Public Health Commons^™

Show Me: Effectively Collaborating With Community Partners To Develop Students' Macro-Practice Skills, Rashida Crutchfield, Simon Funge

Social Work Faculty Publications

No abstract provided.

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

Cultural Competence: New Conceptual Insights Into Its Limits And Potential For Addressing Health Disparities, Shireen S. Rajaram, Susan Bockrath

Journal of Health Disparities Research and Practice

The increasing interest in the role of racism and racialization in health disparities, calls for exploring new paradigms in addressing and eliminating health disparities related to race/ethnicity. Cultural competence is conceptualized as one of the keys ways to address racial/ethnic disparities in public health and healthcare. However, for cultural competence to fulfill this role, it requires a critical understanding of the underlying socio-political and economic processes of power, privilege and institutional racism that create, support and maintain existing health disparities. This paper outlines how the concept of cultural competence can be made more robust, by incorporating concepts such as Public …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

The Effects Of Environmental Prompts On Stair Usage, Lori Andersen, Tim Bungum, Sheniz Moonie Phd

Nevada Journal of Public Health

Experts have advocated exercise with little success, and have turned to encouraging physical activity by incorporating it into daily activities such as taking the stairs over elevators. Much literature exists suggesting that environmental prompts can encourage the use of stairs and literature has established that some messages may be more effective than others. This study aimed to assess the effects of selected signage prompts on stair usage. Methods: Stair and elevator use were monitored in three, two-story buildings. One building served as a control, while a fitness message was placed in another building, and the final building received a weight …

Environmental Health In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

There are a multitude of environmental factors that influence public health. The purpose of this manuscript is to evaluate the Southern Nevada community with respect to environmental conditions and health, including both positive and negative traits, and develop realistic goals and strategies aimed at improving these conditions. Southern Nevada is located in one of the most arid regions of North America. Since annual rainfall averages less than four inches per year, Southern Nevada depends upon the Colorado River for its water supply. It is predicted that water flow to the area will decrease by 5% to 20% by 2050. As …

Use Of Craigslist.Org To Hook Up: Age Differences In Sex Requests, Hiv Disclosure And Negotiated Safety Among Men-Seeking-Men, Kristen Clements-Nolle, Aliya Buttar, Lindsey Dermid-Gray, Tyler Peterson, Andrea Esp

Nevada Journal of Public Health

Data from 984 “men-seeking-men” Craigslist.org postings in five cities were analyzed to assess differences in sexual requests, HIV status disclosure, and negotiated safety between young (18-24 years) and older (25 years and older) men who have sex with men (MSM). Young MSM were less likely than older MSM to post their HIV status or the preferred status of a partner (p=0.04), disclose and/or request a partner who was disease and drug free (p=.01), and request use of a condom in their posting (p=0.01). Interventions aimed at changing the culture and content of postings on Craigslist.org by encouraging HIV status disclosure …

Community Health Indicators In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Shawn Gerstenberger

Nevada Journal of Public Health

Community design and access to services are essential components of healthy and sustainable communities. The purpose of this manuscript is to evaluate Southern Nevada with respect to community design and access, including both positive and negative traits, and to suggest realistic changes that could be made to improve these conditions. The region’s network of parks and open space recreation areas is one of its strongest assets. Clark County enjoys over 42 million acres of federal and state lands which offer a large variety of recreational opportunities. The region has an extensive trail system, with a total of 179 miles of …

Effective Smoking Cessation Methods Among Smokers With Diabetes In Nv, Salome Kapella-Mshigeni, Eunice Kimunai, Peter Anderson, Elizabeth Fildes, Tam Villar

Nevada Journal of Public Health

Smoking and diabetes could both be prevented if individuals would abstain from smoking, eat healthy, and exercise regularly. Smokers with diabetes have an increased risk of serious health outcomes, hence effective smoking cessation interventions are critical. The transtheoretical model was used in this quantitative study analyzing secondary data from the state of Nevada Quitline to examine the relationships between smoking cessation method (counseling versus counseling and medication) and quitting smoking for 720 smokers with/without diabetes. Participants were Nevada residents, ages 18+, men and women, English or Spanish speakers. Descriptive statistics, logistic regression, and a test of two proportions were conducted. …

Education And Educational Attainment In Southern Nevada, Jennifer Pharr, Courtney Coughenour, Shawn Gerstenberger

