Public Health Commons^™

A Descriptive Study Of Childhood Cancer Statistics: Montgomery County, Jamie L. Hartig

Master of Public Health Program Student Publications

Objective: This research describes childhood cancer and identifies variances in childhood cancer statistics in the United States, Ohio, and Montgomery County.

Methods: This is a descriptive analysis of childhood cancer statistics using the Ohio Cancer Incidence Surveillance System (OCISS) (Ohio Department of Health, 2010) and CDC Wonder database (United States Department of Health and Human Services [USDHHS], Centers for Disease Control and Prevention [CDC], & National Cancer Institute [NCI], 2008 & 2011.) Cancer incidences between white children and black children were compared for the years 1999-2009. The OCISS database was also used to compare vital status by race, cancer stage …

Mongolian Women's Voices: A Case Study On Maternal Healthcare, Pregnancy, And Birth In Ulaanbaatar's Public Hospitals, Amelia Olmsted

Independent Study Project (ISP) Collection

Mongolia is a country undergoing an incredible amount of change. Last year, in 2011, they had the fastest growing economy in the world, with a 17.2% increase in their GDP, according to the World Bank. A mere 22 years ago, Mongolia was a communist country, and today they are a parliamentary democracy. The country has opened itself up to the rest of the world and a free market economy, and experienced a very drastic shift in this direction in the early 1990's. Many Mongolians will tell you that the mindset of Mongolia's citizens has made a drastic shift since communism …

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

Independent Study Project (ISP) Collection

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

Achieving Consensus On Measure-Driven Child Health Quality: Maine’S Improving Health Outcomes For Children Initiative, Martha Elbaum Williamson Mpa, Nargiza Fuzailova Md, Mph, Kimberley S. Fox Mpa

Population Health & Health Policy

This brief describes Maine’s process for selecting child health quality measures, including identified strengths and limitations of the CHIPRA core measures that led to the inclusion of additional state-specific measures and the factors considered for selection. Subsequent articles will describe how measures have been implemented and used to improve child health quality and how they have been integrated into systems of care (e.g. health information technology systems, policy changes).

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

School of Nursing & Midwifery

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

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

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

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

ETSU Faculty Works

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

Situation Analysis Of Child Labour In Karachi, Pakistan: A Qualitative Study, Asaad Ahmed Nafees, Kausar S. Khan, Zafar Fatmi, Mubashir Aslam

Community Health Sciences

In Karachi, large employment opportunities, burgeoning population and the availability of cheap labour might be the contributing factors for the increasing prevalence of child labour. A literature review was conducted in 2007 that included published and unpublished literature since 2000. Various organizations working in the field were also covered, while the perception of the child labourers was covered through three focus group discussions. Common health issues among the child labourers in Karachi included respiratory illnesses, fever and generalised pains, as well as drug and sexual abuse. Organisations working for child labour could be broadly categorised into those working for legal …

Faculty And Patient Evaluations Of Radiology Residents' Communication And Interpersonal Skills, Naila Nadeem, Abdul Mueed Zafar, Muhammad Nadeem Ahmad, Rukhsana Wamiq Zuberi

Department for Educational Development

Objective: To assess communication and interpersonal skills (CIS) of radiology residents through faculty and standardised patients (SP).

Methods: In this day-long objective structured clinical examination (OSCE) in January 2009, 42 radiology residents took part at six stations in Karachi, each with a standardised patient and a faculty evaluator. Each encounter lasted 15 minutes followed by independent assessments of the residents by both the evaluators.

Results: Based on rating-scale evaluations, all cases had satisfactory internal consistency (Cronbach\'s alpha 0.6 to 0.9). The alpha values were comparatively diminutive against the checklist scores. Correlation among faculty was 0.6 (p

Conclusion: Both checklists and …

The Effects Of A Group Visit Program On Outcomes Of Diabetes Care In An Urban Family Practice., Jeffrey A Reitz, Mona Sarfaty, James Diamond, Brooke Salzman

Department of Family & Community Medicine Faculty Papers

Diabetes mellitus is a prevalent chronic health condition associated with significant morbidity and mortality. Those with diabetes must acquire self-efficacy in the tasks necessary for them to successfully manage their disease. In this study, a controlled pre- and post-design was used to determine the effect of an adult support and education group visit program embedded in an urban academic family medicine practice on weight and the achievement of treatment goals for hemoglobin A1C, low-density lipoprotein (LDL) blood concentration, and blood pressure (BP) several months after it was implemented. Participants in the program were matched to a comparison group based on …

A Comparison Of Individual Versus Community Influences On Youth Smoking Behaviours: A Cross-Sectional Observational Study, Anna M. Adachi-Mejia, Heather A. Carlos, Ethan M. Berke, Susanne E. Tanski, James Sargent

Dartmouth Scholarship

Objectives: To compare individual with community risk factors for adolescent smoking. Design: A cross-sectional observational study with multivariate analysis.Setting: National telephone survey.Participants: 3646 US adolescents aged 13–18 years in 2007 recruited through a random digit-dial survey.

