Public Health Commons^™

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Developing Countries, Sumera Aziz Ali, Umber S. Khan, Anam Shahil Feroz

Community Health Sciences

Anemia is one of the major causes of maternal mortality and morbidity across the globe, affecting around two-thirds of pregnant women in developing countries. The objective of this study was to synthesise study findings regarding the prevalence and determinants of anemia among women of reproductive age in developing countries. A total of 28 articles were reviewed by two authors for preliminary screening after removing overlapping information. Finally, 15 studies conducted from 2000 to 2015 were included in the review. The average prevalence of anemia was found to be 46.5% with a range of 18.1% to 75% in different studies. Factors …

Google-Truthing To Assess Hot Spots Of Food Retail Change: A Repeat Cross-Sectional Street View Of Food Environments In The Bronx, New York, Nevin Cohen, Michael Chrobok, Olivia Caruso

Publications and Research

Google Street View (GSV) images can be used to “ground-truth” current and historical food retail data from approximately 2007 - when GSV was launched in a few US cities - to the present, facilitating analyses of food environments over time. A review of GSV images of all food retailers listed in a government database of licensed establishments in the Bronx, New York enabled records to be verified, businesses classified, and retail change quantified. The data revealed several trends likely to affect food access and health: increasing overall numbers of food retailers; the growth of dollar stores; and numerous openings, closings, …

Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial, Sangappa M. Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar Herekar, Sunil Vernekar, Yogesh Kumar S

Community Health Sciences

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), …

Effect Of 5-Minute Movies Shown Via A Mobile Phone App On Risk Factors And Mortality After Stroke In A Low- To Middle-Income Country: Randomized Controlled Trial For The Stroke Caregiver Dyad Education Intervention (Movies4stroke), Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Shahvaiz Magsi, Aresha Malani, Zahra Peera, Saadia Sattar, Masood Ahmed Akram, Sumaira Shahnawaz, Maryam Zulfiqar, Abdul Muqeet, Fabiha Zaidi, Saleem Sayani, Azmina Artani, Syed Iqbal Azam, Sarah Saleem

Section of Neurology

Background: Pakistan is the sixth most populous nation in the world and has an estimated 4 million stroke survivors. Most survivors are taken care of by community-based caregivers, and there are no inpatient rehabilitation facilities.
Objective: The objective of this study was to evaluate the effectiveness and safety of locally designed 5-min movies rolled out in order of relevance that are thematically delivered in a 3-month program to deliver poststroke education to stroke survivor and caregiver dyads returning to the community.
Methods: This study was a randomized controlled, outcome assessor–blinded, parallel group, single-center superiority trial in which participants (stroke survivor-caregiver …

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.

A Multicenter Case Control Study Of Association Of Vitamin D With Breast Cancer Among Women In Karachi, Pakistan, Uzma Shamsi, Shaista Khan, Syed Iqbal Azam, Aysha Habib, Amir Maqbool, Mohammad Hanif, Tiffany Gill, Romaina Iqbal, David Callen

Community Health Sciences

Background: The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan.
Methods: A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information …

Support For Rural Practice: Female Physicians And The Life–Career Interface, Kimberly Stutzman, Ruth Ray Karpen, Pragna Naidoo, Sarah E. Toevs, Amanda Weidner, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Introduction: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students’ interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work–life balance. The purpose of this study was to better understand the types of support they need and how they find it, …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala

Numeracy

We propose a relationship between sensory modality, numerical formatting, and performance on a survey simulating healthcare decision-making. We examine the current literature on aural health literacy, and specifically aural literacy coupled with health numeracy. We then create a survey instrument called the Bhala test for this purpose and demonstrate that it is moderately internally consistent and provides results that correlate with the NUMi assessment, a widely accepted measure of health numeracy. The quantitative information provided in the Bhala test has two treatments, percentage and natural frequency formats, in an effort to determine which format is easier for subjects to use …

Using Mobile Phones To Improve Community Health Workers Performance In Low-And-Middle-Income Countries, Anam Shahil Feroz, Rawshan Jabeen, Sarah Saleem

Community Health Sciences

Background: In low-and-middle-income countries community health workers are the core component of the PHC system as they act as a liaison between the communities and the healthcare facilities. Evidence suggests that the services offered by these workers have helped in the decline of maternal and child morbidity and mortality rates and the burden of communicable and non-communicable diseases. However, the coverage and the overall progress towards achieving the SDG targets is very sluggish. The recent consensus concerning this current pace of progress, is that it relates to financial and human resources constraints. CHWs are overburdened as they are expected to …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

Changes In Hospital Utilization By Individuals Experiencing Homelessness After Engaging With Interdisciplinary, Low-Barrier Healthcare Services In Portland, Maine, Sarah Hemphill Ba, Adam Normandin Md, Ms, Debra Rothenberg Md, Phd

Journal of Maine Medical Center

Introduction: The Maine Medical Center Preble Street Learning Collaborative (PSLC) aims to couple medical education with addressing the unmet healthcare needs of those experiencing homelessness in Portland, Maine. The PSLC provides low-barrier medical, psychiatric, dental, and case management services to all-comers and is co-located near many of the city’s social services. The purpose of this study was to evaluate the impact of the PSLC in its first 19 months by describing demographic characteristics and patterns in hospital utilization of patients served by the PSLC.

