Public Health Commons^™

Quantification Of Hiv-1 Rna Among Men Who Have Sex With Men Using An At-Home Self-Collected Dried Blood Spot Specimen: Feasibility Study, Sabina Hirshfield, Richard A. Teran, Martin J. Downing Jr., Mary Ann Chiasson, Hong-Van Tieu, Laura Dize, Charlotte A. Gaydos

Publications and Research

Background: Suboptimal antiretroviral therapy (ART) adherence and disengagement in care present significant public health challenges because of the increased probability of HIV transmission. In the United States, men who have sex with men (MSM) continue to be disproportionately affected by HIV, highlighting a critical need to engage high-risk MSM living with HIV who are not engaged or retained in care.

Objective: The aim of the study was to assess the feasibility of at-home blood self-collection and laboratory quantification of HIV-1 RNA viral load (VL) to report laboratory-based VL outcomes and compare self-reported and laboratory-reported VL

Methods: Between 2016 and 2017, …

The Impact Of Sarcopenic Obesity On Inflammation, Lean Body Mass, And Muscle Strength In Elderly Women, Dahan Da Cunha Nascimento, Samuel Da Cunha Oliveira, Denis Cesar Leite Vieira, Silvana Schwerz Funghetto, Alessandro Oliveira Silva, Renato Valduga, Brad J. Schoenfeld, Jonato Prestes

Publications and Research

Objective: The objective of this study was to apply the newly standardized definition for sarcopenia from the Foundation for the National Institutes of Health (FNIH) and the current definition for obesity to 1) determine the prevalence of sarcopenic obesity (SO) in obese elderly women; 2) compare the muscle strength, lean body mass, and markers of inflammation between obese elderly women with SO and nonsarcopenic obesity (NSO), and 3) elucidate the relation- ship between appendicular lean mass adjusted for body mass index (aLM/BMI) with muscle strength, lean body mass, and obesity indices.

Methods: A total of 64 elderly obese women (age: …

Occupational Health Psychology, Irvin Sam Schonfeld

Publications and Research

Occupational health psychology (OHP) is a cross-disciplinary subspecialty within psychology. OHP derives from two disciplines within applied psychology, health psychology and industrial/organizational psychology. OHP is also linked to disciplines outside of psychology, such as occupational medicine and public health. The discipline has roots in eighteenth, nineteenth, and twentieth century thinkers, including Adam Smith, Friedrich Engels, Karl Marx, Émile Durkheim, and Max Weber. These thinkers were concerned with the impact of the organization of work and the business cycle on human life. Later research by Elton Mayo, Marie Jahoda, Walter B. Cannon, Hans Selye, and investigators at the University of Michigan’s …

Whether, When, And How: Fertility Intentions And Age In The U.S., Andrea Melnikas

Dissertations and Theses

Thinking about, planning for, and having children is a deeply personal experience influenced by myriad factors at individual, intrapersonal, community and larger social levels. Examining fertility intentions is of interest to researchers from numerous social science disciplines in part because these intentions are potentially tied to larger demographic and economic shifts. In recent years in the U.S. the mean age at first birth has been increasing, with more women of older ages (age 35 and older) giving birth, due to both delays in childbearing that accompanied larger social trends such as increased educational and career opportunities and a decrease in …

Reducing Arsenic Exposure From Private Well Water In The United States: The Use, Effect, And Potential Of Testing Requirements, Sara Flanagan

Dissertations and Theses

Over 45 million Americans drink from unregulated private well water of unknown quality. Arsenic is the most concerning groundwater contaminant for health because of its toxicity and widespread natural occurrence. Most residential wells in arsenic-affected areas have not been tested for arsenic; the success of community programs and efforts to motivate testing is limited by a range of psychological, situational, and socioeconomic barriers. However, testing only acts as screening and does not reduce exposure without effective and consistent actions to follow. Given the limitations in relying on individual well owners to be aware, willing, and capable of testing their water, …

Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein

Dissertations and Theses

Background: Young Black and Latina women suffer from higher sexually transmitted disease (STD) incidences than White women, increasing their susceptibility to contracting human immunodeficiency virus (HIV). The adoption and widespread usage of mobile devices has contributed to the public’s ability to access available information at all hours, including information on sexual and reproductive health (SRH). Despite a growing body of mobile health literature, there is limited understanding of how mobile-based sexual and reproductive health interventions for use by young adult Black and Latina women could improve sexual health knowledge and connection to clinical care.

Methods: This pilot randomized controlled trial …

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …

An Examination Of Socioeconomic Equity In Health Experiences In Six Latin American And Caribbean Countries, Jessica Greene, Frederico Guanais

Publications and Research

Objective: Most Latin American and Caribbean (LAC) countries are working toward the provision of universal health coverage, and ensuring equity is a priority for those nations. The goal of this study was to examine the extent to which adults’ socioeconomic status was related to health care experience in six LAC countries.

