Public Health Commons^™

Modeling Health Inequities Research In Context And The Minority Researcher’S Role, Ari Mwachofi, Ngure Wamwachofi

Journal of Health Disparities Research and Practice

Current health inequities research templates are flawed and self-defeating because they do not include historical inequalities as the central context that points to the root causes of health inequities. The context includes structural malformations which are products of the history of colonization and slavery that created racial separation and hierarchies which established Whites as the dominant group and non-Whites (minorities) as the subordinate group. Consequently it is difficult for mainstream researchers to capture the minorities’ core knowledge necessary for the creation of relevant and effective interventions for fundamental and sustainable improvement of their health. This paper proposes a health inequities …

Family Home Visitors: Increasing Minority Women’S Access To Health Services, Mechthild Meyer, Alma R. Estable, Lynne Maclean, Wendy E. Peterson

Journal of Health Disparities Research and Practice

The article describes how service access barriers (language, trust) were addressed at different levels (organization, service provider, community) by involving Family Home Visitors to support Nurse Practitioners in providing pre- and postnatal services to linguis­tic minority women in Ontario. The investigators undertook a secondary analysis of 18 semi-structured interviews with health unit informants, Nurse Practitioners, program us­ers, and community leaders, including Family Home Visitors. Health units facilitated col­laboration between two programs aimed at serving mothers with young children, result­ing in both programs using Family Home Visitors. They enhanced minority women’s trust in Nurse Practitioner services by providing interpretation, outreach and …

Patterns Of Interaction Among Local Public Health Officials And The Adoption Of Recommended Practices, Jacqueline A. Merrill, Kathleen M. Carley, Mark G. Orr, Christie Y. Jeon, Jonathon Storrick

Frontiers in Public Health Services and Systems Research

The network that local health officials use to communicate about professional issues contains two groups of LHDs that are influential for either their ability to spread information or to innovate. Both groups are more likely to conduct community health assessments and develop health improvement plans. Since these activities are fundamental aspects of accreditation and health reform, the findings may present an early indication that these initiatives are having an effect on the public health system.

Public Health Governance And Population Health Outcomes, Scott P. Hays, Janine Toth, Matthew J. Poes, Peter F. Mulhall, David M. Remmert, Thomas W. O'Rourke

Frontiers in Public Health Services and Systems Research

Research reviews have identified a gap in understanding the diversity of health department governance structures and in understanding how the variations in governing relates to health outcomes. This report details the categorization of local public health governance and reveals that certain governance types may be better suited to achieve better population health outcomes. State systems achieve the poorest health outcomes, but the best health outcomes are achieved when the political branches have a key role in local public health governance. Public health systems should consider greater local control and involvement in governance; but local governance should include the political branches …

Using State And Local Health Survey Data To Advance Phssr, Glen P. Mays

Health Management and Policy Presentations

State and local health survey data can be used to evaluate the implementation and impact of public health delivery innovations in real-world practice settings.

Harnessing The Potential Of Comparative Effectiveness Research And Delivery System Innovation Through Practice-Based Research, Glen P. Mays

Health Management and Policy Presentations

Testing delivery system innovations in health care and public health allows the practice-based research enterprise to lead the way toward gains in health and economic efficiency.

Hiv/Sti Risk Factors Among African-American Students Attending Predominantly White Universities, Marya L. Shegog, Lisa Lindley, Melva Thompson-Robinson, David Simmons, Donna Richter

Journal of Health Disparities Research and Practice

Introduction: The majority of African American college students in the U.S. attend predominantly white institutions (PWIs). However, there is minimal research examining this population’s HIV/STI risk behaviors. The purpose of this investigation was to assess HIV/STI behavioral risk factors among African American college students (aged 18 – 24years) attending PWIs. (n = 2,568)

Methods: Backwards step-wise logistic regression analyses were conducted to determine factors associated with a positive HIV/STI diagnosis (past year) among sexually active African American college students who participated in the Spring, 2006 National College Health Assessment.

Findings: Nine factors were significantly associated with an HIV/STI diagnosis among …

Using Concepts From Freire’S Pedagogy Of The Oppressed To Promote Colorectal Cancer Screening In An Urban Minority Population, Corey H. Brouse, Charles E. Basch, Randi L. Wolf

Journal of Health Disparities Research and Practice

This paper briefly introduces Freire’s philosophy of education, as well as examples of how this philosophy can be used in health education. Concepts from Freire’s work are highlighted along with how they are applicable to educating adults about colorectal cancer (CRC) screening, a health behavior that is less prevalent among poor and minority populations. Concepts highlighted in Freire’s writing can be directly applied to reducing disparities in health.

