Public Health Commons^™

Correction Of Verication Bias Using Log-Linear Models For A Single Binaryscale Diagnostic Tests, Haresh Rochani, Hani M. Samawi, Robert L. Vogel, Jingjing Yin

Biostatistics Faculty Publications

In diagnostic medicine, the test that determines the true disease status without an error is referred to as the gold standard. Even when a gold standard exists, it is extremely difficult to verify each patient due to the issues of costeffectiveness and invasive nature of the procedures. In practice some of the patients with test results are not selected for verification of the disease status which results in verification bias for diagnostic tests. The ability of the diagnostic test to correctly identify the patients with and without the disease can be evaluated by measures such as sensitivity, specificity and predictive …

Monitoring For Adverse Events Post Marketing Approval Of Drugs, Karl E. Peace, Macaulay Okwuokenye

Biostatistics Faculty Publications

This brief communication provides information to those developing monitoring plans for serious adverse events (SAE’s) following regulatory approval of a new drug. In addition, we (1) illustrate how many patients would need to be treated in order to have high confidence of seeing at least 1 pre-specified SAE, (2) show that absence of proof of a SAE is not proof of absence of that SAE, and (3) identify statistical methodology that could be used for formal statistical monitoring of SAE’s.

Predictive Factors Of Patient Satisfaction With Pharmacy Services In South Korea: A Cross-Sectional Study Of National Level Data, Sunkyung Lee, Onyeka P. Godwin, Kyungah Kim, Euni Lee

Pharmacy Faculty Articles and Research

Objectives
Patient satisfaction has emerged as a prerequisite to improving patients’ health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.

Methods
A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.

Results
A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom …

The Impact Of Antenatal Care On Maternal Mental Health In Rural Maharashtra, Cameron Barker

India: Public Health, Policy Advocacy, and Community

This study seeks to understand the major mental health concerns experienced by pregnant women and recent mothers in rural villages in Maharashtra and how these concerns are impacted by different elements of holistic antenatal and postnatal care. The risk factors that may lead to poor maternal mental health are strongly tied to social factors and vary from community to community. Unfortunately, in most developing countries mental health takes a back seat to other health issues deemed more pressing. This is especially true for female specific illnesses, given that the overall health of women and girl children is often neglected. The …

Does Mode Of Contact With Different Types Of Social Relationships Predict Depression In Older Adults? Evidence From A Nationally Representative Survey, Alan R. Teo, Hwajung Choi, Sarah B. Andrea, Marica Valenstein, Jason T. Newsom, Steven K. Dobscha, Kara Zivin

Community Health Faculty Publications and Presentations

OBJECTIVES: To determine associations between use of three different modes of social contact (in person, telephone, written or e-mail), contact with different types of people, and risk of depressive symptoms in a nationally representative, longitudinal sample of older adults.

DESIGN: Population-based observational cohort.

SETTING: Urban and suburban communities throughout the contiguous United States.

PARTICIPANTS: Individuals aged 50 and older who participated in the Health and Retirement Survey between 2004 and 2010 (N = 11,065).

MEASUREMENTS: Frequency of participant use of the three modes of social contact with children, other family members, and friends at baseline were used to predict depressive …

Social And Behavioral Implications Of National Collegiate Athletic Association Sickle Cell Trait Screening: The Athletes' Perspective, Raymona H. Lawrence, Alison Scott, Carlton Haywood Jr., Kayin Robinson, Mondi Mason

Community Health Faculty Publications

Background: In August 2010, the National Collegiate Athletic Association (NCAA) implemented a policy mandating sickle cell trait (SCT) testing for all Division I collegiate athletes. Subsequently, all Division II-III athletes were also compelled to undergo SCT testing. This decision has met with controversy among healthcare providers, researchers, and sickle cell advocates. However, there is little information concerning the athletes’ perspective of this policy. The purpose of this paper is to report the findings of a qualitative study that explored college athletes’ perceptions of sickle cell trait SCT, NCAA policies on SCT testing, and potential implications of SCT screening.

