Public Health Commons^™

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

Pilot Evaluation Of The Text4baby Mobile Health Program, William D. Evans, Jasmine L. Wallace, Jeremy Snider

Prevention and Community Health Faculty Publications

Background

Mobile phone technologies for health promotion and disease prevention have evolved rapidly, but few studies have tested the efficacy of mobile health in full-fledged programs. Text4baby is an example of mobile health based on behavioral theory, and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health, health care beliefs, practices, and behaviors in order to improve clinical outcomes. The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign.

Methods

We conducted a randomized pilot evaluation study. All participants were pregnant women first presenting for care …

Multisite Qualitative Study Of Primary Care Physicians’ And Midlevel Providers’ Self-Reported Practices And Perceptions About Maintaining Cognitive Health, Angela K. Hochhalter, Lucinda L. Bryant, Rebecca Hunter, Rui Liu, Daniela B. Friedman, Anna E. Greer, Joseph Sharkey, Swarna Reddy, Anthony J. Caprio, Sindy Mccrystle

All PTHMS Faculty Publications

To facilitate national efforts to maintain cognitive health through public health practice, the Healthy Brain Initiative recommended examining diverse groups to identify stakeholder perspectives on cognitive health. In response, the Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention (CDC), coordinated projects to document the perspectives of older adults, caregivers of people with dementia, and primary care providers (PCPs) on maintaining cognitive health. Our objective was to describe PCPs’ perceptions and practices regarding cognitive health.

Jshp Hosts Region Iii Hiv/Aids Meeting August 2, 2012, Kate Cecil Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Ambiguity, Ambivalence, And Apprehensions Of Taking Hiv-1 Pre-Exposure Prophylaxis Among Male Couples In San Francisco: A Mixed Methods Study, Parya Saberi, Kristine Elizabeth Gamarel, Torsten B. Neilands, Megan Comfort, Nicolas Sheon, Lynae A. Darbes, Mallory O. Johnson

Publications and Research

Objective: We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIVpositive) male couples’ PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple.

Design: Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants’ awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Stories, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Prevention and Community Health Faculty Publications

No abstract provided.

Lower Nutritional Status And Higher Food Insufficiency In Frail Older Us Adults, Ellen Smit, Kerri M. Winters-Stone, Paul D. Loprinzi, Alice M. Tang, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses …

Information On Small Populations With Significant Health Disparities: A Report On Data Collected On The Health Of Asian Americans In Massachusetts, Carolyn Wong, Hannah Hosotani, John Her

Institute for Asian American Studies Publications

An analysis of publicly available sources of data on Asian Americans in Massachusetts with recommendations on ways to improve this collection of data.

Our report begins with a discussion of the important issues of data collection and reporting and then discusses the particular challenges of collecting and reporting on data in Massachusetts. Profiles of major datasets based on records for administrative entities are presented such as the Massachusetts Cancer Registry, hospital discharges, MassHealth, and Medicare, and mortality and natality records. This is followed by a description of major datasets based on population surveys such as the Behavioral Risk Factor Surveillance …

Health Behaviour Changes After Diagnosis Of Chronic Illness Among Canadians Aged 50 Or Older, Jason T. Newsom, Nathalie Huguet, Pamela L. Ramage-Morin, Michael Joseph Mccarthy, Julie Bernier, Mark S. Kaplan, Bentson H. Mcfarland

Community Health Faculty Publications and Presentations

Changes in health behaviors (smoking, physical activity, alcohol consumption, and fruit and vegetable consumption) after diagnosis of chronic health conditions (heart disease, cancer, stroke, respiratory disease, and diabetes) were examined among Canadians aged 50 or older. Results from 12 years of longitudinal data from the Canadian National Population Health Survey indicated relatively modest changes in behavior. Although significant decreases in smoking were observed among all groups except those with respiratory disease, at least 75% of smokers did not quit. No significant changes emerged in the percentage meeting physical activity recommendations, except those with diabetes, or in excessive alcohol consumption, except …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …

Primary Care Survival Skills In An Age Of Reform, Therese M. Zink, Peter Harper, Nancy Arnston, Jean Jansen

Family Medicine Faculty Publications

The Triple Aim - improved outcomes/quality of care, improved patient experience, and reduced cost - is driving health care reform in Minnesota and nationally. Minnesota is among those states moving quickly to new payment models that reward practices for meeting these three goals and is gradually reducing payments based only on increased volume of services. Primary care is growing into a new leadership role to meet these new demands while managing the reality that full funding for population based care is developing more slowly than the rhetoric. There are many encouraging signs, including an expanding interest in primary care medical …

Deteriorating Access To Women's Health Services In Texas: Potential Effects Of The Women's Health Program Affiliate Rule, Leighton C. Ku, Lara Cartwright-Smith, Jessica Sharac, Erika Steinmetz, Julie Lewis, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Based on an earlier study and an in-depth analysis of five market areas, the authors find that Texas' plan to bar Planned Parenthood clinics from participating in the state Women's Health Program (WHP) would leave tens of thousands of women without a source of care, because Planned Parenthood clinics are the dominant WHP providers in those areas and other local family planning clinics lack the capacity to absorb a large number of additional patients.

