Public Health Commons^™

The Qingdao Twin Registry: A Focus On Chronic Disease Research, C. Anderson Johnson, Zengchang Pang, Feng Ning, Jennifer B. Unger, Shaojie Wang, Qian Guo, Weihua Cao, Liming Lee

CGU Faculty Publications and Research

With the changing patterns of morbidity and mortality in China, noncommunicable chronic diseases have become the major threats to the health of the Chinese population. The causes of chronic diseases include genetic factors and behavioral risk factors such as the use of tobacco, alcohol, and other drugs, unhealthy dietary behaviors, and lack of physical activity. Twin studies offer a unique opportunity to disentangle the genetic and environmental risk and protective factors for chronic disease. The Qingdao Twin Registry (QTR) was initiated in 1998 as part of the National Chinese Twin Registry. Over 11,000 pairs of twins and multiples of all …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Energy Balance And Breast Cancer Risk: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Jain Meera, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

While there is evidence that breast cancer risk is positively associated with body mass index (in postmenopausal women) and energy intake and inversely associated with physical activity, few studies have examined breast cancer risk in association with energy balance, the balance between energy intake and expenditure. Therefore, in the cohort study reported here, we studied the independent and combined associations of vigorous physical activity, energy consumption, and body mass index (BMI), with breast cancer risk. The investigation was conducted in 49,613 Canadian women who were participants in the National Breast Screening Study (NBSS) and who completed self- administered lifestyle and …

Perceived Smoking Environment And Smoking Initiation Among Multi-Ethnic Urban Girls, Tracy R. Nichols, Amanda Birnbaum, Sara Birnel, Gilbert J. Botvin

Department of Public Health Scholarship and Creative Works

Purpose

To examine associations between the perceived smoking environment and smoking initiation among urban multi-ethnic adolescent girls in New York City.

Methods

Self-report surveys completed in grades 7, 8, and 9 assessed girls’ (n = 858) smoking initiation, and perceived smoking environment (family smoking, friends’ smoking, smoking norms, and cigarette availability). Carbon monoxide breath samples were collected from girls using a variation of the bogus pipeline procedure.

Results

Differences were found in smoking prevalence with white girls reporting the highest prevalence of smoking at baseline and the greatest increase in smoking prevalence from seventh to eighth grade. Black girls reported …

Hormonal And Reproductive Factors 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. Given the lower incidence rate of glioma in women than in men, it has been hypothesized that reproductive and hormonal factors may be involved in the etiology of glioma. We conducted a secondary analysis of data from 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 from all causes, respectively, with follow‐up ending between 1998 and …

Carotenoid, Vitamin A, Vitamin C, And Vitamin E Intake And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

It is thought that oxidative stress resulting to repeated ovulation may increase the risk of ovarian cancer by inducing DNA damage (1). Consumption of antioxidants may, therefore, decrease ovarian cancer risk by counteracting oxidative stress and the resultant DNA damage (2, 3). Currently, the epidemiologic evidence regarding associations between antioxidants and risk of ovarian cancer is mixed (4-12). Of the two prospective studies, Kushi et al. (4) and Fairfield et al. (7) both reported no association between β-carotene and ovarian cancer risk. In addition, Fairfield et al. …

Understanding Barriers To Community Participation In Hiv And Aids Services: Summary Report, Population Council, Health Systems Trust

HIV and AIDS

In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or on how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. This study collected data …

Fewer And Better-Educated Children: Expanded Choices In Schooling And Fertility In Rural Pakistan, Zeba Sathar, Cynthia B. Lloyd, Minhaj Ul Haque, Mumraiz Khan, Monica J. Grant

Poverty, Gender, and Youth

This report presents the results of a longitudinal study of changing educational opportunities in rural Punjab and N.W.F.P. from 1997 to 2004. The purpose of the study was to answer two major research questions: what were the effects of changes in schooling opportunities in the community over the past six years on enrollment and attainment, and what were the effects on family planning and fertility behavior? This study builds on an earlier study undertaken in 1997. As noted in this report, the study is innovative in several ways: (1) it is longitudinal; (2) it combines consideration of three dimensions of …

Need For Cognition And Message Complexity In Motivating Fruit And Vegetable Intake Among Callers To The Cancer Information Service, Pamela Williams-Piehota, Judith Pizarro, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

This field experiment examined the impact of an individual's need for cognition (NFC; the tendency to enjoy thinking deeply about issues), complex versus simple messages, and the interaction of NFC and message type on encouraging fruit and vegetable consumption. Callers to the Cancer Information Service of the National Cancer Institute (N = 517) were asked to participate in the experiment at the end of their call. Individual NFC was assessed, and participants were assigned randomly to receive a telephone message promoting fruit and vegetable consumption that was either complex and multifaceted or simple and straightforward. Similarly constructed brochures were …

