Public Health Commons^™

How Do Communities Proactively Address Lead Remediation? : Community Case Studies From Iowa, Dr. Angie L. Carter, Emma Nordmeyer

2016-2017: Scott County, Iowa and the Scott County Health Department

In 2016, Scott County Health Department officials reached out to the Sustainable Working Landscapes Initiative (SWLI) program at Augustana College to begin a partnership addressing lead poisoning in our community. Teams of students in the Fall 2016 Contemporary Social Issues class conducted sociological case studies of communities in Iowa that are proactively addressing lead remediation through combinations of United States Department of Housing and Urban Development (HUD) and private funding. Groups of students conducted case studies in Dubuque, Linn, Polk, Marshall, and Black Hawk counties in Iowa. Students researched the demographics of these areas as well as successes, lessons learned, …

Exploring Alternative Funding Methods For The Lead Remediation Program In Scott County, Iowa, Dr. John Delaney, Brittany A. Poynor

2016-2017: Scott County, Iowa and the Scott County Health Department

Lead poisoning is an environmental as well as social problem. Areas with more older housing and higher rates of poverty are also the areas with the most lead poisoned children. Though the United States banned the use of lead paint in in 1978 and lead poisoning is preventable, lead poisoning remains a public health problem. Homes built before 1978 may pose risk of lead paint exposure, but of special concern to Scott County are the number of homes built before 1950.

Scott County, Iowa is home to some of the oldest housing units in the U.S. Iowa ranks fifth among …

Fighting Lead Poisoning With Food, Brenna Whisler, Tracy Ngo

2016-2017: Scott County, Iowa and the Scott County Health Department

No abstract provided.

Liberia : Maternal Health & Ebola, Chelsey Hernandez

Global Public Health

Throughout the world, many low-income countries suffer from poor nutrition, lack of health resources, and little to no access to other valuable resources. Previous research has demonstrated the poor state of health in Liberia as a result of these various socioeconomic factors. Although Liberia faces many public health issues, the 2014 Ebola epidemic reversed whatever progress was made. Maternal and child health in particular has severely decreased, especially in recent years. This brief focuses on the impact of the 2014 Ebola epidemic had on maternal health.

Christians’ Cut: Popular Religion And The Global Health Campaign For Medical Male Circumcision In Swaziland, Casey Golomski, Sonene Nyawo

Anthropology

Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom’s three ecumenical organisations, showing how a diverse group people singly glossed as ‘Christian’ in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision’s promotion and …

Law-Based Arguments And Messages To Advocate For Later School Start Time Policies In The United States, Clark J. Lee, Dennis M. Nolan, Steven W. Lockley, Brent Pattison

Homeland Security Publications

The increasing scientific evidence that early school start times are harmful to the health and safety of teenagers has generated much recent debate about changing school start times policies for adolescent students. Although efforts to promote and implement such changes have proliferated in the United States in recent years, they have rarely been supported by law-based arguments and messages that leverage the existing legal infrastructure regulating public education and child welfare in the United States. Furthermore, the legal bases to support or resist such changes have not been explored in detail to date. This article provides an overview of how …

Cardiovascular Disease Risk Factors Related To Shift Work Among Korean Workers Aged From 30 To 49 Years, Su Jung Choi, Yeon Sook Kim, Eunok Park

Nursing Faculty Publications

This study was to compare health behaviors between day workers (DW ) and shift workers (SW), and to investigate the cardiovascular disease (CVD) risk factors among 30-49 years Korean workers. SW showed higher prevalence of smoking than DW. The proportion of adequate sleep was lower in SW than in DW. DW showed high.er prevalence of impaired fasting glucose, however, there were no significant differences in hypertension, obesity, hypercholesterolemia, and metabolic syndrome between DW and SW. Further research is recommended to include mediating factors such as organizational culture or working time, etc., for scrutinizing the association between work type and CVD …

Evaluation Of The Pepfar/Usaid Asibonisane Community Responses Program In Kwazulu-Natal, South Africa, Project Soar

HIV and AIDS

Few programs intended to improve HIV outcomes or modulate gender norms have been rigorously evaluated in South Africa’s informal settlements where nearly 400,000 people live in KwaZulu Natal province alone. There is limited evidence on how to implement large-scale HIV-prevention programming in these contexts. Project SOAR and partners are addressing these knowledge gaps by conducting an evaluation of the PEPFAR/USAID-funded Asibonisane Community Responses Program in South Africa. Specifically, the study will assess the effectiveness of this community-based HIV-prevention program in informal settlements throughout KwaZulu-Natal—one of four provinces where the program is being carried out. This study aims to influence the …

