Public Health Commons^™

Social Ecological Constraints To Park Use In Communities With Proximate Park Access, J. Aaron Hipp, Deepti Adlakha, Ravikumar Chockalingam

Brown School Faculty Publications

Evidence correlates physical activity, psychological restoration, and social health to proximity to parks and sites of recreation. The purpose of this study was to identify perceived constraints to park use in low-income communities facing significant health disparities, but with proximate access to underutilized parks. The authors used a series of focus groups with families, teens, and older adults in neighborhoods with similar demographic distribution and parks over 125 acres in size. Constraints to park use varied across age groups as well as across social ecological levels, with perceived constraints to individuals, user groups, communities, and society. Policies and interventions aimed …

Los Determinantes De La Diferencia En La Tasa De Fecundidad Adolescente Entre Comunidades Pobres Y Ricas En Buenos Aires, Emily Turner

Independent Study Project (ISP) Collection

The city of Buenos Aires has some of the lowest rates of teenage fertility in Argentina (Gogna, Binstock, Fernández, Ibarlucía, & Zamberlin, 2008). However, this aggregated number obscures the huge variance within the city. In the most current available data (2010/2012) from the government of the city of Buenos Aires (GCBA) broken down by comunas (areas) highest fertility rate for 15-19 year olds was 81.6 births (per 1000) versus the lowest fertility rate which was only 6.2 (D. d. e. d. GCBA). This discrepancy is huge and reflects the incredible economic disparity in Buenos Aires. The comunas with the three …

Opinions Of Individuals In The Greater Durban Area Concerning Government Healthcare, Alexander Braun

Independent Study Project (ISP) Collection

One important determinant of health in South Africa is how government entities, from the local level to the national level, use their health budgets. A complex system of organizations involving many government employees at the various levels are involved in the process of turning a budget allocation of Rand into healthcare services and goods that make their way to the South African people. What do individuals in the greater Durban area think about that process as it exists currently, and what do they think of the services that are eventually delivered to them? This is an important question, especially in …

A Comparison Of Malnutrition Causes And Treatments: A Case Of Mwanamugimu Nutrition Unit, Mulago National Referral Hospital, Kampala District And Nakifuma Government Health Unit, Mukono District, Berkley Singer

Independent Study Project (ISP) Collection

In beginning of the investigation process, the researcher set out to study malnutrition in Uganda. She wanted to study an urban region in comparison to a rural region and so based her research out of both Kampala and the Mukono region. The researcher set out to learn more about the causes of the condition and why children become malnourished. She also was interested in the differences that exist between the two different locations and why they exist. Finally, the researcher was eager to learn what malnutrition meant to each community and how health care professionals go about treating the condition …

I Don't Want To Save Second Base, Chelsea E. Broe

SURGE

Tomorrow kicks off Breast Cancer Awareness Month, and I have one request: This October, let’s not save second base.

I know, I know, you probably think this month is a good thing. If not for all of those T-shirts demanding every female-bodied person to feel their boobies, or the bracelets simply proclaiming “I love boobies,” people with breasts might forget that they even have them, or at the very least might start to think that their breasts are their own business. But the female body seems to be an object owned by the public, so we must always be reminded …

Multi-Criteria Decision Analysis As An Innovative Approach To Managing Zoonoses: Results From A Study On Lyme Disease In Canada, Cécile Aenishaenslin, Valérie Hongoh, Hassane D. Cissé, Anne Gatewood Hoen

Dartmouth Scholarship

ackground: Zoonoses are a growing international threat interacting at the human-animal-environment interface and call for transdisciplinary and multi-sectoral approaches in order to achieve effective disease management. The recent emergence of Lyme disease in Quebec, Canada is a good example of a complex health issue for which the public health sector must find protective interventions. Traditional preventive and control interventions can have important environmental, social and economic impacts and as a result, decision-making requires a systems approach capable of integrating these multiple aspects of interventions. This paper presents the results from a study of a multi-criteria decision analysis (MCDA) approach for …

Adolescents And Parents' Perceptions Of Best Time For Sex And Sexual Communications From Two Communities In The Eastern And Volta Regions Of Ghana: Implications For Hiv And Aids Education, Emmanuel Asampong, Joseph Osafo, Jeffrey Bingenheimer, Clement Ahiadeke

Prevention and Community Health Faculty Publications

Background

Adolescents and parents’ differ in their perceptions regarding engaging in sexual activity and protecting themselves from pregnancy and sexually transmitted infections (STIs). The views of adolescents and parents from two south-eastern communities in Ghana regarding best time for sex and sexual communications were examined.

