Public Health Commons^™

Emergency Department Visits For Sexual Assault By Emerging Adults: Is Alcohol A Factor?, Allison Tadros, Melinda J. Sharon, Shelley M. Hoffman, Danielle M. Davidov

Faculty & Staff Scholarship

Introduction: Emerging adults (18-25 years of age) are at increased risk for sexual assault. There is little Emergency Department (ED) data on sexual assaults that involve alcohol among this population. The purpose of this study was to analyze ED visits for sexual assault and determine if alcohol consumption by the patient was noted.

Methods: This study was a retrospective chart review of patients aged 18-25 presenting to an ED in a college town over a four-year period. Extracted variables included age, gender, delay in seeking care, sexual assault nurse examiner (SANE) evaluation, and alcohol consumption by the patient. For analysis …

Incredible Years (Iy) Parents & Babies Well-Baby Program: Expanding The Reach Through Cultural Adaptation, Ayanda Chakawa, Briana Woods-Jaeger

Posters

No abstract provided.

Medium To Long Term Impacts On Former Participants Of The Shoulder To Shoulder Global Brigades To Ecuador, Craig Borie

Theses and Dissertations--Community & Leadership Development

Medium to Long Term Impacts on Former Participants of the Shoulder to Shoulder Global Brigades to Ecuador. International service learning and voluntourism programs in global health evoke benefits for both community and the intervener. While it is clear that the Shoulder to Shoulder Global program at the University of Kentucky provides a service to an economically resource poor community in Santo Domingo, Ecuador, what is unclear is the impact these interprofessional experiences have on the participants that travel with the four times a year health brigades. This study proposes to answer the question of what are the educational, personal and …

Exploring Disaster Preparedness For The Aging Population, Gladysmarie W.R. Harris

Walden Dissertations and Doctoral Studies

Older adults are encountering harsh recovery after disasters, and compounding this problem is the lack of research on older adults' perceptions on disaster preparedness as aging affects the ability to react to emergency situations. To partially address that gap, the purpose of this general qualitative research study was to use Rotter's spectrum of locus of control theory to examine the level of preparation regarding disaster preparation of older adults who were living independently in single-family homes in a state affected by Hurricane Sandy. Data were collected through a qualitative survey distributed to adults aged 65 to 80-years (N=88) and publicly …

Reducing Arsenic Exposure From Private Well Water In The United States: The Use, Effect, And Potential Of Testing Requirements, Sara Flanagan

Dissertations and Theses

Over 45 million Americans drink from unregulated private well water of unknown quality. Arsenic is the most concerning groundwater contaminant for health because of its toxicity and widespread natural occurrence. Most residential wells in arsenic-affected areas have not been tested for arsenic; the success of community programs and efforts to motivate testing is limited by a range of psychological, situational, and socioeconomic barriers. However, testing only acts as screening and does not reduce exposure without effective and consistent actions to follow. Given the limitations in relying on individual well owners to be aware, willing, and capable of testing their water, …

Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein

Dissertations and Theses

Background: Young Black and Latina women suffer from higher sexually transmitted disease (STD) incidences than White women, increasing their susceptibility to contracting human immunodeficiency virus (HIV). The adoption and widespread usage of mobile devices has contributed to the public’s ability to access available information at all hours, including information on sexual and reproductive health (SRH). Despite a growing body of mobile health literature, there is limited understanding of how mobile-based sexual and reproductive health interventions for use by young adult Black and Latina women could improve sexual health knowledge and connection to clinical care.

