Public Health Commons^™

Improving Access To Children's Mental Health Care: Lessons From A Study Of Eleven States, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Center for Health and Health Care in Schools

Implementation of the Patient Protection and Affordable Care Act (ACA) is well underway, creating long-overdue opportunities for growing the capacity of child and adolescent mental health systems and meeting children’s pressing needs. The good news is that as of January 1, 2014, coverage of mental health conditions and substance use disorders will be required as part of the broad Essential Benefits package of services under the ACA. While states will determine specific benefits, it is widely accepted that mental health and substance abuse coverage will substantially increase, though the details remain to be determined.1 Additionally, as a result of this …

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

Future Competencies Needed For The Direct Service Workforce, William Spears, Carla Clasen, Katherine L. Cauley

Population and Public Health Sciences Faculty Publications

The aging of the baby boom generation and health care policy changes represented by the Affordable Care act create challenges for the long term care industry in America. In 2011 the first of the baby boomers turned 65 years old. By 2030 a total of 78 million baby boomers, 19% of the population, will be 65 or more years old and eligible for Medicare (U.S. Census Bureau 2010). Discussions of potential health care worker shortages often focus on the need for more physicians and nurses to care for an aging population. These changes are putting pressure on long term care …

Patient And Provider Comfort Discussing Substance Use, Moira Ray, Mary Catherine Beach, Christina Nicolaidis, Dongseok Choi, Somnath Saha, P. Todd Korthuis

School of Social Work Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: Substance use is a prevalent issue in primary care with wide-reaching implications, particularly for the care of HIV-infected patients. This analysis identified patient and provider characteristics associated with high comfort discussing substance use in HIV primary care clinics using multivariable logistic regression.

METHODS: A total of 413 patients and 44 providers completed surveys on their comfort discussing substance use. Additional independent variables from surveys included demographics, drug and alcohol use, self-efficacy, and activation for patients. Providerlevel data included demographics, training, practice descriptors, and stress levels.

RESULTS: The majority of patients (76%) and providers (73%) reported high comfort. …

Developing Community Based Rehabilitation For Cancer Survivors: Organizing For Coordination And Coherence In Practice, Karen La Cour, Malcolm P. Cutchin

Wayne State University Associated BioMed Central Scholarship

Abstract

Background

Increasing incidences of cancer combined with prolonged survival have raised the need for developing community based rehabilitation. The objectives of the analysis were to describe and interpret the key issues related to coordination and coherence of community-based cancer rehabilitation in Denmark and to provide insights relevant for other contexts.

Methods

Twenty-seven rehabilitation managers across 15 municipalities in Denmark comprised the sample. The study was designed with a combination of data collection methods including questionnaires, individual interviews, and focus groups. A Grounded Theory approach was used to analyze the data.

Results

A lack of shared cultures among health care …

Proyecto Interconexiones: A Pilot Test Of A Community-Based Depression Care Program For Latina Violence Survivors, Christina Nicolaidis, Angie Mejia, Marlen Perez, Anabertha Alvarado, Rosemary Celaya-Alston, Yolanda Quintero, Raquel Aguillon

Chicano/Latino Studies Faculty Publications and Presentations

Background: Latina intimate partner violence (IPV) survivors often face great barriers to depression care. We sought to use a community-based participatory research (CBPR) approach to create and evaluate a community-based depression care program for Latina IPV survivors.

Methods: We created a multifaceted, culturally tailored intervention, based on principles of chronic illness management. A promotora provided case management services and led 12 weekly group sessions. Participants completed surveys at baseline and 6 months and participated in open-ended exit interviews.

Results: Ten Spanish-speaking Latina women participated in the intervention. The program had excellent attendance, with 100% of women attending …

Prevalence Of Hiv, Hepatitis B And C, And Co-Infection In A Cohort Of Male Injection Drug Users In Delhi, Lopamudra Saraswati, Mary Philip Sebastian, Avina Sarna, Vartika Sharma, Ira Madan, Dean Lewis, Ibou Thior, Waimar Tun

