assess knowledge and experiences of 192 senior nursing students. These students were administered the Health Literacy Knowledge and Experiences Survey (HL-KES), a 2- part survey that included assessment of knowledge about health literacy and experience in working with populations of …

Inequalities And Approximations Of Weighted Distributions By Lindley Reliability Measures, And The Lindley-Cox Model With Applications, Broderick O. Oluyede, Macaulay Okwuokenye, Karl E. Peace

Biostatistics: Faculty Publications

In this note, stochastic comparisons and results for weighted and Lindley models are presented. Approximation of weighted distributions via Lindley distribution in the class of increasing failure rate (IFR) and decreasing failure rate (DFR) weighted distributions with monotone weight functions are obtained including approximations via the length-biased Lindley distribution. Some useful bounds and moment-type inequality for weighted life distributions and applications are presented. Incorporation of covariates into Lindley model is considered and an application to illustrate the usefulness and applicability of the proposed Lindley-Cox model is given.

How Long Does That 10-Year Smoke Alarm Really Last? A Survival Analysis Of Smoke Alarms Installed Through The Saife Program In Rural Georgia, Haresh Rochani, Valamar Malika Reagon, Steve Davidson

Biostatistics: Faculty Publications

Background: When functioning properly, a smoke alarm alerts individuals in the residence that smoke is near the alarm. Smoke alarms serve as a primary prevention mechanism to abate morbidity and mortality related to residential fires.

Methods: Using survival analysis, we examined the length of operability of 10-year lithium battery powered smoke alarms installed through the Georgia Public Health/CDC SAIFE program in Moultrie, Georgia. Attempts were made to reach all homes in the city limits. The premise of the study is that geographic clusters (in the case of Moultrie city quadrants) are associated with decreases in the length of time that …

An Exploration Of Factors Influencing Attrition From A Pediatric Weight Management Intervention, Melissa Ann Kwitowski

Theses and Dissertations

Childhood obesity is a serious health problem in the United States. Numerous weight management programs attempt to address this issue. However, attrition poses significant treatment efficacy challenges. Understanding attendance and attrition from childhood obesity programs is crucial for effective and appropriate resource utilization. NOURISH+ is a community-based treatment program for parents of overweight and obese children (age 5–11 years, BMI ≥ 85th percentile). The current study investigated attrition from NOURISH+ to enhance understanding of pediatric obesity treatment retention factors. NOURISH+ participants (n=70) completed a questionnaire assessing barriers to adherence and general program feedback. Data were analyzed using frequencies, …

Utilization Of Anc And Pnc Services In Nepal : A Multivariate Analysis Based On Nepal Demographic Health Survey 2001 And 2006, Gehendra Mahara, Collins Asweto, Kai Cao, Ali M. Alzain, Andrea Sebastian, Jill Barr, Xiuhua Guo, Wei Wang

Research outputs 2014 to 2021

Background: Maternal Mortality is a public health problem in Nepal, which was highest in 1990 among the South Asian countries. Associated factors of maternal mortality are various; among them maternal health sevices such as antenatal (ANC) and postnatal care (PNC) services are the main. Methods: A multivariate secondary data analysis out based on Nepal Demographic Health Surveys 2001 and 2006. Logistic regression models was performed to compare the utilization of the ANC and PNC services, with background characteristics of women aged between 15 to 49 years old. Results: A total of 8913 reproductive aged groups (15-49) women were taken f …

Health Communication As A Public Health Training And Workforce Development Issue, Nancy L. Winterbauer, Ann P. Rafferty, Katherine A. Jones, Mary Tucker-Mclaughlin, Colleen Bridger

Frontiers in Public Health Services and Systems Research

Effective communication is one of the core competencies for public health professionals and is required for local health department (LHD) accreditation. Public health communication specialists play a critical role as conduits of health information, particularly with regard to managing relationships with media and the message that is ultimately represented by news outlets. However, capacity for engagement with traditional media in community health improvement at the local level has not been well-described. As part of a larger study examining the use and impact of the County Health Rankings in North Carolina, LHD media staffing and interaction with traditional media were examined …

A More Efficient Nonparametric Test Of Symmetry Based On Overlapping Coefficient, Hani M. Samawi, Robert L. Vogel

Biostatistics: Faculty Publications

In this paper we provide a more efficient nonparametric test of symmetry based on the empirical overlap coefficient using kernel density estimation applied to an extreme order statistics, namely extreme ranked set sampling. Our simulation investigation reveals that our proposed test of symmetry is at least as powerful as currently available tests of symmetry. Intensive simulation is conducted to examine the power of the proposed test. An illustration is provided using cardiac output and body weight of neonates in a neonatal intensive care unit.