Disparities In Cause-Specific Cancer Survival By Census Tract Poverty Level In Idaho, U.S., Christopher J. Johnson, Aliza K. Fink, Robert R. German

Journal of Health Disparities Research and Practice

Objective. This population-based study compared cause-specific cancer survival by socioeconomic status using methods to more accurately assign cancer deaths to primary site. Methods. The current study analyzed Idaho data used in the Accuracy of Cancer Mortality Statistics Based on Death Certificates (ACM) study supplemented with additional information to measure cause-specific cancer survival by census tract poverty level. Results. The distribution of cases by primary site group differed significantly by poverty level (chi-square = 265.3, 100 df, p In the life table analyses, for 8 of 24 primary site groups investigated, and all sites combined, there was a significant gradient relating …

American Indian Community Leader And Provider Views Of Needs And Barriers To Colorectal Cancer Screening, Christine M. Daley

Journal of Health Disparities Research and Practice

Colorectal cancer is a great concern for the American Indian/Alaska Native (AI/AN) community, as incidence and mortality rates remain high and screening rates stay low. We conducted interviews with community leaders (n=13) and with providers from the Indian Health Service (IHS), tribal clinics, and urban safety-net clinics (n=17) in Northeast Kansas and the Kansas City Metro Area to determine their understanding of needs and barriers to colorectal cancer screening among American Indians. Using a community-based participatory research (CBPR) approach for this pilot study, community leaders and providers identified similar needs, including: culturally-appropriate education about colorectal cancer and screenings, the potential …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Racial Inequality In The Valuation Of Health Outcomes Expressed By The 1992 Acs Guidelines For Prostate Cancer Screening, C. A. Beam

Journal of Health Disparities Research and Practice

In 1992, the American Cancer Society (ACS) recommended annual screening for prostate cancer for men 50 and older using PSA. In this article, I introduce a method to use race and age-specific PSA accuracy data to evaluate differences in the valuation of outcomes by race and age that were expressed by the ACS guidelines. Using this new method, it can be concluded that the guidelines implied a 4-fold greater valuation was assigned to screening young white males with prostate cancer than the value that was assigned to young black males with cancer. Future implementation of guidelines for screening and testing …

Two Boundaries Separate Borrelia Burgdorferi Populations In North America, Gabriele Margos, Jean I. Tsao, Santiago Castillo-Ramirez, Yvette A. Girard, Anne G. Hoen

Dartmouth Scholarship

Understanding the spread of infectious diseases is crucial for implementing effective control measures. For this, it is important to obtain information on the contemporary population structure of a disease agent and to infer the evolutionary processes that may have shaped it. Here, we investigate on a continental scale the population structure of Borrelia burgdorferi, the causative agent of Lyme borreliosis (LB), a tick-borne disease, in North America. We test the hypothesis that the observed d population structure is congruent with recent population expansions and that these were preceded by bottlenecks mostly likely caused by the near extirpation in the 1900s …

Racial Differences In Preventive And Complementary Health Behaviors And Attitudes, Steven E. Shive, Grace X. Ma, Yin Tan, Jamil I. Toubbeh, Lalitha Parameswaran, Lalitha Parameswaran, Joe Halowich

Journal of Health Disparities Research and Practice

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of …

Equal Care, Unequal Outcomes: Experiences Of A Reach 2010 Community, Diane Neal, Barbara Carlson, Carolyn Jenkins, Gayenell Magwood

Journal of Health Disparities Research and Practice

Diabetes is growing in prevalence and costs. Guidelines for care have been available since 1983, yet diabetes care and outcomes remain less than ideal. CDC’s Racial and Ethnic Approaches to Community Health 2010 (REACH 2010) identified diabetes in African Americans as a priority for action. This article documents the activities, interventions, and current progress of the REACH 2010 diabetes coalition formed in Charleston and Georgetown counties, South Carolina, in reducing health care disparities and describes next steps for improving outcomes. The Chronic Care Model guided many of the implementation activities, and chart audits were used to document outcomes. Ambulatory care …

