Public Health Commons^™

Offering Self-Administered Oral Hiv Testing As A Choice To Truck Drivers In Kenya: Predictors Of Uptake And Need For Guidance While Self-Testing, Elizabeth A. Kelvin, Gavin George, Eva Mwai, Eston N. Nyaga, Joanne E. Mantell, Matthew L. Romo, Jacob O. Odhiambo, Kaymarlin Govender

Publications and Research

We assessed predictors of choosing self-administered oral HIV testing in the clinic with supervision versus the standard provider-administered blood test when offered the choice among 149 Kenyan truck drivers, described the types of guidance participants needed during self-testing and predictors of needing guidance. Overall, 56.38% of participants chose the self-test, 23.49% the provider-administered test, and 20.13% refused testing. In the adjusted regression models, each additional unit on the fatalism and self-efficacy scales was associated with 0.97 (p = 0.003) and 0.83 (p = 0.008) times lower odds of choosing the self-test, respectively. Overall, 52.38% of self-testers did so correctly without …

Zika Virus-Like Particle (Vlp) Based Vaccine, Héléne Boigard, Alexandra Alimova, George R. Martin, Al Katz, Paul Gottlieb, Jose M. Galarza

Publications and Research

The newly emerged mosquito-borne Zika virus poses a major public challenge due to its ability to cause significant birth defects and neurological disorders. The impact of sexual transmission is unclear but raises further concerns about virus dissemination. No specific treatment or vaccine is currently available, thus the development of a safe and effective vaccine is paramount. Here we describe a novel strategy to assemble Zika virus-like particles (VLPs) by co-expressing the structural (CprME) and non-structural (NS2B/NS3) proteins, and demonstrate their effectiveness as vaccines. VLPs are produced in a suspension culture of mammalian cells and self-assembled into particles closely resembling Zika …

How Income And Food Prices Influence Global Dietary Intakes By Age And Sex: Evidence From 164 Countries, Andrew Muhammad, Anna D'Souza, Birgit Meade, Renata Micha, Dariush Mozaffarian

Publications and Research

Background While income and prices are key drivers of dietary choices, how their influence varies by food category, nation, and demographics is not well established. Based on intake data for 164 countries and 11 food categories, we examined how income and food prices relate to food intake globally, including by world region, age, and sex.

Methods We used 2010 intake data from the Global Dietary Database, the first database of consumption estimates for major food categories by country, age, and sex. We combined these data with national per capita GDP and food price data. We estimated intake responsiveness to income …

Encouraging Medicare Advantage Enrollees To Switch To Higher Quality Plans: Assessing The Effectiveness Of A ‘‘Nudge’’ Letter, Benjamin L. Howell, Partha Deb, Sai Ma, Rachel O. Reid, Jesse Levy, Gerald F. Riley, Patrick H. Conway, William H. Shrank

Publications and Research

There are considerable quality differences across private Medicare Advantage insurance plans, so it is important that beneficiaries make informed choices. During open enrollment for the 2013 coverage year, the Centers for Medicare & Medicaid Services sent letters to beneficiaries enrolled in low-quality Medicare Advantage plans (i.e., plans rated less than 3 stars for at least 3 consecutive years by Medicare) explaining the stars and encouraging them to reexamine their choices. To understand the effectiveness of these low-cost, behavioral ‘‘nudge’’ letters, we used a beneficiary-level national retrospective cohort and performed multivariate regression analysis of plan selection during the 2013 open enrollment …

Legal Mapping Analysis Of State Telehealth Reimbursement Policies, Kate E. Trout, Sankeerth Rampa, Fernando A. Wilson, Jim P. Stimpson

Publications and Research

Background: There exists rapid growth and inconsistency in the telehealth policy environment, which makes it difficult to quantitatively evaluate the impact of telehealth reimbursement and other policies without the availability of a legal mapping database. Introduction: We describe the creation of a legal mapping database of state-level policies related to telehealth reimbursement of healthcare services. Trends and characteristics of these policies are presented.

Materials and Methods: Information provided by the Center for Connected Health Policy was used to identify state-wide laws and regulations regarding telehealth reimbursement. Other information was retrieved using: (1) LexisNexis database, (2) Westlaw database, and (3) retrieval …

Health Insurance Coverage Among Puerto Ricans In The U.S., 2010 – 2015, Jennifer Hinojosa

CUNY Centro, The Center for Puerto Rican Studies

The recent debates and issues surrounding the 2010 Affordable Care Act (ACA) have raised major concerns about accessibility to healthcare services in the United States. Puerto Ricans are among the fastest growing groups in the U.S., partially due to natural growth and increasing migration from Puerto Rico. Given this growth, accessibility to healthcare coverage is an important topic of discussion, given the consequences on access.

