Public Health Commons^™

Implementing A Community-Based Intervention For African American Mothers And Daughters, Teri Aronowitz, Nandini Sengupta

Office of Community Partnerships Posters

Adolescents represent one of the fastest growing risk groups for HIV. Inner-city, minority youth are at highest risk because of concentration of HIV in inner-city areas, higher rates of STDs, and early sexual initiation. Mothers are the primary sex educator of daughters, and girls state their relationship with their mother was an important influence on their delaying sexual activity. With 70% of adolescent HIV seroconversions occurring among African American (AA) females, studies are urgently needed to enhance mother-daughter sexual communication. The purpose of this poster is to offer insights on the logistics of carrying out a manualized program.

Two Community Collaborations With Sexual Minority Women’S Ngos In Shanghai & Hong Kong, Connie Chan, Hsin-Ching Wu

Office of Community Partnerships Posters

Based on research with sexual minority communities in the United States, Connie Chan, professor of public policy and public affairs, conducted comparative research with community groups in Hong Kong and Shanghai, China. She provided capacity building training and resources directly to the organization which provides outreach and service to sexual minority women and girls in Shanghai, China. Professor Chan also supported Queer Sisters – an NGO that provides advocacy and community outreach to sexual minority girls and women in Hong Kong – by co-creating a needs assessment survey and helping them to interview their membership in Hong Kong.

Connie Chan …

Grappling With Gatekeepers: Addressing Gender Hindrances To Mhealth, Jack O’Rourke

Independent Study Project (ISP) Collection

This study was conducted in order to understand the social and economic problems associated with Ugandan women’s usage of mobile phones and the ways in which different mHealth groups are approaching these problems. Seeing how these different groups approach this issue added new information and analysis to a relatively unexplored topic

The qualitative methodology undertaken was two pronged. First, single sex focus groups in rural Mukono District were assembled. Men, women without phones and women and with phones were all talked to in Luganda with the use of a translator. In addition to these focus groups in rural Mukono District, …

Selling Life To Abortion-Seekers: A Content Analysis Of Passive And Active Persuasion In Crisis Pregnancy Center Marketing, Alexander Kocman

Masters Theses

For supporters of the pro-life cause, crisis pregnancy centers (or CPC's) have become the "darlings of the movement," according to the New York Times (Belluck, 2013), offering women with unplanned pregnancies free advice, information, classes, childcare, and needed supplies. For abortion advocates, such establishments are intended to seduce vulnerable abortion-seekers into a situation where they will be counseled out of an abortion and possibly even proselytized. Yet for as much controversy as exists in the news media, medical community, and legal realm about CPC's, there is an unsettling lack of understanding of how--and why--CPC's market themselves the way they do. …

Barriers To Successful Cervical Cancer Screening In Rural Kwazulu-Natal, Cato Manor, And Cape Town, Amanda Comai

Independent Study Project (ISP) Collection

In 2000, the South African Department of Health produced a nationwide policy intended to combat the growing crisis of cervical cancer. Nearly fifteen years later, however, the disease remains a significant cause of death among certain female populations, especially those who are rural, poor, and HIV-positive. It is undeniable that challenges of access, awareness, resource demand, and stigmatization stand in the way of complete policy enactment.

In this study, I explore in detail the barriers that prevent successful implementation of the policy. My research combines interviews with a variety of individuals and participant observation at the Cancer Association of South …

Schoolgirls’ Experience Of Menstruation Ss Expressed Through Body Mapping In A Quasi-Rural South African Village, Angela Zablotny

Independent Study Project (ISP) Collection

The aim of this independent study project was to gain an understanding of menstruation as experienced by school aged girls in a quasi-rural village in the KwaZulu-Natal Province of South Africa. Though a fact of life for roughly half of the world’s population, menstruation continues to be a taboo topic and has implications related to both traditional Zulu beliefs as well as expectations for females in a largely patriarchal society.