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000 nationally with an HIV prevalence of 7.2 percent. Historically, the presence of IDU populations and associated HIV infection was concentrated in the northeastern states of the country. Recent evidence documents IDU populations in other parts of the country. Delhi has an estimated 17,000 IDUs and the second highest HIV prevalence in India at 18.3 percent. The probability of becoming infected with HIV after using an infected syringe ranges from 0.34 percent to 1.4 percent. By comparison, the risk for hepatitis C (HCV) ranges from 1.5 percent to 5 …

The Hispanic Paradox And Older Adults’ Disabilities: Is There A Healthy Migrant Effect?, Esme Fuller Thomson, Amini Nuru-Jeter, Dawn M. Richardson, Ferrah Raza, Meredeth Minkler

Community Health Faculty Publications and Presentations

The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged …

High Hiv Incidence Among Male Injection Drug Users In Delhi, India, Waimar Tun, Lopamudra Saraswati, Mary Philip Sebastian, Vartika Sharma, Amita Yadav, Ira Madan, Ibou Thior, Avina Sarna

HIV and AIDS

India has a large injection drug user (IDU) population estimated at 177,000. The overall national HIV prevalence is around 7.2 percent in this group, the highest among all key populations in the country. There is limited HIV incidence data among IDUs in India. In collaboration with Arise—Enhancing HIV Prevention Programs for At-Risk Populations, the Population Council initiated a prospective cohort study at five centers in Delhi to examine HIV incidence and behavior change both pre-introduction and post-introduction of HIV prevention services among IDUs. HIV transmission risk remains high among IDUs in Delhi despite targeted prevention interventions. Despite the widespread availability …

The Patient Process And Affordable Care Act Of 2010: Implementation Challenges In The Context Of Federalism, Robert F. Rich, Eric Cheung, Robert Lurvey

Journal of Health Care Law and Policy

No abstract provided.

An Analysis Of Treatment Retention And Attrition In An Australian Therapeutic Community For Substance Abuse Treatment, Mark Robert Porter

Theses: Doctorates and Masters

Research undertaken in the last three decades has consistently reported that the length of time spent in inpatient and outpatient alcohol and other drug (AOD) treatment programs predicts treatment success (De Leon, Melnick, Kressel, & Jainchill, 1994; Hubbard, Craddock, & Anderson, 2003; Simpson, Joe, Fletcher, Hubbard, & Anglin, 1999). However, treatment attrition rates are high and present a major problem for improving treatment outcomes. Various factors that have been reportedly associated with increased AOD treatment attrition rates include being female, younger clients, clients using methamphetamines, and clients with elevated psychopathology scores. The aim of this thesis is to improve understanding …

Adherence To Physical Activity Among Individuals With Or Without Cardiovascular Disease, Zyad T. Saleh

Theses and Dissertations--Nursing

Cardiovascular disease (CVD) is a major public health problem and a primary cause of morbidity and mortality in the United States. Regular physical activity is recommended for prevention and management of CVD. Despite the cardiovascular health benefits of physical activity most adults are physically inactive. Therefore, the aim of this dissertation was to examine the factors associated with adherence to physical activity among individuals with or without CVD.

The first paper is a report of a study conducted to examine which baseline demographic (age, gender, marital status, socioeconomic status, and place of residency), psychosocial (social support, depression, anxiety, and fatalism), …

Placental Corticotropin-Releasing Hormone Mediates The Association Between Prenatal Social Support And Postpartum Depression, Jennifer Hahn-Holbrook, Christine Dunkel Schetter, Chander Arora, Calvin J. Hobel

Psychology Faculty Articles and Research

Three decades of research point to both biological and psychological risk factors for postpartum depression, but very little research integrates the two. This study bridged this gap by testing whether prenatal social support predicted depressive symptoms at 8 weeks postpartum in a multiethnic sample of 210 women and whether the stress hormone placental corticotropinreleasing hormone (pCRH), measured at 19, 29, and 37 weeks’ gestation, mediated this relationship. We found that prenatal family support predicted significantly fewer depressive symptoms postpartum and more gradual increases in pCRH from 29 to 37 weeks’ gestation. Furthermore, steeper increases in pCRH during this same period …

Tailoring A Physical Activity Promotion Program For A Rural Area, Gavin T. Colquitt, Moya L. Alfonso, Ashley Walker, Vanessa Dunmore

Community Health: Faculty Presentations (1993-2018)

Background/Purpose: VERBTM Summer Scorecard (VSS) has used social marketing to successfully promote physical activity for urban and suburban youth. The purpose of this study was to adapt the program to meet the needs of a minority, rural population.

