Public Health Commons^™

Cultural Beliefs About Health Professionals, Attributions For Mistreatment, And Continuity Of Cancer-Related Care, Jennifer Anne Tucker

Loma Linda University Electronic Theses, Dissertations & Projects

This research examined attributions for health care mistreatment, related emotions, and the role of cultural beliefs about health care professionals as determinants of cancer-related continuity of care among Anglo and Latino women in Southern California. This research was guided by Betancourt’s model of culture adapted for the study of health behavior (Betancourt & Flynn, 2008) and Weiner’s (1996) attribution theory of motivation and emotion. As predicted, higher levels of negative cultural beliefs about health professionals resulted in lower intentions for continuity of care indirectly through mediating psychological perceptions of intentionality for mistreatment, controllability of its causes, and anger toward the …

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Native American Forum on Nuclear Issues

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Socioeconomic Determinants Of Hiv Status In Kenya, Kimberly Fletcher

Masters Theses & Specialist Projects

The spread of Human Immunodeficiency Virus (HIV) is one of the greatest threats to stability and development in Kenya. The country's infection rate is estimated between seven and eight percent, making it one of the highest in the world. Several studies have been done that examine subpopulations such as truck drivers, sex workers, and migrants. However, to date there is little research that examines who, across the country, is contracting HIV. Kenya's 2003 Demographic and Health Survey includes data that make it possible to determine which groups have the highest odds of being infected. The question of who is contracting …

Tribes And Yucca Mountain: Native American Forum On Nuclear Issues, Fred Dilger

Native American Forum on Nuclear Issues

Abstract:

-Yucca Mountain: Extensive history of social-cultural studies

-No interaction on transportation

-Unsuccessful effort began in 1993 and ended in 1995

-DOE tribal policy was a very good start

-Restarted again in 2004-DOE invites tribes to TEC meeting

-Shape future interaction between DOE and other Tribes

-Tribes identify themselves as affected by DOE differently than DOE defines affected tribes

Infant Feeding Decisions Among Pregnant Black Wic Participants And The Role Of Peer Support, Astrid D. Mickens

Loma Linda University Electronic Theses, Dissertations & Projects

The purpose of this study was to identify the important factors that impact infant feeding decisions among Black women, and to determine whether peer support influences the relationship among theoretical constructs of the social learning theory. A convenience sample of 110 Black pregnant women, ages 18-45, attending Women, Infant and Children (WIC) clinics throughout Riverside and San Bernardino Counties were recruited to participate in the study through the Nutrition Services Department. Eligible participants included pregnant Black WIC clients in any stage of pregnancy.

The survey questions contained information about perceived support, cognitive knowledge, abilities and beliefs regarding breastfeeding. The goal …

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

Assessment Of Risk Factors For Hiv Infection Among Men Who Have Sex With Men In The Metropolitan Area Of Campinas City, Brazil, Using Respondent-Driven Sampling, Maeve De Mello, Adriana De Araujo Pinho, Magda Chinaglia, Waimar Tun, Aristides Barbosa Junior, Maria Cristina, F.J. Ilario, Paulo Reis, Regina C.S. Salles, Suzanne Westman, Juan Diaz

HIV and AIDS

The Population Council, in collaboration with the Brazil Ministry of Health, the Municipal Program of STD/AIDS of Campinas, and the US Centers for Disease Control and Prevention/Global AIDS Program/Brazil, conducted a study to characterize the sociodemographic, behavioral, and environmental factors associated with subgroups of MSM who are most at risk for HIV infection. This research is the first Brazilian study to provide population-based estimates for HIV, syphilis, and HIV-related risk behaviors using an innovative sampling technique to reach members of the target population. Our data suggest the importance for HIV prevention programs to address not only sexual risk reduction, but …

Is It Feasible To Integrate Alcohol-Related Risk Reduction Counseling Into Vct Services? Findings From Kenya, Caroline Mackenzie, Karusa Kiragu, George Odingo, Rukia Yassin, Peter Shikuku, Patrick Angala, Nduku Kilonzo, William Sinkele, Melania Akinyi