Transdisciplinary Approaches To Ameliorating Racial Disparities In Prostate Cancer Outcomes, Chanita H. Halbert, Katrina Armstrong, John Holmes, David Fenstermacher, Janet Weiner, Carmen Guerra, J. S. Schwartz, Jerry C. Johnson, Edmund Weisberg, Chantal Montagnet, Benita Weathers, Charnita Zeigler-Johnson, Ernestine Delmoor, Timothy R. Rebbeck

Journal of Health Disparities Research and Practice

Though prostate cancer is the second leading cause of cause cancer deaths among men in the US, it ranks first among African American men in terms of incidence, morbidity, and mortality. To address this and other complex health issues, some researchers advocate transdisciplinary research as a framework for analysis; however, few examples exist that indicate how the framework should be applied. This report uses prostate cancer outcomes as a paradigm to describe how such a framework can be used to identify determinants of racial disparities. By integrating diverse scientific disciplines, methods, and analytic approaches from psychology, sociology, epidemiology and genetics, …

A Study Of Potential Risk Factors Of Depression Among Latina Breast Cancer Survivors, Claudia Ximena Aguado Loi

USF Tampa Graduate Theses and Dissertations

Women with breast cancer commonly experience depression. However, this condition often goes unrecognized, undertreated, and understudied, especially in ethnic minorities. If left untreated, co-existing depression in women with cancer can complicate cancer treatment, lead to poor treatment adherence for both conditions, and decrease survival. These negative consequences are considerably higher among Latinas. With the growing number of Latinos and diversity within the Latino community, the literature has identified the need to disaggregate Latinos by region of origin. Unfortunately, few studies account for these differences and no study to date has examined risk factors of depression among Latinas diagnosed with breast …

Quality And Severity Of Lower Urinary Tract Symptoms Among African American Elders, Daniel L. Howard, Bennett G. Edwards, Kimberly Whitehead, M. A. Amamoo, Paul A. Godley

Journal of Health Disparities Research and Practice

Lack of population-based data on lower urinary tract symptoms (LUTS) among African American men represents a significant gap in understanding. This study examined LUTS among a racially over-sampled, mixed urban/rural, elderly cohort of African Americans and whites in the South to discern whether racial differences exist in the prevalence, severity, and associated risk factors of LUTS. Longitudinal analyses using generalized estimating equations (GEE) were conducted on the 1994–1998 EPESE dataset for 5 North Carolina counties. In 1994, the analytic cohort included 482 African Americans and 407 whites; by 1998, 249 and 222, respectively. In 1994, 49.4% of African Americans reported …

African American And Non-Hispanic White Births In Enhanced Prenatal Care Programs And Wic, Monica Cain

Journal of Health Disparities Research and Practice

North Carolina uses Maternity Care Coordination (MCC), an enhanced prenatal care program, to improve birth outcomes for high risk women. The WIC program provides similar services to achieve the same goal. Women in North Carolina Medicaid can choose to participate in either, both, or neither the MCC and WIC programs. The study compares the percentages of low birth weight (LBW)—less than 2500 grams—births and maternal risk characteristics of women: (1) participating in the MCC program only, (2) participating in WIC only, or (3) participating in both programs, to those women who receive conventional Medicaid prenatal care. The analysis is further …

Seeking Cancer Information: An Appalachian Perspective, Robin C. Vanderpool, Bin Huang, Brent J. Shelton

Journal of Health Disparities Research and Practice

There are noted disparities by ethnicity, race, age, gender, and socioeconomic status in the reported use of and access to cancer information. Missing from this list of variables that predict these disparities are specific geographic locales, such as Appalachia, a region recognized as a medically underserved, “special population”. Through a secondary analysis of NCI’s 2003 HINTS dataset, we are able to describe the cancer information-seeking behaviors of Appalachians as compared to non-Appalachians with a focus on actual versus preferential information-seeking behaviors, information-seeking experiences, and demographics. In general, Appalachians and non-Appalachians do not significantly differ in their cancer information-seeking behaviors and …

Process Evaluation In Action: Lessons Learned From Alabama Reach 2010, M. C. Nagy, Rhoda E. Johnson, Robin C. Vanderpool, Mona N. Fouad, Mark Dignan, Theresa A. Wynn, Edward E. Patridge, Isabel Scarinci, Cheryl Holt, Sharina D. Person

Journal of Health Disparities Research and Practice

The CDC-funded Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) project is designed to reduce and eliminate disparities in breast and cervical cancer between African American and white women in six rural and three urban counties in Alabama. In this manuscript, we report on the development, implementation, results, and lessons learned from a process evaluation plan initiated during the Phase I planning period of the Alabama REACH 2010 program. The process evaluation plan for Alabama REACH 2010 focused on four main areas of activity that coincided with program objectives: assessing coalition development, building community capacity, conducting a needs …

Lung Cancer Screening For The Poor And Underserved: Should Routine Screening Be Performed?, Vaibhav Verma, Vladimir K. Gotlieb, Joshua Fogel, Alan S. Multz, Geeti Sharma

Publications and Research

Background: Lung cancer is a leading cause of death in United States. A recent study using low dose CT scans for screening long term smokers for lung cancer has, for the first time, demonstrated reduction in mortality, although it is not a standard of care in the community yet.