The qualitative research method of body mapping was used with teenage girls in an effort to facilitate both reflection and discussion on their lived experiences with their periods. Supplemental interviews …

Eating Disorders: Prevalence, Perceptions, And Treatments In Jordan, Brenda Gable

Independent Study Project (ISP) Collection

This study examines the perceptions that young women in Jordan have regarding their bodies and eating disorders, in addition to their opinion regarding media and familial pressures to fit societal norms. The study further examines eating disorders as a mental disorder and the obstacles that individuals face when seeking treatment. This study was implemented by 95 surveys distributed to women in a first aid course at Jordan University and by interviewing professionals in the nutritional, mental health, and educational field. It was found that 86% of surveyed students believed that young women in Jordan struggled with body image and 72% …

El Significado Cultural Del Parto: Perspectivas De Mujeres Mapuche, Erin Drake

Independent Study Project (ISP) Collection

The aim of this study is to understand the cultural meaning of childbirth within Mapuche culture, in order to promote culturally respectful childbirth practices related to intercultural programs of the public health system in Chile. This study focuses on the problem of the institutionalization and medicalization of childbirth in Chile, and how these processes have affected the childbirth experiences of Mapuche women. While there have been many studies on the cultural meaning of childbirth in distinct places of the world, very few studies focus on this theme within Mapuche culture. The few studies that have described Mapuche cultural practices regarding …

Smoking Behaviors Among Pregnant Women: A Romanian Case Study, Katherine Lemasters

Independent Study Project (ISP) Collection

Smoking behavior during pregnancy is one of few preventable factors associated with poor health outcomes for both women and children. The post-communist countries in Central and Eastern Europe face many challenges in this realm, as tobacco control efforts have not adequately addressed this behavioral health issue that has arisen since 1989. To better inform these efforts in Romania, this study categorizes the determinants of pregnant women’s prior smoking, current smoking, and current smoke exposure by using both quantitative and qualitative analysis. We find that those living with other smokers, exposed to smoke on a daily basis, and experiencing stress during …

The Intersection Of Depression, Partner Violence And Poverty During The Perinatal Period, Catherine L. Kothari

Dissertations

Problem: Despite the wealth of research documenting the individual links between maternal depression, partner violence, and poverty, important gaps remain regarding their combined interactions, and their variation related to perinatal timing (pregnancy and postpartum). The current dissertation examined the interplay of these phenomena across perinatality.

Methods: This dissertation utilized secondary analysis of telephone survey data from a representative sample of women recruited during their postpartum hospital stay and interviewed four times over the subsequent 18 months. Linear regression was used for predictive modeling of fixed effects, and generalized estimating equation regression was used for multivariate analysis of temporal trends.

Findings: …

Community Health Revolving Fund: Equity Fund For Mccs, Muhammad Ashar Malik

Community Health Sciences

No abstract provided.

Effectiveness, Safety And Acceptability Of Sino-Implant (Ii) During The First Year Of Use: Results From Kenya And Pakistan, Anja Lendvay, Rose Otieno-Masaba, Syed Khurram Azmat, Angie Wheeless, Waqas Hameed, Babar Tasneem Shaikh, Shiphrah Kuria, Markus J. Steiner, Mario Chen, Paul J. Feldblum

Community Health Sciences

Background: Sino-implant (II) is a two-rod subcutaneous contraceptive implant used up to 4 years, containing 150 mg of levonorgestrel. We conducted two observational studies of Sino-implant (II) to evaluate its performance in routine service delivery settings.
Methods: We enrolled 1326 women age 18-44 who had Sino-implant (II) inserted at clinics in Pakistan and Kenya. Women were followed-up using either an active or passive follow-up scheme in each study. Study outcomes were: one-year cumulative pregnancy and discontinuation rates; rates of insertion and removal complications; adverse event and side effect rates; reasons for discontinuation; and implant acceptability and satisfaction with clinic services. …

Hpv Vaccine Status And Bmi Correlation, Ezhilarasi Manickavasagam, Hongying Dai, Joan R. Griffith