Methods

Focus Group interviews were conducted with parents and adolescents (both In-school and Out-of school) from two communities (Somanya and Adidome) in the Eastern and Volta regions of Ghana with epidemiological differentials in HIV infection.

Results

Findings showed parents and adolescents agree that the best timing for sexual activity amongst adolescents is determined by socioeconomic …

Providing Outreach And Enrollment Assistance: Lessons Learned From Community Health Centers In Massachusetts, Julia Paradise, Sara J. Rosenbaum, Peter Shin, Jessica Sharac, Carmen Alvarez, Julia Zur, Leighton Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2006, major health care reform legislation was enacted in Massachusetts. In many ways a prototype for the Affordable Care Act (ACA), the Massachusetts law required nearly all state residents to obtain health insurance, and made insurance accessible and affordable by reforming the health insurance market and providing subsidies for coverage through expansions of Medicaid and CHIP and a new program for low-income adults who are not eligible for Medicaid, known as Commonwealth Care. The law also created the “Connector,” which, like the ACA’s health insurance Marketplaces, is designed to facilitate and simplify access to insurance for individuals, families, and …

Determining Who Responds Better To A Computer Vs. Human-Delivered Physical Activity Intervention: Results From The Community Health Advice By Telephone (Chat) Trial, Eric B. Hekler, Matthew P. Buman, Jennifer Otten, Cynthia M. Castro, Lauren Grieco, Bess Marcus, Robert H. Friedman, Melissa A. Napolitano, Abby C. King

Prevention and Community Health Faculty Publications

Background

Little research has explored who responds better to an automated vs. human advisor for health behaviors in general, and for physical activity (PA) promotion in particular. The purpose of this study was to explore baseline factors (i.e., demographics, motivation, interpersonal style, and external resources) that moderate intervention efficacy delivered by either a human or automated advisor.

Methods

Data were from the CHAT Trial, a 12-month randomized controlled trial to increase PA among underactive older adults (full trial N = 218) via a human advisor or automated interactive voice response advisor. Trial results indicated significant increases in PA in both …

Assessing The Burden Of Crime And The Criminal Sanction: A Public Health Perspective On Critical Issues In Criminal Justice, Jeremy Travis

Publications and Research

No abstract provided.

Chhs October 2013 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Health Disparities Report, Sara J. Paton, Sylvia Ann Ellison, Nikki Lynn Rogers

Population and Public Health Sciences Faculty Publications

Through a Centers for Disease Control and Prevention Community Transformation Grant (CTG), Public Health – Dayton & Montgomery County (PHDMC) is working to improve the health of our community by reducing preventable chronic diseases such as lung cancer, heart disease, stroke, and type 2 diabetes. Our CTG initiatives focus on engaging community partners to implement policy, systems, and environmental (PSE) changes to promote tobacco-­free living, active living and healthy eating, and clinical preventive services. These PSE changes are intended to reduce death and disability due to tobacco use, rate of obesity, and death and disability due to heart disease and …

Exercise Participation During Weight Loss On A High Protein – Low Carbohydrate Diet Plan In Females Aged 15-25 Years, Margaret Mobley-Meulman

Electronic Theses and Dissertations

Weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year (U.S. Department of Health and Human Services, 2010). Obese adults have an increased risk for serious health conditions including high blood pressure and cholesterol, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers (National Cancer Institute, 2012). Participation in exercise can help control weight, strengthen muscles and bones, and reduce the incidence of cardiac events, stroke, hypertension, type 2 diabetes, colon and breast cancers, osteoporotic fractures, gallbladder disease, obesity, depression, anxiety, and delay mortality …

Unpacking The Temperament Weight Relationship: The Mediating Role Of Food Preferences, Sarah A. Berry

Electronic Theses and Dissertations

The current study examined the mediating role of possible food preferences on the temperamentweight relationship among 18-month-old toddlers. Parents of 37 typically developing toddlers completed the Early Childhood Behavior Questionnaire (ECBQ). During a lab visit toddlers’ weight and recumbent length were measured and recorded. Toddlers also completed a sequential touching task to examine their ability to categorize a healthy group of foods and an unhealthy group of foods. The only temperament measure found to associate with both child weight status and food categorization was inhibitory control. Toddlers’ food categorization was not found to mediate the relationship between inhibitory control and …