Impact Of Health Policy Changes On Emergency Medicine In Maryland Stratified By Socioeconomic Status, Laura Pimentel, David Anderson, Bruce Golden, Edward Wasil, Fermin Barreuto, Jon M. Hirshon

Publications and Research

Introduction: On January 1, 2014, the financing and delivery of healthcare in the state of Maryland (MD) profoundly changed. The insurance provisions of the Patient Protection and Affordable Care Act (ACA) began implementation and a major revision of MD’s Medicare waiver ushered in a Global Budget Revenue (GBR) structure for hospital reimbursement. Our objective was to analyze the impact of these policy changes on emergency department (ED) utilization, hospitalization practices, insurance profiles, and professional revenue. We stratified our analysis by the socioeconomic status (SES) of the ED patient population.

Methods: We collected monthly mean data including patient volume, hospitalization percentages, …

Development And Validation Of Measures To Evaluate Adolescents' Knowledge About Human Papillomavirus (Hpv), Involvement In Hpv Vaccine Decision-Making, Self-Efficacy To Receive The Vaccine And Fear And Anxiety, A. S. Forster, K. A. Mcbride, C. Davies, T. Stoney, H. Marshall, K. Mcgeechan, Spring C. Cooper, S. R. Skinner

Publications and Research

Objectives: We describe the development and validation of measures of human papillomavirus (HPV)/HPV vaccination knowledge, fear/anxiety about vaccination, involvement in HPV vaccine decision-making, and self-efficacy with regard to getting the vaccine, designed to evaluate the efficacy of an intervention to affect these domains (collectively termed the HAVIQ: HPV Adolescent Vaccine Intervention Questionnaire). Study design: Literature search, cognitive interviews and cross-sectional survey.

Methods: A literature search identified existing items that were modified for the present measures. Experts reviewed draft measures for face and content validity. Cognitive interviews with adolescents were also used to assess content validity. Adolescents completed the measures and …

Identifying Inequities In Maternal And Child Health Through Risk Stratification To Inform Health Systems Strengthening In Northern Togo, Katharine J. Mccarthy, Sandra Braganza, Kevin Fiori, Christophe Gbeleou, Vivien Kpakpo, Andrew Lopez, Jennifer Schechter, Alicia Singham Goodwin, Heidi E. Jones

Publications and Research

Objective
In Togo, substantial progress in maternal and child health is needed to reach global development goals. To better inform clinic and community-based health services, this study identifies factors associated with maternal and child health care utilization in the Kara region of Northern Togo.

Methods
We conducted a population-representative household survey of four health clinic catchment areas of 1,075 women of reproductive age in 2015. Multivariable logistic regression was used to model individual and structural factors associated with utilization of four maternal and child health services. Key outcomes were: facility-based delivery, maternal postnatal health check by a health professional within …

Longitudinal Associations Between Body Mass Index, Physical Activity, And Healthy Dietary Behaviors In Adults: A Parallel Latent Growth Curve Modeling Approach, Youngdeok Kim, Jung-Min Lee, Jungyoon Kim, Emily Dhurandhar, Ghada Soliman, Nizar K. Wehbi, James Canedy

Publications and Research

Background Physical activity (PA) and healthy dietary behaviors (HDB) are two well-documented lifestyle factors influencing body mass index (BMI). This study examined 7-year longitudinal associations between changes in PA, HDB, and BMI among adults using a parallel latent growth curve modeling (LGCM).

Methods We used prospective cohort data collected by a private company (SimplyWell LLC, Omaha, NE, USA) implementing a workplace health screening program. Data from a total of 2,579 adults who provided valid BMI, PA, and HDB information for at least 5 out of 7 follow-up years from the time they entered the program were analyzed. PA and HDB …

A Place-Based Community Health Worker Program: Feasibility And Early Outcomes, New York City, 2015, Priscilla M. Lopez, Nadia Islam, Alexis Feinberg, Christa Myers, Lois Seidl, Elizabeth Drackett, Lindsay Riley, Andreas Mata, Juan Pinzon, Elisabeth Benjamin, Katarzyna Wyka, Rachel Dannefer, Javier Lopez, Chau Trinh-Shevrin, Karen Aletha Maybank, Lorna E. Thorpe

Publications and Research

Introduction: This study examined feasibility of a place-based community health worker (CHW) and health advocate (HA) initiative in five public housing developments selected for high chronic disease burden and described early outcomes.