Private Sector Costing Of Voluntary Medical Male Circumcision In South Africa, Michel Tchuenche, Steven Forsythe

HIV and AIDS

In 2010, after voluntary medical male circumcision (VMMC) had been shown to be one of the most cost-effective strategies for preventing HIV infections, South Africa initiated a VMMC program with an ambitious target of performing 4.3 million circumcisions by 2016. However, because of a gap in knowledge concerning the overall cost of scaling up services, the South African National Department of Health requested that Project SOAR—Supporting Operational AIDS Research—conduct a private-sector costing of providing VMMC services in South Africa. The findings presented in this report provide a detailed investigation, through a comprehensive bottom-up approach, of the costs to private providers …

Stakeholder Considerations For Prep Introduction To Adolescent Girls And Young Women: Laying The Groundwork For Research Utilization In Tanzania, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council is conducting an implementation science research study in that country to build needed evidence to inform decisionmaking around oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) aged 15–24. The study uses quantitative and qualitative methods to gather data from AGYW, policymakers and other stakeholders, health providers, and AGYW’s parents and male partners to: assess their knowledge and attitudes toward oral PrEP; determine opportunities and approaches for providing PrEP; and identify potential facilitators and barriers to PrEP introduction and use. …

Training Us Health Care Professionals On Human Trafficking: Where Do We Go From Here?, Clydette Powell, Kirsten Dickins, Hanni Stoklosa

Pediatrics Faculty Publications

Some 21 million adults and children are labor-trafficked or sex-trafficked through force, fraud, or coercion. In recognition of the interface between trafficking victims and the healthcare setting, over the last 10 years there has been a notable increase in training of health care professionals (HCPs) on human trafficking (HT) and its health implications. Many organizations have developed curricula and offered training in various clinical settings. However, methods and content of this education on trafficking vary widely, and there is little evaluation of the impact of the training. The goal of this study was to assess the gaps and strengths in …

Policymakers' Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

There is limited evidence from Tanzania to inform decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW). To help fill this evidence gap, the Population Council in collaboration with the National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district (Dar es Salaam) and one rural district (Mbeya) in Tanzania to explore policymakers’ and key stakeholders’ perceptions and attitudes toward the introduction of PrEP to different groups, including AGYW, as well as to identify key issues that must be considered prior to its introduction. …

Training Locally Elected Representatives To Act As Change Agents To Promote Egalitarian Gender Norms: Lessons Learned From The Do Kadam Barabari Ki Ore Programme—Policy Brief, K.G. Santhya, Shireen J. Jejeebhoy

Poverty, Gender, and Youth

This policy brief describes an intervention, the Do Kadam Barabari Ki Ore (Two Steps Towards Equality) project in Patna district, India that sought to train locally elected representatives to act as change agents to promote egalitarian gender norms among men and women in their communities, and the effects of exposure to the project among members of the Panchayati Raj Institutions (PRIs, local self-governance bodies) and men and women from the community. The project was undertaken by the Population Council, together with partners, the Centre for Catalysing Change and the London School of Hygiene and Tropical Medicine, and with support from …

Adolescent Girls And Young Women’S Perceptions Of Oral Pre-Exposure Prophylaxis Introduction In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council, in collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing pre-exposure prophylaxis (PrEP) antiretroviral medication to adolescent girls and young women (AGYW) at substantial risk of HIV infection. This brief presents results from qualitative in-depth interviews and focus group discussions with AGYWs. Based on the findings, the brief recommends including sensitization and education of communities, parents, and male partners of AGYWs in demand-creation activities; training providers to deliver adequate education about PrEP to avoid misperceptions about its intended use, side effects, and …

Are We Meeting The Hiv Service Needs Of People Living In Informal Settlements In Kwazulu-Natal, South Africa?, Project Soar

HIV and AIDS

This brief summarizes the characteristics and circumstances of approximately 1,500 men and women living in 18 informal settlements in KwaZulu-Natal, South Africa. The data come from a baseline survey conducted in mid-2017 as part of an evaluation of the PEPFAR/USAID-funded Asibonisane Community Responses program. Project SOAR/Population Council conducted the evaluation in partnership with the MatCH Research Unit at the University of Witwatersrand. The findings presented here highlight the need for HIV treatment services to be more responsive to residents living with HIV in informal settlements. Furthermore, continued efforts are needed to reduce HIV risk and intimate partner violence among young …

