Public Health Commons^™

What Is Comprehensive Sexuality Education Really All About? Perceptions Of Students Enrolled In An Undergraduate Human Sexuality Course, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

The purpose of this study was to use qualitative evaluation techniques to explore the perceptions of students enrolled in undergraduate human sexuality classes regarding their expectations for the course as well as outcomes. One hundred forty-eight students were surveyed at the beginning and again at the end of the semester-long course. While pregnancy and STI prevention were considered important components of their courses, other outcomes associated with positive, healthy sexuality were given greater emphasis. Results suggest that while primary and secondary level sexuality education have been increasingly focused on abstinence-only education with a focus on pregnancy and STI reduction, this …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

The Process Of Research In International Settings: From Risk Assessment To Program Development And Intervention, M. Catherin Freier, Duane C. Mcbride, Gary Hopkins, Talin Babikian, Lloyd Richardson, Herbert W. Helm

Faculty Publications

Although there are many challenges, international HIV prevention research and program evaluation are critical to advances in the health and welfare of people around the globe. While there is an increasing amount of literature describing outcomes of international prevention programs, there is sparse information regarding the process of developing and implementing international research. This brief report describes key elements in the development of collaborative international prevention research and programmatic implementation. © The Author 2005. Published by Oxford University Pressen behalf of the New York Academy of Medicine. All rights reserved.

Hiv Research Within The Global Context: Introduction To The Special Issue, Clyde B. Mccoy, Duane C. Mcbride

Faculty Publications

No abstract provided.

Dietary Folate, Alcohol Consumption, And Risk Of Ovarian Cancer In An Italian Case-Control Study, Claudio Pelucchi, Monia Mereghetti, Renato Talamini, Eva Negri, Maurizio Montella, Valerio Ramazzotti, Silvia Franceschi, Carlo La Vecchia

Department of Public Health Scholarship and Creative Works

An increasing number of studies are focusing on the potential association between dietary folate intake and risk of various cancers (1), particularly of the colorectum and breast (2, 3). A low folate status can induce misincorporation of uracil into DNA, leading to chromosome breaks in humans and hence increasing cancer risk (4). Alcohol may increase folate requirements in the body and cause relative folate deficiencies (2). Although several findings on the relation between folate intake and ovarian cancer risk are inconsistent (5-9), recent results from two prospective …

Self-Management Strategies Mediate Self-Efficacy And Physical Activity, Rod K. Dishman, Robert W. Motl, James F. Sallis, Andrea L. Dunn, Amanda Birnbaum, Greg J. Welk, Ariane L. Bedimo-Rung, Carolyn C. Voorhees, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Background

Self-efficacy theory proposes that girls who have confidence in their capability to be physically active will perceive fewer barriers to physical activity or be less influenced by them, be more likely to pursue perceived benefits of being physically active, and be more likely to enjoy physical activity. Self-efficacy is theorized also to influence physical activity through self-management strategies (e.g., thoughts, goals, plans, and acts) that support physical activity, but this idea has not been empirically tested.

Methods

Confirmatory factor analysis was used to test the factorial validity of a measure of self-management strategies for physical activity. Next, the construct …

News From Cart, Patricia J. Fanning, Amos Nwosu

Bridgewater Review

No abstract provided.

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Glycemic Index, Glycemic Load, And Pancreatic Cancer Risk (Canada), Stephanie A. Navarro Silvera, Thomas E. Rohan, Meera Jain, Paul D. Terry, Geoffrey R. Howe, Anthony B. Miller

Department of Public Health Scholarship and Creative Works

There is some evidence that plasma insulin and post-load plasma glucose may be associated with the risk of pancreatic cancer. Glycemic index and glycemic load are measures, which allow the carbohydrate content of individual foods to be classified according to their postprandial glycemic effects and hence their effects on circulating insulin levels. Therefore, we examined pancreatic cancer risk in association with a glycemic index (GI), glycemic load (GL), and intake of dietary carbohydrate and sugar in a prospective cohort of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 …