Method: Qualitative marketing research methods including focus groups were used to gather data from parents (N = 12) and their children (N =12) in April 2012. A structured, open-ended focus group guide was developed specific to parents and youth and based on the social marketing framework. Marketing topics covered included Product, Price, Place and Promotion. Attention was given to testing two previously …

School Mental Health: Views Of Services Integration And Attitudes Toward Evidence-Based, Donna L. Burton

USF Tampa Graduate Theses and Dissertations

ABSTRACT

Purpose of the study. Through secondary data analysis of results from the School Mental Health Services Integration Survey (SMHSIS), this study describes indicators of school mental health integration preparedness, including role identification, willingness to engage in tasks associated with mental health services integration and implementation facilitators. The study also investigated the utility of a modified version of the Evidence-Based Practice Attitude Scale (EBPAS) for use with school staff.

Study rationale. With as many as 20% of children meeting criteria for mental disorders that cause impairment, the gaps in mental health services delivery to this special needs population are evident …

Long-Term Effects Of Alcohol Consumption [Annotated Bibliography], Polly Cowan

Undergraduate Research Award

No abstract provided.

Children And Adults With Long Term Services And Support Needs: Mainecare And Medicare Expenditures And Utilization, State Fiscal Year 2010, Stuart Bratesman Mpp, Julie T. Fralich Mba, Tina Gressani, Eileen Griffin Jd

Disability & Aging

This report is one of a series of reports prepared by the USM Muskie School on MaineCare members who are dually eligible for MaineCare and Medicare Services. An earlier report provided a high level overview of the MaineCare and Medicare use and expenditure patterns for all members who were dually eligible in state fiscal years (SFY) 2008 to 2010. Both reports were prepared as part of the Maine State Profile Tool grant funded by the Centers for Medicare & Medicaid Services. This second report analyzes the characteristics, use and expenditure patterns of sub-populations of long term service users including adults …

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, …

Building A Strategic Framework For Comparative Effectiveness Research In Complementary And Integrative Medicine, Claudia M. Witt, Margaret Chesney, Richard Gliklich, Lawrence Green, George Lewith, Bryan Luce, Anne Mccaffrey, Shelly Rafferty Withers, Harold C. Sox, Sean Tunis, Brian M. Berman

Dartmouth Scholarship

The increasing burden of chronic diseases presents not only challenges to the knowledge and expertise of the professional medical community, but also highlights the need to improve the quality and relevance of clinical research in this domain. Many patients now turn to complementary and integrative medicine (CIM) to treat their chronic illnesses; however, there is very little evidence to guide their decision-making in usual care. The following research recommendations were derived from a CIM Stakeholder Symposium on Comparative Effectiveness Research (CER): (1) CER studies should be made a priority in this field; (2) stakeholders should be engaged at every stage …

Art As A Cure: Analyzing Healthcare Treatment For The Mentally Ill Through The Lens Of Art Therapy Programs In Dakar, Senegal, Sofia Porter-Castro

Independent Study Project (ISP) Collection

Mental illness is a malady that affects roughly 2.3 million people in Senegal ("Statistics by Country” 2012), but the wide and sometimes opposing range of healing practices suggests that the attitudes surrounding mental illness are still largely contested. This is especially true in Senegal’s capital, where advances in medicine in big city hospitals are growing while ties to traditional beliefs and practices remain strong. Alternative therapies, such as art therapy, provide an opportunity for practitioners to explore different techniques for treating the mentally ill while still integrating elements of the local culture. It is precisely this integration that this paper …

Storytelling And Healing: The Influence Of Narrative On Identity Construction Among Hiv Positive Individuals In Kisumu, Kenya, Kimberly Leon

Independent Study Project (ISP) Collection

The principle objective of this Independent Study Project is to investigate the influence of storytelling as a counseling method on conceptions of HIV among HIV positive individuals in the city of Kisumu. Interviews with counselors, community health workers, and HIV support group members were used to determine the role of storytelling in the counseling process. Stories and life experiences were gathered and analyzed in order to extract themes and draw a relationship between the act of storytelling and a person’s perception of their HIV status. Data was collected at various support groups in the Kisumu area and through the help …