Barriers To Depression Treatment Among Low-Income, Latino Emergency Department Patients, Anjanette A. Wells, Isabel T. Lagomasino M.D., Lawrence A. Palinkas, Jennifer Green, Diana Gonzalez Msw

Brown School Faculty Publications

Objectives. Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. Methods. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79% female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Results. Although most patients acknowledged signs of depression, there …

Juxtaposing Nasa’S Aeronet Aod With Carb Pm Data Over The San Joaquin Valley To Facilitate Multi-Angle Imaging Spectroradiometer (Misr) Pm Pollution Research, John Kanemoto

STAR Program Research Presentations

Airborne particulate matter (PM) has been shown to increase the risk for asthma, chronic bronchitis, cardiopulmonary complications, and respiratory cell membrane damage/infection/leakage. PM levels are currently analyzed from two perspectives: stationary land-based monitoring (LBM) sites and total Aerosol Optical Depth (AOD) atmospheric column measurements. Both perspectives often leave miles of space between measuring locations and will have a continually increasing cost from introducing/maintaining sites. The Multi-angle Imaging SpectroRadiometer (MISR) satellite team hopes to begin investigating/archiving PM levels comprehensively via inputting MISR AOD measurements into a function/model which predicts the amount of ground level PM.

In the future, multivariable spatial correlations …

Open Streets Initiatives In The U.S. : Closed To Traffic, Open To Physical Activity, Jill A. Kuhlberg, J. Aaron Hipp, Amy A. Eyler, Genevieve Cheng

Brown School Faculty Publications

Background: The ciclovía, or open streets concept, is a community level physical activity promotion strategy where streets are closed to motorized traffic and open for individuals to engage in PA. This paper presents an overview of such initiatives in the U.S. to understand their potential in PA promotion, comparing event and city characteristics. Methods: We searched ciclovía and open streets initiatives held in 2011 in the U.S. using internet searches, publication databases, social media, and personal contacts. We extracted data on the each initiative’s frequency, route length, attendance, evaluation procedures, and sociodemographic characteristics of host cities. Results: Our search yielded …

Medicare Advantage Update: Benefits, Enrollment, And Payments After The Aca, Kathryn Linehan

National Health Policy Forum

In 2012, the Medicare program paid private health plans $136 billion to cover about 13 million beneficiaries who received Part A and B benefits through the Medicare Advantage (MA) program rather than traditional fee-for-service (FFS) Medicare. Private plans have been a part of the program since the 1970s. Debate about the policy goals—Should they cost less per beneficiary than FFS Medicare? Should they be available to all beneficiaries? Should they be able to offer additional benefits?—has long accompanied Medicare's private plan option. This debate is reflected in the history of Medicare payment policy, and policy decisions over the …

Best Practice Use To Address Tobacco-Related Disparities By California Community Coalitions, Rodney K. Mccurdy

Frontiers in Public Health Services and Systems Research

Tobacco-related disparities (TRDs) are a major public health concern. This study surveyed community tobacco coalition project directors in California to determine the usage of 11 CDC-published best practices to address TRDs. Response rate was 80 percent. Communities had implemented, on average, one-half of the 11 practices surveyed. Differences were observed between rankings for best practice implementation and perceived level of importance in addressing TRDs in the community. Resource constraints and community context were the highest reported barriers to best practice use. Study findings could assist tobacco program officials and local coalitions in addressing TRDs in their communities.

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Approaches To Mental Illness In Madagascar: A Case For Reconciling Reason With Faith, Raisa Tikhtman

Independent Study Project (ISP) Collection

This paper expounds the shortcomings of the mental health provisions inherent in the current primary health care system in Madagascar in light of its limited accessibility to the Malagasy. Integrating traditional medicine with allopathic psychiatric care is proposed, with attention to prevailing Malagasy beliefs in spiritual possession as the basis for mental illness, in order to accommodate the discrepant worldviews espoused by physicians and their Malagasy patients that inhibit the efficacy of public mental health care. Through an integrated system based on the model piloted at the Clinique de Manongarivo in northwestern Madagascar, the financial, physical, and epistemological barriers that …

Role Of Environment And Sex Differences In The Development Of Autoimmune Diseases: A Roundtable Meeting Project, Monica P. Mallampalli, Erika Davies, Debra Wood, Hillary Robinson, Federica Polato, Christine L. Carter