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions:School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Predictors Of Violent Behavior In An Early Adolescent Cohort: Similarities And Differences Across Genders, Jonathan L. Blitstein, David M. Murray, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

The authors assessed a cohort of 2,335 students from the Minneapolis, Minnesota, area to identify predictors of violent behavior and to determine whether the predictors varied by gender. The sample was 76% White; boys and girls were equally represented. The majority lived with two parents. A measure of violent behavior collected at the end of the eighth-grade year (2000) was entered into Poisson regression against baseline data collected at the beginning of the seventh-grade year (1998). Predictors of violent behavior influencing both boys and girls included depressive symptoms, perceived invulnerability to negative future events, paternal nonauthoritative behavior, and drinking alcohol. …

The Role Of Peer Social Network Factors And Physical Activity In Adolescent Girls, Carolyn C. Voorhees, David Murray, Greg Welk, Amanda Birnbaum, Kurt M. Ribisi, Carolyn C. Johnson, Karin Allor Pfeiffer, Brit Saksvig, Jared B. Jobe

Department of Public Health Scholarship and Creative Works

Objective: To study the relationship between peer-related physical activity (PA) social networks and the PA of adolescent girls.

Methods: Cross-sectional, convenience sample of adolescent girls. Mixed-model linear regression analyses to identify significant correlates of self-reported PA while accounting for correlation of girls in the same school.

Results: Younger girls were more active than older girls. Most activity-related peer social network items were related to PA levels. More PA with friends was significantly related to self-reported PA in multivariate analyses.

Conclusions: Frequency of PA with friends was an important correlate of PA among the peer network variables …

Using Media Messaging To Promote Healthful Eating And Physical Activity Among Urban Youth, B.J Carter, Amanda Birnbaum, Lisa Hark, Brian Vickery, Charles Potter, Michael P. Osborne

Department of Public Health Scholarship and Creative Works

National trends show consistent increases, as well as racial and ethnic dis- parities, in the prevalence of overweight children and adolescents. Such disparity is evident regarding behaviors such as a poor diet and a lack of physical activity and in the prevalence and outcomes of associated health problems. It has been suggested that grounding interventions in cultural traditions and norms are critical for preventing obesity among ethnic and racial minority youth; however, with some notable exceptions, few community interventions have used this approach. Moreover, urban minority youth may face additional barriers to healthful eating and physical activity behaviors, such as …

Systematic Screening As A Strategy To Increase Services Integration And Revenues In Honduras, Ricardo Vernon, James R. Foreit, Fiorella Mancini, Suyapa Pavon, Jheisy Torres

Reproductive Health

This operations research study, undertaken by the Honduras Family Planning Association (Asociación Hondureña de Planificación de Familia—ASHONPLAFA), tested the effectiveness of systematic screening to increase the number of services and revenue per visit in a reproductive health program. Despite monitoring plans, provider compliance with the intervention was low; the overall proportion of clients screened was less than 11 percent, and the frequency of screening varied greatly by clinic contact point. Although the study did not show an increase in the mean number of services per client, the negative results could reasonably be attributed to lack of implementation of the intervention. …

Enquêtes D'Acceptation De Paiment Destinées À Déterminer Les Prix Des Produits Et Services Dans Le Domaine De La Santé De La Reproduction : Manuel De L'Utilisateur, Karen G. Fleischman Foreit, James R. Foreit

Reproductive Health

Les enquêtes d’acceptation de paiement (willingness to pay—WTP) permettent aux directeurs de programmes de simuler les changements intervenant dans la demande en raison des prix sans les modifier réellement, ce qui leur donne un moyen de prendre des décisions relatives à la détermination des prix sur la base d’informations empiriques. Le présent document décrit une méthode d’enquête simple qui donne une estimation de l’acceptation de paiement par les clients pour les biens et services, ce qui permet aux directeurs de prendre des décisions rationnelles dans ce domaine. Il présente les avantages et les précautions à prendre lors d’une enquête WTP. …