Prioritizing Interventions And Research To Address The Cancer Disparities Of Arizona’S American Indian Population, Norman J. Petersen, Sujata Joshi, Tim Flood, Kathryn Coe

Journal of Health Disparities Research and Practice

The aim of the Southwest American Indian Collaborative Network (SAICN) is to reduce cancer disparities by closing the gap between community needs and the promise of cancer prevention and cure through participatory education, training and research programs. In an effort to provide evidence-based recommendations and promote the use of relevant data in tribal communities, the SAICN Data and Evaluation Core developed two comparison matrices that present scientifically sound practices for use by community health decision makers in prioritizing activities likely to reduce the irrespective community’s burden of cancer. In their current configurations, Matrix A considers those cancers for which prevention …

A Communication Strategy To Address Health Inequities In Municipal Settings, Christine Unson, Ben Tyson, Angela Funaiole, Comfort Agaba

Journal of Health Disparities Research and Practice

This study assessed knowledge of health inequities, importance and benefits/barriers of addressing inequities, and ways of communicating information about inequities among municipal officials. Five focus groups (N=47) were conducted with officials from economic development, land use and housing, public safety, education, and environment departments. Discussions were recorded, transcribed and analyzed for key themes. Findings show that participants had an uneven understanding of the symptoms and causes of health inequities and identified limitations to participating in health equity initiatives and collaborating with local health departments. Recommendations are that a communication strategy to reduce health inequities should aim to increase awareness of …

Pap Test Follow-Up Pattern Among American Indian Women In Arizona, Merrill Eisenberg, Kathryn Coe, Charlton Wilson, Kathleen Evans, Elizabeth Brewer

Journal of Health Disparities Research and Practice

Objective: To quantify the loss to follow-up rate after abnormal Pap test results at the Phoenix Indian Medical Center, an Indian Health Service regional facility, and identify barriers to follow-up from the patients’ point of view.

Materials and Methods: Patient records were used to identify women who had abnormal Pap tests in 2002 and to document the status of their follow-up care. Women who had no clinical record of follow-up were contacted by telephone to arrange a follow-up appointment and to request participation in a structured qualitative interview to identify barriers to follow-up at the individual, family, community, and health …

Application Of The Pen-3 Model In A Diabetes Prevention Intervention, Joan E. Cowdery, Shandowyn Parker, Amy Thompson

Journal of Health Disparities Research and Practice

More effective strategies for addressing health issues in African American communities are needed. As part of a three year NIH funded Project Export grant, this community campus partnership used community-based participatory research principles and thePEN-3 Cultural Framework to develop a culturally specific, locally relevant intervention to prevent Diabetes among African-Americans. A comprehensive needs assessment which included 13 elicitation interviews, 3 focus groups, and 217 surveys resulted in identifying major themes including overall lack of knowledge regarding Diabetes,issues of denial and stigma, sense of inevitability, influence of family on perceptionsand behaviors, communication issues with health care providers, and lack of culturally …

Racial Differences In The Use Of Most Commonly Performed Medical Procedures In The United States, Syed S. Haque, Mohammad A. Faysel, Hafiz M. R. Khan

Journal of Health Disparities Research and Practice

Objective: This study investigates racial disparities in the use of commonly performed medical procedures in U.S. hospitals. Methods: To examine racial disparities, we calculated age-adjusted rate of procedures used by all Whites, Blacks, Hispanics, Asians or Pacific Islanders and Native Americans and calculated corresponding Relative Risks(RRs) of White vs. all other races based on procedure utilizations and insurance types using 20% random sample of Nationwide Inpatient Sample (NIS) data between 2001 and2003. Results: Whites were significantly more likely to receive 3 of the study procedures than Blacks, 3 of the procedures than Hispanics, 2 of the procedures than Asians or …

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

Children’S Vulnerability Related To Chlorine Exposure, Container Confusion, And Mixing Household Cleaners – Florida, 2006-2008, Roxie Zarate, Alan Becker, Ivette A. López, Jay L. Schauben

Florida Public Health Review

Acute and chronic effects of exposure to chlorine and chloramines can result in the irritation of the skin and mucous mem- branes, often leading to airway edema resulting in respiratory difficulties, burning in the throat, eyes and nose. Ingestion of bleach or bleach-containing products often results in adverse gastrointestinal effects. Data captured by the three centers com- prising the Florida Poison Information Center Network (FPICN) between 2006 and 2008 was examined to characterize the extent oftoxic effects from chlorine gas exposures related to misuse ofhousehold cleaners. A known outcome was determined in 48.4% of the 5315 cases. Of those with …

A Report Of Florida’S Cancer History, Risk Factors, And Screening Behaviors: Data From The National Health Interview Survey, Laura A. Mcclure, Tainya C. Clarke, Cristina A. Fernandez, Kristopher L. Arheart, William G. Leblanc, Lora E. Fleming, David J. Lee