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Factors That Affect Attachment Between The Employed Mother And The Child, Infancy To Two Years, Naureen Kassamali, Salma Amin Rattani

School of Nursing & Midwifery

To explore a mother's feeling of attachment and the affects her working status on the attachment relationship with her child, upon ethical clearance from the institutional ethics committee, in-depth interviews of nine participants were conducted. Mothers enrolled were those who resumed the employment within the first year of post-delivery and were having a child up to two years of age. Results revealed that maternal employment itself does not enhance or deteriorate attachment with the child. It is combinations of factors that revolve around it impact on their bond. Overall, maternal integration or the balance of the dual roles of employment …

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …

La Atención De Mujeres Con Complicaciones Post-Aborto En Un Hospital Público Del Partido De La Matanza: La Perspectiva De Los Profesionales De La Salud / The Perspective Of Health Professionals On The Quality Oftreatment For Women With Complications Post-Abortion Ina Public Hospital In La Matanza, Hannah Collins

Independent Study Project (ISP) Collection

Background: In Argentina, abortion is illegal under all circumstances except for when a woman has been raped, has a mental disability or her life is in danger. There are approximately 500,000 abortions practiced each year in Argentina, and the majority is performed in an unsafe manner, which can result in complications that require medical attention. In 2010, over 50,000 women were hospitalized because of complications post-abortion. These complications can include hemorrhages, infections, or other toxic illnesses. After the International Conference on Population and Development in 1994 they identified post-abortion care as a worldwide problem. Subsequently, Argentina created a guide for …

Overview Of Inference About Roc Curve In Medical Diagnosis, Jingjing Yin

Biostatistics: Faculty Publications

Medical diagnosis aims to identify diseased individuals through the evaluation of the measurements of some biomarkers by performing a diagnostic test based on some biomarker measurements. Biomarkers are measured on either discrete or continuous scale and continuous biomarkers are utilized more often in medical practice. This article introduces the most popular tool for evaluating continuous biomarkers: the Receiver Operating Characteristic (ROC) curve.

Lung Flute Improves Symptoms And Health Status In Copd With Chronic Bronchitis: A 26 Week Randomized Controlled Trial, Sanjay Sethi, Jingjing Yin, Pamela K. Anderson

Biostatistics: Faculty Publications

Background: Chronic obstructive pulmonary disease (COPD) is characterized by mucus hypersecretion that contributes to disease related morbidity and is associated with increased mortality. The Lung Flute® is a new respiratory device that produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance. We hypothesized that the Lung Flute, used on a twice daily basis will provide clinical benefit to patients with COPD with chronic bronchitis.

Methods: We performed a 26 week randomized, non-intervention controlled, single center, open label trial in 69 patients with COPD and Chronic Bronchitis. The primary endpoint was change in respiratory symptoms measured …

Association Analysis Of Reported Attitudes And Culturally Competent Behavior Engagement Among Public Health Department Employees, Marla B. Hall Phd, Jeffrey J. Guidry Phd, E. Lisako Mckyer Phd, Corliss Outley Phd, Danny Ballard Phd

Journal of Health Disparities Research and Practice

Objective: The purpose of this research is to analyze the association of attitudes and beliefs on engaging in culturally competent behavior.

Design: Explorational case study of individuals employed within an urban public health department.

Participants: Employees (n=90) from four metropolitan clinical sites of an urban public health department located in the southwest region of the United States were solicited and recruited during a monthly staff meeting. This sample is representative of 84% of the total employees which is comprised of 107 individuals.

Main Outcome Measures: The Cultural Competence Assessment is designed to explore individual knowledge, feelings …

Trauma Informed Practices For Oakland Unite Service Providers, Maereg D. Haile

Master's Projects and Capstones

Oakland, California - a home to almost 400,000 residents - is the top five most violent cities of the nation. There are lots of factors that greatly contribute to violence including: Poverty, housing/homelessness, unemployment, food insecurity, educational attainment, substance abuse. These factors feed to greater healthy disparities and increased trauma in low-income communities – specifically in east and west Oakland. Measure Y, now called Oakland Unite, is the current violence prevention effort that is set for reauthorization in November 2014. In order for these efforts to continue, Oakland Unite has started looking at comprehensive violence prevention initiatives that includes mental …

The Fatherhood Factor: The Impact Of The Father-Child Relationship On The Social, Interpersonal, And Recidivism Risk Factors Of Previously Incarcerated Men, Larissa A. Maley

Seton Hall University Dissertations and Theses (ETDs)

Of the men who return home from prison, nearly 7 out of 10 will be re-arrested and sent back within 3 years of their release (Travis, Solomon, & Waul, 2001). This trend has large- scale implications, not just for individuals, but for their families and communities as well. Clearly, understanding the factors that contribute to a man’s success or failure in staying out of prison is extremely important in constructing policy and programs to assist these at-risk individuals and communities. Of the few studies that have explored the lives of previously incarcerated men, some have found fatherhood to be a …