Public Health Commons^™

Child Obesity And The Interaction Of Family And Neighborhood Socioeconomic Context, Ashley W. Kranjac, Justin T. Denney, Rachel T. Kimbro, Brady S. Moffett, Keila N. Lopez

Sociology Faculty Articles and Research

The literature on neighborhoods and child obesity links contextual conditions to risk, assuming that if place matters, it matters in a similar way for everyone in those places. We explore the extent to which distinctive neighborhood types give rise to social patterning that produces variation in the odds of child obesity. We leverage geocoded electronic medical records for a diverse sample of over 135,000 children aged 2 to 12 and latent profile modeling to characterize places into distinctive neighborhood contexts. Multilevel models with cross-level interactions between neighborhood type and family socioeconomic standing (SES) reveal that children with different SES, but …

Syndemics Of Severity And Frequency Of Elder Abuse: A Cross-Sectional Study In Mexican Older Females, Mireya Vilar-Compte, Pablo Gaitán-Rossi

Department of Public Health Scholarship and Creative Works

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.

Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.

Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had …

One-Sentence, One-Word: An Innovative Data Collection Method To Enhance Exploration Of The Lived Experiences, Shannon L. Sibbald, Dylan Brennan, Aleksandra Zecevic

The Qualitative Report

Experienced-based methods are growing in popularity and are increasingly being utilized in a variety of research programs and investigations. They enable researchers and participants to co-design research strategies and outcomes and subsequently propose solutions to potential problems in the partnership. By applying an experience-based methods lens, we sought to augment traditional qualitative interviewing methodologies by using a novel method we named “one-sentence, one-word” (1S1W). To apply our 1S1W method, we used a phenomenological study that examined the relationship between the risk of falling and the desire of master athletes to engage in competitive sports. Participants reflected and recorded their subjective …

Subject Level Clustering Using A Negative Binomial Model For Small Transcriptomic Studies., Qian Li, Janelle R. Noel-Macdonnell, Devin C. Koestler, Ellen L. Goode, Brooke L. Fridley

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Unsupervised clustering represents one of the most widely applied methods in analysis of high-throughput 'omics data. A variety of unsupervised model-based or parametric clustering methods and non-parametric clustering methods have been proposed for RNA-seq count data, most of which perform well for large samples, e.g. N ≥ 500. A common issue when analyzing limited samples of RNA-seq count data is that the data follows an over-dispersed distribution, and thus a Negative Binomial likelihood model is often used. Thus, we have developed a Negative Binomial model-based (NBMB) clustering approach for application to RNA-seq studies.

RESULTS: We have developed a Negative …

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

“Are You Accepting New Patients?” A Pilot Field Experiment On Telephone-Based Gatekeeping And Black Patients’ Access To Pediatric Care, Tamara Leech, Amy Irby-Shasanmi, Anne L. Mitchell

Department of Public Health Scholarship and Creative Works

Study Objectives

To determine whether the name and accent cues that the caller is Black shape physician offices’ responses to telephone‐based requests for well‐child visits.

Method and Data

In this pilot study, we employed a quasi‐experimental audit design and examined a stratified national sample of pediatric and family practice offices. Our final data include information from 205 audits (410 completed phone calls). Qualitative data were blind‐coded into binary variables. Our case‐control comparisons using McNemar's tests focused on acceptance of patients, withholding information, shaping conversations, and misattributions.

Findings

Compared to the control group, “Black” auditors were less likely to be told …

Assessment Of Interprofessional Team Collaboration Scale (Aitcs): Further Testing And Instrument Revision., Carole Orchard, Linda L Pederson, Emily Read, Cornelia Mahler, Heather Laschinger

Nursing Publications

INTRODUCTION: The need to be able to assess collaborative practice in health care teams has been recognized in response to the direction for team-based care in a number of policy documents. The purpose of this study is to report on further refinement of such a measurement instrument, the Assessment of Interprofessional Team Collaboration Scale (AITCS) first published in 2012. To support this refinement, two objectives were set: Objective 1: to determine whether the items from the data collected in 2016 load on the same factors as found for the 2012 version of the 37-item AITCS. Objective 2: to determine whether …

Evaluation Of The Hiv Infant Tracking System (Hitsystem) To Optimise Quality And Efficiency Of Early Infant Diagnosis: A Cluster-Randomised Trial In Kenya., Sarah Finocchario-Kessler, Brad Gautney, Anlin Cheng, Catherine Wexler, May Maloba, Niaman Nazir, Samoel Khamadi, Raphael Lwembe, Melinda Brown, Thomas A. Odeny, Jacinda K. Dariotis, Matthew Sandbulte, Natabhona Mabachi, Kathy Goggin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: The HIV Infant Tracking System (HITSystem) is a web-based intervention linking providers of early infant diagnosis, laboratory technicians, and mothers and infants to improve outcomes for HIV-exposed infants. We aimed to evaluate the efficacy of the HITSystem on key outcomes of early infant diagnosis.

