Public Health Commons^™

Environmental Degradation In Baía De Todos Os Santos, Brazil: A Review Of The Evidence, Amanda Chen, Amanda Northcross, Shanell Folger

GW Research Days 2016 - 2020

The communities living in Baía de Todos os Santos (BTS) has been subjected to toxicants released into the environment by the growing petrochemical industry surrounding the area. Community members are concerned about the effects that these chemicals have on the health and wellbeing of the people, as well as the natural environment. Many of the communities are artisanal fishers and rely on the fish and shellfish produced by the bay for a living. Working in collaboration with the Movement of Artisanal Fisher People (MPP), this research aims to summarize previous research conducted in the BTS. The research describes the environmental …

Disparities In Diabetes Rates And Quality Of Care Within Immigrants In The Usa, Anyun Chatterjee, Martin Blanco, George Gray

GW Research Days 2016 - 2020

Immigrants to the USA present an interesting opportunity to test the classical public health question of the impact of place on a health outcome. Diabetes is a prevalent disease in the USA which is slated to rise in rate in the future. Currently, 9.4% of the country is diabetic, and another 28% of the country is prediabetic. We posed the question - is this impact felt disproportionately by immigrants as they live in the US for a decade or more? Our preliminary literature search indicated that this has not been studied extensively, although the impact of American fast food on …

(Video) Differences In Psychosocial And Behavioral Risk Profiles Of Cigarette Smokers And E-Cigarette Users Among Minnesota Adolescents: 2016, Tara E. Jenson

GW Research Days 2016 - 2020

Background/Objectives: Rates of cigarette smoking among adolescents have been trending downward, however rates of adolescent e-cigarette use rates are now twice those of adolescent cigarette smoking nationally. The objective of this study was to examine the association of demographic, socioeconomic, psychosocial and health behavioral factors as surveyed by the Minnesota Student Survey with cigarette smoking and e-cigarette use among Minnesota adolescents.

Methods: This study analyzed the 2016 Minnesota Student Survey (MSS), an anonymous, school-based, cross-sectional survey of students in grades five, eight, nine and eleven. The 2016 MSS contains a total of 168,733 records, 118,198 of which were …

The Trans Pacific Partnership Agreement, Intellectual Property And Medicines: Differential Outcomes For Developed And Developing Countries, Deborah Gleeson, Joel Lexchin, Ruth Lopert, Burcu Kilic

Health Policy and Management Faculty Publications

The final text of the Trans Pacific Partnership Agreement (TPP), agreed between the 12 negotiating countries in 2016, included a suite of intellectual property provisions intended to expand and extend pharmaceutical company exclusivities on medicines. It drew wide criticism for including such provisions in an agreement that involved developing countries (Vietnam, Peru, Malaysia, Mexico, Chile and Brunei Darussalam) because of the effect on delaying the introduction of low-cost generics. While developing nations negotiated transition periods for implementing some obligations, all parties would have eventually been expected to meet the same standards had the TPP come into force. While the TPP …

Physical Activity Across The Lifespan And Liver Cancer Incidence In The Nih-Aarp Diet And Health Study Cohort., Hannah Arem, Erikka Loftfield, Pedro F Saint-Maurice, Neal D Freedman, Charles E Matthews

Epidemiology Faculty Publications

While liver cancer rates in the United States are increasing, 5-year survival is only 17.6%, underscoring the importance of prevention. Physical activity has been associated with lower risk of developing liver cancer, but most studies assess physical activity only at a single point in time, often in midlife. We utilized physical activity data from 296,661 men and women in the NIH-AARP Diet and Health Study cohort to test whether physical activity patterns over the life course could elucidate the importance of timing of physical activity on liver cancer risk. We used group modeling of longitudinal data to create physical activity …

Associations Between Nurse Experience, Clinical Specialty Setting, And Level Of Nursing Education With Adherence To Clinical Practice Guidelines For Inpatient Influenza And Pneumococcal Vaccination Administration, Amy C. Alsante, Dnp, Ms, Rn, Ne-Bc, Chep

Doctor of Nursing Practice Projects

Background: This research project examines associations between years of nursing practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. Previous research demonstrates novice nurses are at higher risk for errors of omission and face challenges with critical thinking.

Objectives: 1) Identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration and 2) to identify associations among independent variables including levels of education, and specialty setting.

Methods: A retrospective chart review was conducted to identify associations between years of practice and compliance with clinical practice guidelines for inpatient influenza/pneumococcal vaccination administration. …

Evaluation Of The Carestarttm Glucose-6-Phosphate Dehydrogenase (G6pd) Rapid Diagnostic Test At Community And Health Center Level, Cambodia, Bertha Nyagaya-Wojnarski, Dnp, Fnp-Bc, Mph

Doctor of Nursing Practice Projects

Background: Primaquine (PQ) is the only FDA-approved drug for radical cure of Plasmodium vivax (P.v) malaria, but treatment can result in life-threatening hemolysis if given to a glucose-6- phosphate dehydrogenase deficient (G6PDd) patient. Therefore, the G6PD status of the patient with P.v must be known prior to prescribing PQ. However, patient G6PD status in rural malaria endemic settings is generally unknown, illuminating the need for reliable point of care G6PD diagnostic tests as a prerequisite to safely administer PQ. To increase community PQ access in Cambodia, performance of CareStartTM G6PD rapid diagnostic tests (RDTs) needs to be evaluated in healthcare …

Evaluation Of Disparities In Healthcare Experiences Between Racial Identities And Age Cohorts, Christopher Ruckman, Dnp, Mba, Msn, Rn, Cen

Doctor of Nursing Practice Projects

Background: Healthcare consumers have their own perspectives and expectations of what should occur during an encounter of care; these unmet expectations create healthcare disparities. However, there is limited data regarding healthcare experiences among racial and aging groups.