Methods: This pilot randomized controlled trial …

Adolescent Girls Empowerment Program (Agep), Population Council

Poverty, Gender, and Youth

For Zambian girls, social isolation, economic vulnerability, and lack of appropriate health information and services are critical problems that prevent a healthy transition from girlhood to womanhood. The challenges that girls are confronted with—high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, lack of agency and participation—are linked together through their root causes. Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for vulnerable adolescent girls in Zambia. This brief summarizes …

Adolescent Girls Empowerment Program (Agep): Sexual And Gender-Based Violence, Karen Austrian, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Acceptability and experience of sexual and gender-based violence is alarmingly high among adolescent girls in Zambia. Even more striking is the very young age from which notions of violence are ingrained and experience with violence begins. This brief summarizes the Adolescent Girls Empowerment Program (AGEP) evaluation which demonstrated that in the Zambian context, a program focused on changing norms among girls themselves is not enough to impact attitudes toward and experience of violence. Social and cultural norms are shaped by households, schools, communities, and all of the adults that girls interact with in these places—even the mentors of their own …

Child Domestic Work And Transitions To Commercial Sexual Exploitation: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

There are an estimated 17.2 million child domestic workers in the world, and the vast majority are girls. Domestic work keeps children out of school, confined to the home, socially isolated, and burdened with excessive domestic duties. Furthermore, evidence is emerging that domestic work is a feeder profession for sex work. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in Ethiopia. The domestic work conditions described in this brief create unbearable conditions for girls who enter into commercial sex work as an alternative, hoping for an improvement in their work situation. The study found that a …

Forced Child Unions: From Legal Reform To Social Disruption—Formative Research In Five Communities In Chisec, Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

Evidence has shown that child early and forced marriage/unions (CEFM/U) are harmful to the rights and development of girls and adolescents. It has also shown that increasing the minimum marriage age is not enough to eradicate this phenomenon because of the underlying practices of social institutions at the community level. This report details an investigation undertaken when a modification to the Civil Code was approved, then modified, in order to increase the minimum age of marriage in Guatemala. The investigation aimed to identify the norms, practices, and attitudes prevailing in the school, family, religion, government, and economy with regard to …

Girlsread! E-Reader Curriculum, Natalie Jackson Hachonda, Nicole Haberland, Abdul-Kahad Alhassan, Beatrice Ani-Asamoah, Pamela Nyirenda, Barbara Mensch

Poverty, Gender, and Youth

Zambian adolescent girls are at risk for premature school leaving and HIV infection due to a host of contextual factors including child marriage, early childbearing, harmful gender norms, and intimate partner violence. This report describes the GirlsRead! program, whose overall goal is to enhance learning and increase progression to secondary school among Zambian adolescent girls in grade 7, the last year of primary school. Through GirlsRead!, the Population Council, together with FAWEZA and Worldreader are aiming to improve school retention by bolstering girls’ learning outcomes, furthering social connections, improving critical thinking skills, increasing agency, and fostering community norms supportive of …

Migration And Child Domestic Work: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

Domestic work is frequently the initial survival strategy for rural Ethiopian girls migrating to urban areas. Following migration from rural areas, most girls enter the workforce as domestic workers, because it is a readily available form of work requiring little or no education. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in urban and rural areas in six Ethiopian regions which demonstrated that this is a common phenomenon. Originating from poor rural areas and armed with little in the way of education, domestic workers receive low pay and frequently work in abusive situations, including sexual abuse. …

Nisitu (Nisikilize Tujengane): Listen To Me, Let’S Grow Together, Population Council

Poverty, Gender, and Youth

Evidence from several studies, including in Kenya, supports the idea that empowerment and asset-building interventions targeting multiple levels of the socio-ecological environment can improve education, health, economic and social capital, gender-equitable attitudes, and violence outcomes for girls. This brief describes efforts by researchers to test the effects of engaging boys and men alongside girl-centered programming to improve the lives of adolescent girls. In 2017, the Population Council and partners undertook formative research to understand from girls: 1) what are the most influential types of males in their lives; 2) how and what they influence; and 3) what behavior changes among …

Building Resilience In Communities Most Vulnerable To Environmental Stressors, Jessie Pinchoff