Assessing Hiv-Related Outcomes Among Key Populations Accessing Community-Based Test And Start Services In Nigeria, Project Soar

HIV and AIDS

This activity brief describes a research study Project SOAR is conducting to better understand how to use existing key population community platforms in Nigeria to expand access to HIV treatment, the cost of such care provided outside of clinical health facilities, and the extent to which false positive misclassification may occur in outreach settings. Given the global “treat all” emphasis and the need to effectively scale up test and start services and minimize misclassification rates, these findings will be important in expanding timely antiretroviral treatment coverage in vulnerable communities in Nigeria and elsewhere.

Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Kenya, Population Council

HIV and AIDS

The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Kenya and similar ones in Zambia and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW’s vulnerability to HIV.

Assessment Of Comprehensive Hiv-Risk Reduction Programming For Adolescent Girls And Young Women: Implementation Science Research In Zambia, Population Council

HIV and AIDS

The Population Council is conducting implementation research to build needed evidence to inform decisionmaking around effective implementation of community-based, girl-centered interventions and to assess their effectiveness in reducing HIV vulnerability among adolescent girls and young women (AGYW)—a population in which AIDS is the leading cause of death in the region. Learnings from this study in Zambia and similar ones in Kenya and Malawi will be valuable for informing each country and the region how to implement AGYW programming that goes beyond the health sector to reduce AGYW's vulnerability to HIV.

Assessment Of The Implementation Of The Treat-All Guidelines (Test And Start) In Namibia, Project Soar

HIV and AIDS

The Government of Namibia has adopted “treat-all” guidelines, commonly referred to as test and start (TnS), as a national policy effective April 2017. These guidelines recommend that anyone who has tested positive for HIV should begin antiretroviral therapy (ART) as soon as possible. This brief describes the proposed research of a study team led by the Population Council to generate evidence on how the national rollout of the TnS guidelines and decentralization of ART services affect client-level treatment outcomes, quality of ART services, and treatment costs in Namibia. The results of this study will inform the implementation and scale-up of …

Characteristics Associated With Hiv And Hsv-2 Among Adolescents In Malawi, Barbara Mensch, Erica Soler-Hampejsek

HIV and AIDS

The DREAMS (Determined, Resilient, Empowered AIDS-free, Mentored, and Safe) partnership aims to significantly reduce new HIV infections in adolescent girls and young women (AGYW) in Malawi and other sub-Saharan African countries. To better understand the epidemiological context for the DREAMS programming, Project SOAR analyzed previously collected quantitative cohort data from the Population Council’s Malawi Schooling and Adolescent Study to identify the factors associated with the prevalence and incidence of HIV and the herpes simplex virus, commonly referred to as genital herpes. SOAR’s analysis provides a deeper understanding of the epidemiological and gendered context of the HIV epidemic in Malawi. This …

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Hiv Services: Implementation Science Research In Swaziland, Population Council

HIV and AIDS

The Population Council is conducting implementation research in Swaziland, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Uganda, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Swaziland and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In South Africa, Population Council

HIV and AIDS

The Population Council is conducting implementation research in South Africa, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in Uganda, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in South Africa and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.

Effective Engagement Of Male Partners Of Adolescent Girls And Young Women In Uganda, Population Council

HIV and AIDS

The Population Council is conducting implementation research in Uganda, in collaboration with local partner organizations, to learn more about men’s relationships with adolescent girls and young women (AGYW) and how HIV services can better engage them—two neglected areas of research. Similar studies are being conducted in South Africa, Swaziland, and Malawi. Learnings from these studies will be valuable for informing ongoing programming in Uganda and the region, as well as HIV prevention, care, and treatment efforts for AGYW and their male partners globally, particularly in this era of test and start.

