Public Health Commons^™

Obesity: The Elephant In The Room We Can No Longer Afford To Ignore, Joanie Sompayrac, Katharine Linehart Trundle

Journal of Health Ethics

Everyone pays the price for the obesity-related illnesses of our fellow citizens – through increased premiums on our group health insurance policies, through reduced productivity of our co-workers, through taxpayer support of hospitals that provide indigent care and through soaring Medicare costs, to name a few. The fact that our entire society often ends up paying many of the costs for the obesity-related illnesses of not only ourselves but also our family members, our friends, our co-workers and even strangers raises questions: Why doesn’t insurance pay to help overweight and obese people to make lifestyle changes that could save us …

Hiv Diagnosis Disclosure To Infected Children And Adolescents; Challenges Of Family Caregivers In The Central Region Of Ghana, Anna Hayfron-Benjamin, Dorcas Obiri-Yeboah, Stephen Ayisi-Addo, Peter Mate Siakwa, Sylvia Mupepi

Peer Reviewed Articles

Background

Disclosure of Human Immunodeficiency Virus (HIV) to infected older children and adolescents is essential for both personal health maintenance and HIV prevention within the larger population. Non-disclosure of HIV status has been identified as one of the potential barriers to optimum adherence especially in children and adolescents. Like many other countries in the SSA region, Ghana has significant number of children and adolescents infected by HIV, who have increased survival times, due to increased access to ART. However, both family caregivers and healthcare workers face an array of challenges with the disclosure process, including the timing, what information about …

Patient Barriers For Weight Management Among African American Women, Owen Bowie, Jennifer Kusch, George L. Morris Iii, Tracy Flood, Jessica Gill, Renee E. Walker, Ron A. Cisler, Jennifer T. Fink

Journal of Patient-Centered Research and Reviews

Purpose: The primary aim of this study was to assess the perceptions of local African American women who are overweight or obese using semi-structured focus groups to identify barriers to weight management and factors that support strategy success. The secondary aim of this study was to determine recommendations for patient-centered weight management interventions established specifically for African American women in the Milwaukee-area community.

Methods: Three semi-structured focus groups to explore barriers to weight management were performed among women patients. Participants (N = 41) were recruited via email, postal mail, and phone as available from an academic medical center in Milwaukee, …

Implementing Community-Created Self-Management Support Tools In Primary Care Practices: Multimethod Analysis From The Insttepp Study, Douglas H. Fernald, Matthew J. Simpson, Donald E. Nease Jr., David L. Hahn, Amanda E. Hoffmann, Leann C. Michaels, Lyle J. Fagnan, Jeanette M. Daly, Barcey T. Levy

Journal of Patient-Centered Research and Reviews

Purpose: With one-half of Americans projected to be living with at least one chronic condition before 2020, enhancing patient self-management support (SMS) may improve health-related behaviors and clinical outcomes. Routine SMS implementation in primary care settings is difficult. Little is known about the practice conditions required for successful implementation of SMS tools.

Methods: Four primary care practice-based research networks (PBRNs) recruited 16 practices to participate in a boot camp translation process to adapt patient-centered SMS tools. Boot camp translation sessions were held over a 2-month period with 2 patients, a clinician, and a care manager from each practice. Qualitative case …

How To Translate Self-Management Support Tools Into Clinical Practice, Matthew J. Simpson, Jeanette M. Daly, Douglas H. Fernald, John M. Westfall, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients.

Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs). The typical model of boot camp translation was adapted for the purpose of the Implementing Networks’ Self-management Tools Through Engaging Patients and …

Adapting Boot Camp Translation Methods To Engage Clinician/Patient Research Teams Within Practice-Based Research Networks, Lyle J. Fagnan, Matthew J. Simpson, Jeanette M. Daly, Leann C. Michaels, David L. Hahn, Barcey T. Levy, Douglas H. Fernald, John M. Westfall, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Boot camp translation is a proven process to engage community members and health professionals in translating and disseminating evidence-based “best practices” models for health prevention and chronic illness care. Primary care practice improvement studies, particularly involving patient-driven change, as seen with self-management support (SMS), require engaged practice teams that include patients. Models of engagement such as boot camp translation may be effective.