METHODS: We did a cluster-randomised trial at six hospitals in Kenya, which were matched on geographic region, resource level, and volume of patients (high, medium, and low). We randomly allocated hospitals within a matched pair to either the HITSystem (intervention; n=3) or standard of care (control; n=3). A random number generator was used to assign …

Factors Associated With Participant Attrition In A Longitudinal, Survey-Based Rheumatic Disease Databank, Kathryn A. Grafel

Capstone Experience: Master of Public Health

Introduction: Participant attrition is a problem common to many longitudinal studies, and when it occurs nonrandomly, it can impact the study’s validity and generalizability. Identifying factors associated with attrition can help to detect bias and aid in developing targeted interventions to reduce attrition. Methods: Logistic regression and Cox proportional hazards regression models were constructed separately for patients with rheumatoid arthritis, systemic lupus erythematosus, and other rheumatic diseases who participated in the FORWARD study between 1998 and 2018. Results: Patient characteristics associated with attrition included male sex, younger age, non-White race, and less education, each of which was identified in multiple …

Philosophia Soteria: How Occupational Safety And Health Professionals Influence Decision Makers, Daniel Jay Snyder

Graduate Theses and Dissertations

The purpose of this study was to identify ideas about how occupational safety and health (OSH) professionals influence decision-makers on matters impacting occupational health and safety management systems. A modified nominal group technique was used that involved 67 participants in ten nominal groups and identified the most important ideas about how OSH professionals can influence workplace safety and health decision making. The research produced themes of communication, scientific, professionalism, leadership, adaptability, and business acumen that resulted in six domains of occupational safety and health professional influence.

Pizza And Hamburger Consumption To Overweight Among Adolescents In Jambi City, Ummi Kalsum, Sahridayanti Nainggolan, Nawi Ng

Kesmas

Junk food is unhealthy and poor in nutrient quality, and may result in weight gain, obesity, and coronary heart disease, if consumed regularly. The prevalence of overweight in adolescents is 5-10% higher in urban areas. Adolescents undergo lifestyle changes, including in food consumption behavior. This study aimed to determine relation between junk food consumption patterns and overweight in adolescents. This study was conducted based on a cross-sectional design. A total of 137 high school students in Jambi City were involved in this study. Patterns of junk food consumption were assessed using food frequency questionnaires that examined the eating habits of …

Adolescents' Attitude Toward Hiv/Aids Prevention In Yogyakarta, Meysa Tiranda, Nanik Setiyawati, Anita Rahmawati

Kesmas

Acquired immunodeficiency syndrome (AIDS) is the second leading cause of death in adolescent groups in the world. In Indonesia, the rate of human immunodeficiency virus (HIV)-infected adolescents increases annually. Yogyakarta, well-known as the education city, has the highest number of HIV/AIDS cases in the productive age group of 20–29 years old, which means that they have been already infected with HIV since teen age. This study aimed to determine influential factors that affect adolescents' attitude toward HIV/AIDS prevention. The study was an analytic survey research with a cross-sectional design. Stratified random sampling was applied to select a sample size of …

Role Stress, Personality Type, Burnout, And Performance Of Midwives Towards Postnatal Care Program Achievement In Surabaya City, Elita Halimsetiono, Thinni Nurul Rochmah, Dewi Retno Suminar

Kesmas

The coverage of postnatal care program in Surabaya City had declined since 2011–2013 and could not reach the target. This analytic observational study used a cross-sectional design and was conducted during April–May 2015 to analyze the effect of role stress, personality type, and burnout on midwives’ performance towards postnatal care program achievement in Surabaya City. A total sample of 45 midwives was collected from eight primary health care centers in Surabaya City with basic emergency obstetric and neonatal care services. Accidental sampling was used for sample selection. This study indicated that most of the midwives were aged 20–30 years and …