Priority Setting For Reproductive Health At The District Level In The Context Of Health Sector Reforms In Ghana, Harriet Birungi, Philomena Nyarko, Ian Askew, Ayorinde Ajayi, Gifty Addico, Edward Addai, Caroline Jehu-Appiah

Reproductive Health

This report outlines results of an in-depth assessment carried out in Ghana in order to provide a better understanding of key factors affecting reproductive health (RH) prioritization at the district level; and to make recommendations for policy dialogue, advocacy, resource allocation, and RH program implementation. In particular, the study examined whether or not districts are connecting to the central process of priority setting and reasons for not doing so. The report includes recommendations for bridging the policy implementation gap, including: ensuring that RH advocates participate in national policy dialogue; investing in systems development for procurement and delivery of drugs and …

Understanding The Hiv/Sti Prevention Needs Of Men Who Have Sex With Men In Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel

HIV and AIDS

Understanding the sexual behaviors of populations who are vulnerable to HIV is an important component in the battle against AIDS. Yet policymakers in developing countries, particularly in Africa, have often overlooked men who have sex with men (MSM) as a vulnerable group because of stigmatization of homosexual behavior and denial of the existence of MSM and the role they may play in HIV transmission. A growing body of literature not only documents the presence of this population in Africa but also the importance of reaching them with information and services to prevent HIV and other sexually transmitted infections (STIs). In …

Understanding Barriers To Community Participation In Hiv And Aids Services: Final Report, Ashnie Padarath, Catherine Searle, Eka Esu-Williams

HIV and AIDS

In 2003, South Africa announced its intention to roll out possibly the largest HIV and AIDS treatment program in the world. Much attention is currently focused on supply-side issues, particularly drug procurement and pricing. Far less attention has been paid to demand for and delivery of treatment, care, and support services. Further, although the role of the community and community organizations is articulated in government policy there has been little active engagement with NGOs on the development of these roles or how to encourage community organizations to support and participate in the antiretroviral (ARV) rollout. As noted in this final …

Context And Dynamics Of Same-Sex Behavior Among Long-Distance Truckers In India: Findings From Qualitative Research, Vaishali Sharma Mahendra, Ravi K. Verma, Pertti J. Pelto, Sarat Chandra Pradhan, Vibha Singh, Asha Rao, Tarun Vij

HIV and AIDS

It is well established that truckers (drivers and helpers) have higher rates of nonmarital sex than any other occupational group. Because of this multipartner sexual activity, truckers form a key group of prevention efforts for HIV and sexually transmitted infections (STIs). Thus far, HIV/STI prevention interventions for truckers have been geared to providing risk-reduction information and services within a heterosexual context. Recent evidence suggests that a significant number of truckers engage in male-to-male (MSM) sexual activity that has implications for HIV/STI transmission. Therefore, information on the nature and extent of MSM activity among these populations is urgently needed for the …

Reducing Stigma And Discrimination In Hospitals: Positive Findings From India, Vaishali Sharma Mahendra, Laelia Gilborn, Bitra George, Luke Samson, Rupa Mudoi, Sarita Jadav, Indrani Gupta, Shalini Bharat, Celine Daly

HIV and AIDS

People living with HIV (PLHIV) in India face stigma and discrimination in a variety of contexts. Stigma and discrimination against HIV-positive people is common in hospitals and acts as a barrier to seeking and receiving critical treatment and care services. Three New Delhi hospitals, SHARAN, and the Horizons Program collaborated on an operations research project to assess responses to hospital-based stigma and discrimination against PLHIV. A baseline survey to measure HIV/AIDS-related attitudes, knowledge, and practices was conducted in 2000 with a random sample of 884 health workers from four departments: medicine, STD and skin, obstetrics and gynecology, and surgery. Based …

Cómo Identificar Y Satisfacer La Necesidad De Servicios Adicionales: Manual Para Gerentes, Ricardo Vernon, James R. Foreit, Emma Ottolenghi

Reproductive Health

Este manual está diseñado para ayudar a los encargados de tomar decisiones, los administradores, los supervisores y los proveedores de programas a introducir la detección sistemática en sus servicios de salud. La detección sistemática puede mejorar la salud de la mujer al abordar múltiples necesidades no satisfechas de servicios de salud reproductiva y otros. Este manual proporciona: actividades necesarias para implementar una detección sistemática; cómo seleccionar las instalaciones, los servicios que se examinarán y quién lo hará; desarrollo, adaptación y pruebas preliminares de listas de verificación de detección sistemática; asesoramiento para capacitar a los evaluadores/proveedores y supervisores; y un esquema …