Methods: This cross-sectional study examined the relationship between educational attainment and seven health experience outcomes in three areas: assessment of the health system, access to care, and experience with general practitioner. For this work, we used data from an Inter-American Development Bank survey of adults in Brazil, Colombia, El …

Day-Level Associations Between Substance Use And Hiv Risk Behavior Among A Diverse Sample Of Transgender Women, Brett M. Millar, Devin English, Raymond L. Moody, H. Jonathon Rendina, Demetria Cain, Nadav Antebi-Gruszka, Joseph A. Carter, Jeffrey T. Parsons

Publications and Research

Purpose: Transgender women in the United States face elevated rates of HIV and of substance use. Studies measuring overall or aggregate levels of substance use have linked use to increased HIV transmission risk behavior (TRB). Although intensive longitudinal studies in other populations have found day-level links between substance use and TRB, no study has yet explored such links among transgender women. This study aimed to fill this gap in the literature.

Methods: Utilizing survey and 60-day timeline follow-back interview data from a sample of 214 transgender women in New York City, we tested whether day-level heavy drinking, marijuana use, and/or …

On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley

Publications and Research

Hawryluck and Brindley (2018) addressed the issue of burnout—a syndrome thought to be induced by job stress—among critical care medicine (CCM) practitioners. Although we agree that the practice of CCM can be stressful, relying on burnout as an indicator of the practitioners’ response to occupational adversity is unwarranted. Despite its popularity, burnout remains poorly defined. Disconcertingly, investigators have widely relied on the Maslach Burnout Inventory (MBI) for “diagnosing” burnout in spite of the fact that the MBI is not a diagnostic instrument.Experiencing fatigue or distancing oneself from one’ work—what burnout is about—is not necessarily a sign of ill-being in itself. …

Is A Meta-Analytic Approach To Burnout’S Prevalence Timely?, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Cañadas‐De la Fuente et al. performed a meta‐analysis of the prevalence of emotional exhaustion, depersonalization, and diminished personal accomplishment—the three definitional components of the burnout syndrome—among nursing professionals working in oncology units. All in all, their meta‐analysis was inconclusive because of the very state of burnout research. Because there is mounting evidence that burnout is a depressive condition, we recommend that investigators focus on depression, rather than burnout, in occupational health research and practice.

When We Say 'Physician Burnout,' We Really Mean Depression, Irvin Sam Schonfeld

Publications and Research

There has been controversy regarding the extent to which burnout overlaps depression. I enumerate eight reasons explaining to why depression is at the heart of burnout. Some of these reasons pertain to the highly similar work-related causes of burnout and depression, burnout adherents' faulty categorical and dimensional conceptualizations of burnout and depression, problematically high correlations between emotional exhaustion (the core of burnout) and depressive symptoms, research on physicians and dentists that underline burnout-depression overlap, and the problem of alexithymia being similarly related to burnout and depression. Suggestions for addressing the problem of burnout-depression among physicians are presented.

What Is The Difference Between Depression And Burnout? An Ongoing Debate, Irvin Sam Schonfeld, Renzo Bianchi, Stefano Palazzi

Publications and Research

Il burnout è concepito come una sindrome che si sviluppa in risposta a condizioni di lavoro cronicamente avverse. Si ritiene che il burnout comporti esaurimento emotivo, depersonalizzazione e riduzione della realizzazione personale. Storicamente, tuttavia, il burnout è stato difficile da separare dalla depressione. In effetti, i sintomi del burnout coincidono con i sintomi della depressione. L'evidenza della validità discriminante del burnout nei confronti della depressione è debole, sia a livello empirico sia a livello teorico. L'esaurimento emotivo, il nucleo del burnout, riflette una combinazione di umore depresso e affaticamento / perdita di energia e si correla molto bene con altri …

Burnout And Depressive Symptoms Are Not Primarily Linked To Perceived Organizational Problems, Renzo Bianchi, Eric Mayor, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this 257-participant study (76% female; mean age: 44.84), we examined two ideas that are widespread among burnout researchers: (a) the idea that burnout is primarily related to occupational-level factors; and (b) the idea that burnout should be considered a sentinel indicator in research on negative occupational outcomes. We investigated the links between burnout and a series of generic and work-related variables, namely, depressive symptoms, neuroticism, extraversion, effort-reward imbalance in the job (ERI), social support at work (SSW), and turnover intention. Burnout was assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, neuroticism and extraversion with the NEO-Five …

Adolescent Medicine Trials Network For Hiv/Aids Interventions Data Harmonization: Rationale And Development Of Guidelines, Micah Mccumber, Demetria Cain, Sara Legrand, Kenneth H. Mayer, Debra A. Murphy, Matthew A. Psioda, Arlene C. Seña, Tyrel J. Starks, Michael Hudgens

Publications and Research

Background: The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) research program aims to defeat the rising HIV epidemic among adolescents and young adults in the United States.