Poverty, Gender, and Youth

Evidence suggests that the frequency and intensity of environmental hazards such as floods, cyclones, and droughts may be increasing, leading to high volatility in many parts of the world. The impact of these events falls unequally on the most vulnerable individuals, households, and communities. To fully understand and address the needs of vulnerable communities, the Population Council is building on its existing research, deep global research expertise, and proven approaches in reaching and working with vulnerable populations to examine how humans interact with their environments and explore how to test and develop successful strategies for building resilience. This report presents …

Accelerating Action To End Child Marriage In Bangladesh, Sajeda Amin, Jyotirmoy Saha, Masuma Billah, Nargis Sultana, Eashita Haque, Surojit Kundu

Poverty, Gender, and Youth

Despite considerable social and economic progress in Bangladesh, child marriage remains the norm. The Population Council is partnering with UNFPA and the Ministry of Women and Children Affairs to empower girls with gender, life, and livelihood skills, and to engage communities to address fundamental normative drivers of child marriage. The objective of the baseline study is to generate a set of indicators against which change can be measured, and to provide specific information about the status of adolescents in the study area in ways that can guide intervention strategies and inform programs and policies. Baseline findings will provide a benchmark …

Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

La evidencia ha demostrado que el matrimonio y las uniones infantiles forzadas (M/UIF) son nocivos a los derechos y el desarrollo de las niñas y adolescentes. También se ha demostrado que aumentar la edad mínima del matrimonio no es suficiente para erradicar este fenómeno que subyace en la práctica de las instituciones sociales a nivel comunitario. Se ha realizada esta investigación en el momento en que se aprobó la modificación al Código Civil, seguido de una modificación para aumentar la edad mínima para el matrimonio en Guatemala, con el propósito de identificar las normas, prácticas, y actitudes vigentes en la …

What Works To Improve Outcomes For Kenya's Adolescent Girls?, Population Council

Poverty, Gender, and Youth

This fact sheet outlines results from the Adolescent Girls Initiative–Kenya, a study that evaluates the long-term impact of a multi-sectoral intervention targeted at adolescent girls aged 11 to 15 years from Kibera and rural Wajir. The intervention consists of four different components: a community-based violence-prevention program, an education conditional cash transfer (CCT), health-focused girls' empowerment clubs, and wealth creation for girls via financial education and savings. Results indicate that the approach was a cost-effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes.

Community-Level Assessment Of Heatwaves In Odisha State, India: Effects, Resilience And Implications, Sangram Kishor Patel

Poverty, Gender, and Youth

Heatwaves constitute a potential threat to many of India’s states, including Odisha, and their impact could become acute without adaptive capacity. This research brief explores the perceived causes and experiences of climate change and heatwave by stakeholders in the district. It summarizes reported effects on livelihoods, food security, and livestock; water and sanitation; and health, and reviews coping strategies offered by respondents. The report includes a number of recommendations to meet the needs of the population as indicated by the findings.

Adolescent Girls Initiative–Kenya: Midline Results Report, Karen Austrian, Erica Soler-Hampejsek, Joyce Mumah, Beth Kangwana, Yohannes Dibaba Wado, Benta Abuya, Valsa Shah, John A. Maluccio

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. In addition to low educational attainment and health risks, other factors that impact education and health outcomes include household poverty, lack of economic independence, limited income-earning opportunities, illiteracy, violence, and social isolation. Younger adolescent girls who live in environments laden with these vulnerabilities are at risk of experiencing negative outcomes such as school dropout, early sexual initiation, unintended pregnancy, early marriage, and sexual and gender-based violence. The Adolescent Girls Initiative–Kenya (AGI-K) delivered multisectoral interventions to over 6,000 girls aged 11–15 in …

Stories Of Strength: Chicago Latin@S' Navigation Of Health, Well-Being, And Chronic Disease, Lilian L. Milanés