Safe Motherhood Applied Research And Training (Smart) Report 2: The Interventions, Abdul Wajid, Zakir Hussain Shah, Ashfa Hashmi, Zeba Tasneem, Lubna Shireen

Reproductive Health

The Safe Motherhood Applied Research and Training (SMART) project, an operations research project designed to develop and test interventions to reduce maternal, perinatal, and neonatal mortality and morbidity in predominantly rural districts of Pakistan, was a three-year project (2003 to 2006) funded by the European Union. The study area was in the district of Dera Ghazi Khan; the control area was in the district of Layyah. The project focused on three areas to accomplish its goals: empowering women to seek appropriate and timely general, maternal, and newborn care; supporting methods that encourage men to play a positive and active role …

Make Better Use Of Provider Time In Public Health Clinics, Barbara Janowitz

Reproductive Health

Funding for reproductive health services is stagnant or declining globally, yet population projections, particularly in Africa, indicate that demand for services will increase in the near term. Between 2002 and 2025, for example, the population of women of childbearing age (15–49) is expected to increase by 2 percent annually in sub-Saharan Africa. With this growth will come increased demand for contraception, and other reproductive health services such as antenatal care, safe birthing services, and postpartum care for mothers and children. Concern about increasing demand for services has led program managers to examine the productivity and costs of existing programs. While …

Safe Motherhood Applied Research And Training (Smart) Report 1: Project Overview, Gul Rashida, Peter C. Miller

Reproductive Health

Maternal mortality in Pakistan is believed to be quite high, at about 350–500 maternal deaths per 100,000 live births. Reducing maternal mortality is one of the major objectives of the Government of Pakistan. Interventions required to address maternal mortality include safe motherhood, which means a woman’s ability to have a safe and healthy pregnancy and delivery. The Safe Motherhood Applied Research and Training (SMART) project was an operations research project designed to develop and test interventions to reduce maternal and neonatal mortality in a predominantly rural district of Pakistan. The vast majority of maternal deaths are attributed to delays in …

Social Medicine In The Twenty-First Century, Scott Stonington Phd, Md, Seth M. Holmes Phd, Md, The Plos Medicine Editors

Seth M. Holmes PhD, MD

No abstract provided.

Health Is Still Social: Contemporary Examples In The Age Of The Genome, Timothy Holtz Md, Seth M. Holmes Phd, Md, Scott Stonington Phd, Md, Leon Eisenberg Md

Seth M. Holmes PhD, MD

No abstract provided.

Parce Qu'ils Sont Plus Pres Sol: L'Invisibilisation De La Souffrance Sociale Des Cueilleurs De Baies, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

No abstract provided.

Operations Research To Improve Financial Sustainability In Three Bolivian Ngos, Martha Merida, Javier Arce, Douglas Moscoso, Carlo Ramirez, Patricia Riveros, John H. Bratt

Reproductive Health

The FRONTIERS project worked with three Bolivian NGOs (Prosalud, the Center for Research, Education and Services or CIES, and the Association of Rural Health Programs or APSAR) to improve their ability to conduct research on market analysis and cost recovery. Following a one-week workshop on conducting cost studies, staff from the three NGOs designed operations research studies to help with decisions on planning and cost recovery. Study findings showed that cost recovery varied from high (Prosalud, 83-109%) to low (CIES, 38-46%) and very low (APSAR, 10-25%), depending on the service. All three studies focused on alternative options to client fees, …

Building Capacity To Utilize Operations Research: Strategies And Lessons Learned, James R. Foreit

Reproductive Health

The effectiveness of development assistance depends on good decision-making. Many donors and international health agencies such as USAID, DFID, and WHO are placing more emphasis on the utilization of research results for policy and program development. Yet, while there is a long tradition of training researchers to produce research, there are few lessons on how to teach managers to request and use research results for making program decisions. Addressing this gap has been a major strategy of the Population Council’s Frontiers in Reproductive Health Program (FRONTIERS). Since its inception in 1998, FRONTIERS has complemented its support for operations research (OR) …

Influencing Girls' Lives: Acceptability And Effectiveness Of A Livelihoods Skill Building Intervention In Gujarat, Sewa, Sewa Academy, Shveta Kalyanwala, Rajib Acharya, Sunetra Deshpande

Poverty, Gender, and Youth

The Self Employed Women’s Association (SEWA), a key Indian micro-finance nongovernmental organization, in partnership with the Population Council, undertook a pilot livelihoods skill-building program to support adolescent girls aged 13–19 years (mostly unmarried, in school and out of school). Like other such programs, this livelihoods program focused on exposing girls to new ideas, building social networks, exposing them to the world around them, and providing the technical skills needed to enhance their access to income generating opportunities. The study’s findings are mixed, but suggest that a life and livelihoods skill-building intervention program for girls is acceptable to adolescents (and their …