Objective: This study aims to optimize cross-study analyses and comparisons of standardized measures (variables) collected in the ATN. Methods: Guidelines were developed for harmonizing measures to be collected across ATN studies.

Results: Eight domains were identified for harmonization—Demographics and Socioeconomic Characteristics, Sexual Behavior and Risk, Substance Use and Abuse, HIV-Positive Cascade, HIV-Negative Cascade, Mental Health, Social Support and Isolation, and Pre-exposure Prophylaxis Cascade.

Conclusions: The collection of selected key measures in a …

A Web-Based Interactive Tool To Reduce Childhood Obesity Risk In Urban Minority Youth: Usability Testing Study, Sandra Verdaguer, Katrina F. Mateo, Katarzyna Wyka, Tracy A. Dennis, May May Leung

Publications and Research

Background: Childhood obesity is a serious public health issue among minority youth in the United States. Technology-enhanced approaches can be effective for promoting healthy behavior change.

Objective: The purpose of this study was to test the usability of prototypes of a Web-based interactive tool promoting healthy dietary behaviors to reduce childhood obesity risk in urban minority youth. The Web-based tool comprised a manga-style comic with interactive features (eg, sound effects, clickable pop-ups), tailored messaging, and goal setting, and was optimized for use on tablet devices.

Methods: Latino and black/African American children ages 9 to 13 years were recruited to participate …

Burnout Research: Eyes Wide Shut, Irvin Sam Schonfeld, Eric Laurent, Renzo Bianchi

Publications and Research

In a study published in a recent issue of Critical Care Medicine, Colville and Smith (2017) found modest overlap between burnout and depression and assumed that burnout and depression are distinct entities. For four reasons, we think that the study is seriously flawed. First, Colville and Smith assessed burnout symptoms with an abbreviated version of the Maslach Burnout Inventory (MBI), the psychometric properties of which are unclear. Second, they used clinically and theoretically arbitrary cutoff scores for categorizing burnout, a modus operandi that, unfortunately, has become commonplace in studies of medical professionals. Third, participants could be categorized as “burned out” …

Burnout-Depression Overlap: Nomological Network Examination And Factor-Analytic Approach, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has been defined as a condition in which individuals are left exhausted by a long-term confrontation with unmanageable job stressors. The question of whether burnout reflects anything other than depressive responses to unresolvable stress remains an object of debate. In this 911-participant study (83% female; mean age: 42.36), we further addressed the issue of burnout-depression overlap. Burnout was assessed with the exhaustion subscale of the Maslach Burnout Inventory-General Survey (MBI-GS) and depression with the PHQ-8. The relationships of burnout and depression with three jobrelated variables – illegitimate work tasks, work-nonwork interference, and job satisfaction – and three “context-free” variables …

Online Communication Settings And The Qualitative Research Process: Acclimating Students And Novice Researchers, Katherine Gregory

Publications and Research

In the last 20 years, qualitative research scholars have begun to interrogate methodological and analytic issues concerning online research settings as both data sources and instruments for digital methods. This article examines the adaptation of parts of a qualitative research curriculum for understanding online communication settings. I propose methodological best practices for researchers and educators that I developed while teaching research methods to undergraduate and graduate students across disciplinary departments and discuss obstacles faced during my own research while gathering data from online sources. This article confronts issues concerning the disembodied aspects of applying what in practice should be rooted …

“We Hide…”: Perceptions Of Hiv Risk Among Black And Latino Msm In New York City, Ashley Murray, Zaneta Gaul, Madeline Y. Sutton, Jose Nanin

Publications and Research

Black and Latino men who have sex with men (BLMSM) are disproportionately infected with HIV; they comprised 66% of HIV diagnoses among men who have sex with men (MSM) in the United States in 2015. Risk factors for HIV infection among BLMSM include a high community prevalence of diagnosed and undiagnosed HIV/STDs, and dense sex partner networks. Perceptions of HIV risk among BLMSM were explored to inform HIV prevention efforts. During 2011–2012, semistructured interviews were conducted with BLMSM in New York City. Using computer-assisted thematic analyses (NVivo), transcribed interview responses to questions regarding HIV risk for main themes were examined. …

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

Do Mothers Affect Daughter’S Behaviors? Diet, Physical Activity, And Sedentary Behaviors In Kuwaiti Mother–Daughter Dyads, Lemia H. Shaban, Joan A. Vaccaro, Shiryn D. Sukhram, Fatma G. Huffman

Publications and Research

The objective of the study was to evaluate 169 Kuwaiti mother– daughter dyads and their associations with health behaviors for eating healthy, engaging in physical activity, daughters perceived body weight, time spent with computer/video, and time viewing television. Female students aged 10–14 years were selected from private and public schools in the State of Kuwait. Results demonstrated that daughters exhibited similar behaviors to their mothers in their perceived eating behavior, physical activity, computer/ video game use, and TV screen time. Future research is essential to determine the role of mothers in effective health behavior intervention strategies for female Kuwaiti adolescents.