Nevada Journal of Public Health

Failure to complete high school has a direct impact on a person’s earning potential and quality of life. Higher levels of education are associated with better health. Because of this association, it is important for children and adults to have access to quality education. The percentage of adults who have successfully pursued higher education in Southern Nevada is lower than the peer Mountain West metropolitan areas and the national average. Nevada high school graduation rates are the lowest in the nation. High school graduation rates and dropout rates vary by race/ethnicity in the Clark County School District. High school graduation …

Building On Social Capital To Improve Health: The Interactional Approach To Community Development, Matthew Charles Tomlin Mr

Student Research – Stevenson Center

Since political scientist, Robert Putnam, (1995) brought the concept of social capital into popular discourse, there has been a surge in debate over its definition, causes, and consequences in a range of social science disciplines. While social capital has been found to support self-rated overall health at the state level (Kawachi et al, 1999), there is still a dearth of data and research on localities in different regions of the country. This study analyzes survey data collected in the United Way of McLean County’s 2014 Community Assessment to better understand the dynamic between social capital and health in one Central …

Trends In Hiv Prevalence, Sexual And Health Seeking Behaviors, And Hiv-Related Discrimination Among Nigerian Youth, Population Council

HIV and AIDS

Nigeria, home to over 170 million people, has a disproportionately heavy youth population of 32 percent whose well-being is intricately tied to the country’s prospects for sustainable development. Nigeria has an HIV prevalence of 3.4 percent, the second highest number of infections in the world. In 2013, it was estimated that 160,000 adolescents in Nigeria were living with HIV. Although Nigeria has developed a national HIV strategic plan that forms a basis for the HIV response, national AIDS and related policies contain few youth-centered provisions. Overall, the national strategic plan targets youth as part of the general population. To fill …

Do Clinical Decision-Support Reminders For Medical Providers Improve Isoniazid Prescription Rates Among Hiv-Positive Adults?, Eric P. Green, Caricia Catalani, Aggrey Keny, Lameck Diero, Charity Ndwiga, Dennis Israelski, Paul Biondich

HIV and AIDS

People living with HIV (PLHIV) are at increased risk of developing active tuberculosis (TB) and dying from TB. Isoniazid preventive therapy (IPT) can prevent this, but only a small fraction of HIV-positive individuals are on IPT. Previous research suggests that clinical decision support systems (CDSS)—electronic systems that use existing patient data and established algorithms to generate alerts, reminders, or recommendations intended to aid clinical decision-making—have the potential to improve provider adherence to diagnostic and treatment guidelines. Researchers conducted a cluster randomized controlled trial of a new CDSS intervention for TB screening, prevention, and treatment in a high HIV and TB …

A Secondary Analysis Of Retention Across The Pmtct Cascade In Selected Countries: Rwanda, Malawi, Kenya, And Swaziland, Godfrey Woelk, Aida Y. Berhan, Kwashie Kudiabor, Martha Mukaminega, John On'gech, Epiphanie Nyirabahizi, Caspian Chouraya, David Kimosop, Dieudonne Ndatimana, Mafayo Phiri, Heather Hoffman

HIV and AIDS

There is global consensus that transmission of HIV from mother to child can be eliminated. The Global Task Team, co-chaired by UNAIDS and the US Office of the Global AIDS Coordinator, has developed a global framework with the goal of eliminating new HIV infections among children (transmission rate of less than 5 percent) by 2015. Reaching the goal depends on optimal execution of each step in a complex cascade of activities, including testing and counseling for HIV, early attendance for antenatal care to optimize antiretroviral prophylaxis for prevention of mother-to-child transmission (PMTCT), adherence to the drugs, CD4 count testing, and, …

Addressing Mental Health Disorders And Hiv Vulnerability Of Marginalized Adolescents In Addis Ababa, Ethiopia, Nrupa Jani, Lung Vu, Sam Kalibala, Gebeyehu Mekonnen, Kay Lynn

HIV and AIDS

Ethiopia is experiencing an increasingly urban, female-centered HIV epidemic alongside a rise in rural migration of adolescents to Addis Ababa. Often these migrants are confronted by social challenges such as lack of education, inadequate housing, unstable employment conditions, and physical and sexual abuse. These difficult living circumstances contribute to psychological and mental health problems among these adolescents, potentially putting them at greater risk of acquiring HIV. However, knowledge about how targeted mental health interventions can impact HIV-related outcomes worldwide, and in Ethiopia, remains limited. The goal of this study was to pilot test a strategy for addressing mental health problems, …

