Public Health Commons^™

The Ingredients Of Change: A Political Ecology Approach To Diabetes In The Somali Community Of Minnesota, Mina Tehrani

Geography Capstone Projects

In the early 1990’s, due to political circumstances at home, Somali immigrants and refugees began arriving in the state of Minnesota in large numbers. Over the past two decades, Somali immigrants have come to comprise one of the most populous ethnic groups in the Twin Cities, and are the largest Somali population in the world outside of Eastern Africa. Although quantitative data is unavailable, qualitative evidence and testimonies of healthcare professionals support the conclusion that Somali immigrants in Minnesota suffer from higher rates of diabetes than non-immigrant groups and than they likely did before migration. Why might this be the …

Subsidized Housing, Public Housing, And Adolescent Violence And Substance Use, Tamara Leech

Department of Public Health Scholarship and Creative Works

This study examines the separate relationships of public housing residents and subsidized housing residence to adolescent health risk behavior. Data included 2,530 adolescents aged 14 to 19 who were children of the National the Longitudinal Study of Youth. The author uses stratified propensity methods to compare the behaviors of each group—subsidized housing residents and public housing residents—to a matched control group of teens receiving no housing assistance. The results reveal no significant relationship between public housing residence and violence, heavy alcohol/marijuana use, or other drug use. However, subsidized housing residents have significantly lower rates of violence and hard drug use, …

Agenda: 2010 World Energy Justice Conference: Emerging Solutions For The Energy Poor: Technological, Entrepreneurial And Institutional Challenges, University Of Colorado Boulder. Center For Energy & Environmental Security, Colorado Journal Of International Environmental Law And Policy

2010 World Energy Justice Conference (November 5)

This conference is a sequel to the 2009 World Energy Justice Conference (WEJC 2009) which began examining ways of mainstreaming safe, clean, and efficient energy for the world's Energy Poor (EP). The EP number two and a half billion people living on less than $1-2 a day who have no access to modern energy services. WEJC 2010 more fully develops these themes. WEJC 2010 will explore how the next round of global warming meetings in Cancun could design new flexibility mechanisms that give credits, for example, for the reduction of black carbon by the adoption of cookstoves, and embrace small …

Hiv Prevention Cost-Effectiveness: A Systematic Review, Omar Gálarraga, M. Arantxa Colchero, Richard G. Wamai, Stefano Bertozzi

Richard G. Wamai

Background: After more than 25 years, public health programs have not been able to sufficiently reduce the number of new HIV infections. Over 7,000 people become infected with HIV every day. Lack of convincing evidence of cost-effectiveness (CE) may be one of the reasons why implementation of effective programs is not occurring at sufficient scale. This paper identifies, summarizes and critiques the CE literature related to HIV-prevention interventions in low- and middle-income countries during 2005-2008. Methods: Systematic identification of publications was conducted through several methods: electronic databases, internet search of international organizations and major funding/implementing agencies, and journal browsing. Inclusion …

Implications Of Lifecourse Epidemiology For Research On Determinants Of Adult Disease, Sze Yan Liu, Richard N. Jones, M. Maria Glamour

Department of Public Health Scholarship and Creative Works

Many diseases commonly associated with aging are now thought to have social and physiologic antecedents in early life. Understanding how the timing of exposure to early life risk factors influences later-life health may illuminate mechanisms driving adult health inequalities and identify possible points for effective interventions. Recognizing chronic diseases as developing across the life course also has implications for the conduct of research on adult risk factors for disease. We review alternative conceptual models that describe how the timing of risk factor exposure relates to the development of disease. We propose some expansions of lifecourse models to improve their relevance …

Reasons For Reducing Breastfeeding Duration Among Chinese Mothers In Ireland:A Qualitative Study, Qianling Zhou