In Liberia: A Silent Health Care Catastrophe Replaces A Viral One, Clarissa Sosin

Capstones

Underfunded and understaffed, the structural issues within the Liberian healthcare system were first exposed during the 2014 Ebola Epidemic when the system collapsed under the pressure. Its failure to respond effectively resulted in the deaths of nearly 5,000 people, the highest fatality rate out of the three countries most affected by the epidemic. Years later, despite efforts to rebuild and strengthen the system, many of the issues still remain.

http://www.clarissasosin.com/liberianhealthcare

The Gift That Keeps One Living, Scott R. Axelrod

Capstones

This long-form narrative feature article reports on the shortage of living kidney donors and those in desperate need of kidney transplants. It features interviews with doctors, transplant coordinators, patients, living kidney donors, and kidney recipients. The story culminates with my own personal experience as a kidney donor to my late dad over a decade ago. The presentation includes an extensive photo component capturing characters and elements from the story through a series of detailed portraits, photo essays, and infographics.

https://saxelrod718.wixsite.com/livingkidneydonors

Poisoned By My Government: How The Military Let Families Drink Contaminated Water For Decades And Didn’T Learn From It, Alana Pipe, Lori Freshwater

Capstones

This story is about a quest to find classmates from Camp Lejeune and put together a record of a school, where in the early 1980s the children drank and breathed heavily contaminated water and air. Not only were the children involved in what is widely accepted as the worst water contamination case in U.S history, they were there during the years when the levels of chemical contaminants peaked. The United States Marine Corps knew this at the time and did nothing to protect the children in its custody. While looking into the past contamination on Camp Lejeune, it was discovered …

Mental Hell, Jesenia De Moya, Hanaa' Tameez, Maritza Villela

Capstones

Mental Hell explores how difficult it is for low-income Latinos in New York City to access mental health care. Through explanations from experts and the personal stories of three Latinas New Yorkers who have gone through the process of trying to get the care they need, the story guides the reader through the many roadblocks this demographic encounters specifically under the insurance of Medicaid.

This is an extremely important topic that affects many New Yorkers, and we believe something needs to be done to make this type of healthcare more accessible for Latinos. New York City has a very high …

Protocol For Project Impact (Improving Millions Hearts For Provider And Community Transformation): A Quasi-Experimental Evaluation Of An Integrated Electronic Health Record And Community Health Worker Intervention Study To Improve Hypertension Management Among South Asian Patients, Priscilla M. Lopez, Jennifer Zanowiak, Keith Godfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam

Publications and Research

Background: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative. Building …

Doula Services Within A Healthy Start Program: Increasing Access For An Underserved Population, Mary-Powel Thomas, Gabriela Ammann, Ellen Brazier, Philip Noyes, Aletha Maybank

Publications and Research

Purpose: Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support.

Description: To address this issue, the New York City Department of Health and Mental Hygiene’s Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along …

Patients’ Willingness To Participate In Rapid Hiv Testing: A Pilot Study In Three New York City Dental Hygiene Clinics, Susan H. Davide, Anthony J. Santella, Winnie Furnari, Petal Leuwaisee, Marilyn Cortell, Bhuma Krishnamachari

Publications and Research

Purpose: One in eight people living with an HIV infection in the United States is unaware of their status. Rapid HIV testing (RHT) is an easily used and accepted screening tool that has been introduced in a limited number of clinical settings. The purpose of this study was to investigate patient acceptability, certainty of their decision, and willingness to pay for screening if RHT was offered in university-based dental hygiene clinics.

Methods: A cross-sectional survey was administered to 426 patients at three dental hygiene clinics in New York City over a period of four months. The survey questionnaire was based …

Barriers To And Facilitators Of Help-Seeking Behavior Among Men Who Experience Sexual Violence, Martina Delle Donne, Joseph Deluca, Pavel Pleskach, Christopher Bromson, Marcus P. Mosley, Edward T. Perez, Shibin G. Matthews, Rob Stephenson, Victoria Frye

Publications and Research

Research on sexual violence and related support services access has mainly focused on female victims; there is still a remarkable lack of research on men who experience sexual violence. Research demonstrates that people who both self-identify as men and are members of sexual-orientation minority populations are at higher risk of sexual violence. They are also less likely to either report or seek support services related to such experiences. The present study is an exploratory one aimed at filling the gap in the literature and better understanding how men, both straight and gay as well as cisgender and transgender, conceptualize, understand, …