Florida Public Health Review

To target populations at greatest risk ofdeveloping cancer, it is vital to understand the patterns ofrisk factors and screening behaviors along with cancer surveillance data. This study provides data on the prevalence of self-reported cancer history, can- cer risk factors, and cancer screening behaviors in Florida and compares them to rates in the rest ofthe U.S. Data were ob- tained from the National Health Interview Survey (NHIS), an annual, cross-sectional household survey of the U.S. civilian non-institutionalized population. We analyzed pooled data from the 2000 and 2005 Cancer Control Modules. Compared to the rest ofthe U.S., Floridians reported a lower …

Obesity And Food Insecurity Are Both Florida Public Health Issues – A Commentary, Judy E. Perkin

Florida Public Health Review

Florida faces an epidemic of overweight and obesity primarily due to an imbalance of caloric intake and physical activity modulated by multiple physiologic and cultural factors. The overweight and obesity issue notwithstand- ing, Florida’s public health efforts must also continue to address problems related to food insecurity and hunger. Although much of the focus concerning food insecurity has been at the individual or household level, there is also discussion among policymakers, food experts, and community members about the need to focus on food security at the community-level as well. This commentary examines Florida’s current food security issues.

The Sandwich Generation: A Review Of The Literature, Leaanne Derigne, Stephen Ferrante

Florida Public Health Review

Many Americans balance dual caregiving responsibilities for both children and aging family, dubbed the “sandwich genera- tion.” Between 1 out of8 and 1 out of11 households with an adult aged 30 or older is comprised ofdual-earner, sandwiched generation couples. There are psychological, physical, employment, and financial outcomes ofbalancing multiple caregiving duties. The literature shows positive benefits for caregivers too. A review ofliterature in the past 30 years, citing only U.S.- based studies is summarized in this paper. Policy, clinical, and research implications are included. It is possible that multi- generational caregiving responsibilities will continue to rise for the children ofbaby …

Impact Of The Florida Birth-Related Neurological Injury Compensation Association (Nica) On Obstetrician And Attorney Practices, Karen W. Geletko, Andrew Hunt, Leslie M. Beitsch

Florida Public Health Review

As health reform continues to unfold nationally, one ofthe more dramatic strategies for reform ofthe current medical liability system is to move towards a no-fault compensation system. Although, no state has established a comprehensive no-fault medical malpractice system, the Florida Birth-Related Neurological Injury Compensation Association (NICA) is a unique and rare working model ofa functioning no-fault insurance program. A cross-sectional design was utilized to survey obstetricians and health law attorneys practicing in Florida in 2011 to ascertain their knowledge and opinions of NICA and its impact on practice patterns and defensive medicine. The findings indicate that respondents believe NICA has …

Infectious Syphilis In Non-Hispanic Blacks And Hispanics In An Urban Std Clinic, Tai Hunte, Maria L. Alcaide, Ricardo Franco, Khaled Deeb, Jose G. Castro

Florida Public Health Review

Syphilis is a complex infectious disease caused by Treponema pallidum and acquired through sexual contact or vertical transmission. The natural history of syphilis is divided in primary, secondary, latent and tertiary stages. The syphilis epidemic has evolved over the years. National rates of syphilis infection dropped to the lowest in 2000 and have since increased in certain populations. Men who have sex with men (MSM) account for 60% of new infections and high rates occur in individuals with human immune deficiency virus co-infection. This study describes and compares the demographic characteristics, risk factors, and clinical presentation ofinfectious syphilis cases diagnosed …

Comparing Risk Factors Of Hiv Among Hijra Sex Workers In Larkana And Other Cities Of Pakistan: An Analytical Cross Sectional Study, Arshad Altaf, Aysha Zahidie, Ajmal Agha

Community Health Sciences

Background

In 2005, Pakistan was first labeled as a country with concentrated epidemic of Human Immunodeficiency Virus (HIV). This was revealed through second generation surveillance conducted by HIV/AIDS Surveillance Project (HASP). While injection drug users (IDUs) were driving the epidemic, subsequent surveys showed that Hijra (transgender) sex workers (HSWs) were emerging as the second most vulnerable group with an average national prevalence of 6.4%. An exceptionally high prevalence (27.6%) was found in Larkana, which is a small town on the right bank of river Indus near the ruins of Mohenjo-Daro in the province of Sindh. This paper presents the risk …

Parallel Lives: Similarities Between The Lived Experiences Of Persons With Cancer And Hiv, Danielle Boyd '12

Honor Scholar Theses

Thave chosen to focus this analysis on the shared experiences of patients with the socially stigmatized and incurable illnesses of cancer and HIV. These people cannot have their patient experience ended by a nice little pill or vaccine. They must blindly put their hopes in painful treatment regimens that can offer only management of their condition. They often undergo the tremendously helpless experience of feeling one’s body decline. As their treatment or the illness itself progresses they must enlist the help of family and friends to help them with daily tasks. Obviously the shared experiences of these two patient populations …

