Public Health Commons^™

Unintended Pregnancies In Kenya: A Country Profile, Joyce Mumah, Caroline W. Kabiru, Carol Mukiira, Jessica Brinton, Michael Mutua, Chimaraoke O. Izugbara, Harriet Birungi, Ian Askew

Reproductive Health

This research report presents a country profile of Kenya, and looks at differential access to and quality of family planning (FP) and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Since 2000, Kenya has passed several new sexual and reproductive health (SRH) and population-related policies, including a new population and development policy that addresses rapid population growth. Results of this country profile highlight the need for further research on: 1) innovative ways through which SRH information can be brought to schools; 2) FP/SRH indicators in people living with disabilities; …

Postpartum Family Planning In Burkina Faso, Marina Daniele

Reproductive Health

This is a formative study aiming to identify the main barriers to the provision and uptake of quality postpartum family planning (PPFP) services at the supply, access, demand, and policy levels in Burkina Faso. This study reveals that there are substantial shortfalls in the availability of quality PPFP at all these levels. Most of the difficulties observed in the provision of PPFP services are due to the failure to translate largely sound policies and guidelines into practice. This study contributes to identifying priority areas and makes recommendations for improvement in order to respond to unmet need for family planning in …

Summarizing Bodies Of Evidence On The Implementation And Effectiveness Of Fp/Rh Interventions, Ian Askew

Reproductive Health

No abstract provided.

Promoting Respectful Maternity Care: A Training Guide For Facility-Based Workshops—Participant's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. Workshop objectives outlined in the Participant’s Guide: Outline current status of maternal and neonatal health in relation to respectful care. Discuss key RMC concepts, terminology, legal and rights-based approaches related to respectful maternity care and …

Promoting Respectful Maternity Care: A Training Guide For Community-Based Workshops—Community Facilitator's Guide, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

This guide was produced as part of the Respectful Maternity Care (RMC) Resource Package. The Resource Package was designed to support health facility managers, health care providers, and communities in confronting disrespect and abuse (D&A) during facility-based childbirth and to promote respectful maternity care. The Resource Package includes a facilitator’s guide (facility-based workshops), facilitator’s guide (community-based workshops), participant’s guide, community flipchart, tools, and program briefs. The Community Facilitator’s Guide, designed to be used by facilitators to promote respectful maternity care at the community level, can be adapted to educate a variety of stakeholders in community settings (i.e., Community Health Extension …

Promoting Respectful Maternity Care (Rmc) At Birth: Orientation For Community-Based Workshops, Population Council

Reproductive Health

The goal of “Promoting Respectful Maternity Care (RMC) at Birth: Orientation for Community-Based Workshops” is to orient community-health workers on the RMC concept. Objectives of the workshop as indicated in this slide deck are: Outline the current status of maternal health in relation to RMC. Discuss rights-based approaches related to RMC. Discuss selected strategies that reduce disrespect and abuse (D&A). Discuss the role of the community in promoting RMC. Demonstrate knowledge and use of the Alternative Dispute Resolution mechanism. Develop action plans to support the implementation of RMC interventions at the community level. Summary: D&A deters facility-based childbirth and Skilled …

Preventing Childhood Obesity: A Mixed Methods Study Into The Perceptions Of African Americans In A Rural Community, Dayna S. Alexander

College of Graduate Studies: Theses & Dissertations

Preventing childhood obesity is a global priority due to adverse health risks and financial burdens. With childhood obesity rates stabilizing it is difficult to determine which factors alone (i.e., genetic, environmental, behavioral, or demographic) increase susceptibility to childhood obesity. Parents influence childhood obesity risk factors through their parenting styles and behaviors. Social behavioral theories and public health evidence demonstrate including parents in childhood obesity efforts could assist in reducing childhood obesity rates. The objective of this study was to assess perceptions of childhood obesity among African Americans with children enrolled in a rural elementary school in the Deep South. The …

Unintended Pregnancy By The Numbers: A Look At Kenya, Carol Mukiira, Joyce Mumah, Caroline W. Kabiru, Chimaraoke O. Izugbara

Reproductive Health

This fact sheet summarizes data collated during the development of the STEP UP Country Profile Report on Unintended Pregnancies for Kenya, which presents a range of key evidence aimed at informing readers about the trends, magnitude, determinants, and consequences of unintended pregnancy in Kenya. The data shown in this fact sheet are drawn mainly from the 1993, 1998, 2003 and 2008/09 Kenya Demographic and Health Surveys (KDHS) as well as other secondary sources.