Methods: Four geographically dispersed practice-based research networks (PBRNs) from the Meta-LARC consortium engaged 16 practices to form SMS implementation teams involving a clinician, care manager, and 2 patients in each team. Our study adapted the boot camp …

Almost Everything We Need To Better Serve Children Of The Opioid Crisis We Learned In The 80s And 90s, Kimberly A. Horn, Robert P. Pack, Robert Trestman, Gerard Lawson

ETSU Faculty Works

Opioid use disorder impedes dependent parents' abilities to care for their children. In turn, children may languish in unpredictability and persistent chaos. Societal responses to these children are often guided by a belief that unless the drug dependent parent receives treatment, there is little help for the child. While a preponderance of the drug dependence research is adult-centric, a significant body of research demonstrates the importance of not only addressing the immediate well being of the children of drug dependent caregivers but preventing the continuing cycle of drug dependence. The present commentary demonstrates through a brief review of the US …

Perceptions Of Needs, Assets, And Priorities Among Black Men Who Have Sex With Men With Hiv: Community-Driven Actions And Impacts Of A Participatory Photovoice Process, Christina J. Sun, Jennifer L. Nall, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Black men who have sex with men (MSM) with HIV experience significant health inequities and poorer health outcomes compared with other persons with HIV. The primary aims of this study were to describe the needs, assets, and priorities of Black MSM with HIV who live in the Southern United States and identify actions to improve their health using photovoice. Photovoice, a participatory, collaborative research methodology that combines documentary photography with group discussion, was conducted with six Black MSM with HIV. From the photographs and discussions, primary themes of discrimination and rejection, lack of mental health services, coping strategies to reduce …

Epidemiology Of Asthma And Associated Factors In An Urban Pakistani Population: Adult Asthma Study-Karachi, Shama Razzaq, Asaad Ahmed Nafees, Unaib Rabbani, Muhammad Irfan, Shahla Naeem, Muhammad Arslan Khan, Zafar Fatmi, Peter Burney

Community Health Sciences

Background: This study was conducted in order to determine the prevalence of asthma and associated risk factors in the adult population of Karachi, Pakistan.
Methods: This multi-stage, cross-sectional survey was conducted from May 2014-August 2015; comprising 1629 adults in 75 randomly selected clusters in Karachi, Pakistan. Definitions included: 'self-reported asthma', 'reversibility in FEV₁^' and 'respiratory symptoms and reversibility in FEV₁'.
Results: Prevalence of asthma was 1.8% (self-reported) (95% CI: 1.0-2.6), 11.3% (reversibility in FEV₁) (95% CI: 9.4-13.3) and 6.6% (symptoms and reversibility in FEV₁) (95% CI: 5.1-8.1). Asthmatics were more likely to …

Children As Agents Of Change: Parent Perceptions Of Child-Driven Environmental Health Communication In The Apsáalooke (Crow Indian) Community, Jessica Milakovich, Vanessa W. Simonds, Frances L. Kim, Deborah Laveaux, Velma Pickett, Suzanne Held, Christine Martin, Jason Cummins, Lynn Kelting-Gibson

Journal of Health Disparities Research and Practice

While previous research suggests children have successfully acted as health change agents, no studies have examined the role of children in promoting environmental health knowledge and awareness. This study describes parent perceptions of the impact of a five-day water-focused environmental health summer camp on elementary school children in an American Indian community. We interviewed parents about their perception of changes in their child's environmental health knowledge, attitudes, and behaviors. Parents in this study confirmed that their child had shared information related to the camp activities. In addition, parents perceived that their children had increased knowledge and positive changes in attitudes …

An Examination Of Active Commuting By Race/Ethnicity, Income And Location, Dangaia Sims, Melissa Bopp

Journal of Health Disparities Research and Practice

Introduction

Active commuting (AC; walking and biking to work) is associated with a number of positive health outcomes, low participation remains low in the USA. Our objective was to examine the multi-level influences on AC considering social determinants of health: race/ethnicity, income level and location.