Impact Of Budget Increase On Primary Health Care Performance In The Era Of National Health Insurance: Case Study In Buleleng District, Kadek Suranugraha, Ni Made Sri Nopiyani, Pande Putu Januraga

Kesmas

Since 2014, there has been an increase in funds for primary health care (PHC) coming from the National Health Insurance program capitation funds and the Health Operational Assistance Fund. This study aimed to explore the effect of this budget increase on the health care services at PHC. The case study used a qualitative approach and interviews from 19 PHC health workers with the highest and lowest budget. Data were analyzed using thematic analysis and supported by quantitative data. The positive impact of the increasing PHC budget was felt by PHC staff due to the addition of operational equipment and incentives …

Utilization Of Styrofoam As Soundproofing Material With Auditory Frequency Range, Sjahrul Meizar Nasri, Iting Shofwati

Kesmas

The utilization of bricks made of styrofoam is expectedly able to be a soundproof for noise control and as a preventive action to reduce the steadily increasing prevalence of hearing loss. This study aimed to assess the use of sound absorption material in which styrofoam was utilized to reduce the noise exposure. In this study, fine aggregates (sand and styrofoam) were made with a mixture of cement with a composition of 1:4 and 1:6, also the addition of polystyrene waste with a percentage of 0%, 20%, 40%, 60%, and 80%. Determination of acoustical property of the mixture was done by …

Risk Factors Associated With Low Birth Weight, Mohammad Zen Rahfiludin, Yudhy Dharmawan

Kesmas

Neonatal deaths are associated with preterm birth complications. The aim of this study was to analyze risk factors associated with LBW. This was a crosssectional study held in Bulu Primary Health Care, Temanggung, Central Java, Indonesia. The sample size required for this study was 69 based on the Slovin formula. Data were collected using questionnaires and semi-quantitative Food Frequency Questionnaire forms. Data on infant birth weight was taken from midwives’ delivery cohort records. Mid upper arm circumference (MUAC), hemoglobin level, blood pressure, maternal age, parity, nutritional intake, and serum transferrin receptor data were taken from the infant’s mother using a …

Family Perception Towards Health Role In Filariasis Countermeasures Using The Health Belief Model Approach In Aceh Besar District, Said Devi Elvin, Mutia Yusuf, Wirda Hayati, Teuku Alamsyah

Kesmas

Aceh Besar District is a filariasis endemic area. This endemic state is strongly influenced by people’s perception of filariasis countermeasures. This study aimed to determine relation between family perceptions towards health role in filariasis countermeasures using the Health Belief Model. An analytical survey was applied with a cross-sectional study approach. The study population was families at three villages that are Lambaro Bileu, Lambaet, and Cot Preh of Kuta Baro Primary Health Care. This represents 1,113 families with a sample of 92 families that were selected using a proportionate stratified random sampling technique. The study instrument was a questionnaire and data …

Work-Related Skin Diseases Among Workers In The Sewing Section At Pt. X Shoe Company In West Java, Hendra Hendra, Eva Nirwana, Marzuki Isahak

Kesmas

Occupational skin diseases are the most common work-related diseases in many countries. Shoe industry workers are potential to be affected by work-related skin diseases (WRSDs). This study aimed to analyze the risk factors associated with WRSDs among workers in the sewing section at a shoe company in West Java. A total of 477 workers were examined and interviewed using the modified Nordic Occupational Skin Questionnaire-2002/LONG from May 2016 to July 2016. Chi-square test and logistic regression were used to analyze the risk factors related to WRSDs. The results showed that 57.7% of the workers suffered from WRSDs. Most of the …

Health Promotion Toward Knowledge And Intention For Early Detection Of Cervical Cancer In Commercial Sex Workers, Desi Rusmiati, Tiurlan Yunetty Silitonga, Warendi Warendi

Kesmas

Cervical cancer is one of the cancer types that become a haunting danger for many women in the world. In Indonesia, the prevalence rate reached 0.8% or an estimated 98,692 patients. Its prevalence increased to 10% in the commercial sex worker group. This study aimed to explain the effect of health promotion on knowledge and intention for early detection of cervical cancer using the inspection of visual acetate method in the commercial sex workers. This study was quantitative with a quasi-experimental type, one group of pretest and posttest design. The population sample included the commercial sex workers at Genteng Subvillage, …