Other resources

Introduction: The Ireland Chinese Mother Survey has revealed a remarkable decline of breastfeeding duration among Chinese mothers who gave birth in Ireland [1]. This qualitative study was undertaken to explore the reasons for such a decrease and to determine the influence of residency in Ireland on breastfeeding practices among immigrant Chinese. Methods: Purposive sampling together with the snowball technique was used to recruit immigrant Chinese women who have given birth in Ireland. Seven focus groups were conducted and thematic content analysis was performed to analyse the data. Results: Decline in breastfeeding duration was not mainly due to the formula feeding …

Can Daytime Use Of Bed Nets Not Treated With Insecticide Reduce The Risk Of Dengue Hemorrhagic Fever Among Children In Vietnam?, Ataru Tsuzuki, Vu Dinh Thiem, Motoi Suzuki, Hideki Yanai, Toru Matsubayashi, Lay-Myint Yoshida, Le Huu Tho, Truong Tan Minh, Dang Duc Anh, Paul E. Kilgore, Masahiro Takagi, Koya Ariyoshi

Department of Pharmacy Practice

The purpose of this study was to investigate the prevalence of bed net use and elucidate the effect of daytime bed net use on preventing dengue hemorrhagic fever (DHF) among children in Vietnam. We conducted a population-based cross-sectional survey and a matched case–control study in Khanh Hoa Province where not only some pre-schoolchildren but also some school children, who take a nap during lunch break prior to returning to school, used bed nets during the day. Among 36,901 children 2–10 years of age, most used untreated bed nets during the night (98.3%) compared with 8.4% during the day. The results …

Practice Notes: Strategies In Health Education, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Objective: To monitor the progress in the promotion of walkable community initiatives.

Everything's Better In Moderation: Young Women's Gender Role Attitudes And Risky Sexual Behavior, Tamara Leech

Department of Public Health Scholarship and Creative Works

Purpose This study examines the association between gender role attitudes and risky sexual behavior among young women. Previous studies have posed seemingly contradictory arguments: that either traditional attitudes or egalitarian attitudes are associated with riskier behavior. Methods Data are based on the children of the National Longitudinal Survey of Youth, representing 520 sexually active 18–19-year-old women. Propensity radius matching was used to assess differences in rates of multiple sexual partners and sex outside of a committed relationship. Results Relative to moderate gender role attitudes, both egalitarian gender role attitudes and traditional gender role attitudes are associated with higher rates of …

Reinvention Of Depression Instruments By Primary Care Clinicians, Seong-Yi Baik, Junius Gonzales, Barbara J. Bowers, Jean S. Anthony, Bas Tidjani, Jeffrey L. Susman

Publications from Provost Junius J. Gonzales

PURPOSE Despite the sophisticated development of depression instruments during the past 4 decades, the critical topic of how primary care clinicians actually use those instruments in their day-to-day practice has not been investigated. We wanted to understand how primary care clinicians use depression instruments, for what purposes, and the conditions that influence their use.

METHODS Grounded theory method was used to guide data collection and analysis. We conducted 70 individual interviews and 3 focus groups (n = 24) with a purposeful sample of 70 primary care clinicians (family physicians, general internists, and nurse practitioners) from 52 offices. Investigators’ field notes …

Assessing The Sensitivity Of The Canadian Adverse Event Following Immunization Surveillance System ( Caefiss), Mina Tadrous

Theses and Dissertations (ETD)

Background: Vaccines are important to public health, but because of the way they are manufactured, their mechanism of action, and their indicated population, careful monitoring of their adverse events is necessary. Canada has a national surveillance system that collects reports on adverse events that may be associated with vaccine administration. Sensitivity is one of the tools used with surveillance systems to study the extent and characteristics of reporting of a surveillance system. To date, the sensitivity of the Canadian system has not been assessed.

Purpose: To assess the sensitivity of the Canadian Adverse Event Following Immunization Surveillance System …

Impact Belize 2010 Executive Report, Ritchie D. Taylor, Jordan Norris, Molly Calico, Bernie Strenecky, Daniel Carter, Dawn Garrett Wright, Eve Main, Bonny Petty, Molly Kerby, Jill Norris

Impact Belize

No abstract provided.