Librarians Collaborate To Touch The Lives Of Patients Through Community Pediatricians, Keri Swaggart, Nancy Allen

Posters

MCMLA 2012 Annual Meeting Presentation

The Development Of Hiv-Prevention Programs In Public Health Centers And Their Impact On Women: Opportunities For Changes In The City Of Buenos Aires - El Desarrollo De Programas De Prevención Contra El Vih Y Sus Impactos En Las Mujeres En El Primer Nivel De Atención. Oportunidades Por Cambios En La Ciudad De Buenos Aires., Anna Longo

Independent Study Project (ISP) Collection

The focus of my research is the implementation and continued efforts of HIV-prevention plans that are provided in primary care public health centers in the city of Buenos Aires. Much of the outline for these programs has been created and maintained by la Coordinación SIDA, a government-based AIDS group that works to organize and moderate public sector prevention efforts in the city. Public health centers are an effective channel through which HIV-prevention can be provided, due to the fact that they are often very integrated in their communities and tend to have a good sense of the social context that …

Pepfar Problems: How Does The United States’ Presidential Emergency Program For Aids Relief Empower Women?, Caitlin H.

Independent Study Project (ISP) Collection

This study looks to examine how the Presidential Emergency Program for AIDS Relief (PEPFAR) works to achieve one of its key goals, the empowerment of women, in the Western Cape. Human immunodeficiency virus (HIV) affects women disproportionately, around the world and in South Africa. Thus, women should be a key focus of Acquired Immunodeficiency Syndrome (AIDS) relief and HIV prevention. This paper analyzes the work of PEPFAR to empower women through three lenses. Women’s empowerment in general is discussed, to see how organizations view their own methods of empowerment. PEPFAR’s work with sex workers is examined, as they are often …

Los Factores Sociales Que Influyen En El Embarazo Y En El Uso De Anticonceptivos De Adolescentes En El Barrio 25 De Mayo, Maipú, Mendoza., Isabel Odean

Independent Study Project (ISP) Collection

Background: Adolescent pregnancy is a common phenomenon among those living in poverty. Adolescent pregnancy is influenced by many social and cultural factors, leading to lack of use of contraceptives. This study took place in the neighborhood 25 de Mayo, in the city of Maipú, Mendoza in Argentina. This community is mostly composed of people with low incomes and limited education. Socioeconomic and the attitudes toward teenage pregnancy, as well as the use of contraceptives by adolescents, are distinct from those in wealthier better educated groups. This neighborhood is approximately 10,000 people, the majority of whom are women. Most of the …

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi, …

Trends In Condom Use Among Female Sex Workers In Andhra Pradesh, India: The Impact Of A Community Mobilisation Intervention, Jennifer T. Erausquin, Monica Biradavolu, Elizabeth Reed, Rebekah Burroway, Kim M. Blankenship

Prevention and Community Health Faculty Publications

Background

Community mobilisation interventions for HIV prevention among female sex workers (FSWs) aim to organise FSWs for collective action and challenge the structures of power that underlie HIV risk. Assessing intervention impact is challenging because the importance of direct individual exposure to intervention components may decrease over time as change occurs at social-normative, policy and other structural levels. In this paper, the authors examine changes over time in consistent condom use among FSWs in Rajahmundry, Andhra Pradesh, the location of a long-standing community mobilisation intervention.

Methods

The authors analyse cross-sectional data collected among FSWs at three time points (n=2276) using …

Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan

School of Nursing & Midwifery

Objectives: To assess and describe the experiences of those caring for hepatitis C patients in Karachi, Pakistan.

Methods: Using a qualitative approach, the study adopted a descriptive exploratory design for which 8 caregirers were selected through snowball sampling technique from different parts of Karachi. Data was collected between May and July 2010 through semi-structured interviews from the caregivers. The interviews were recorded on tape and were transcribed verbatim. The data was manually analysed for extracting themes and categories.