Update: Rural/Urban Disparities In Pneumococcal Vaccine Service Delivery Among The Fee-For-Service Medicare Population, 2012-2015, Joseph C. Vanghelof, Aric Schadler, Patricia R. Freeman, Jeffery C. Talbert

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Between 2014 and 2015, the number of pneumococcal vaccine services delivered to fee-for-service (FFS) Medicare beneficiaries increased by 380% as a result of uptake of PCV13 vaccine.
• Continued disparities in delivery of pneumococcal vaccine services to FFS Medicare beneficiaries in rural and urban communities are noted, with a 63% higher vaccination rate observed in urban areas.
• The majority of pneumococcal vaccine services delivered to FFS Medicare beneficiaries were provided by primary care providers, although pharmacy providers delivered close to one-fourth (24.2%) of these services.
• Pharmacy providers in rural communities play an increasing role in pneumococcal vaccine …

Correctional Nurse Competency And Quality Care Outcomes, Deborah Shelton, Bill Barta, Louise A. Reagan

Journal for Evidence-based Practice in Correctional Health

Purpose: In this paper, we report on the clinical care outcomes resulting from implementing a nurse competency education intervention to a nursing staff in a statewide correctional system. Background: State correctional healthcare systems face ongoing and serious challenges attracting and retaining an adequate number of qualified health professionals owing to the perceived undesirability of working in correctional facilities; high occupational stressors; and the effects of high turnover on the workloads of remaining nursing staff.

Methods: Nursing outcomes were evaluated on four most frequently used nursing protocols. The education intervention consisted of self-directed computer-based modules, hands-on clinical review of skills, and …

Core Curricular Priorities For Professional Development Of Nurses In Correctional Systems: A Delphi Study, Deborah Shelton, Annette T. Maruca, Louise A. Reagan

Journal for Evidence-based Practice in Correctional Health

Objective: To identify the core curricular elements to assure competency and professional development of registered nurses working with justice-involved populations.

Background: Numerous assessments of education priorities have been articulated for nurses working with patients who interface with justice systems. But no consensus of what comprises the core elements of a curriculum for nurses employed by justice systems has been published. Guidance from correctional nurse education experts is needed.

Design: A web-based Delphi survey methodology was used. Three de-identified surveys were sent to academic and clinical correctional nurse educators two weeks apart by email following an invitation and voluntary agreement to …

From Prison To The Community: Opportunities For Pharmacists To Support Inmate Medication Adherence, Elliott Bosco, Deborah Shelton

Journal for Evidence-based Practice in Correctional Health

The United States correctional system is a vital treatment source for chronic illnesses. Whether treating a chronic mental or physical illness, correctional healthcare requires effective resource utilization. Limited research exists on pharmacists' ability to directly address inmate medication adherence. Thus, this study explores inmate perception of medication adherence and management as part of their treatment plan. Semi-structured interviews were conducted with inmates throughout Connecticut. Diseases of interest were divided into a physical illness group (hypertension, diabetes mellitus, HIV/AIDS) and a mental illness group (depression, bipolar disorder, schizophrenia, substance abuse). A content analysis was conducted on four questions: 1) Do you …

Patient Perceptions Of Their Own Data In Mhealth Technology–Enabled N-Of-1 Trials For Chronic Pain: Qualitative Study, Robin Whitney, Deborah Ward, Maria Marois, Christopher Schmid, Ida Sim, Richard Kravitz

Faculty Publications

Background: N-of-1 (individual comparison) trials are a promising approach for comparing the effectiveness of 2 or more treatments for individual patients; yet, few studies have qualitatively examined how patients use and make sense of their own patient-generated health data (PGHD) in the context of N-of-1 trials. Objective: The objective of our study was to explore chronic pain patients’ perceptions about the PGHD they compiled while comparing 2 chronic pain treatments and tracking their symptoms using a smartphone N-of-1 app in collaboration with their clinicians. Methods: Semistructured interviews were recorded with 33 patients, a consecutive subset of the intervention group in …

The Critical Need For Mental Health Education To Be Mandated In New Mexico's Public Schools, Bonnie L. Murphy