Methods

We conducted a cross-sectional survey examining correlates of AC in the Mid-Atlantic region of the United States. The sample consisted of 1,310 adults over the age of 18 who were employed part- or full-time outside of the home and physically able to walk and bike. One-way ANOVAs, t-tests, and Pearson correlation analyses were run …

Promoting Community And Population Health In Public Health And Medicine: A Stepwise Guide To Initiating And Conducting Community-Engaged Research, Scott D. Rhodes, Amanda E. Tanner, Lilli Mann-Jackson, Jorge Alonzo, Florence Siman, Eunyoung Y. Song, Jonathan Bell, Megan B. Irby, Aaron T. Vissman, Robert E. Aronson

Journal of Health Disparities Research and Practice

Various methods, approaches, and strategies designed to understand and reduce health disparities, increase health equity, and promote community and population health have emerged within public health and medicine. One such approach is community-engaged research. While the literature describing the theory, principles, and rationale underlying community engagement is broad, few models or frameworks exist to guide its implementation. We abstracted, analyzed, and interpreted data from existing project documentation including proposal documents, project-specific logic models, research team and partnership meeting notes, and other materials from 24 funded community-engaged research projects conducted over the past 17 years. We developed a 15-step process designed …

Increase Referrals To Medaccess At The Smhc Pharmacy, Sarah Jones, Kim Beaudoin

Southern Maine Health Care

Problem/Impact Statement: The MedAccess Program is losing referrals at point of sale in the SMHC Pharmacy.

Scope: Patients who are currently serviced by the SMHC Pharmacy that are uninsured or under insured and meet the % Federal Poverty Level for prescription assistance.

Integration Of A Pharmacist In A Pediatric Medical Home For Children With Medical Complexity, Alannah K. Yoder, Richard K. Ogden Jr., Ingrid A. Larson, Emily J. Goodwin

Pharmacy Posters

Background/Objectives

Children with medical complexity require unique care, specialized attention, and a dedicated team to meet the needs of the patient & caregivers. Drug-therapy related problems in complex, chronic conditions influence financial, institutional, and patient outcomes. The addition of a pharmacist allows for collaboration and delivery of comprehensive medication management in order to provide value-added medication services to optimize complex therapeutic regimens and patient outcomes through evidence-based practice, medication adherence, medication use coordination, and medication safety processes.

Description

Our program provides a pediatric medical home for hundreds of children with medical complexity. Families are cared for by a comprehensive …

Lifetime Economic Burden Of Intimate Partner Violence Among U.S. Adults, Cora Peterson, Megan C. Kearns, Wendy Likamwa Mcintosh, Lianne Fuino Estefen, Christina Nicolaidis, Kathryn E. Mccollister, Amy Gordon, Curtis Florence

School of Social Work Faculty Publications and Presentations

Introduction: This study estimated the U.S. lifetime per-victim cost and economic burden of intimate partner violence.

Methods: Data from previous studies were combined with 2012 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Intimate partner violence was defined as contact sexual violence, physical violence, or stalking victimization with related impact (e.g., missed work days). Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Mean age at first victimization was assessed as 25 years. Future costs were discounted by 3%. The main outcome measures were the mean per-victim (female and …

“If You Seek, You Know You Will Find And If You Find You Have Cancer, Why Do You Seek?” Knowledge And Practices Regarding Cancer Screening And Prevention In Cato Manor, Lilly Hennessey

Independent Study Project (ISP) Collection

The incidence of cancer continues to increase in South Africa, creating a serious concern for public health. There are currently several cancer awareness programs operating in the Durban area, but little is known as to whether they are having a positive impact on communities. This project aimed to understand the knowledge and practices regarding cancer screening and prevention in Cato Manor, KwaZulu-Natal. In doing so, it assessed the effectiveness and knowledge of current programs which work to increase cancer awareness.

This study used a mixed methodology approach. Surveys were given to 30 residents of Cato Manor to gain a quantitative …

Ua12/2/1 Fit: A Health & Wellness Guide, Wku Student Affairs

WKU Administration Documents

Special magazine of College Heights Herald regarding health and fitness.

• Childress, Nicole. Welcome to Fit
• Southers, Mariah. CVS Shares 4 Ways to Beat the Flu
• Childress, Nicole. Do It Yourself Face Masks
• Goodlett, Ryan. Juices Add Zest to Life
• Southers, Mariah & Bryson Lacasse. Classic Shortcuts – WKU Campus Map
• Wells, Spencer. Little Fox Bakery Offers Sweet Treats for Every Diet
• Southers, Mariah. Turning Up the Heat – Hot Yoga
• Goodlett, Ryan. Iron Woman – Melinda Grimsley-Smith
• Wells, Spencer. Preston Health & Fitness Center: More Than Just a Gym