Methods: This intervention was informed by a mixed-method needs assessment performed December 2014–January 2015 (representative telephone survey, n¼1,663; six focus groups, n¼55). Evaluation design was a non-randomized, controlled quasi-experiment. Intake and 3-month follow-up data were collected February–December 2015 (follow-up response rate, 93%) on 224 intervention and 176 comparison participants, and analyzed in 2016. All participants self-reported diagnoses of hypertension, diabetes, or asthma. The intervention consisted of chronic disease …

Nourishing Nycha: Food Policy As A Tool For Improving The Well-Being Of New York City’S Public Housing Residents, Nevin Cohen, Nicholas Freudenberg, Craig Willingham

Publications and Research

This policy brief examines food environments in New York City public housing. It looks at the food public housing residents buy, prepare and eat and the role food plays in the health, environment and economy of the city’s NYCHA population. Our goal is to contribute new insights into how NYCHA can use food policy and programs to improve the well-being of its residents and make New York City healthier, more self-sufficient, safer and more sustainable.

Prospective Prediction Of Juvenile Homicide/Attempted Homicide Among Early-Onset Juvenile Offenders, Michael T. Baglivio, Kevin T. Wolff

Publications and Research

While homicide perpetrated by juveniles is a relatively rare occurrence, between 2010 and 2014, approximately 7%–8% of all murders involved a juvenile offender. Unfortunately, few studies have prospectively examined the predictors of homicide offending, with none examining first-time murder among a sample of adjudicated male and female youth. The current study employed data on 5908 juvenile offenders (70% male, 45% Black) first arrested at the age of 12 or younger to prospectively examine predictors of an arrest for homicide/attempted homicide by the age of 18. Among these early-onset offenders, males, Black youth, those living in households with family members with …

A Mendelian Randomization Study Of The Effect Of Calcium On Coronary Artery Disease, Myocardial Infarction And Their Risk Factors, Lin Xu, Shi Lin Lin, C. Mary Schooling

Publications and Research

Meta-analyses of randomized controlled trials (RCTs) suggest calcium could have adverse effects on cardiovascular disease, although these findings are controversial. To clarify, we assessed whether people with genetically higher calcium had a higher risk of coronary artery disease (CAD), myocardial infarction (MI) and their risk factors. We used a two-sample Mendelian randomization study. We identified genetic variants (single nucleotide polymorphisms (SNPs)) that independently contributed to serum calcium at genome-wide significance which we applied to large extensively genotyped studies of CAD, MI, diabetes, lipids, glycaemic traits and adiposity to obtain unconfounded estimates, with body mass index (BMI) as a control outcome. …

Redeamericas: Building Research Capacity In Young Leaders For Sustainable Growth In Community Mental Health Services In Latin America, L. Yang, C. Pratt, E. Valencia, S. Conover, R. Fernández, M.S. Burrone, M.T. Cavalcanti, G. Lovisi, G. Rojas, R. Alvarado, S. Galea, L. N. Price, E. Susser

Publications and Research

The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional ‘Hubs’ funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities – Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina – working together with a team affiliated …

Hepatitis C Serosorting Among People Who Inject Drugs In Rural Puerto Rico, Ian Duncan, Ric Curtis, Juan Carlos Reyes, Roberto Abadie, Bilal Khan, Kirk Dombrowski

Publications and Research

Due to the high cost of treatment, preventative measures to limit Hepatitis C (HCV) transmission among people who inject drugs (PWID) are encouraged by many public health officials. A key one of these is serosorting, where PWID select risk partners based on concordant HCV status. Research on the general U.S. population bySmith et al. (2013) found that knowledge of one's own HCV status facilitated serosorting behaviors among PWID, such that respondents with knowledge of their own status were more likely to ask potential partners about their status prior to sharing risk. Our objective was to see if this held true …

Impact Of Cannabis Use On Treatment Outcomes Among Adults Receiving Cognitive-Behavioral Treatment For Ptsd And Substance Use Disorders, Lesia M. Ruglass, Alina Shevorykin, Vanja Radoncic, Kathryn M. Z. Smith, Philip H. Smith, Isaac R. Galatzer-Levy, Santiago Papini, Denise A. Hien