Living With Autism In Vietnam, Libie Motchan

Independent Study Project (ISP) Collection

This paper examines the many implications of living with Autism in Vietnam on both affected children and their families. The lack of information, statistics and awareness of autism in Vietnam is reflected in the limited treatment resources available. This study calls attention upon what problems parents are most affected by what they feel needs to change. It also looks at the current sentiment and understanding of autism and its perceived causes. The results of this paper come from background research, observation at clinics and special education facilities, interviews with professionals in the fields of psychology and education, interviews with parents …

The 2002 Bali Bomb: Models Of Sustainable Philanthropy, Lauren Livingston

Independent Study Project (ISP) Collection

Within the first few weeks in Bedulu, I read an ISP written in 1990 concerning mental health facilities in Bali. It was by far one of the most engaging and provocative ISPs I was introduced to; however, giving today’s security precautions and my lack of background in psychology, I easily dismissed it as a possible project. Yet, as ISP time lurched closer, I still had not found an idea that equally excited me. I talked with Bu Ari, and she encouraged me to talk to Ibu Luh Ketut Suryani, the leading psychologist in Indonesia and founder of the Suryani Institute …

Using Photovoice In Pete Programs To Initiate Positive Change, Gavin T. Colquitt, Jody Langdon, Tony A. Pritchard, Starla Mccollum

Community Health: Faculty Presentations (1993-2018)

The purpose of this presentation will be to provide teacher educators with an overview of the Photovoice methodology and its potential utility in curricular change. The National Association for Sport and Physical Education’s ([NASPE], 2008) PETE standards state educators should allow diversity to drive instructional related decision-making. Photovoice, a participatory action research methodology, is a tool teacher educators can use to be responsive to the continuously changing contexts of public schools.

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 …

College Drinking: A Call To Physicians, Shawn Sorrel, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper was to review literature related to prevalence of drinking on college campuses and current prevention practices targeting this population. This paper focuses on current data surrounding alcohol use and misuse. It further discusses strategies which have been successful to prevent alcohol abuse. Finally, it discusses the need for further research to determine the role of the physician in alcohol prevention at university student health services.

Socio-Economic Determinants Of Out-Of-Pocket Payments On Healthcare In Pakistan, Ashar Muhammad Malik, Syed Iqbal Azam Shah

Community Health Sciences

BACKGROUND:

Out-of-pocket (OOP) payment on healthcare is dominant mode of financing in developing countries. In Pakistan it is 67% of total expenditure on healthcare. Analysis of determinants of OOP health expenditure is a key aspect of equity in healthcare financing. It helps to formulate an effective health policy. Evidence on OOP in Pakistan is sparse. This paper attempts to fill this research gap.

METHODS:

We estimated determinants of OOP payments on healthcare in Pakistan. We used data sets of Pakistan Household Integrated Economic Survey (HIES) and Pakistan Standard of Living Measurement (PSLM) Survey for the year 2004-05. We developed a …

Disparities In Mental Health Utilization Among Persons With Chronic Diseases, Saundra Glover, Keith Elder, Sudha Xirasagar, Jong-Deuk Baek, Crystal Piper, Dayna Campbell

Journal of Health Disparities Research and Practice

This study used Aday and Andersen’s Behavioral Model of Health Services Use to examine the role of chronic disease and the joint impact of race and chronic disease type on mental health utilization. Using data from Community Tracking Survey Household Survey, we tested the assumption that chronic disease, chronic disease type, and race are related to lower rates of mental health visits when adjusted for predisposing, enabling, and need factors. After adjusting for population characteristics, we found that race significantly moderated the impact of chronic disease type on mental health utilization, showing that African Americans with cardiovascular disease were half …

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 …

Cannabis Use In Cape York Indigenous Communities: High Prevalence, Mental Health Impacts And The Desire To Quit, India Bohanna, Alan R. Clough

Aboriginal Policy Research Consortium International (APRCi)

Anecdotal reports suggest that high rates of cannabis use and dependence are significant issues in Indigenous communities in north Queensland; however, there is little scientific evidence to support or refute this.The Cape York Cannabis Project seeks to investigate cannabis use rates, cannabis dependence and mental health impacts for the first time in three Cape York Indigenous communities.