Theses and Dissertations--Anthropology

Health inequalities take many forms related to race, gender, socioeconomic status, ethnic, language and many other axes throughout communities around the world. Type two diabetes, high blood pressure, and high cholesterol are examples of conditions (among many others) that disproportionately affect Latino@s in the U.S.. The research of this dissertation is based on fieldwork conducted throughout several predominantly Latin@ neighborhoods in Chicago, IL. This dissertation examines how Latin@s in Chicago navigate health and well-being, and how they engage in agentive strategies in the face of chronic disease. I recorded individual life histories and semi-structured interviews, focus groups, and participant observation …

Addressing Barriers To Quality Of Underutilized Commodities And Services For Prevention And Management Of Pre-Eclampsia And Eclampsia In Kenya, Charity Ndwiga, Pooja Sripad, Charlotte E. Warren

Reproductive Health

The Ending Eclampsia Project seeks to increase access to quality, underutilized interventions and commodities for the prevention, detection, and management of pre-eclampsia and eclampsia (PE/E), including promoting correct use of antihypertensive drugs and magnesium sulphate (MgSO4). This final report details the findings of a qualitative study that explored health system bottlenecks that prevent access to quality maternal and newborn health care in two Kenyan counties, Kakamega and Kitui, with a specific focus on PE/E. The study explored policy implementation gaps in Kenya’s newly devolved county government structure, to:1) assess the policy and health system environment for PE/E diagnosis, referral, and …

How Are Educated Women In Ghana Regulating Fertility Without High Levels Of Modern Contraceptive Use?, Kazuyo Machiyama, Cicely Marston, Nancy Termini Lachance, Terence Adda-Balinia, Placide Tapsoba

Reproductive Health

While Ghana has made striking gains in enabling its women to use family planning to reduce family size—the total fertility rate shifted from 7.0 to 4.2 children per woman from the 1970s to the 2010s—the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) studies found that educated women in Ghana are achieving their fertility goals by limited use of highly effective contraceptive methods. Their fertility regulation strategies involve contraceptive method mosaics that have not been captured by the DHS. This evidence summary aggregates research from the STEP UP Research Programme Consortium along with other related evidence to explore this …

Expanding Access To Family Planning For Married Adolescent Girls In The Urban Slums Of Dhaka, Fauzia Akhter Huda, Nancy Termini Lachance

Reproductive Health

Early pregnancy is associated with adverse health, social, and economic consequences for girls, and Bangladesh has an adolescent fertility rate that is among the highest in the region. Poor, slum-dwelling girls are especially vulnerable. This policy brief outlines a project that icddr,b, a STEP UP project partner, initiated to test three innovative strategies aiming to support the unmet family planning needs of these girls. This brief concludes with government-level policy and program recommendations based on the evidence of this project for leveraging existing government health programs to better serve the needs of married adolescent girls and reduce their risks of …

Accelerating Uptake Of Voluntary, Rights-Based Family Planning In Developing Countries, Kazuyo Machiyama, Francis Obare, Venkatraman Chandra-Mouli, Doris Chou, Mario Festin, Rajat Khosla, James Kiarie, Lale Say, Nandita Thatte

Reproductive Health

This brief summarizes evidence on the benefits of family planning for girls and women, their children, families, and societies. It also provides evidence on the cost-effectiveness of family planning programs; discusses reasons for unmet need for contraception and identifies ways to reduce unmet need and discontinuation; and describes progress in meeting FP2020 and the Sustainable Development Goals (SDGs). To meet the FP2020 and SDGs, significant investments are required by countries and donors in the following priority areas: sustainable financing, reaching all adolescents, expanding availability of services to the poorest and hard-to-reach populations, improving the quality of services, increasing the range …

Expanding Contraceptive Choice, Heather Clark, Saumya Ramarao, Catherine Unthank, Kazuyo Machiyama, Nandita Thatte