Results: The analyses of data led to one theme - \'deadly, dangerous, and devastating. Two associated categories could also be noted: \'perceptions …

Comunicación Entre Personal Médico Y Pacientes Indígenas Un Estudio De La Medicina Intercultural En Huancarani, Cusco, Peru, Jordan Cahn

Independent Study Project (ISP) Collection

Esta investigación describe la relación entre personal médico y el paciente en un contexto intercultural. La ubicación del estudio es un centro de salud en la comunidad rural de Huancarani, Cusco, Perú. El personal médico viene de un perspectivo occidental y mayormente hablan castellano mientras que los pacientes son de orígenes indígenas y hablan quechua. El objetivo de la investigación es para observar la interacción intercultural entre el personal médico y los pacientes para determinar si las barreras culturales y preferencias para biomedicina o medicina tradicional infringen la calidad de servicios médicos. El personal médico prefiere la biomedicina y ve …

Body Mass Index And The Risk Of Prostate Cancer, Daniel Lee Mcgee, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: This article presents cohort studies that use data from the National Health Information Survey from 1986 to 1994 and compares the effectiveness of Cox proportional hazards models that assume a linear relationship between body mass index (BMI) and the risk of prostate cancer with models that assume a J-shaped relationship. Methods and results: Our study found that for black males over 40 years of age, neither a linear nor a J-shaped relationship yielded a statistically significant model. With white males over 40 years, assuming a linear relationship did not yield a statistically significant model (P = 0.582). When we …

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

ETSU Faculty Works

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

Homelessness: Causes, Culture And Community Development As A Solution, Kaitlin Philipps

Pell Scholars and Senior Theses

This thesis seeks to explain the reasons that homelessness occurs, and how it is currently being dealt with in public policy. Triggers and predictors of homelessness are explored and it is shown that triggers are almost always compounded, indicating a multitude of factors that lead to homelessness. The culture and community surrounding the homeless lifestyle is seen as playing a significant role in how the individual copes with their homelessness. The norms and values of their culture are investigated and its role in rehabilitation is explored. Current institutions for helping the homeless are analyzed for different success rates. Additionally, initiatives …

Nutrition And Diabetic Management In Urban Kenya, Madeline Jackson

Independent Study Project (ISP) Collection

This Independent Study project sought to identify the changes in nutrition from the traditional Luo culture to the new urban setting and explore the management, perceptions and prevalence of Type II diabetes in an increasingly urban area. The focus was on Type II diabetes since the majority of disease burden stems from this acquired form of the diabetes. Through speaking with elderly community members and shadowing the first line diabetic treatment centers in Kisumu, an assessment of the relationship between changing nutrition and diabetic management showed numerous gaps in the system that will continue to increase unless something is done. …

Is It Really Just All About Sex And Money? A Case Study Of Teenage Motherhood In The Village Of Kwaximba In The Valley Of A 1,000 Hills, Margaret Nelson

Independent Study Project (ISP) Collection

The aim of this learnership at the Valley Trust was to gain insight into why teenage girls in the Valley of the 1,000 Hills fall pregnant and what is the cost of early motherhood on the future of young women. Previous research of the province KwaZulu-Natal has revealed that teenage pregnancies are a large problem in school districts and restricting the future academic pursuits of teenage mothers. The learner worked alongside the Valley Trust in coordination with their outreach programs in the local villages of the Valley of a 1,000 Hills to learn fundamental and underlying reasons behind teenage pregnancy …

The Valley Trust: A Historical Review Of Food Security And Nutrition-Related Programs At A Health Promotion Non-Governmental Organization In The Valley Of A Thousand Hills, Kwazulu-Natal, Jeannine Garcia

Independent Study Project (ISP) Collection

The aim of this study is to provide an in-depth review and analysis of past and present programs focused on food security and nutrition at The Valley Trust, in the Valley of a Thousand Hills, KwaZulu-Natal. The Valley Trust is a socio-medical health promotion NGO that works to improve the health of the communities it serves through development, empowerment, and educational initiatives. The study will seek to provide an overview of the various activities The Valley Trust has engaged in over its long history related to improving the nutritional status of communities it influences.

Data was collected on the history …

El Dengue En Puerto López La Incidencia Y El Nivel De Conocimiento De La Gente Sobre Las Enfermedades Transmitidas Por Los Mosquitos, Mckenzie Momany

Independent Study Project (ISP) Collection

This study took place in Puerto López, Manabí, Ecuador and focuses primarily on the level of knowledge the townspeople have about dengue and how it is transmitted. It also looks at the incidence of dengue in the town and across neighborhoods. In order to carry out this study, I spent a month living in the coastal town of Puerto López and interviewed 50 townspeople – 10 in each of the five neighborhoods of Jonas Gonzalez, Miraflores, Luís Gencón, San Alejo, and the central neighborhood. Interviewees were questioned about their past history of dengue, as well as their knowledge of the …