Berhane Hewan ('Light For Eve'): A Program To Support Married And Unmarried Adolescent Girls In Rural Amhara Region, Ethiopia, Population Council

Poverty, Gender, and Youth

Berhane Hewan (meaning “Light for Eve” in Amharic) is a program in rural Amhara region designed to assist unmarried girls by imparting the knowledge, skills, and resources they need to avoid child marriage as well as give support to adolescent girls who are already married. With support from UNFPA, DFID, and the Turner Foundation, the program is implemented by the Ministry of Youth and Sport and the Regional Youth Bureaus, with technical assistance from the Population Council. The program promotes functional literacy, life skills, livelihoods skills, and reproductive health education. In developing the project, the Regional Youth Bureau staff felt …

Measuring Women's Work: A Methodological Exploration, Ray Langsten, Rania Salem

Poverty, Gender, and Youth

In this working paper, the authors contrast two approaches to the measurement of women’s work applied to the same population of ever-married women. These women were interviewed on two occasions—first during the 2003 Interim Egypt DHS, and again during the Slow Fertility Transition (SFT) survey conducted in 2004. The DHS uses a standard keyword question to measure work, while the SFT employs an activities list question format. The authors argue that the widely used keyword approaches to measuring women’s work underestimate the level of female labor force activity. They demonstrate that the activities list approach captures a wider range of …

Facts About Adolescents From The Demographic And Health Survey—Statistical Tables For Program Planning: Malawi 2000, Population Council

Poverty, Gender, and Youth

The Population Council initiated its work on adolescents in the mid-1990s. At that time, those advocating greater attention to adolescent issues were concerned about adolescent fertility—particularly outside of marriage—and adolescent “risk-taking” behavior. As an international scientific organization with its mandate centered around the needs of developing countries, the Council sought a more nuanced and context-specific understanding of the problems confronting adolescents in the developing world. In working with colleagues inside and outside the Council, it became clear that information on adolescents, and the way data are organized, were limiting the ability to understand the diversity of their experiences or to …

Costs Of Reproductive Health Services Provided By Four Christian Health Association Of Ghana (Chag) Hospitals, James Boateng, Henry Surnye, Alex Mensah, Bismark Boateng, Philomena Nyarko, Nzoya Munguti, John H. Bratt

Reproductive Health

The Christian Health Association of Ghana (CHAG) is a large faith-based NGO which currently serves an estimated 35 percent of the Ghanaian population, mainly in remote rural areas. This study built capacity within the CHAG secretariat to calculate the economic cost and cost recovery levels of selected reproductive health services in four CHAG-affiliated hospitals. Techniques learned in the study are applicable to most costing problems, not just to reproductive health. Information obtained in the study forms the basis for negotiating reimbursement under the Ghana National Health Insurance Scheme, and for setting cost recovery and containment policies. CHAG senior managers plan …

Comment Mener Un Exercice De Couverture : Outil D'Évaluation Rapide De Programmes Et Services, Carey Meyers, Solene Lardoux

Poverty, Gender, and Youth

Un exercice de couverture (EC) est un instrument d’évaluation simple, économique et rapide pouvant servir à profiler les personnes touchées par un prestataire donné, un groupe de prestataires ou des organisations partageant une clientèle commune dans une zone géographique particulière. Cet instrument a été mis au point pour assister les programmes de jeunesse, mais il peut également être utilisé par d’autres bénéficiaires ayant des services offerts en établissement ou en antenne. L’EC collecte les données relatives à différentes caractéristiques, y compris le sexe, la scolarisation, l’habitat, l’activité rémunératrice et l’état matrimonial des personnes bénéficiant d’un programme ou d’un service. Il …

Integrating Adolescent Livelihood Activities Within A Reproductive Health Programme For Urban Slum Dwellers In India, Population Council

Poverty, Gender, and Youth

Although a wide variety of livelihood programs for adult women exist in India, they rarely include adolescent girls. Of those that do, few employ rigorous scientific methods to evaluate program impact. This brief describes a project conducted in slum areas of Allahabad, in Uttar Pradesh. The Population Council, in collaboration with CARE-India, tested the feasibility and impact of adding four livelihoods and life-skill components to a reproductive health program for adolescent girls (both school-going and out-of-school) aged 14–19. Using a quasi-experimental pre- and post-test design that contrasted the experimental group with a comparison group of adolescents, the project investigated whether …