Methods: We performed a retrospective chart review of 888 patients with one or more …

Community Outreach And Education Project: Hepatitis A And B Vaccines In High Risk Populations, Ellen Wright

Master of Science in Nursing Theses and Projects

The Community Outreach and Education Project targets high risk groups within Gaston County to increase education and vaccination against Hepatitis to, in turn, lower countywide Hepatitis rates. Through implementation of the project, Gaston County Department of Health and Human Services-Public Health (GCDHHS-PH) will partner with Community sponsors to gain access to their high-risk clients. Sponsors will be educated on the impact of prompt intervention in slowing the spread of hepatitis throughout high risk groups. Once an agreement is made between GCDHHS-PH and Community sponsors, GCDHHS-PH will present to participating facilities and begin screening, educating, and vaccinating high-risk individuals.

Association Between Sports Participation And Levels Of Physical Fitness, Jordan Italiano

Scholarship in Medicine - All Papers

Objective: Physical activity is a major component of overall health, especially in children. Increased physical activity in children provides many health benefits, and organized sports provide a great opportunity to meet the physical activity recommendations. In fact, participation in organized sports provides further health advantages, such as lower BMIs, compared to those who engaged in self organized physical activity and has shown to promote continued healthy habits throughout life. However, there has not been research looking at which sports are associated with the greatest level of fitness and provide the greatest health benefit for participants. In this study, we examine …

Covid-19’S Effects On New York City’S Food System: Lessons For Public Health Responses, Nevin Cohen, Nicholas Freudenberg

Publications and Research

The COVID-19 pandemic disrupted food availability and affordability and changed the daily food practices of New Yorkers. Eleven surveys of samples of 1,000 New York City adults from March 13 through June 28 illustrate three effects on food access and food insecurity: (1) closing restaurants, schools, and other sources of prepared foods reduced access and changed shopping patterns, food expenditures, and diets; (2) economic disruption exacerbated food insecurity and increased demand for food assistance; and (3) altered food practices affected diets and health. These impacts were disproportionately borne by vulnerable populations. This paper reports survey responses illustrating the effects of …

Design Thinking For Community-Provider Collaboration: Designing A Culture- And User-Friendly Refugee Wellness Center, Ellen Solomon, Oluwatoni Okuboyejo, Shandon Coffman, Brandon Joa, Bon Ku, Md, Mpp

Phase 1

Background: Designing South Philadelphia’s first permanent healthcare facility dedicated to refugee health presents a unique opportunity to integrate cultural sensitivity with principles of community health. Design thinking (human-centered design) is a promising strategy to address health and social justice concerns through the development of innovative products and services that prioritize population needs. This project utilized design thinking to inform suggestions to the design of Hansjörg Wyss Wellness Center that promote a culturally sensitive and welcoming environment in order to improve healthcare outcomes for the refugee population in Philadelphia.

Methods: Standard qualitative data gathering methods were used to gather insight into …

The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md

Journal of Health Ethics

Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.

Perceptions Of Workload And Job Impact As Predictors Of Child Welfare Worker Health Status, Austin G. Griffiths, David Royse, Chris Flaherty, Crystal Collins-Camargo

Social Work Faculty Publications

Turnover in the child welfare workforce remains a problem with detrimental consequences. While a robust body of literature has explored the influence of job factors on employee retention, and the presence of secondary traumatic stress and other related experiences in this population, little is known about the impact of such factors on the physical health of the practitioner. This manuscript is a first step in documenting the relationship between worker characteristics, perceptions of their job, and their self-reported health status. Utilizing the Child Welfare Employee Feedback Scale (CWEFS), a Binary Logistic Regression model identified Workload and Job Impact as significant …

Analysis Of Personality, Suicide, And Self‐Injury In Emerging Adulthood, Amanda C. La Guardia, Robert J. Cramer, Claire N. Bryson, Kelly Emelianchik-Key

Community & Environmental Health Faculty Publications

Nonsuicidal self‐injury (NSSI) is a maladaptive coping strategy that is of significant clinical concern for behavioral health professionals in college settings. Relationships between NSSI, acquired capability for suicide, interpersonal cognitions, and five‐factor model personality traits were assessed in a survey‐based study that included 192 young adults in a college setting. Results indicated that those with an affirmative suicide attempt history, greater acquired capability for suicide, and elevated neuroticism had an increased likelihood of lifetime NSSI.