Sexual And Reproductive Health And Rights Among Young People Living With Hiv In Uganda: Findings From The Link Up Baseline Survey, Population Council

HIV and AIDS

An estimated 3.7 percent of young people aged 15–24 years are living with HIV in Uganda, and face unique challenges in navigating a wide array of social, health, and developmental challenges as they transition to adulthood. Like all young people, those who live with HIV are starting to learn about their sexuality, often beginning to have intimate relationships or marry. In addition, they confront a myriad of complex issues associated with HIV status disclosure, initiation of and adherence to antiretroviral therapy, and deeply entrenched HIV-related stigma and discrimination. Young women bear a disproportionate share of this burden. Compared with men …

Sexual Health And Hiv Risk Behaviors Of Men Who Have Sex With Men In Myanmar—Baseline Findings From Link Up, Population Council, Burnet Institute

HIV and AIDS

In 2013, an estimated 189,000 people were living with HIV in Myanmar. The overall adult HIV prevalence is estimated to be around 0.5 percent, but key populations such as men who have sex with men (MSM) bear a disproportionate disease burden. According to national estimates, HIV prevalence among MSM is 20 times higher than in the general population, at 10 percent. Effective, targeted, innovative, and culturally appropriate interventions that have been shown to significantly reduce high-risk sexual behaviors among MSM are needed to reduce the HIV burden among this population. In Myanmar, as part of the Link Up project, Alliance …

Annotated Bibliography Of Nigerian Youth-Focused Hiv And Sexual And Reproductive Health Project Publications (Grey Literature), Population Council

HIV and AIDS

Adolescents and young adults (15–24 years) constitute about one-third of the total population of Nigeria, and their well-being is intricately tied to the country’s prospects for sustainable development. The HIV prevalence among 15–24-year-old men and women is 2.5 percent and 3.1 percent, respectively. In 2013, it was estimated that 160,000 adolescents (aged 10–19) in Nigeria were living with HIV. Rightfully, an increasing focus is being paid to the sexual and reproductive health (SRH) of young Nigerians, however it is essential that the dialogue and interventions around young people’s SRH be informed and take into account the body of evidence available …

Arv-Based Hiv Prevention For Women: State Of The Science And Considerations For Implementation In Zimbabwe. Report From A Provider Workshop, Population Council

HIV and AIDS

This report provides an overview of the presentations and discussions emerging from a Provider Workshop on ARV-Based HIV Prevention for Women: State of the Science and Considerations for Implementation in Zimbabwe convened by the Ministry of Health and Child Care and the Population Council in Harare in May 2014. The workshop in Zimbabwe is part of a broader global process to begin paving the path for microbicides introduction while awaiting the results of the ongoing confirmatory trial (FACTS 001) of tenofovir gel in South Africa. USAID is spearheading a global effort toward a “Shared Vision and Strategic Plan for Microbicide …

Introducing Antiretroviral (Arv)-Based Prevention Products For Women: A Guide To Strategic Decisionmaking And Planning, Population Council

HIV and AIDS

As evidence mounts that antiretrovirals (ARVs) are effective for HIV prevention, policymakers and program managers will need to determine whether and how best to introduce specific products into health care systems. Determining the most appropriate users within a particular country will depend on the overall context, the nature of the HIV epidemic within the country, and the opportunities available to reach and serve HIV-negative women with ARV-based prevention products and services. This toolkit was developed by the Population Council for use by governments, organizations, and donors who are in a position to support or add new HIV-prevention products into programs. …

Reach: Randomized Evaluation Of Hiv/Fp Service Models, Paul C. Hewett, Mutinta Nalubamba, Fiammetta Bozzani, Mardieh Dennis, Jean Digitale, Lung Vu, Eileen Yam, Mary Nambao

HIV and AIDS

The REacH (Randomized Evaluation of HIV/FP Service Models) project compares health service uptake of two models for HIV prevention and family planning service linkage and integration. This report details results which indicate that the enhanced client add-on service referral and follow-up arm with and without the escort increased the uptake of HIV testing and counseling services among women who had entered at family planning care entry points. The effect of the intervention was greater in the shorter term, improving uptake within six weeks, but nonetheless remained important through six months. The results indicate that the intervention can increase the numbers …

Burundi Program Implementation Workshop, 3–5 June 2014: Link Up Meeting Report, Population Council, Alliance Burundaise Contre Le Sida