HIV and AIDS

In Kenya, an estimated 30 percent of men report to be alcohol users which may be fueling the HIV pandemic, due to its association with high-risk sexual behavior and reduced inhibitions. The Population Council’s Horizons program collaborated on a study to improve screening of clients for alcohol use, provision of feedback of screening results, and referrals to care and support during voluntary testing and counseling (VCT) for HIV. Overall, the results indicate that it is feasible to integrate alcohol risk reduction counseling into VCT, and that it is generally accepted by providers and clients alike. This study therefore supports the …

Promoting Gender Equity As A Strategy To Reduce Hiv Risk And Gender-Based Violence Among Young Men In India, Ravi K. Verma, Julie Pulerwitz, Vaishali Sharma Mahendra, Sujata Khandekar, A.K. Singh, S.S. Das, Sunil Mehra, Anita Nura, Gary Barker

HIV and AIDS

The Horizons Program, CORO for Literacy, MAMTA, and Instituto Promundo developed, piloted, and scaled-up a behavior-change intervention in India to examine the effectiveness of interventions to improve young men’s attitudes toward gender roles and sexual relationships, and to reduce HIV risk behaviors and partner violence. The results of this study suggest that young men became less supportive of inequitable gender norms after participating in the interventions. Similarly, there were significant improvements among intervention participants in key outcome indicators, including condom use, partner communication, partner violence, and attitudes toward PLHIV. To maximize the chances of long-term sustainability of these positive changes, …

Catalyzing Personal And Social Change Around Gender, Sexuality, And Hiv: Impact Evaluation Of Puntos De Encuentro´S Communication Strategy In Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Propiciando Cambio Personal Y Social Alrededor Del Género, Sexualidad Y Vih: Evaluación De Impacto De La Estrategia De Comunicación De Puntos De Encuentro En Nicaragua, Irela Solorzano, Amy Bank, Rodolfo Pena, Henry Espinoza, Mary Ellsberg, Julie Pulerwitz

HIV and AIDS

Somos Diferentes, Somos Iguales (SDSI) is a communication for social change strategy whose objective is to prevent future HIV infections in Nicaragua, through mass communication actions that include educational entertainment programs, strengthening of local capacity, and the development of alliances within the communities. This report presents the results of an interinstitutional evaluation to explore the impact of SDSI on gender equity, stigma reduction, personalization of risk perception, knowledge and use of services, interpersonal communication, HIV prevention practices, and individual and collective effectiveness for HIV prevention. The impact evaluation showed that the SDSI strategy made a great contribution in key aspects …

Caring For Caregivers: An Hiv/Aids Workplace Intervention For Hospital Staff In Zambia—Evaluation Results, Karusa Kiragu, Mutinta Nyumbu, Thabale J. Ngulube, Panganani Njobvu, Chilufya Mwaba, Arthur Kalimbwe, Spike Bradford

HIV and AIDS

The Horizons Program collaborated on a Caring for Caregivers initiative in Zambia whose objective was to develop and test a risk-reduction workplace program for hospital staff. This was motivated by the recognition that hospital workers are often overlooked in HIV programming, and yet many are infected or affected by HIV. It was also motivated by the fact that hospital staff are heterogeneous, with both clinical and non-clinical staff having varying levels of understanding regarding HIV transmission. Caring for Caregivers was a peer education program targeted at hospital staff and implemented in two hospitals in Zambia, with a combined staff of …

Repositioning Postnatal Care In A High Hiv Environment: Swaziland, Charlotte E. Warren, Rachel Shongwe, Allen Waligo, Mohammed Mahdi, Goldy Mazia, Indira Narayanan

HIV and AIDS

This Horizons report from the Swaziland Ministry of Health and Social Welfare discusses findings from an intervention which aimed to reposition postnatal care within the context of a high HIV prevalence environment. The objectives were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirms that the introduction …

Improving Hospital-Based Quality Of Care In Vietnam By Reducing Hiv-Related Stigma And Discrimination, Khuat Thi Hai Oanh, Kim Ashburn, Julie Pulerwitz, Jessica Ogden, Laura Nyblade