Reproductive Health

Expanding the range of contraceptive options helps individuals to make choices appropriate to their needs and circumstances, allows them to switch from one method to another if desired, and reflects a program focus on quality and rights. This policy brief outlines policy and program considerations in order to establish and maintain well-functioning supply chains for an expanded choice of contraceptives: introducing new contraceptive technologies to satisfy the diverse preferences of women and their partners; overcoming access barriers to existing methods such as adverse economic and social circumstances, including gender norms; and maximizing the potential of expanded contraceptive choice by ensuring …

Ensuring Adequate Financing Of Family Planning Commodities And Services, Moazzam Ali, Benjamin Bellows

Reproductive Health

Increasing efficient and effective investment in family planning (FP) through the public and private sectors is key to meeting the FP2020 goal of helping 120 million additional women become modern contraceptive users. This policy brief identifies several policy and program considerations to ensure adequate financing of family planning commodities and services: sustained fundraising, pooling, and strategic purchasing; reaching new users and improving continuation rates among current users; and conducting further research on family planning quality performance metrics to test their correlation with higher continuation rates. Future efforts to reduce unmet need for FP must consider consumers’ out-of-pocket costs, programmatic cost-effectiveness, …

Reducing Early And Unintended Pregnancies Among Adolescents, Francis Obare, Caroline W. Kabiru, Venkatraman Chandra-Mouli

Reproductive Health

Interventions to reduce unmet need for contraception and early and unintended pregnancies among adolescents should be critical components of family planning programs in developing countries. This evidence brief highlights evidence and provides research and program considerations for improving access to family planning and reducing unintended pregnancy. It describes the following five elements that must be in place in order to apply evidence to large-scale, national-level programs: collect, analyze, and use accurate and up-to-date data; formulate or revise national laws and policies; develop national adolescent sexual and reproductive health strategies; implement strategies with careful monitoring; and conduct periodic program reviews.

Using Evidence To Improve Quality Of Pharmacy-Delivered Medical Abortion, Katharine Footman, Nancy Termini Lachance

Reproductive Health

The goal of family planning and reproductive health operations research is to generate evidence that helps policies and programs maximize access to and quality of services for women and their families. Yet the crucial step of ensuring the utilization of that evidence often receives inconsistent or inadequate attention. The goal of this case study is to document an activity of Marie Stopes International (MSI) in Kenya, part of the STEP UP research program consortium, which resulted in successful evidence utilization. STEP UP research on quality of care for medical abortion, particularly on pharmacy provision of medical abortion, has provided the …

Assessing The Feasibility And Acceptability Of Community Health Extension Workers To Treat Hypertension Associated With Pregnancy: An Analysis Of Post-Intervention Findings, Salisu Mohammed Ishaku

Reproductive Health

This brief reports on a study that tested the feasibility of tasking community health extension workers (CHEWs) with detecting and managing hypertension, and prescribing an oral antihypertensive drug at primary health care (PHC) facilities in Nigeria as part of a package of care for women with pre-eclampsia and eclampsia (PE/E). This evaluation measured improvements in knowledge retention and increases in early detection, prevention, and management of PE/E. Findings indicate that trained CHEWs working at intervention PHCs can correctly identify, differentiate, and manage normal, mild, moderate, and severe hypertension. These findings are important contributions to implementing Nigeria’s national task-shifting policy at …

Baseline Evaluation Of Project Mesha In Bihar: Factsheet Results 2017-2018, Population Council

Reproductive Health

This fact sheet presents baseline results for an evaluation survey among women who were the primary decisionmakers in the rearing of goats in Bihar, India. The study underpins the Aga Khan Foundation’s implementation of “Project Mesha,” a community-based program to develop the potential of goat farming among women goat rearers in four blocks of Muzaffarpur district. The aim of the project is to increase the income and empowerment of women goat rearers through the implementation of Project Mesha in JEEViKA-run self-help groups. The fact sheet includes data on demographic and household profiles; goat ownership, rearing, income, and productive resources; access …