Manuscripts, Articles, Book Chapters and Other Papers

Obese women are at increased risk of death from cervical cancer compared to non-obese women. Yet, research indicates a lower rate of cervical cancer screening among obese women, especially severely obese white women. Cited reasons for delaying screening include embarrassment, perceived weight stigma, lack of appropriately sized examination equipment and poor patient-provider communication. Parental acceptance of the Human Papillomavirus (HPV) vaccine for overweight adolescent females may decrease the incidence of cervical cancer among obese women in later years. This study seeks to determine the Human Papillomavirus (HPV) vaccination status of females, ages 11 to 21 years, in a university-based pediatric …

Gender-Based Screening For Chlamydial Infection And Divergent Infection Trends In Men And Women, Susan M. Rogers, Charles F. Turner, William C. Miller, Emily Erbelding, Elizabeth Eggleston, Sylvia Tan, Anthony Roman, Marcia Hobbs, James Chromy, Ravikiran Muvva, Laxminarayana Ganapathi

Publications and Research

Objectives: To assess the potential impact of chlamydial screening policy that recommends routine screening of women but not men.

Methods: Population surveys of probability samples of Baltimore adults aged 18 to 35 years in 1997–1998 and 2006–2009 collected biospecimens to estimate trends in undiagnosed chlamydial infection. Survey estimates are compared to surveillance data on diagnosed chlamydial infections reported to the Health Department.

Results: Prevalence of undiagnosed chlamydial infection among men increased from 1.6% to 4.0%, but it declined from 4.3% to 3.1% among women (p = 0.028 for test of interaction). The annual (average) number of diagnosed infections was substantially …

Expanding Women’S Healthcare Access In The United States: The Patchwork “Universalism” Of The Affordable Care Act, Randy Albelda, Diana Salas Coronado

Center for Social Policy Publications

This paper explores the promise of the Patient Protection and Affordable Care Act, commonly called “Obamacare” (referred to here as the ACA), with attention to the ways gender matter by tracing the development and implementation of key US social protection systems, an examination of the current health system with particular attention to women’s coverage, and the potential impacts of the ACA, including how it conforms to international human rights norms for health care. The ACA promises to vastly improve the key dimensions of health coverage in the US, but it conforms with other US social policy by relying on market-based …

Maternal Biomarkers Of Endothelial Dysfunction And Preterm Delivery, Xinhua Chen, Theresa O Scholl

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Endothelial dysfunction is key to the development of atherosclerosis. Preterm delivery foreshadows later maternal cardiovascular disease (CVD), but it is not known if endothelial dysfunction also occurs. We prospectively measured circulating biomarkers of endothelial dysfunction in pregnant women with preterm or term delivery.

METHODS: We conducted a case-control study nested within a large prospective epidemiological study of young, generally healthy pregnant women. Women who delivered preterm (gestation, n = 240) and controls who delivered at term (n = 439) were included. Pregnancies complicated by preeclampsia were analyzed separately. Circulating endothelial dysfunction biomarkers included soluble intercellular adhesion molecule-1 (sICAM-1), vascular …

Balika Fact Sheet: Highlight On Livelihoods, Population Council

Poverty, Gender, and Youth

There are few income-earning opportunities for adolescent girls in the Bangladeshi Association for Life Skills, Income, and Knowledge for Adolescents (BALIKA) study area, and livelihoods opportunities vary considerably by economic status and education. The ability to acquire livelihood-relevant skills, networks, and work experience during adolescence can be an important predictor of productive capacity later in life. However, across the study districts, the proportion of adolescent girls who are working is low. Most girls work as tutors or are engaged in the agricultural and poultry sector. Better-educated girls are more likely to be engaged in paid work. This BALIKA “Highlight on …

Policy And Programme Considerations For Arv-Based Prevention For Women: Insights From Key Opinion Leaders In Zimbabwe About Tenofovir Gel, Samukeliso Dube, Barbara Friedland, Saiqa Mullick, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

Zimbabwe has seen a tremendous shift in the HIV landscape in the last decade, particularly regarding prevalence. Yet many people, especially women, are still at high risk and efforts to identify and implement additional HIV-prevention options remain critical. After nearly 20 years of microbicides research, 1 percent tenofovir gel is the first vaginal microbicide to show promise. Since 2011, Zimbabwe has been scaling up use of tenofovir-based regimens as first-line therapy for adults infected with HIV. A randomized, placebo-controlled, double-blind trial demonstrated that women assigned to use 1 percent tenofovir gel had a 39 percent lower risk of HIV infection …

Correlates Of Body Image Of Undergraduate Females Attending Andrews University, Jennifer L. Dabros

Dissertations

Problem: Literature on the relationship between ethnic identity and body image has been scarce, focusing almost entirely on the Asian and/or Hispanic population. The purpose of this study is to examine the influence that ethnic identity has on the body image of undergraduate females.