HIV and AIDS

To address HIV-related stigma and discrimination, and improve the quality of care in the healthcare setting in Vietnam, the Institute for Social and Development Studies, the International Center for Research on Women, and the Horizons Program conducted intervention research in four hospitals. The study team conceptualized two fundamental causes of HIV-related stigma: 1) fear of casual transmission; and 2) negative values/social judgments and associations between HIV and certain behaviors and groups, such as sex workers and injecting drug users. Both intervention strategies successfully reduced stigma and discrimination toward HIV-positive patients in these healthcare settings. The findings show that addressing stigma …

Assessment Of Risk Factors For Hiv Infection In Female Sex Workers And Men Who Have Sex With Men In Ciudad Del Este, Paraguay, Magda Chinaglia, Waimar Tun, Maeve Mello, Magdalena Insfran, Juan Diaz

HIV and AIDS

Research conducted by the Population Council/Brazil, supported by the USAID-funded Horizons Project, documents findings from a study in Paraguay among men who have sex with men and female sex workers to estimate HIV and syphilis prevalence; examine knowledge, attitudes, and risk behaviors related to HIV and STIs; and describe the contextual and behavioral factors influencing HIV and STI transmission. Findings provide guidance to the development of HIV and STI prevention and care interventions and further operations research to test strategies and interventions to reduce the spread of HIV and STIs in these groups.

School As A Workplace In Kenya: Evaluation Of The Teachers Matter Hiv/Aids Project, Karusa Kiragu, Caroline Mackenzie, Jennifer Weiss, Murungaru Kimani, Debbie Gachuhi

HIV and AIDS

The Horizons program of the Population Council embarked on an operations research initiative in Kenya to test the feasibility of implementing a teacher-centered workplace program based in schools. The study was conducted in partnership with the Ministry of Education, the Kenya Institute of Education, the Teachers Service Commission, and UNICEF. Called Teachers Matter, the project’s main audience was primary and secondary school teachers. The purpose of the research was to assess whether such a program would improve teachers’ HIV-related knowledge, attitudes, and behaviors; increase the proportion of teachers seeking voluntary testing and counseling; and enhance their ability to cope with …

Migration/Mobility And Vulnerability To Hiv Among Male Migrant Workers: Andhra Pradesh 2007-08, Niranjan Saggurti, Anrudh K. Jain, Saumya Ramarao, Hanimi Reddy Modugu, Ajay Kumar Singh, Suvakanta N. Swain, Ravi K. Verma

HIV and AIDS

The Population Council, in collaboration with TNS India Pvt. Ltd., undertook a study in Andhra Pradesh, India, to examine the patterns of male migration and its links with HIV risk. The goal was to provide evidence to inform the design and implementation of HIV interventions for male migrant workers. The study documented the volume and patterns of mobility, including the social dynamics within the contract system that employs these men as laborers, and the sexual risk behaviors and addictive behaviors of male migrants. The results suggest a predominance of interdistrict movements of men within Andhra Pradesh with a strong positive …

Migration/Mobility And Vulnerability To Hiv Among Male Migrant Workers: Karnataka 2007-08, Shiva S. Halli, Raluca Buzdugan, Niranjan Saggurti, Ravi K. Verma, Stephen Moses, James Blanchard, Anrudh K. Jain, Saumya Ramarao, Ajay Kumar Singh, Suvakanta N. Swain

HIV and AIDS

The present study was undertaken by the Population Council and the Karnataka Health Promotion Trust to study the patterns and factors driving migration among men and the extent to which they engage in high-risk activities associated with HIV. The specific objectives of the study were: to understand the patterns and factors driving the migration of men seeking work in the state of Karnataka; to describe the characteristics of vulnerable subpopulations among migrant men; and to examine the determinants of high-risk sexual behavior among the subpopulations of migrant men, with an emphasis on their mobility as one possible factor. Results suggest …

Migration/Mobility And Vulnerability To Hiv Among Male Migrant Workers: Maharashtra 2007-08, K. Anil Kumar, Shalini Bharat, Niranjan Saggurti, Ravi K. Verma, Anrudh K. Jain, Saumya Ramarao, Kanchan Mukherjee, Ajay Kumar Singh, Suvakanta N. Swain