Prevention and Community Health Faculty Publications

Autoimmune diseases (ADs) impose substantial health and financial burdens in the United States and in many parts of the world. Women are disproportionately affected by many of these disorders, which often contribute to lifelong disabilities. While the number of patients with some ADs appears to be rising, the complexities of conducting epidemiological studies prevent a thorough understanding of the prevalence and incidence of these various conditions. Research on environmental influences of these illnesses is limited, although they are generally hypothesized to result from the interaction of environmental agents in genetically susceptible individuals. Further, there is little known regarding the role …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Assessing The Effectiveness Of Nutrition And Physical Activity Self-Assessment For Child Care (Nap Sacc) For Changes In Physical Activity Behavior, Policy, And Environment In Nebraska Family Child Care Homes, Katie K. Bolte

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Nebraska is the first state to utilize NAP SACC and to modify the evidence-based program for family child care homes (FCCHs). The purpose of this study was to conduct a secondary data analysis to assess the effectiveness of a modified version of the NAP SACC approach in achieving changes in physical activity behavior, policy, and environment in Nebraska FCCHs caring for children ages 2-5 years. Results from this study will be used to improve the NAP SACC physical activity components for FCCHs and will help to inform trainers and the Nebraska Department of Health and Human Services, Nutrition and Activity …

The Relevance Of Social Contexts And Social Action In Reducing Substance Use And Victimization Among Women Participating In An Hiv Prevention Intervention In Cape Town, South Africa, Elizabeth Reed, Andrea N. Emanuel, Bronwyn Myers, Kim Johnson, Wendee M. Wechsberg

Prevention and Community Health Faculty Publications

Objectives: To examine qualitatively how women's social context and community mobilization (eg, mobilizing women to take social action and engaging their community in social change) influence substance use abstinence and victimization among women participating in a human immunodeficiency virus (HIV) intervention in Cape Town, South Africa.
Methods: Thirty women who had participated in a randomized controlled trial of a group-delivered intervention to address substance use, gender-based violence, and associated risk for HIV (The Women's Health CoOp) were selected to participate in semi-structured interviews about their perceived impact of the intervention on their substance use and exposure to victimization. The Women's …

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.

Cms's Proposed Rule Implementing The Aca-Mandated Medicaid Dsh Reductions, Kathryn Linehan

National Health Policy Forum

State Medicaid programs make Medicaid disproportionate share hospital (DSH) payments to hospitals to help offset costs of uncompensated care for Medicaid and uninsured patients. Unlike most Medicaid spending, annual DSH allotments for each state are capped. Under the Patient Protection and Affordable Care Act of 2010 (ACA), DSH payments will decrease starting in fiscal year (FY) 2014 and continuing through FY 2020. This paper describes the proposed rule for reducing these federal allotments, which was released on May 15, 2013, by the Centers for Medicare & Medicaid Services (CMS). Comments on the proposed rule are due July 12, 2013.

2014 …

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Systematic Examination Of Infant Size And Growth Metrics As Risk Factors For Overweight In Young Adulthood, Andrew O. Odegaard, Audrey C. Choh, Ramzi W. Nahhas, Bradford Towne, Stefan A. Czerwinski, Ellen W. Demerath

Population and Public Health Sciences Faculty Publications

Objective:To systematically examine infant size and growth, according to the 2006 WHO infant growth standards, as risk factors for overweight status in young adulthood in a historical cohort. Specifically, to assess: Whether accounting for length (weight-for-length) provides a different picture of risk than weight-for-age, intervals of rapid growth in both weight-for-age and weight-for-length metrics, and what particular target ages for infant size and intervals of rapid growth associate most strongly with overweight as a young adult.Patients/Methods:Data analysis of 422 appropriate for gestational age white singleton infants enrolled in the Fels Longitudinal Study. Odds ratios (OR) for overweight and obesity in …

Access To Primary Care: Comparing Driving Distance From Health Professional Shortage Area (Hpsa) Counties Versus Non-Hpsa Counties, Molly Cashion, Stephanie Jilcott-Pitts, Doyle Cummings, Christopher Duffrin, John Jones, Qiang Wu

Frontiers in Public Health Services and Systems Research

The criteria used to identify Health Professional Shortage Areas dates back to the 1970’s and very little has changed since then. This study examined driving distance from patient address to provider address as one component of a geographical HPSA. Primary care-related services located in adjacent areas to whole-county HPSAs are considered excessively distant when travel time exceeds 30 minutes or the equivalent of 20 miles in this study. We found similarities in travel distance to primary care-related services from patients living in HPSA counties compared to those living in non-HPSA counties. This could indicate the need to re-examine HPSA definitions …