Publications and Research

Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary …

Preventive Healthcare: A Neural Network Analysis Of Behavioral Habits And Chronic Diseases, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

The research aims to explore the association between behavioral habits and chronic diseases, and to identify a portfolio of risk factors for preventive healthcare. The data is taken from the Behavioral Risk Factor Surveillance System (BRFSS) database of the Centers for Disease Control and Prevention, for the year 2012. Using SPSS Modeler, we deploy neural networks to identify strong positive and negative associations between certain chronic diseases and behavioral habits. The data for 475,687 records from BRFS database included behavioral habit variables of consumption of soda and fruits/vegetables, alcohol, smoking, weekly working hours, and exercise; chronic disease variables of heart …

Reproductive History Before And After Hiv Diagnosis: A Cross-Sectional Study In Hiv-Positive Women In Spain, Victoria Hernando, Belen Alejos, Marta Montero, M Jesús Pérez-Elias, José Ramón Blanco, Livia Giner, Juan Luis Gómez-Sirvent, Jose Antonio Iribarren, Enrique Bernal, Francisco Bolumar

Publications and Research

The aim of this study is to examine the reproductive history of human immunodeficiency virus (HIV)-positive women, before and after HIV diagnosis, to describe the characteristics of women with pregnancies after HIV diagnosis, and to assess the prevalence of mother-to-child transmission.

A cross-sectional study was performed among women within reproductive ages (18–49) selected from the cohort in the Spanish AIDS Research Network (CoRIS). A descriptive analysis of the pregnancy outcomes was made according to women’s serostatus at the moment of pregnancy and association of women’s characteristics with having pregnancy after HIV diagnosis was evaluated using logistic regression models.

Overall, 161 …

Expanding Intersectionality Praxis: Informing Culturally-Responsive Programming For Black And Latino Gay And Bisexual Young Men, Justin T. Brown

Dissertations, Theses, and Capstone Projects

Black/Latino gay/bisexual young men face a multitude of health disparities caused by various determinants of health. However, despite the awareness of the gaps, health intervention research rarely explores the impact of current health intervention strategies on Black/Latino gay/bisexual young men’s overall health and well-being. Traditional health interventions are deficit-based, health condition-specific, and often limited in their cultural-specificity. As health-related fields move toward holistic, evidence-based practices, new primary prevention approaches need to emerge. Using qualitative investigation strategies, this study included primary analysis of participatory workshop artifacts, and secondary analysis of survey and focus group data. This study identified critical factors necessary …

Characteristics Of Hiv-Infected Children At Enrollment Into Care And At Antiretroviral Therapy Initiation In Central Africa, Adebola Adedimeji, Andrew Edmonds, Donald Hoover, Qiuhu Shi, Jean D'Amour Sinayobye, Martin Nduwinmana, Patricia Lelo, Denis Nash, Kathryn Anastos, Marcel Yotebieng

Publications and Research

Background Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described.

Materials and Methods Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0±15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and …

Conceptualizing Care Continua: Lessons From Hiv, Hepatitis C Virus, Tuberculosis And Implications For The Development Of Improved Care And Prevention Continua, David C. Periman, Ashly E. Jordan, Denis Nash

Publications and Research

Background: To examine the application of continuum models to tuberculosis, HIV, and other conditions; to theorize the concept of continua; and to learn lessons that could inform the development of improved care and prevention continua as public health metrics.

Methods: An analytic review of literature drawn from several fields of health care.

Results: The continuum construct is now part of public health evaluation systems for HIV, and is increasingly used in public health and the medical literature. Issues with the comparability and optimal design of care continuum models have been raised, and their methodologic and theoretic underpinnings and scope of …

Research Methods In Occupational Health Psychology, Irvin Sam Schonfeld, Chu-Hsiang Chang

Publications and Research

http://www.springerpub.com/occupational-health-psychology.html

Occupational Health Psychology (OHP) is a rapidly expanding interdisciplinary field that focuses on the science and practice of psychology in promoting and developing workplace health- and safety-related initiatives. This comprehensive text for undergraduate and graduate survey courses is the first to encompass a wide range of key issues in OHP. It draws from the domains of psychology, public health, preventive medicine,nursing, industrial engineering, law, and epidemiology to focus on the theory and practice of protecting and promoting the health, well-being, and safety of individuals in the workplace and improving the quality of work life.