HIV and AIDS

HIV prevalence in Maharashtra is one of the highest among Indian states. The specific objectives of this study were: to understand the patterns and drivers of migration/mobility of men who migrate for the purpose of work in the state of Maharashtra; to describe the characteristics of vulnerable subpopulations among migrant men; and to examine the determinants of high-risk sexual behavior among the subpopulations of migrant men with particular emphasis on the role of mobility in determining the sexual risk behavior. The present study clearly demonstrates that these male migrants, married or otherwise, retain strong connectivity to their native villages, but …

Patterns Of Migration/Mobility And Hiv Risk Among Female Sex Workers: Andhra Pradesh 2007-08, Niranjan Saggurti, Ravi K. Verma, Hanimi Reddy Modugu, Saumya Ramarao, Ajay Kumar Singh, Vaishali Sharma Mahendra, Anrudh K. Jain

HIV and AIDS

This report presents the findings from the female sex workers study in Andhra Pradesh, India implemented by TNS India Private Limited and the Population Council in New Delhi. Specifically the study was undertaken to assess the volume and patterns of mobility of female sex workers; to describe the characteristics of mobile female sex workers; and too examine the determinants of HIV risk among female sex workers, with particular emphasis on mobility-related characteristics. The report concludes that targeting such highly mobile female sex workers in intervention programs requires a comprehensive understanding of their places of solicitation and sex. Female sex workers …

Patterns Of Migration/Mobility And Hiv Risk Among Female Sex Workers: Maharashtra 2007-08, Niranjan Saggurti, Vaishali Sharma Mahendra, Rajendra Singh, Saumya Ramarao, Suvakanta N. Swain, Ajay Kumar Singh, Anrudh K. Jain, Ravi K. Verma

HIV and AIDS

According to recent estimates, Maharashtra, India recorded high HIV prevalence among female sex workers, however there is a dearth of research documenting the migration patterns of sex workers and the linkages between their mobility and vulnerability to HIV. This Population Council study attempts to answer some of the questions on mobility and migration of female sex workers in Maharashtra as they relate to the HIV epidemic. Findings show an association between degree of mobility and the indicators of HIV risk such as consistent condom use with different types of partners, STI symptoms reported, sexual violence, and self-perception of risk for …

Informed Consent In Hiv Prevention Trials: Highlights From An International Workshop, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.

Consentement Éclairé Dans Les Essais De Prévention Du Vih: Points Saillants D'Un Atelier International, Population Council

HIV and AIDS

Résumé adapté du rapport de l'atelier co-organisé par le Population Council et Family Health International en mai 2005. Le résumé se concentre spécifiquement sur les outils et stratégies présentés lors de l'atelier qui sont utilisés dans les essais de prévention du VIH pour faciliter le consentement éclairé, expliquer concepts difficiles et évaluer la compréhension parmi les participants à l'essai. Des exemples illustratifs d'essais achevés et en cours sont mis en évidence. Ce résumé sera utile à un public de chercheurs locaux, d'avocats et de membres du personnel des essais cliniques.

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Brief adapted from the report of a workshop co-hosted …

Training Youth Caregivers To Provide Hiv Education And Support To Orphans And Vulnerable Children In South Africa, Tobey C. Nelson, Eka Esu-Williams, Lungile Mchunu, Pinkie Nyamakazi, S'Fiso Mnguni, Katie D. Schenk, Catherine Searle, Jennifer Redner

HIV and AIDS

In KwaZulu Natal, South Africa, in Durban’s peri-urban community of Valley of 1000 Hills, Horizons partnered with Valley Trust to implement and evaluate a program to provide education and support to orphans and vulnerable children. The study utilized a pre-post test design to assess the feasibility and impact of building the capacity of youth aged 18–24 years to provide HIV education and support to in-school orphans and vulnerable children in their communities. The Valley Trust Youth Caregiver Program trained older youth to provide HIV education, homework assistance, and psychosocial support to orphans and vulnerable children aged 11–15 years. The program …

Engaging Communities In Supporting Hiv Prevention And Adherence To Antiretroviral Therapy In Zambia, Fiona Samuels, Joseph Simbaya, Avina Sarna, Scott Geibel, Phillimon Ndubani, Jolly Kamwanga