Practice Notes: Strategies In Health Education, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Objective: The purpose of the Be Red Cross Ready Community Outreach Project (BRCR) was to train health education students to provide high-quality, theory-driven community preparedness education in a community on the U.S.-Mexico border. This aim was achieved through an innovative partnership between a community organization, a federal research center, and a university. The ultimate goal of the project was to increase disaster and emergency preparation to protect, promote, and preserve the health of the public.

Culturally-Adapted And Audio-Technology Assisted Hiv/Aids Awareness And Education Program In Rural Nigeria: A Cohort Study, Ighovwerha Ofotokun, Jose Nilo G. Binongo, Eli S. Rosenberg, Michael Kane, Rick Ifland, Jeffrey L. Lennox, Kirk A. Easley

Faculty Articles

Background: HIV-awareness programs tailored toward the needs of rural communities are needed. We sought to quantify change in HIV knowledge in three rural Nigerian villages following an integrated culturally adapted and technology assisted educational intervention.

Methods: A prospective 14-week cohort study was designed to compare short-term changes in HIV knowledge between seminar-based education program and a novel program, which capitalized on the rural culture of small-group oral learning and was delivered by portable digital-audio technology.

Results: Participants were mostly Moslem (99%), male (53.5%), with no formal education (55%). Baseline HIV knowledge was low (< 80% correct answers for 9 of the 10 questions). Knowledge gain was higher (p < 0.0001 for 8 of 10 questions) in the integrated culturally adapted and technology-facilitated (n = 511) compared with the seminar-based (n = 474) program.

Conclusions: Baseline HIV-awareness was low. Culturally …

Perceived Stress, Sources And Severity Of Stress Amongts Medical Undergraduates In A Pakistani Medical School, Mohsin Shah

Mohsin Shah

No abstract provided.

Increasing Institutional Delivery And Access To Emergency Obstetric Care Services In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative in rural Uttar Pradesh (UP), India to determine the impact of the Janani Suraksha Yojana (JSY) scheme on the current status of institutional delivery in the region, to understand the facilitating factors and barriers in delivering in a health facility, and to identify programmatic and behavior change communication (BCC) initiatives that could accelerate the adoption of institutional delivery. JSY was launched as an intervention to address the barriers to institutional delivery, through the introduction of community-based women volunteers. The study shows that with the introduction of the JSY the rate of institutional delivery jumped …

Intégration Des Services Au Sénégal, Population Council

Reproductive Health

With financial support from USAID and technical support from IntraHealth, The Population Council, Siggil Jigeen Network, and Helen Keller International, Senegal’s Ministry of Health and Prevention has built a package of integrated services called SMNI/PF/PALU. Integrating services allow women to access a wider range of information and care during the same visit and thus increases the utilization of services while also improving their quality and efficiency. Findings in this report indicate that integration of services is a central feature of SMNI/PF/PALU’s success. In conjunction with integrated service delivery models, program activities which strengthen systems and support efficient implementation of services …

Income And Long-Term Breast Cancer Survival: Comparisons Of Vulnerable Urban Places In Ontario And California, Kevin M. Gorey

Social Work Publications

Effects of socioeconomic status on the long-term survival of 808 women with node-negative breast cancer in Canada and the United States were observed. Ontario and California samples diagnosed between 1988 and 1990 were followed until 2006. Socioeconomic data were taken from population censuses. Compared with their California counterparts, residents of low-income urban areas in Ontario experienced a significant 15-year survival advantage (RR = 1.66 [95% CI: 1.00, 2.76]). In these and other vulnerable, lower-middle- to working-class neighborhoods, significantly more Ontario residents gained access to adjuvant radiation therapy (RR = 1.75 [1.21, 2.53]) which seemed associated with better long-term survival (RR …