Maternal And Newborn Health Behaviors In Rural Uttar Pradesh: Findings From Learning Phase Baseline Survey 2013, M.E. Khan, Praween Kumar Agrawal, Avishek Hazra, Anvita Dixit, Isha Bhatnagar, Jaleel Ahmad, D.N. Ahmad

Reproductive Health

The Uttar Pradesh Community Mobilization Project (2011–16) aims to develop and scale up evidence-based interventions to improve reproductive, maternal, neonatal, and child health and nutrition health behaviors by an average of 10 percentage points among marginalized populations in Uttar Pradesh, India. The goal is to reduce neonatal mortality by improving maternal and child health behaviors through developing and scaling up a package of family health interventions and strengthening the management of Behavior Change Communication using self-help groups as the platform. The project is being carried out in two phases—a learning phase covering 10 blocks and a scale-up phase covering 100 …

Optimism And Planning For Future Care Needs Among Older Adults, Silvia Sörensen, Jameson K. Hirsch, Jeffrey M. Lyness

ETSU Faculty Works

Aging is associated with an increase in need for assistance. Preparation for future care (PFC) is related to improved coping ability as well as better mental and physical health outcomes among older adults. We examined the association of optimism with components of PFC among older adults. We also explored race differences in the relationship between optimism and PFC. In Study 1, multiple regression showed that optimism was positively related to concrete planning. In Study 2, optimism was related to gathering information. An exploratory analysis combining the samples yielded a race interaction: For Whites higher optimism, but for Blacks lower optimism …

Libertarian Patriarchalism: Nudges, Procedural Roadblocks, And Reproductive Choice, Govind Persad

Georgetown Law Faculty Publications and Other Works

Cass Sunstein and Richard Thaler's proposal that social and legal institutions should steer individuals toward some options and away from others-a stance they dub "libertarian paternalism"-has provoked much high-level discussion in both academic and policy settings. Sunstein and Thaler believe that steering, or "nudging," individuals is easier to justify than the bans or mandates that traditional paternalism involves.

This Article considers the connection between libertarian paternalism and the regulation of reproductive choice. I first discuss the use of nudges to discourage women from exercising their right to choose an abortion, or from becoming or remaining pregnant. I then argue that …

Influences Of Maternal Stress During Pregnancy On The Epi/Genome: Comparison Of Placenta And Umbilical Cord Blood, Jia Chen, Qian Li, Alexender Rialdi, Elana Mystal, Jenny Ly, Jackie Finik, Taira Davey, Luca Lambertini, Yoko Nomura

Publications and Research

Background: Maternal stress during pregnancy is one of the major adverse environmental factors in utero that is capable of influencing health outcomes of the offspring throughout life. Both genetic and epigenetic processes are susceptible to environmental insults in utero and are potential biomarkers of the experienced environment including maternal stress.

Methods: We profiled expression level of six genes in hypothalamic pituitary adrenal (HPA) axis functioning (HSD11B2, SLC6A4, NR3C1, NR3C2, CRHR1 and CRHR2), two imprinted genes (IGF2 and H19) and one neurodevelopmental gene (EGR1), from 49 pairs of placenta and umbilical cord blood (UCB) samples from a birth cohort. We also …

Massachusetts Healthy Aging Data Report: Community Profiles, Elizabeth Dugan, Frank Porell, Nina Silverstein, Ruth Palombo, Stacey Mann

Gerontology Institute Publications

The Massachusetts Healthy Aging Data Report: Community Profiles was created by researchers at the Gerontology Institute of the John W. McCormack Graduate School of Policy and Global Studies at the University of Massachusetts Boston and commissioned by the Tufts Health Plan Foundation.