HIV and AIDS

In Zambia, the prevalence of HIV is estimated at 16 percent among 15–49-year-olds. This brief presents findings from an operations research study to access the outcomes of the Antiretroviral Community Education and Referral (ACER) project in two urban areas in Zambia—Lusaka and Ndola. The ACER project was implemented by the International HIV/AIDS Alliance, based in England, and the Alliance’s Zambia office, in conjunction with local Zambian partners. Launched in mid-2004, the two-year project built on previous formative research that examined knowledge and attitudes about prevention and treatment. The research was conducted by the Institute of Eco­nomic and Social Research in …

Helping Youth Prevent Hiv: An Evaluation Of The Straight Talk Program In Uganda, Susan E. Adamchak, Karusa Kiragu, Cathy Watson, Medard Muhwezi, Tobey Nelson Sapiano, Ann Akia-Fiedler, Richard Kibombo, Milka Juma

HIV and AIDS

Mass media initiatives are being implemented globally to provide information and foster HIV preventive behavior, however there has been limited evaluation of these efforts in sub-Saharan Africa. The Straight Talk (ST) program in Uganda has targeted youth with HIV and reproductive health (RH) information for over a decade. Evaluation results show positive associations between exposure to ST media and a number of key outcomes among youth, including sexual behavior, knowledge, and attitudes. In 2005–06, the Horizons Program conducted the first impact evaluation of the ST program in Uganda to document its effects on young people. This brief focuses on the …

'Dare To Be Different': Enhancing Life Skills Education For Hiv Prevention In South African Schools, Tobey Nelson Sapiano, Nathi Sohaba, Eka Esu-Williams

HIV and AIDS

In South Africa, approximately 5.5 million people are living with HIV. One of the main strategies the South African Government has used to build HIV prevention awareness and promote behavior change among young people is school-based life skills education. Since 2000, the Horizons Program has conducted research exploring the impact of life skills education and other school-based HIV prevention activities on young South Africans. In contrast to the high HIV prevalence among youth ages 15–24, estimated to be over 10 percent, prevalence for youth ages 10–14 is estimated at just over 1 percent. People aged 10–14 are particularly receptive to …

Food On The Table: The Role Of Livelihood Strategies In Maintaining Nutritional Status Among Art Patients In Kenya And Zambia, Fiona Samuels, Naomi Rutenberg, Joseph Simbaya, Jerry Okal, Nicodemus Kisengese, Stanley Luchters, Susan Kaai, Scott Geibel

HIV and AIDS

As understanding of the multidimensional nature of HIV epidemics improves, it is increasingly recognized that policy and program interventions, whether focusing on prevention, treatment and care, or impact mitigation, must take into account the integral role of food and nutrition security. More broadly, interventions need to consider how people’s livelihoods evolve and adapt to deal with the multifaceted nature of HIV. In eastern and southern Africa, evidence pointing to a vicious cycle between HIV and food and nutrition insecurity is mounting. Programs are now being implemented that link HIV to food and nutritional security, as well as to livelihoods. However, …

Involving Young People In The Care And Support Of People Living With Hiv In Zambia: An Evaluation Of Program Sustainability, Eka Esu-Williams, Catherine Searle, Anderson Zulu

HIV and AIDS

In 2005, approximately 17 percent of the population of reproductive age in Zambia was infected with HIV and nearly 710,000 under the age of 18 were orphans. As the needs of people living with HIV (PLHIV) and orphans and vulnerable children (OVC) escalate, communities are seeking new ways of helping those affected by the disease. A Horizons intervention study conducted in northern Zambia from 2000–02 found that youth could be trained to help meet the care and support needs of PLHIV and their families, including OVC. Study participants belonged to anti-AIDS clubs that taught about HIV and how to prevent …

Idhini Fahamishi Katika Majaribio Ya Kikliniki Ya Ukingaji Wa Virusi Vya Ukimwi, Population Council

HIV and AIDS

Brief adapted from the report of a workshop co-hosted by the Population Council and Family Health International in May 2005. The brief focuses specifically on tools and strategies presented at the workshop that are being used in HIV-prevention trials to facilitate informed consent, explain difficult concepts, and assess comprehension among trial participants. Illustrative examples from completed and ongoing trials are highlighted. This brief will be useful for an audience of local researchers, advocates, and clinical trial staff.