Frequency Of Bloodstream Infection In Febrile Neutropenic Patients, Experience From A Developing Country, Basit Siddiqui, Rabeea Azmat, Shiyam Sunder Tikmani, Shumaila Rafi, Beenish Syed, Muhammad Tahir Khan, Hareem Rehman, Saleemullah Paracha

Section of Nephrology

Introduction: About 20% of febrile neutropenic patients are presented with bloodstream infection which is a leading cause of mortality among these patients. Awareness of the locally prevalent pathogens and their susceptibility pattern is important for proper treatment of infection which improves survival in these patients. The objective of this study was to determine the frequency of bloodstream infection in patients with febrile neutropenia admitted in Abbasi Shaheed Hospital.
Methods; This cross-sectional study was conducted in the Medical wards in Abbasi Shaheed Hospital, Karachi from 21-2-2016 to 20-8-2017. Patients of over 15 years of age of either gender with severe neutropenia …

Grandparent Caregivers’ Perceptions And Lived Experiences: Their Health And Wellbeing, Access To Health And State Of Health Services In Zimbabwe, Magen M. Mutepfa Dr

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

The study explored the perceptions and lived experiences of self-rated health, access to health, and state of health services for grandparent caregivers in Zimbabwe. In–depth interviews using semi-structured interview guides were carried out to elicit perceptions of lived experiences from grandparent caregivers (N=31; Mean age= 65.7; SD= 10.7). The data was thematically analysed and the software Nvivo 10 was used to help categorize emergent themes. The study found that grandparent caregivers experienced multiple chronic and complex self-rated health conditions (e.g., High blood pressure (HBP), arthritis, diabetes, hypertension, back pain, and heart problems), which influenced their health and Quality of Life …

Increasing Access To Pre-Exposure Prophylaxis (Prep) Among Transgender Women And Trans Feminine Non-Binary Individuals In New York City, Augustus Klein

Dissertations, Theses, and Capstone Projects

In the United States transgender women (i.e., individuals born male whose gender identity is on the feminine spectrum) are a highly vulnerable and marginalized population at high risk for HIV. Substance use, survival sex work, depression, unstable housing, and high levels of victimization and violence are commonly reported by transgender women and trans feminine individuals, indicating the potential for multiple concurrent HIV risks and underlying vulnerabilities. Structural forms of discrimination may contribute to these risk factors, possibly leading to poor outcomes such as unemployment or underemployment, homelessness, and lack of access to gender-affirming health care. Given this context, a biomedical …

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

It's About Communities: The Commitment To Promoting A Culturally Competent Environmental Health Workforce, Clint Pinion Jr., Leslie D. Mitchell, Jason W. Marion

EKU Faculty and Staff Scholarship

Environmental health and public health are profoundly local. The Association of Environmental Health Academic Programs (AEHAP) firmly agrees and for this reason, it is important to have local environmental health experts who know the pulse of their communities. AEHAP believes in supporting the advanced scientific education of environmental health in these communities through people from these communities. Accordingly, AEHAP has sought to promote and support accredited environmental health programs among a diverse cross-section of the U.S. higher education landscape. AEHAP’s students are diverse in many ways, including socioeconomically, racially, ethnically, and culturally. The value of this approach enhances the overall …

The Association Between Physical Inactivity And Obesity Is Modified By Five Domains Of Environmental Quality In U.S. Adults: A Cross-Sectional Study, Christine L. Gray, Lynne C. Messer, Kristen M. Rappazzo, Jyotsna S. Jagai, Shannon C. Grabich, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we conducted a cross-sectional study by linking county-level Behavioral Risk Factor Surveillance System data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, sociodemographic) across all U.S. counties. We estimated the county-level association (N = 3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for …

Characteristics And Clinical Outcomes Of Hospitalized Patients With Community-Acquired Pneumonia Who Are Active Intravenous Drug Users, Vidyulata Salunkhe, Paula Peyrani, Leslie A. Beavin, Stephen P. Furmanek, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Intravenous drug users (IVDU) have a 10-fold increased risk of community-acquired pneumonia (CAP) compared to the general population. There is scarce data available evaluating the clinical outcomes of IVDU hospitalized patients with CAP and that data mostly focuses on mortality. The objective of this study was to evaluate the clinical characteristics, incidence and outcomes of hospitalized patients with CAP in active intravenous drug users in Louisville, Kentucky.