In this report, we have created a custom profile of nearly 100 healthy aging indicators for every city and town in Massachusetts including the 16 neighborhoods of Boston (367 Community Profiles). Each Community Profile is designed to help community residents, agencies, providers, and governments understand the older adults who live in their cities and towns – their ages, …

Evaluation Of The Jewish Community Housing For The Elderly Memory Support Initiative, Joan Hyde

Gerontology Institute Publications

Jewish Community Housing for the Elderly (JCHE) is a large, multi-campus organization that houses and serves 1,500 residents (80 market rate and 1,420 low income). The average age is 80 years old, with one-third of residents 85 and older. Three quarters of the residents are not native English speakers. Through HUD and other funding, JCHE offers a range of supports to these residents, including translators, interpreters and staff with language and cultural competence, meals, transportation and, through their Service Coordinators, facilitation of resident access to government benefits, home care and other services.

According to the Alzheimer’s Association’s 2012 special report …

Assessing Transgender Attitudes Toward Health Care: Can These Attitudes Help Predict Health Outcomes?, Sara M. Shane

PCOM Psychology Dissertations

Research has identified the fact that race/ethnicity, sexual orientation, gender identity, socioeconomic status, education level, geographic location, help seeking behaviors, and experiences of discrimination are associated with health outcomes. In addition, attitudes towards providers can also help determine health outcomes. The transgender community experiences barriers to health care services and therefore their overall health is affected. There is not a sufficient amount of literature that assesses, using standardized measure, the attitudes of the transgender community and their health. The present study will assess the attitudes of the transgender community toward health care (mental and medical health) and, using standardized measures, …

Study On Private Health Insurance Coverage For Adults Under 65: 34 States From 2003 To 2010, Weisheng Gu

MPA/MPP/MPFM Capstone Projects

Objectives: The analysis in this paper is designed to find out what factors contributed to the change of uninsured rate of people aged between 18 and 65 from 2003 to 2010.

Method: A fixed-effect analysis with panel data is conducted. The analysis unit is state. The main independent variable is the private health insurance cost per enrollee per year. The private insurance cost data covered 34 states sampled in Medical Expenditure Panel Survey from 2003 to 2010.

Key finding: The private insurance cost per enrolled adult below 65, private insurance cost per enrolled adult below 65 as a proportion of …

Health Behaviors Among College Students: The Influence Of Future Time Perspective And Basic Psychological Need Satisfaction, Preston L. Visser, Jameson K. Hirsch

ETSU Faculty Works

Health behavior change may prevent many fatal diseases, and may be influenced by social and motivational constructs. We assessed the interaction effect of future time perspective and basic psychological need fulfillment on positive and negative health behaviors. Future time perspective was associated with more positive, and less negative, health behaviors. Need fulfillment was associated with only positive health behaviors. In moderation analyses, individuals reporting both high need fulfillment and future perspective reported greater positive health behaviors, and were especially unlikely to smoke. Enhancing future-mindedness and supporting need satisfaction in interventions targeting modifiable health behaviors is encouraged.

The Global Health Security Agenda In An Age Of Biosecurity, Lawrence O. Gostin, Alexandra Phelan

Georgetown Law Faculty Publications and Other Works

Historically, the Oval Office has been a leader in global health assistance. From the President’s Emergency Plan for AIDS Relief (PEPFAR) and the President’s Malaria Initiative (PMI) under the Bush Administration, to the Global Health Initiative launched by President Obama in 2009. However, unlike PEPFAR and PMI, the Global Health Initiative met an untimely end with the launch of a bold new global health measure by the Obama Administration: the Global Health Security Agenda (GHS Agenda). The GHS Agenda aims to “accelerate progress toward a world safe and secure from infectious disease threats” through a US-led diplomatic collaboration with 30 …