Shared Knowledge Conference

Based on a review of research and best practices in mental health awareness and skills, this inquiry project argues for state legislative policies that would require mental health awareness and skills in the K-12 curriculum. Mental health affects individual accomplishments in every stage of people’s lives beginning in early childhood and throughout the life cycle. Prevention and treatment of mental illness plays a key role in the ability of an individual to cope with loss and develop resiliency and perseverance in challenging times and to make better decisions that improve the individual’s life and the lives of those around them. …

Tell Me More: Promoting Compassionate Patient Care Through Conversations With Medical Students, Danielle Qing, Anjali Narayan, Kristin Reese, Sarah Hartman, Taranjeet Ahuja, Alice Fornari

Patient Experience Journal

Tell Me More^® (TMM) is a medical student driven project that represents a movement amongst the rising generation of physicians to practice humanistic, patient-centered medicine through a collaborative approach. Students interviewed patients to create individualized posters designed to build rapport and trust between patients and clinicians, remind patients of their special strengths by highlighting their unique interests and qualities, and encourage more personal and compassionate patient-clinician interactions in order to enhance the patient experience. Students asked each patient three questions: 1. “How would your friends describe you?” 2. “What are your strengths?” 3. “What has been most meaningful to …

Effectiveness Of The Communication Model, C.O.N.N.E.C.T., On Patient Experience And Employee Engagement: A Prospective Study, Agnes Barden, Nicole Giammarinaro

Patient Experience Journal

Northwell Health is a large integrated healthcare organization comprised of 66,000+ employees, 23 hospitals and over 650 medical practice locations located geographically across New York State. In an effort to align and structure interactions between patients, families and healthcare professionals, Northwell Health created a communication model, C.O.N.N.E.C.T. This unique, humanistic model is an acronym that stands for: Contact, Opening Greeting, Name/Title, Needs, Explanation, Closing and Thank. This prospective 3-part study explores the impact of the C.O.N.N.E.C.T. model on professional education, engagement and patient experience. A holistic approach was utilized including a pre and post e-learning module assessment, direct observation behavioral …

Perceptions Of Patient-Centered Care Among Veterans With Gastroesophageal Reflux Disease On Proton Pump Inhibitor Therapy, Salva N. Balbale, Andrew Gawron, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

The aim of this study was to explore perceptions of patient-centered care (PCC) among Veterans with gastroesophageal reflux disease (GERD) on proton pump inhibitor (PPI) therapy using patient-reported outcome (PRO) measures. We used three validated surveys to measure PCC concepts in a national sample of Veterans with GERD on PPI therapy. The Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness (COMRADE) measures patient experiences with risk communication and decision-making. The Patient Activation Measure (PAM) evaluates confidence and knowledge needed for self-management. The Patient Assessment of Care for Chronic Conditions (PACIC) assesses views of chronic care received. We …

A Photo-Elicitation Study Of Homeless And Marginally Housed Veterans’ Experiences With Patient-Centered Care, Samuel F. Sestito, Keri L. Rodriguez, Kristina L. Hruska, James W. Conley, Michael A. Mitchell, Adam J. Gordon

Patient Experience Journal

As part of a qualitatively-driven mixed-methods study, this analysis aimed to describe Veterans Affairs (VA) Homeless Patient Aligned Care Team patients’ experiences with patient-centered care. Veterans participated in audio-recorded, semi-structured photo-elicitation interviews about their health and VA health care. Transcripts were analyzed by two coders using template analysis. In 31/36 interviews, 19/20 participants discussed patient-centered care. Veterans noted Picker’s Patient-Centered Care Principles; 1) access to care, 2) respect for patient-centered values, preference and expressed needs, 3) information, communication, and education, and 4) coordination and care integration were most commonly discussed, followed by 5) physical comfort, 6) transition and …

Rules Of Engagement: Strategies Used To Enlist And Retain Underserved Mothers In A Mental Health Intervention, Maureen J. Baker Phd, Rn, Cnl, Beth Perry Black Phd, Rn, Faan, Linda S. Beeber Phd, Pmhcns-Bc, Faan

Patient Experience Journal

Patient engagement has been identified as both a goal and strategy to lower health care costs and improve health care outcomes. However, a lack of consensus and clarity exists as to how the process of patient engagement is implemented in clinical practice. Research addressing the underlying and crucial components of effective patient engagement is limited, leaving a significant gap as to how providers engage patients as active collaborators in their health and health care.

This study provides specific, detailed insight and description into the processes through which advanced practice mental health nurses engaged low-income depressed mothers in a mental health …