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. At a workshop held in Burundi, 3–5 June 2014, the Population Council, Alliance Burundaise contre le SIDA, and local partners in Burundi identified successful activities, highlighted important challenges and best practices, and found innovative ways to improve Link Up programming. This document contains a selection of the most …

Sexual And Reproductive Health Among Young Female Sex Workers In Bangladesh Brothels—Baseline Findings From Link Up, Population Council

HIV and AIDS

Link Up is a global consortium of international and local nongovernmental organizations led by the International HIV/AIDS Alliance. Link Up aimed to improve the sexual and reproductive health and rights of young people in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda who are living with HIV or are affected by the HIV pandemic. Consortium members PIACT Bangladesh and Marie Stopes Bangladesh implemented a brothel-based program for female sex workers to address sexual and reproductive health and rights. Working in eight brothels in seven districts, trained female sex worker peer educators provided face-to-face education, including referrals to on-site and off-site health care …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Belize 2011, Population Council, Unicef Belize

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Belize 2011” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Improving The Experiences Of Informal And Formal Alzheimer's Disease And Dementias Caregivers, Roxroy Anthony Reid

Walden Dissertations and Doctoral Studies

Informal and formal caregivers of persons with Alzheimer's disease and related dementias (ADRD) encounter a more difficult and unique set of challenges than do caregivers of individuals with general disabilities. If adequate caregiver supports are not provided, caregivers may experience increased strain as the disease progresses, increasing the likelihood of unnecessary institutionalization of their care recipients and increasing the cost to the public. Using rational choice theory and political systems theory, the purpose of this study was to differentiate between the phenomenological experiences of formal and informal caregivers of ADRD patients. The overall research was a qualitative design that used …

Predictors Of Physician Use Of The New Nia Alzheimer's Assessment Protocols, Richard Norman Schultz

Walden Dissertations and Doctoral Studies

Consensus is lacking on early diagnostic criteria and the exact symptoms of Alzheimer's disease (AD). A new, in-office test may help physicians detect the early symptoms of AD, based upon new National Institute of Aging (NIA) criteria. However, a gap exists in knowledge regarding physicians' current use or intent to use the new protocols. Choreographing the descriptive AD terminology in the Diagnostic and Statistical Manual of Mental Disorders IV-TR and the International Classification of Diseases (ICD-10) is recommended. Thus, the purpose of this study was to understand possible contributing factors to physician's use or intent to use of the new …

Interpersonal Safety Of Active Duty Women In The Deployed Environment Of Bagram Afghanistan, Cynthia Tara Ferguson

Walden Dissertations and Doctoral Studies

In the United States Armed Forces, 30% of women in the military suffer physical assault each year; in 2009, there were 22 reported cases of sexual assault in the U.S. Central Command. Aggravated assault, gang violence, sexual assault, homicide, and suicide can damage the morale of military personnel at a deployed site and collectively cost millions of dollars over time. Interpersonal violence in the United States military is destructive to the military system and directly diminishes mission readiness. This study was designed to illuminate the environmental, cultural, and political influences that affect interpersonal safety among military women in the deployed …

Adhd Versus Ptsd In Preschool-Aged Children: Implications For Misdiagnosis, Klaudette D. Stewart

PCOM Psychology Dissertations

Attention Deficit Hyperactivity Disorder (ADHD) has been one of the most diagnosed disorders in children since it was included in the Diagnostic and Statistical Manual of Mental Disorders−III (DSM−III) in 1980. The number of children who have been diagnosed since that time has grown significantly, raising concerns about the overwhelming number of young children being diagnosed and prescribed medication. According to the literature, young children are diagnosed at a higher rate by pediatric primary care physicians (PCPs) than clinical child psychologists (CCPs) because they are taken to a PCP’s office by a parent, rather than referred from a school environment, …

A Couple’S Marital Disharmony And Its Psychological Effects On Their Children During The Hiv Disclosure Process In Kenya, Grace Gachanja

Walden Faculty and Staff Publications

Limited published data exists on how HIV-positive parents perform disclosure to all their children. A couple’s HIV disclosure experience to all their children is presented. They participated in a larger study conducted to understand the lived experiences of HIV-positive parents and their children during the disclosure process. Each underwent individualized in-depth semi-structured interviews. Interviews were transcribed and transferred into NVivo 8 for analysis using the Van Kaam method. Three themes emerged including HIV testing, full disclosure delivery accompanied by marital disharmony, and postdisclosure psychological effects on the family. Marital disharmony and non-involvement of the father caused the mother to fully …