The text addresses key psychosocial …

Creating Integrated Strategies For Increasing Access To Healthy Affordable Food In Urban Communities: A Case Study Of Intersecting Food Initiatives, Michele Silver, Afia Bediako, Tracey Capers, Aysu Kirac, Nicholas Freudenberg

Publications and Research

In New York and other cities, substantial evidence documents that community food environments interact with inequitable allocation of power, wealth and services to shape the distribution of diet-related diseases and food insecurity. This case study shows how one Central Brooklyn community organization, Bedford Stuyvesant Restoration Corporation, has launched multiple coordinated food initiatives in order to reduce the burden of food-related health problems and boost community development. The report used standard case study methods to document the implementation of the New York City Food and Fitness Partnership in Central Brooklyn. The case study shows how two distinct strands of activities, a …

Burnout-Depression Overlap: A Study Of New Zealand Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Mayor, Eric Laurent

Publications and Research

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression …

Incentives To Change: Effects Of Performance-Based Financing On Health Workers In Zambia, Gordon C. Shen, Ha Thi Hong Nguyen, Ashis Das, Nkenda Sachingongu, Collins Chansa, Jumana Qamruddin, Jed Friedman

Publications and Research

Background: Performance-based financing (PBF) has been implemented in a number of countries with the aim of transforming health systems and improving maternal and child health. This paper examines the effect of PBF on health workers’ job satisfaction, motivation, and attrition in Zambia. It uses a randomized intervention/control design to evaluate before–after changes for three groups: intervention (PBF) group, control 1 (C1; enhanced financing) group, and control 2 (C2; pure control) group.

Methods: Mixed methods are employed. The quantitative portion comprises of a baseline and an endline survey. The survey and sampling scheme were designed to allow for a rigorous impact …

Perceived Discrimination And Self-Rated Health In The Immigrant Population Of The Basque Country, Spain, Elena Rodriguez-Alvarez, Yolanda Gonzalez-Rabago, Luisa N. Borrell, Nerea Lanborena

Publications and Research

Objective

To examine the effect of perceived discrimination and self-rated health among the immigrant population in the Basque Country, Spain, and determine whether this effect varies according to region of origin, age, sex and education. Methods

Descriptive cross-sectional study. The study population included immigrants aged 18 and older residing in the Basque Country. Data from the 2014 Foreign Immigrant Population Survey (n=3,456) were used. Log-binomial regression was used to quantify the association between perceived discrimination and self-rated health before and after checking for the selected characteristics. Results

Almost 1 in 10 immigrant adults reports perceiving discrimination. In adjusted analyses, the …

Countermarketing Alcohol And Unhealthy Food: An Effective Strategy For Preventing Noncommunicable Diseases? Lessons From Tobacco, P. Christopher Palmedo, Lori Dorfman, Sarah Garza, Eleni K. Murphy, Nicholas Freudenberg

Publications and Research

Countermarketing campaigns use health communications to reduce the demand for unhealthy products by exposing motives and undermining marketing practices of producers. These campaigns can contribute to the prevention of noncommunicable diseases by denormalizing the marketing of tobacco, alcohol, and unhealthy food. By portraying these activities as outside the boundaries of civilized corporate behavior, countermarketing can reduce the demand for unhealthy products and lead to changes in industry marketing practices. Countermarketing blends consumer protection, media advocacy, and health education with the demand for corporate accountability. Countermarketing campaigns have been demonstrated to be an effective component of comprehensive tobacco control. This review …

Burnout Or Depression: Both Individual And Social Issue, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended in our that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. The phenomena of interest (burnout or depression) should not be confused with the perspectives (individual or social) adopted to elucidate those phenomena. Both burnout and depression are best explained through the interaction of social or external conditions with individual or internal dispositions.

Comparing Cmaq Forecasts With A Neural Network Forecast Model For Pm2.5 In New York, Samuel D. Lightstone, Fred Moshary, Barry Gross

Publications and Research

Human health is strongly affected by the concentration of fine particulate matter (PM2.5). The need to forecast unhealthy conditions has driven the development of Chemical Transport Models such as Community Multi-Scale Air Quality (CMAQ). These models attempt to simulate the complex dynamics of chemical transport by combined meteorology, emission inventories (EI’s), and gas/particle chemistry and dynamics. Ultimately, the goal is to establish useful forecasts that could provide vulnerable members of the population with warnings. In the simplest utilization, any forecast should focus on next day pollution levels, and should be provided by the end of the business day (5 p.m. …