The Impact Of Prostate Cancer On Survivors' Sense Of Meaning In Life, Carol Lynn Brady

Walden Dissertations and Doctoral Studies

Research has shown that meaning in life is a universal human need, regardless of cultural identity or education. This research study investigated how the encounter with prostate cancer impacted men's sense of well-being and what they considered meaningful in life. An interpretative phenomenological research design was used because of its descriptive nature and its focus on the individual's perspective. The sample included 6 men between the ages of 18 and 65 who had been out of treatment for 1 year. Participants completed essays about their perceptions and experiences over 3 periods of time: before diagnosis, during treatment, and as survivors. …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

Inspiring Change: Exercise Self-Efficacy, Dispositional Optimism, And Perceived Stress In College Seniors, Joshua M. Garrin

Walden Dissertations and Doctoral Studies

Prohealth competencies, positive outcome expectancies, and adaptive stress appraisals have profound implications for the real-world transition of college seniors—a population for which engagement in physical activity reflects a preeminent concern. Prior studies on exercise self-efficacy (ESE), dispositional optimism (DO), perceived stress (PS), and physical activity have yielded inconclusive evidence of the emergent psychosocial challenges encountered during the final year of the college experience. Using a triadic framework of self-efficacy, attribution, and cognitive appraisal theories, this crosssectional, quantitative study was conducted using a web survey to examine (a) the impact of physical activity level on ESE, DO, and PS; (b) the …

Structural And Functional Support In The Prediction Of Smoking Cessation In Caregivers Of Children With Asthma, Erin M. Tooley, Andrew Busch

Arts & Sciences Faculty Publications

Caregivers of children with asthma smoke at a rate similar to the general population. Research on the relative importance of structural or functional social support in smoking cessation has been mixed. Participants were smokers (N=154) who were caregivers of children with asthma. Both functional (perception of social support measured by the Interpersonal Support Evaluation List) and structural social support (living with another smoker, partner status, and the proportion of smoking friends) were measured at baseline. Participants received an asthma-education and smoking cessation intervention based on Motivational Interviewing. Biochemically-verified abstinence was assessed at 6-months post treatment. Hierarchical logistic regression analyses indicated …

Effects Of A Classroom Curriculum On Physical Activity And Its Psychological Predictors In High School Students, John Trinity Edd, James J. Annesi Ph.D.

Journal of Social, Behavioral, and Health Sciences

Recent research indicates that recommended amounts of physical activity suggested for health benefits are rarely met in high-school–age adolescents. A pilot study was conducted to investigate the effects of a classroom health-education–based curriculum intervention on the physical activity of high school students. A within-group research design was used on data from a sample of ninth grade boys and girls (N = 104) who received six classroom health education lessons over 5 weeks based on social cognitive theory. The lessons focused on improvements in the theory-based psychological variables of mood, body satisfaction, physical self-concept, and exercise self-efficacy. Mixed-model repeated-measures ANOVAs …

Finding Them Before They Find Us: Informatics, Parasites, And Environments In Accelerating Climate Change, Daniel R. Brooks, Eric P. Hoberg, Walter A. Boeger, Scott Lyell Gardner, Kurt E. Galbreath, David Herczeg, Hugo H. Mejía-Madrid, S. Elizabeth Rácz, Altangerel Tsogtsaikhan Dursahinhan

Harold W. Manter Laboratory of Parasitology: Faculty Publications

Parasites are agents of disease in humans, livestock, crops, and wildlife and are powerful representations of the ecological and historical context of the diseases they cause. Recognizing a nexus of professional opportunities and global public need, we gathered at the Cedar Point Biological Station of the University of Nebraska in September 2012 to formulate a cooperative and broad platform for providing essential information about the evolution, ecology, and epidemiology of parasites across host groups, parasite groups, geographical regions, and ecosystem types. A general protocol, documentation–assessment–monitoring–action (DAMA), suggests an integrated proposal to build a proactive capacity to understand, anticipate, and respond …