Methods: We analyzed lung cancer data for stages 0 through 4 for 1,412 individuals from, a public hospital, Nassau University Medical Center (NUMC) with patients of lower income, two private hospitals, North Shore University Hospital (NSUH) and Long Island Jewish Hospital (LIJ), with patients of higher income, with average household income …

Foodborne Illness Outbreak Response: A Snapshot Of Ohio, Calen Wherry

Master of Public Health Program Student Publications

Biosurveillance is one of the primary roles of local Public health offices. As the all-hazards (biological, chemical, and radiation emergencies) approach adds to the responsibilities already performed in foodborne illness outbreak response, it is crucial to assess the capabilities and robustness of the local public health Foodborne Illness (FBI) response. By surveying the most populated counties in Ohio with a checklist based on the 2009 Council for Improvement of Foodborne Outbreak Response (CIFOR) guidelines, it was possible to obtain a snapshot of the current outbreak response capabilities. Though only one county reported 100% compliance with the checklist, the overall average …

Post-Abortion Care Family Planning Use In Pakistan, Syed Khurram Azmat, Waqas Hameed, Muhammad Ishaque, Ghulam Mustafa, Aftab Ahmed

Community Health Sciences

Introduction: The stagnated CPR and high unmet need for contraception lead to approximately 890,000 induced abortions every year in Pakistan. A fairly recent study from Pakistan also revealed that around 40% of abortions are performed by unskilled workers in backstreet clinics. Considering these grave statistics, it should not come as surprise that unwanted pregnancies are the leading cause of induced abortions in Pakistan. Despite country's inferior situation, there is no data available in Pakistan that unveils the much needed information pertaining to post-abortion care family planning (PAC) use. Thus, this paper attempts to document socio-demographic profile seeking post-abortion care clients; …

Research Brief: An Examination Of The Social And Clinical Influences In Prostate Cancer Treatment In African American And White Men, Keith Elder, Bettina F. Drake, Sara Wagner, James Hebert

Journal of Health Disparities Research and Practice

BACKGROUND: The death rate for prostate cancer (PrCA), the most commonly diagnosed cancer in African-American (AA) men, is twice the rate of European-American (EA) men. AA men in South Carolina have the highest age-adjusted death rate in the nation. Studies have shown that treatment offered to AA men with PrCA is systematically different from that offered to EA men. METHODS: Surveys were mailed to 1,866 men in South Carolina with a diagnosis of PrCA. South Carolina men diagnosed with PrCA between 1996 and 2002 were eligible to participate. We performed a descriptive assessment of the factors that influenced …

Cancer-Related Disparities Among Residents Of Appalachia Ohio, James L. Fisher, Holly L. Engelhardt, Julie A. Stephens, Bette R. Smith, Georgette G. Haydu, Robert W. Indian, Electra D. Paskett

Journal of Health Disparities Research and Practice

The authors sought to identify cancer-related disparities in Appalachia Ohio and better understand reasons for the disparities. Data from the Ohio Cancer Incidence Surveillance System, among other sources, were used to examine potential cancer disparities among residents of Appalachia Ohio. Using Ohio census data, the authors examined contributions of household income, educational attainment and population density to disparities in cancer incidence. Results suggest the following disparities in Appalachia Ohio (compared to non-Appalachia Ohio): greater cancer incidence and mortality rates for cancers of the cervix, colon and rectum, lung and bronchus and melanoma of the skin; a later stage at diagnosis …

Family Breast Cancer Education: A Model For African American Women, Frankie D. Powell, Edwin D. Bell, Jamilla Shepperson, Thomas Coaxum

Journal of Health Disparities Research and Practice

The purpose of this study, funded by the American Cancer Society, was to increase knowledge and understanding, i.e., the willingness and ability to discuss, of breast cancer in southern minority women and their families. A family model of health education guided the research questions. (a) To what extent will an action research intervention increase knowledge about the causes and treatment of breast cancer in minority women? (b) To what extent will an action research intervention increase willingness to talk with family members? The t-test analysis of a 67-item, self- administered survey indicated significant increases in knowledge of cancer and in …