Evaluation Of The “One Community” Program In Malawi, Project Soar

HIV and AIDS

“One Community” is the United States Agency for International Development’s flagship community-based response to Malawi’s HIV epidemic. The primary objective of One Community is to support the government’s efforts to reduce new infections and to mitigate the impact of HIV among orphans and vulnerable children, out-of-school adolescent girls and young women, and other at-risk populations in eight districts in the southern region of Malawi. Project SOAR is conducting a rigorous evaluation of One Community in five of the eight program districts. The results from this evaluation will be used to inform Malawi’s support strategies for at-risk populations, improve the United …

Introducing Oral Pre-Exposure Prophylaxis To Adolescent Girls And Young Women In Tanzania: Overview Of Findings From Implementation Science Research, Population Council

HIV and AIDS

The Population Council in collaboration with Tanzania’s National AIDS Control Program and CSK Research Solutions Limited conducted implementation science research in one urban district and one rural district in the country, to provide needed evidence for informing decisionmaking on whether and how to introduce oral pre-exposure prophylaxis (PrEP) to adolescent girls and young women (AGYW) in Tanzania. The aims of the research were to: assess the acceptability of PrEP among AGYW, their male partners, their parents/guardians, healthcare providers, and policymakers; determine the feasibility of and opportunities for providing PrEP to AGYW; and identify key facilitators and barriers to PrEP introduction …

Improving Uptake Of Hiv Testing Services And Linkage To Care After Diagnosis In Kenya, Project Soar

HIV and AIDS

Project SOAR is conducting two complementary research activities in Kenya, to 1) understand the barriers to and facilitators of HIV testing among men seeking HIV testing services, and 2) to develop and pilot test an HIV post-test assessment tool to promote linkage to HIV care and treatment among newly diagnosed HIV-positive clients. This study will provide needed information to help Kenya and other countries that are scaling up test and start programs to develop effective strategies to increase uptake of HIV testing services among men and linkage to care and treatment among all newly diagnosed HIV-positive clients.

Optimizing Community Services For An Improved Continuum Of Hiv Care, Project Soar

HIV and AIDS

Project SOAR, together with Aurum Institute, is conducting research in Ekurhuleni District and Bojanala District in South Africa to improve the availability of effective care continuum services to meet the communities’ HIV treatment needs. The two districts have a combined population of 3.6 million inhabitants and approximately 350 public clinics and hospitals. Through improved information on community HIV care services and their relationship to care continuum outcomes, the study will provide valuable new knowledge about service gaps and approaches to planning and delivering services that best achieve HIV treatment goals.

Preventing Pediatric Tuberculosis: A Randomized Trial Of Symptom-Based Screening Of South African Children Exposed To Tuberculosis, Population Council

HIV and AIDS

In South Africa, a country with one of the highest levels of HIV prevalence, HIV-positive adults are the source case for a large proportion of pediatric tuberculosis (TB) cases. Unfortunately, TB index cases are not consistently asked about their child contacts, not all child contacts present to the clinic for TB screening, and it remains unknown what proportion of child contacts receive isoniazid preventive therapy (IPT)—a highly effective treatment for preventing TB in these children, long recommended by the World Health Organization. Project SOAR is assessing whether a symptom-based screening approach by TB nurses in community health clinics is more …

Men's Perceptions Of Prep Use By Their Adolescent And Young Adult Female Partners In Tanzania In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

Prevailing gender norms about sexuality and relationship power dynamics have been shown to affect how women make decisions about the use of sexual and reproductive health products, including microbicides, condoms, and other contraceptives. It is therefore important to understand male partners’ views of oral pre-exposure prophylaxis (PrEP) to inform how to effectively introduce PrEP among adolescent girls and young women (AGYW) in Tanzania to ensure they use it correctly and consistently. The Population Council, in collaboration with the National AIDS Control Programme and CSK Research Solutions Ltd., conducted implementation science research in Tanzania to identify key considerations for introducing PrEP …

Providers' Views On Prep For Adolescent Girls And Young Women In Tanzania: Findings From Implementation Science Research, Population Council

HIV and AIDS

In collaboration with the Tanzania National AIDS Control Programme and CSK Research Solutions Ltd., the Population Council conducted an implementation science research study to identify key considerations among healthcare providers for oral pre-exposure prophylaxis (PrEP) introduction to adolescent girls and young women (AGYW) in an urban and a rural setting in Dar Es Salaam and Mbeya districts, respectively. This brief presents results from a survey and in-depth interviews conducted with healthcare providers in each setting, assessing their knowledge, attitudes, and perceptions about PrEP; willingness to prescribe PrEP to AGYW; and perceived barriers and facilitators to providing PrEP to AGYW. The …