The Pregnancy Cycle Approach To Safe Motherhood, Saumya Ramarao, Sarah Raifman

Reproductive Health

The Population Council's Reproductive Health program partnered with the Maternal Health Task Force (MHTF), the Partnership for Maternal, Newborn and Child Health (PMNCH), and the PAC Consortium, to address the UN Millenium Development Goal of improving maternal health, and reducing child mortality. Specifically this brief examines the pregnancy cycle approach whereby women’s needs from facilitating a desired pregnancy to successful parturition are addressed in a range of settings—home, community and health facility. This brief covers the different stages including abortion and postabortion care, antenatal care, delivery, and postpartum and beyond.

Maternal And Neonatal Health Services In Sudan: Results Of A Situation Analysis, Nahla G. Abdel-Tawab, Maha El-Rabbat

Reproductive Health

This project brief is based on the results of a situation analysis (SA) study that was done collaboratively by the Population Council and Sudan Ministry of Health (MOH) with funds from UNFPA, UNICEF, and Packard Foundation. The analysis showed an uneven distribution of reproductive health (RH) staff across Sudan, and nurses and nurse midwives are the key in RH services. There was also limited access to family planning services. Antenatal care was limited, and pregnant women in the study seldom received counseling on birth spacing or birth preparedness. Birth attendants also lacked adequate knowledge and skills. Emergency obstetric care was …

Increasing Early And Exclusive Breastfeeding In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

The Population Council conducted a formative study in rural Uttar Pradesh, India to determine the current status of early and exclusive breastfeeding, understand the facilitating factors and barriers in adopting the desired breastfeeding practices, and identify programmatic and behavior change communication (BCC) initiatives to promote the practice. Findings indicate that efforts by Primary Health Centre staff to counsel and encourage women to breastfeed early could significantly increase adoption of this practice. The policy brief identifies barriers that reflect a lack of knowledge and misperceptions about breastfeeding, but finds that education, supportive family members, and knowledgeable health workers can facilitate breastfeeding. …

A Strategy For The Reduction Of Maternal And Neonatal Mortality, Population Council

Reproductive Health

As part of the strategies to reduce maternal and neonatal mortality, the introduction of a minimum integrated package of maternal and newborn care including Active Management of the Third Stage of Labor (AMTSL) and Essential Newborn Care (ENC) are simple and inexpensive approaches in poor countries. This brief reports on a study conducted by the Senegal Ministry of Health and Prevention, with support from IntraHealth and the Population Council, whose objectives included: 1) evaluating the functional capacity of the targeted health structures to offer the AMTSL and ENC, 2) evaluating the knowledge and skills of the providers, and 3) identifying …

Une Bonne Surveillance De La Grossesse Pour Préparer L'Accouchement, Population Council

Reproductive Health

This brief reports on a situation analysis conducted to provide basic information to help Senegal’s SMNI/PF/PALU program identify priority intervention areas or readjust the interventions originally proposed. More specifically, the analysis aimed to assist in the development of the integrated RH service package to be implemented at the service delivery points and to develop the training resources needed for capacity-building among providers and for the organization of services. The analysis recommends: dissemination of new procedures and protocols and orientation of providers, with a view to improving implementation; providing supervision and post-training follow-up of providers; and orienting providers to the systematic …

Life-Skills Education Leads To Improved Effect On Adolescents' Sexual Behavior, Population Council

Reproductive Health

The Kenya Adolescent Reproductive Health Project (KARHP) was a three-pronged program implemented in schools, communities, and health facilities, to provide information and services to adolescents in order to improve their reproductive health outcomes. This operations research summary from the Population Council sought to discover whether the activities started under the project and desired reproductive health outcomes had been sustained in the 10-year period since inception, and to identify challenges experienced in sustaining the model. Although the survey suggests that the efforts to sustain KARHP/ASRH activities may be having desirable behavioral outcomes among adolescents, there is a need to strengthen these …