Factors Associated With Tobacco Smoking Among Saudi College Students: A Systematic Review, Saad A. Alotaibi, Praveen K. Durgampudi

Community & Environmental Health Faculty Publications

INTRODUCTION There has been an increase in tobacco smoking among Saudi college students in recent years. However, no study has examined, with a systematic approach, the extent to which specific factors are associated with tobacco smoking among this population.

METHODS PubMed, ProQuest, CINAHL, and Web of Science were utilized to retrieve studies addressing risk factors associated with tobacco smoking among Saudi college students between 2010 and 2019. After confirming their eligibility criteria, studies were imported to the NVivo software for data collection and synthesis. All included articles were critically appraised, based on a modified STROBE.

RESULTS Twenty-one out of 300 …

Prenatal Perception Of Wic Breastfeeding Recommendation Affects First Month Postpartum Breastfeeding Outcomes, Qi Zhang, Lamichhane Rajan, Joanne Guthrie

Community & Environmental Health Faculty Publications

No abstract provided.

Association Between Usage Of An App To Redeem Prescribed Food Benefits And Redemption Behaviors Among The Special Supplemental Nutrition Program For Women, Infants, And Children Participants: Cross-Sectional Study, Qi Zhang, Junzhou Zhang, Kayoung Park, Chuanyi Tang

Community & Environmental Health Faculty Publications

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is one of the most important food assistance programs in the United States, serving 6.4 million low-income, eligible women, infants, and children under 5 years of age in 2019. In the program, participants are prescribed a list of food benefits, which can be redeemed in WIC-authorized stores. However, there are multiple behavioral barriers in the program and the stores that prevent participants from redeeming the benefits fully.

OBJECTIVE: This study aims to examine the relationship between the use of a widely used mobile phone app, WICShopper, and the …

2017 Statewide Child Death Report, Nevada Institute For Children's Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Mental Health Advocacy: Building An Interdisciplinary Program For Agriculture Professionals, Abby E. Blankenship, Erica E. Nason, Olivia Hayes, Sebastian Bliss

Contemporary Rural Social Work Journal

The suicide rate among agriculturalists is 3.5 times higher than the general population. A number of external factors related to the farming and veterinary work put individuals in agricultural populations at risk for poor mental health outcomes, including economic variables (e.g. tariffs, market prices), environmental factors affecting yield (e.g. drought, pests), and exposure to difficult or traumatic life events (e.g., mistreatment of animals, loss of crop). Rural values including self-reliance, work orientation, and individualism combined with logistical and systemic barriers to competent behavioral health care further increase risk. Project GROW (Generating Resilience in Our Workforce) is a multifaceted full semester …

Development And Guiding Principles Of The Icelandic Model For Preventing Adolescent Substance Use, Alfgeir L. Kristansson, Michael J. Mann, Jon Sigfusson, Ingibjorg E. Thorisdottir, John P. Allegrante, Inga Dora Sigfusdottir

Public and Population Health Faculty Publications and Presentations

Adolescent substance use—the consumption of alcohol, tobacco, and other harmful drugs—remains a persistent global problem and has presented ongoing challenges for public health authorities and society. In response to the high rates of adolescent substance use during the 1990s, Iceland has pioneered in the development of the Icelandic Model for Primary Prevention of Substance Use—a theory-based approach that has demonstrated effectiveness in reducing substance use in Iceland over the past 20 years. In an effort to document our approach and inform potentially replicable practice-based processes for implementation in other country settings, we outline in a two-part series of articles the …

Covid-19 Personal Protective Equipment Sterilization System, Uwe Reischl

Public and Population Health Faculty Publications and Presentations

A portable system based on a non-destructive sterilization method was developed that consists of a chamber producing ozone concentration levels reported in the scientific literature to deactivate 99.9% of all microorganisms. The system includes a small cordless 30mg/h ozone generator placed inside a 20L enclosed chamber. Personal protective equipment is loaded into the chamber and automatically exposed to an ozone concentration up to 18 ppm for 30 minutes. PPE is then removed and ventilated in open air to allow residual ozone to degrade to oxygen. The paper describes the design and performance characteristics of this technology.

Ua12/4 Student Affairs Health Services, Wku Archives

WKU Archives Collection Inventories

Records created by Health Services.