Methods: …

Exploring Cyber Harassment Among Women Who Use Social Media, Sloane Burke Winkelman, Jody Oomen-Early, Ashley D. Walker, Lawrence Chu, Alice Yick-Flanagan

Community Health Faculty Publications

The number of Internet users around the word is at an all-time high. The majority of North Americans are internet users and over two-thirds participate in some kind of social network (i.e. Facebook, Twitter, etc.). Social networks and mobile technology enable individuals to connect instantaneously or asynchronously, across geographic boundaries publicly or anonymously. Few studies exploring cyber harassment have been conducted, primarily because these technologies are relatively recent. The purpose of this descriptive study was to examine U.S. women's experiences with and attitudes toward cyber harassment by way of an anonymous electronic survey. A total of 293 adult women (mean …

Sexuality Education Websites For Adolescents: A Framework-Based Content Analysis, Sara Silverio Marques, Jessica S. Lin, Summer Starling, Aubrey G. Daquiz, Eva Goldfarb, Kimberly Garcia, Norman A. Constantine

Department of Public Health Scholarship and Creative Works

The web has unique potential for adolescents seeking comprehensive sexual health information. As such, it is important to understand the nature, scope, and readability of the content and messaging provided by sexuality educational websites. We conducted a content analysis of 14 sexuality education websites for adolescents, based on the 7 essential components (sexual and reproductive health and HIV, relationships, sexual rights and sexual citizenship, pleasure, violence, diversity, and gender) of the International Planned Parenthood Framework for Comprehensive Sexuality Education. A majority of content across all sites focused on sexual and reproductive health and HIV, particularly pregnancy and STI prevention, and …

Size And Power Of Tests Of Hypotheses On Survival Parameters From The Lindley Distribution With Covariates, Macaulay Okwuokenye, Karl E. Peace

Biostatistics Faculty Publications

The Lindley model is considered as an alternative model facilitating analyses of time-to-event data with covariates. Covariate information is incorporated using the Cox’s proportional hazard model with the Lindley model at the timedependent component. Simulation studies are performed to assess the size and power of tests of hypotheses on parameters arising from maximum likelihood estimators of parameters in the Lindley model. Results are contrasted with that arising from Cox’s partial maximum likelihood estimator. The Linley model is used to analyze a publicly available data set and contrasted with other models.

Joint Modeling Of Treatment Effect On Time-To-Event Endpoint And Safety Covariates In Control Clinical Trial Data Analysis, Kao-Tai Tsai, Karl E. Peace

Biostatistics Faculty Publications

It is a common practice to perform a separate analysis of efficacy and safety data from clinical trials to estimate the benefit and risk aspects of a particular treatment regimen. However, by doing so, one is likely to miss the complete picture of the treatment effect given that these data are generated from the same study subjects and therefore most likely will be correlated. Therefore, it is desirable to analyze these data jointly to obtain a more complete profile of the treatment regimen. A substantial number of statistical methodologies have been proposed in the last decade to model the time-to-event …

A Step By Step Methodological Approach To Appraise The Quality Of Written Feedback Using Comment Analysis, Lubna Ghazal, Raisa B. Gul, Amina Aijaz Khowaja

School of Nursing & Midwifery

Several studies have been conducted to analyze the quality of written feedback given by teachers on students’ written assignments. However, it has been observed that there is no clear existing method or tool to facilitate the analysis of teachers’ written feedback. This paper aims to document a step by step methodological approach to analyze teachers’ comments and appraise the quality of feedback on students’ written assignments. A self-initiated tool was developed from the comment analysis process which revealed the use of various formats and modes employed to provide written feedback to the students. In addition, this tool helped to determine …

The Associations Between Environmental Quality And Preterm Birth In The United States, 2000–2005: A Cross-Sectional Analysis, Kristen M. Rappazzo, Lynne C. Messer, Jyotsna S. Jagai, Christine L. Gray, Shannon C. Grabich, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Background: Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measure of cumulative environmental exposure across all US counties from 2000—2005, was used to investigate associations between ambient environment and PTB.

Methods: With 2000–2005 birth data from the National Center for Health Statistics for the United States (n = 24,483,348), we estimated the association between increasing quintiles of the EQI and county-level and individual-level PTB; we also considered environmental domain-specific (air, …

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 …

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

Stevenson Center for Community and Economic Development—Student Research

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 …

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 …

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 …