Greenstar Social Marketing Private-Sector Activities In Paiman Project: Process Evaluation Of Greenstar Social Marketing Initiatives To Improve And Expand Maternal And Newborn Health Services And Coverage, Munir Afridi

Reproductive Health

The Population Council provided support for this process evaluation of Greenstar Social Marketing which established a healthcare private provider network (GoodLife clinics) primarily in the urban areas in 10 districts of the PAIMAN project in Pakistan. This network provides maternal and newborn health and reproductive health and family planning services and products. The information collected in this survey points to areas where Greenstar strategies are close to being fully met as well as to areas where the strategies are not being met. The detailed findings should allow Greenstar to focus on those areas most in need of attention: all groups—provider, …

Initial Assessment Of Community Midwives In Rural Pakistan, Abdul Wajid, Zubaida Rashid, Ali M. Mir

Reproductive Health

The goal of this Population Council study, funded by USAID through the Pakistan Initiative for Mothers and Newborns (PAIMAN) project, was to assess the potential of community midwifery services in rural Pakistan in order to provide necessary evidence for future decisions regarding the training, practice, and placement of community midwives (CMWs). The introduction of a new cadre of skilled birth attendants is significant, especially at a time when Pakistan is working toward achieving the Millennium Development Goals. The report makes the following recommendations: 1) opportunities for practical training should be followed meticulously; 2) selection criteria should be revised especially for …

Improving The Health Care Response To Gender-Based Violence: Project Evaluation Report, Meiwita P. Budiharsana, Mai Quoc Tung

Reproductive Health

Consistent with previous studies, this study provides evidence that gender-based violence (GBV) remains a problem in Viet Nam with indications that it may be on the increase. In 2009 the Population Council Viet Nam in collaboration with the Hanoi Health Department, carried out an evaluation among the staff of Duc Giang Hospital to assess the extent to which awareness and perceptions of GBV had changed since a pilot intervention project commenced in 2005. Overall the project has been very effective in raising awareness and willingness to integrate GBV screening in the health services. This report documents the results and lists …

Effect Of Dai Training On Maternal And Neonatal Care: An Operations Research Study, Peter C. Miller, Gul Rashida, Abdul Wajid, Zeba Tasneem, Lubna Mahmood, Minhaj Ul Haque

Reproductive Health

This study examines the use of training traditional birth attendants, or "dais" as they are known in Pakistan, to reduce maternal mortality. By training dais to adopt safer routine delivery, newborn care practices, and recognize and refer in case of emergencies, dais can improve maternal and neonatal health. While one group of women met with specially trained dais who received Safe Motherhood Applied Research Training (SMART), a control group met with dais who offered health services only. The objectives of this evaluation were to determine whether dais substantially improved their performance after attending the "SMART dai" training course, to determine …

Reach Of Media And Interpersonal Communication In Rural Uttar Pradesh: Implications For Behavior Change Communication, Population Council

Reproductive Health

RK Swamy BBDO and the Population Council carried out an analysis to assess the reach of the media and interpersonal communication (IPC). The advertising agency and partner in a Population Council–led consortium analyzed data to explore the reach of various mass media and viewership patterns. The Population Council analyzed the reach of other sources of information, including mobile phones, mid-media, IPC, and mass media (print media, radio, and TV). This policy brief discusses describes the current status and trends in mass media exposure and media reach by audience segmentation. It also explores the reach of mid-media and IPC between frontline …

Future Of Family Planning Program In Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan

Reproductive Health

Bangladesh experienced large population growth in the past, but due to a successful family planning program, the total fertility rate (TFR) declined rapidly until the mid-nineties. Over the last decade, the country experienced a slow pace in fertility decline with a small increase in the contraceptive prevalence rate (CPR). This slow pace in fertility decline is causing serious concern for reaching replacement level fertility by 2015. CPR increased seven-fold from 1975 to 2000, but there was no significant increase from 2000-09, demonstrating the weakness of present program efforts. This raises concern among researchers, policymakers, and program managers about the prospect …