Female Genital Cutting Among The Somali Of Kenya And Management Of Its Complications, Jaldesa Guyo, Ian Askew, Carolyne Njue, Monica Wanjiru

Reproductive Health

The Somali community living in Kenya (and in their native Somalia) has practiced the severest form of female genital cutting (FGC)—infibulation—for centuries. To understand the context within which the practice takes place, and how its complications are managed, the Population Council’s Frontiers in Reproductive Health Program undertook a diagnostic study that confirmed that FGC is a deeply rooted and widely supported cultural practice. Several closely related reasons are used to sustain the practice: religious obligation, family honor, and virginity as a prerequisite for marriage; an aesthetic preference for infibulated genitalia was also mentioned. The study also found that the health …

Operations Research To Improve Postabortion (Pac) Services In Three Public Hospitals, Bolivia, Fernando Gonzales Salguero, Mariel Loayza

Reproductive Health

In the last five years, Pathfinder Bolivia has provided technical assistance, training and equipment to the Ministry of Health (MOH) to implement postabortion care (PAC) services in eight hospitals. They invited Frontiers in Reproductive Health (FRONTIERS) to provide the technical assistance and training for conducting operations research (OR) activities. This report describes the second stage of this collaborative effort as presented in a three-day workshop attended by providers and staff members of the participant hospitals. During the workshop, participants received OR training and developed draft OR proposals seeking to improve PAC service delivery problems identified during the first study. The …

Cross-Cultural Adaptation Of Reproductive Health Services In Bolivia, Fernando Gonzales Salguero, Antonieta Martin, Rosario Perez Mendoza, Ricardo Vernon

Reproductive Health

The Bolivian Ministry of Health and Sports and the Integral Health Project, with the technical assistance of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS), tested several strategies to make health services in Bolivia more culturally appropriate for the country’s indigenous peoples. The goal of the project was to increase women’s access to, use of, and satisfaction with health services in general, and reproductive health services in particular, through: a) enhanced understanding and acceptance of the “other” culture; b) improving communication skills; c) facilitating and promoting use of the Quechua language in clinics; d) systematically screening clients’ health service …

Willingness-To-Pay For Services Provided By The Clinical Services Improvement Project (Csi) In Egypt, John H. Bratt, Nahla G. Abdel-Tawab, Magdi A. Ibrahim, Mohammed Edress

Reproductive Health

Willingness-to-pay (WTP) surveys are increasingly used in reproductive health programs to predict the impact of price changes on revenues, utilization, and client profile. The FRONTIERS program worked with the Clinical Services Improvement (CSI) project and the Cairo Demographic Center to carry out a WTP survey in six CSI clinics in Egypt. The survey found that most clients would be willing to pay higher prices for CSI services, and WTP did not vary much by client economic status. However, predictive validity was low when all reasons for client discontinuation were included. WTP surveys have the potential to be useful tools for …

Trends In The Timing Of First Marriage Among Men And Women In The Developing World, Barbara Mensch, Susheela Singh, John B. Casterline

Poverty, Gender, and Youth

The timing of first union merits investigation not only because of the close temporal link between marriage and the onset of childbearing, but also because the age when men and women marry has implications for the organization of family life and for gender relations within society. This paper begins by reviewing the contributions of various social science disciplines to an understanding of the timing of marriage. Using current status data from 73 countries provided by the United Nations Population Division and retrospective data from 52 Demographic and Health Surveys conducted between 1990 and 2001, we then examine recent trends in …

The Impact Of Childhood Mortality On Fertility In Six Rural Thanas Of Bangladesh, Mian Bazle Hossain, James F. Phillips, Thomas K. Legrand