Evaluating Effectiveness Of A Public Mental Health Re-Entry Program: Strategic Statewide Partnerships, Stephanie Hartwell

Office of Community Partnerships Posters

This study is the first ever initiative to merge administrative data base in Massachusetts to evaluate an important public mental health program. It examines post-incarceration outcome of adults with serious mental illness (SMI) enrolled in the Massachusetts Department of Mental Health (DMH) Forensic Transition Team (FTT) program. The Program began in 1998 with the goal of transitioning offenders with SMI released from state and local correctional facilities utilizing a core set of transition activities. In this study we evaluate the program's effectiveness using merged administrative data from various state agencies for the years 2007 - 2011, comparing FTT clients to …

Honduras: Local, Regional And Global Partnerships To Improve Health In Olancho, Lisa Kennedy Sheldon, Hasan Bailey, Carlo Najera, Mary Roy

Office of Community Partnerships Posters

The Honduran Mission Team-New Hampshire (HMT-NH) in partnership with the Olancho Aid Foundation (OAF), works in the Olancho department to improve the health and education of the Honduran people. The HMT-NH 2012 Healthcare Team included UMass Boston faculty and a nursing student working with American and Honduran doctors and nurses to provide culturally-appropriate healthcare and collect data about the needs of the Honduran people in Olancho.

Institute For Community Inclusion (Ici) Leadership Education In Neurodevelopmental Disabilities (Lend) Partners With Community-Based Organizations (Cbos), David Helm, Institute For Community Inclusion, University Of Massachusetts Boston

Office of Community Partnerships Posters

This Interdisciplinary Leadership Education in Neurodevelopmental and Related Disabilities (LEND) and Maternal and Child Health Bureau (MCHB) funded-program aims at providing long-term, graduate level interdisciplinary training to health professionals and family members. The purpose of this project is to develop leadership potential to improve the health status of infants, children, and adolescents with or at risk for neurodevelopmental and related disabilities and to enhance the systems of care for these children and their families.

Working Together: Recruiting African American Female Caregivers And Pre-Adolescent Girls For Longitudinal Study, Teri Aronowitz, Wendy Pavlovich

Office of Community Partnerships Posters

The aim of this project is to implement an enhanced sexual communication intervention with mother-pre adolescent girls. It also aims to maintain the short term enhanced sexual communication intervention and evaluate the long term efficacy (9 months) of an enhanced sexual communication intervention with mothers and pre-adolescent girls. Finally the project aims to determine whether the constructs of the Information-Motivation-Behavioral skills (IBM) Model can account for variability in enhancing sexual communication intervention of mother and pre-adolescent girls.

Gokids Boston Youth Fitness, Training, And Research Center, Meghan Feeley, Sarah Camhi, Dana Commesso, Gokids Boston, University Of Massachusetts Boston

Office of Community Partnerships Posters

GoKids Boston embodies innovation and leadership in youth health through life-changing programs, groundbreaking research, exceptional training opportunities, and dedication to the community with a focus on eliminating health disparities.

Increasing Physical Activity In Inner City Youth Using Novel Interactive Gaming, Sd De Ferranti, Sk Steltz, Scott Crouter, A Kim, Sk Osganian, Jessica Whiteley, H Feldman, Laura L. Hayman, Gokids Boston, University Of Massachusetts Boston

Office of Community Partnerships Posters

The aim of this project was to assess the feasibility of participation in an afterschool physical activity program incorporating novel exercise technologies on changing physical activity level and physical fitness, compared to a nutrition education intervention alone. A second objective was to assess whether this type of intervention could modify cardiovascular risk factors and anthropometrics.

Give Us Your Poor: A National Public Education Campaign Addressing Homelessness, Barbara L. Graceffa, Center For Social Policy, University Of Massachusetts Boston

Office of Community Partnerships Posters

The objective of this campaign to create awareness that the Government alone cannot solve homelessness. The campaign also creates awareness that corporations need to be involved to help bring to scale solutions as well as promote innovation. The aim of the project is to create an awareness that collaboration between government, non-profits, academia, corporations, faith communities, and individuals is key to solving the issue.

Pay-For-Performance In Five State Medicaid Programs: Lessons For The Nursing Home Sector, Edward M. Miller, Julia Doherty

Office of Community Partnerships Posters

This project looks at the pay-for-performance program in five state Medicaid programs and lists the lessons that the Nursing Home Sector can learn from. They are: The federal government has traditionally sought to ensure quality outcomes through nursing home (NH) surveys conducted by state officials; Some states have begun to experiment with pay-for-performance (P4P) incentives, which provider higher Medicaid reimbursement to those facilities achieving desired outcomes; By 2007, there were 9 state P4P programs covering 20% of NHs and 16.7% of residents; Little is known about the use of P4P to promote quality and efficiency in the NH sector.