Method: In the present study, I explored the extent to which body image is related to ethnicity in a diverse sample of 345 undergraduate females (43.5% Caucasian American, 17.4% African American, 9.3% West Indian/Caribbean, 14.8% Hispanic American, 12.5%, Asian American, & 2.6% Multi-ethnic) from a Seventh-day Adventist university. Possible correlates of body dissatisfaction such as ethnic …

Program And Policy Considerations For Tenofovir Gel In India: An Overview, Population Council

HIV and AIDS

The 2011 National Sentinel Surveillance estimated that 1.9 million people in India aged 15 and older were living with HIV. An estimated 39 percent are women. Given the urgent need for HIV-prevention options for women, a number of efforts are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a guide to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The guide includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. The …

Reduce Contraception Discontinuation In Bangladesh By Improving Counseling On Side Effects, Fauzia Akhter Huda, Sabiha Chowdhuri

Reproductive Health

High rates of contraceptive discontinuation and method failure could cause Bangladesh to lose the progress made in increasing contraceptive use over the past 20 years. This policy brief concludes that if women are adequately counseled and supported to sustain their use of more effective contraceptive methods, they will need less medical attention, have fewer unintended pregnancies, and reduce the workload for medical clinics. Furthermore, if providers are adequately trained and supported in counseling and managing side effects and in helping women to switch methods when they do have a problem, the Family Planning Clinical Contraception Services Delivery Program would meet …

Assessment Of Sex Selection In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Forhana Rahman Noor

Reproductive Health

According to UN estimates, the sex ratio at birth (SRB) has persisted at its natural level of 105 male per 100 female newborns for the past half century in Bangladesh. Generally, the SRB becomes skewed in a setting where fertility is declining or low and where son preference exists. Strong son preference compounded by the availability of measures to implement such preference can lead to increased SRB. For example, the increasing availability of prenatal diagnostic technologies, together with declining fertility desires and persistent son preference, has contributed to increased gender-biased sex selection in several Asian countries, including China and India. …

Education Sector Response To Early And Unintended Pregnancy (Eup): A Review Of Country Experiences In East And Southern Africa, Harriet Birungi, Chi-Chi Undie, Francis Onyango

Reproductive Health

No abstract provided.

Assessing Provider Adherence To An Emergency Contraception Guideline In Reproductive Age Women, Amber E. Davis

DNP Projects

Purpose: To determine current provider adherence to the 2010 ACOG Emergency Contraception (EC) guidelines, specifically by assessing provider EC counseling with patients at well-woman annual exam visits or during contraceptive counseling visits. A second aim of this study is to identify provider facilitators and barriers of EC discussion with patients.

Methods: Using a retrospective design, 90 medical records of patients presenting to a university clinic within the previous year were reviewed for the discussion of EC during annual exams or contraceptive counseling. Forty-five medical records were reviewed prior to implementation of the Ambulatory Electronic Health Record (AEHR) and forty-five medical …

Breastfeeding Knowledge, Practice, Attitudes, And Influencing Factors: Findings From A Selected Sample Of Breastfeeding Mothers In Bemidji, Minnesota, Hadeel Adnan Tanash

All Graduate Theses, Dissertations, and Other Capstone Projects

Breastfeeding is generally considered by health professionals as the ideal feeding practice for infants. It is the first communication pathway between the mother and her infant. This study was designed to describe breastfeeding knowledge, attitudes, practice and influencing factors among breastfeeding mothers in Bemidji, MN. This cross-sectional study allowed the researcher to determine trends and other information about the sample in the Bemidji area. The participants for this study were breastfeeding mothers who gave a birth at Sanford Health located in Bemidji, MN. A written data collection instrument containing forty nine questions was used to collect data. The findings of …