Poverty, Gender, and Youth

This Population Council working paper examines the causal structure of the relationship between child mortality events and subsequent fertility during a time of rapid decline in fertility in Bangladesh. Results lend support to the hypothesis of an insurance effect, while demonstrating that its demographic significance is likely to be less prominent than that of replacement behavior. Findings indicate that the insurance motive remains intact even after total fertility declined to fewer than three children per woman. The well-documented role of gender bias as a determinant of child health and survival is also a factor in child-replacement decisionmaking. Although the rapid …

Accelerating Reproductive And Child Health Program Development: The Navrongo Initiative In Ghana, James F. Phillips, Ayaga A. Bawah, Fred N. Binka

Poverty, Gender, and Youth

Successive global health and development agendas have been embraced by African governments—Alma Ata in 1978, the Bamako Initiative in 1987, the 1994 Cairo International Conference on Population and Development, and more recently the Millennium Development Goals (MDGs)—only to be followed by widespread implementation failure. This paper presents an approach to program development in Ghana that is using research to accelerate policy implementation. Originally launched in 1994 as a participatory pilot project of the Navrongo Health Research Centre, a controlled experimental study was initiated in 1996 to assess the fertility and child-survival impact of alternative community health and family planning service …

Using Systematic Screening To Increase Integration Of Reproductive Health Services Delivery In Senegal, Diouratie Sanogo, Ricardo Vernon, James R. Foreit, Awa M. Coll-Seck, Colonel Adama Adoye, Laty G. Ndoye, Cheikh Bamba Diop, Balla Mbacke Mboup, Omar Sarr

Reproductive Health

This study tested the systematic screening technique to increase the integration of reproductive health services in Senegal. The study took place in four urban health posts in the city of Dakar and three rural health posts in the district of Kebemer. A before and after design tested the hypothesis that the use of the systematic screening tool would result in more services received per client visit. In Dakar, services per visit increased significantly by 20 percent, while in Kebemer, services per visit also increased significantly by 35 percent. The study also examined several techniques to improve provider compliance with the …

The Un And The Responsibility To Practice Public Health, David P. Fidler

Articles by Maurer Faculty

No abstract provided.

International Trade Agreements: Vehicle For Better Public Health?, David P. Fidler, Jason Sapsin, Ann Marie Kimball

Articles by Maurer Faculty

No abstract provided.

Use Of Systematic Screening To Increase The Provision Of Reproductive Health Services In Bolivia, James R. Foreit, Ricardo Vernon, Patricia Riveros Hamel

Reproductive Health

The objective of this study was to determine if the use of a checklist to screen for unmet service needs could increase the number of services per visit provided to clients using rural Bolivian health facilities. Measurement included changes in services per visit before and after the introduction of the intervention, and a comparison of services received at screened and non-screened visits. Findings show that, to the degree that provider compliance can be secured, systematic screening of clients appears to be an effective method for reducing unmet health service needs. The findings of this study replicate those of other studies …

Programming For Hiv Prevention In South African Schools: A Report On Program Implementation, Priscilla Reddy, Shegs James, Ann P. Mccauley

HIV and AIDS

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective …

Reducing The Transmission Of Hiv And Sexually Transmitted Infections In A Mining Community: Findings From The Carletonville Mothusimpilo Intervention Project: 1998 To 2001, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam, Yodwa Mzaidume, Bareng Rasego, Solly Moema

HIV and AIDS

The Horizons program, in collaboration with the Center for Scientific and Industrial Research, the South African Institute for Medical Research, and the London School of Economics, conducted an intervention study in the mining town of Carletonville, South Africa to examine the social determinants of the HIV epidemic, and to assess the impact of a targeted program of HIV and STI prevention and service delivery. The project did not reduce STI prevalence or HIV prevalence, as changing sexual behavior is far more complex than educating individuals about HIV. The report recommends interventions to support behavioral change education, STI treatment, the role …