Factors Influencing U.S Army Personnel Meeting Body Mass Index Standards, Salma Theus

Walden Dissertations and Doctoral Studies

Factors Influencing U.S. Army Personnel Meeting Body Mass Index Standards

by

Salma Theus

MS, California State University, Dominguez Hills, 2008

BA, La Sierra University, 2005

Dissertation Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Philosophy

Psychology

Walden University

September 2014

U.S. Army Regulations require soldiers to be fit, as excessive weight negatively impacts their readiness, health, and morale. A quantitative study examined if personal, behavioral, and/or environmental factors predict a soldier's self-efficacy and body mass index. Data were obtained from 117 soldiers on 6 scales: the Armed Services Vocational Aptitude Battery, the Army Physical Fitness …

Physician As Teacher: Promoting Health And Wellness Among Elementary School Students, Jill E. Stefaniak, Victoria C. Lucia

STEMPS Faculty Publications

BACKGROUND: Every day, physicians engage in teaching during their patient encounters. It may be that medical students who are introduced to the principles of teaching and learning are more likely to become good communicators and learners. Service-learning may be an effective way for medical students to practice skills in teaching and communication in a real-world setting, while also filling a need within the community. The purpose of this study was to identify common themes within medical students' reflections on what they learned through participating in a teaching exercise with local elementary school children.

METHODS: As a required component of a …

Public Health Emergencies: What Counts?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccines and drugs to prevent and treat Ebola Virus Disease that have never been tested in humans, and in scarce supply raise profound ethical challenges. What if good evidence emerged demonstrating safety and efficacy of drugs? What would be an ethical method of allocating scarce beneficial resources? The apparent preference given to foreign aid workers over West Africans provoked a firestorm. In addition to discussing the ethical allocation of scarce drugs, this article also asks a more fundamental question: Why did it take nearly 40 years after the first Ebola outbreak in 1976 to launch clinical trials?

Disparities In Adverse Childhood Experiences And Sexual Health In The Us: Results From A Nationally Representative Sample, Monique J. Brown

Theses and Dissertations

Background: Adverse childhood experiences (ACEs) are a major public health problem in the US, and have been linked to risky sexual behavior and psychopathology. However, studies examining the link between the wide range of ACEs and sexual health outcomes and behaviors, and the associated mediational role of psychopathology are lacking.

Objectives: The main objectives of this dissertation project were: 1) To determine the association between ACEs and sexual health outcomes and behaviors (early sexual debut, intimate partner violence (IPV) perpetration, and HIV/STIs); 2) To examine the disparities among selected populations; and 3) To assess the mediational role of psychopathology in …

Stress Management For Cancer Survivors Using A Technologically Adapted Psychosocial Intervention: A Randomized Trial Determining The Effect Of Expressive Writing On Psychoneuroimmunology Based Outcomes, Utkarsh B. Subnis

Theses and Dissertations

Patients with cancer transitioning from completing their final cancer treatments to survivorship are particularly at risk for experiencing psychosocial stress, and the Institute of Medicine (IOM) has referred to these cancer patients as “lost in transition.” In this study, patients with cancer in their transition phase after completing their final radiation treatment were defined as cancer survivors (CS). CS must deal with chronic stressors such as the fear of cancer recurrence as well as the resumption of their roles in their family and work lives. Chronic stress impacts the nervous system and increases secretion of stress hormones (e.g. cortisol) from …

Legalization Of Medical Marijuana In Minnesota: Implications For Rural Substance Treatment Centers, Ann Przybilla

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this project was to identify the anticipated impacts of legalization of medical marijuana (cannabis) in Minnesota on rural substance abuse treatment center professionals. The goal is to utilize the implications of those impacts to guide the implementation of the recently passed legislation and to provide recommendations for future policy regarding medical marijuana in Minnesota.