Setting The Stage For Arv-Based Prevention For Women: A Snapshot Of The Zimbabwean Context, Population Council

HIV and AIDS

Zimbabwe, with an estimated population of 12.7 million people, is among the countries in sub-Saharan Africa most affected by the HIV epidemic. Given the urgent need for HIV-prevention options for women, a number of projects are underway to prepare for introduction of tenofovir gel should it be shown to be effective. One of these is a toolkit developed by the Population Council to assist policymakers and program managers in identifying the most strategic opportunities for introducing tenofovir gel. The toolkit includes three related components: a landscape analysis, a discussion guide for key opinion leader interviews, and a program planning tool. …

25 Years After Vi Typhoid Vaccine Efficacy Study, Typhoid Affects Significant Number Of Population In Nepal, Deepak Bajracharya, M. Imran Khan, Alfred Pach Iii, Parisha Shrestha, Nilesh Joshi, Shyam R. Upreti, Thomas Wierzba, Mahesh Puri, Sushant Sahastrabuddhe, R. Leon Ochiai

Centre of Excellence in Women and Child Health

Salmonella Typhi, first isolated in 1884, results in infection of the intestines and can end in death and disability. Due to serious adverse events post vaccination, whole cell killed vaccines have been replaced with new generation vaccines. The efficacy of Vi polysaccharide (ViPS) vaccine, a new generation, single-dose intramuscular typhoid vaccine was assessed in Nepal in 1987. However, despite the availability of ViPS vaccine for more than 25 years, Nepal has one of the highest incidence of typhoid fever. Therefore we collected information from hospitals in the Kathmandu Valley from over the past five years. There were 9901 enteric fever …

Validating Indicators Of The Quality Of Maternal Health Care: Final Report, Kenya, Charlotte E. Warren, James Kelly Kimani, Jackline Kivunaga, Brian Mdawida, Charity Ndwiga, Katharine Mccarthy, Ann K. Blanc

Reproductive Health

Despite widespread use, the majority of indicators proposed as measures of the quality of maternal health services have not been sufficiently validated. To accurately track progress toward national and global maternal health goals, the present study sought to validate and identify a set of maternal health indicators that can be practically applied in facility and population-based surveys. To evaluate indicators, the study employed a facility-based design. The study was conducted in public/government hospital facilities in Kenya and Mexico. Participants included women aged 15–49 who underwent labor and delivery at participating study facilities and the providers who attended them. Women’s self-report …

Achieving Mdgs 4 And 5 In Punjab: The Role Of Family Planning, Population Council

Reproductive Health

This brief focuses on the policy options available to the Punjab government to affect the province’s population growth by 2050 and its potential to achieve MDGs 4 and 5. Maternal mortality is a leading cause of death among women of reproductive age in Punjab—about 16 percent of the deaths in this age group are pregnancy-related. Approximately 6,000 women die each year in Punjab due to pregnancy-related factors. Pregnancies that occur too early, too late, or too frequently increase the risk of maternal death. Lowering fertility rates by increasing the use of family planning can help reduce pregnancy-related deaths. The good …

Training Manual On Basic Monitoring And Evaluation Of Social And Behavior Change Communication Health Programs, Praween Kumar Agrawal, Kumudha Aruldas, M.E. Khan

Reproductive Health

Social and behavior change communication (SBCC) interventions are key for addressing social and cultural barriers and achieving goals laid out for health programs. Often these interventions are not evidence based and monitoring and evaluation (M&E) is limited. Lack of trained and skilled human resources for M&E has been a limitation in general. A serious effort is needed to build the capacity of M&E personnel to monitor and evaluate performance of SBCC interventions in terms of reach and effectiveness among intended audiences. The Improving Healthy Behaviors Program of FHI360 aims to provide technical assistance to strengthen capacities to monitor and evaluate …