Methods: This was a secondary data analysis of the University of Louisville Pneumonia study. IVDU patients were propensity score matched to a non-IVDU group. Study outcomes were time to clinical stability (TCS), …

Pulmonary Histoplasmosis In A Patient With Cough, Dyspnea, Pulmonary Nodule And Rheumatologic Manifestations: Case Report And Review, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report we describe a case of pulmonary histoplasmosis in a healthy adult female living in Kentucky. The patient presented with two months history of poly-arthralgia and myalgia, intermittent dry cough, chest tightness, exertional dyspnea, malaise, fatigue and one week history of skin rash. She did not respond to broad-spectrum antibiotic therapy and she also had extensive endocrine and rheumatologic work up that was negative. A diagnosis of histoplasmosis was established based on radiological findings as well as endobronchial ultrasound-guided transbronchial needle aspiration cytology (EBUS-TBNA) of mediastinal lymph nodes demonstrating necrotizing granuloma with fungal stains positive for Histoplasma. …

A Continuum Of Disease From Community-Acquired Pneumonia To Multiple Organ Dysfunction Syndrome, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Pulmonary Aspergillosis: A Review On Diagnosis And Management, Bilal A. Jalil, Juan M. Galvis, Karim A. El Kersh, Mohamed Saad, Mostafa M. Fraig, Juan J. Guardiola Ii

The University of Louisville Journal of Respiratory Infections

Aspergillosis is acquired by inhalation of spores of Aspergillus, a ubiquitous species in the environment. In normal hosts, spore inhalation rarely causes lung disease.

Pulmonary aspergillosis covers a wide spectrum of clinical syndromes depending on the interaction between Aspergillus and the host (immune-status, prior bronchopulmonary disease). It runs the gamut from invasive aspergillosis to Aspergillus bronchitis and colonization.

Invasive aspergillosis occurs in severely immunocompromised patients, typically with neutropenia. Chronic pulmonary aspergillosis affects patients with chronic structural lung disease such as chronic obstructive pulmonary disease, mycobacterial lung disease, but without significant immunocompromise. Aspergillus bronchitis affects patients with bronchial disease such …

Lemierre’S Syndrome, A Case Report And Review Of Literature, Casmiar I. Nwaigwe, Jason Greenwood

The University of Louisville Journal of Respiratory Infections

Lemierre’s syndrome is a suppurative thrombophlebitis of the internal jugular vein. In this paper we describe a case of severe Lemierre’s syndrome in a healthy 18 year-old woman. She initially presented with sore throat, and failed outpatient antibiotic therapy. She quickly progressed to septic shock, internal jugular vein septic thrombophlebitis, septic pulmonary emboli, empyema and respiratory failure. Successful treatment included intravenous antibiotics and thoracotomy. It is a rare disease that has been kept at bay with the widespread use of antibiotics for upper respiratory infections. However in recent years there seems to be an increase in number of cases being …

Empowering With Prep (E-Prep), A Peer-Led Social Media–Based Intervention To Facilitate Hiv Preexposure Prophylaxis Adoption Among Young Black And Latinx Gay And Bisexual Men: Protocol For A Cluster Randomized Controlled Trial, Viraj V. Patel, Zoë Ginsburg, Sarit A. Golub, Keith J. Horvath, Nataly Rios, Kenneth H. Mayer, Ryunh S. Kim, Julia H. Arnsten

Publications and Research

Background: Young black and Latinx, gay, bisexual, and other men who have sex with men (YBLGBM, aged 18-29 years) have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions. Preexposure prophylaxis (PrEP), an oral antiretroviral regimen taken daily by HIV-uninfected individuals to prevent HIV acquisition, is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM. Use of social media (eg, Facebook, Twitter, online dating sites) is ubiquitous among young people, providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption.

Objective: …

The Early Steps Project: Occupational Therapy In A Pediatric Primary Care Setting, Anne H. Zachry, J. Flick, P. Richey

Faculty Presentations

The purpose of this study is expand on the Early STEPs project goal of identifying early developmental delays in infants and young children in a health disparate population and to collect preliminary data to lay the groundwork for a future NIH grant proposal. Individuals with less education have poor health and shorter life expectancies than well-educated individuals, and research reveals that poverty is directly related to limited education. An innovative approach is needed to overcome barriers, improve health literacy, and educate parents on effective parenting strategies for this population. Technology may be the part of the solution to this issue. …