Objectives: To compare the physical and emotional responses of healthcare experiences among racial/ethnic and aged cohorts in the United States.

Methods: Applying a descriptive-correlational design, secondary data from the 2014 Behavioral Risk Factor Surveillance System related to healthcare experiences among racial groups (White, Black, Hispanic, and Asian) and aged cohorts (18-39, 40-54, and 55- 69 years) were assessed.

Results: In the sample, there …

Cancer Screening Practices Among Sexual Orientation Groups, Scott Kilgore, Dnp, Msn, Bs, Rn

Doctor of Nursing Practice Projects

Background: Increasing cancer screening testing is a national health initiative to decrease the mortality rates of all Americans; however, cancer screening practices among sexual minorities have been understudied.

Objectives: To assess and compare breast, cervical, prostate, and colorectal cancer screening practices among straight, lesbian, gay, and bisexual individuals.

Methods: A descriptive-correlational study was conducted using data from the Center for Disease Control and Prevention 2014 Behavioral Risk Factor Surveillance System survey. Respondents who answered questions about their cancer screening practices and sexual orientation were included.

Results: This study identified disparities in breast cancer screening practices with bisexual women (81.9%) meeting …

Variables Related To Colon Cancer Screening Rates Among Male Veterans, Patricia D. Dotson, Dnp, Msn, Aprn

Doctor of Nursing Practice Projects

Background/Problem: The Center for Disease Control & Prevention (CDC) recommends colon cancer screening colonoscopy beginning at age 50 years and every 10 years thereafter. The purpose of this study was to compare differences in meeting the colorectal cancer (CRC) screening recommendations between male Veterans and non-Veterans and identifying any association among Veterans social economic status (SES).

Methods: A descriptive-comparative design was used to address the study question, aims and hypotheses, using the 2014 Behavioral Risk Factor Surveillance System (BRFSS) data. A national representative sample of 20,360 Veterans and 36,183 non-Veterans between 50-74 years, were included in analysis. The associations between …

Designing A Socio-Normative Intervention To Reduce Anemia In Odisha India: A Formative Research Protocol [Version 1; Referees: 2 Approved], Erica Sedlander, Rajiv N Rimal, Sameera A Talegawkar, Hagere Yilma, Wolfgang Munar

Prevention and Community Health Faculty Publications

Background: More than half of women of reproductive age in India are anemic. Anemia is associated with increased risk of preterm delivery, higher maternal mortality and contributes to fatigue, which affects women’s work productivity. The World Health Organization (WHO) recommends daily oral iron and folic acid (IFA) supplements during pregnancy and weekly supplements for women of reproductive age. Government programs and global donors have distributed and promoted IFA supplements in India for over four decades. However, initial intake and compliance remain inadequate.
Objectives: This protocol describes the formative research phase of a larger study, which will test, through a randomized …

Perceived Access And Barriers To Care Among Illicit Drug Users And Hazardous Drinkers: Findings From The Seek, Test, Treat, And Retain Data Harmonization Initiative (Sttr)., Mika Matsuzaki, Quan M Vu, Marya Gwadz, Joseph A C Delaney, Irene Kuo, Maria Esther Perez Trejo, William E Cunningham, Chinazo O Cunningham, Katerina Christopoulos

Epidemiology Faculty Publications

BACKGROUND: Illicit drug use (DU) and hazardous drinking (HD) among marginalized populations may be associated with greater barriers to care.

METHODS: We used baseline data on the participants of the Seek, Test, Treat, and Retain data harmonization initiative. DU includes use of any illicit drugs within the past 6 months. HD was defined as scores ≥8 for men and ≥ 7 for women on Alcohol Use Disorders Identification Test within the past 12 months. Social support scores were assigned by summing scores from individual questions related to social support. Two outcomes for multivariable regression models and mediation analysis were perceived …

Defining Care Patterns And Outcomes Among Persons Living With Hiv In Washington, Dc: Linkage Of Clinical Cohort And Surveillance Data., Amanda D Castel, Arpi Terzian, Jenevieve Opoku, Lindsey Powers Happ, Naji Younes, Michael Kharfen, Alan Greenberg, Dc Cohort Executive Committee

Epidemiology Faculty Publications

BACKGROUND: Triangulation of data from multiple sources such as clinical cohort and surveillance data can help improve our ability to describe care patterns, service utilization, comorbidities, and ultimately measure and monitor clinical outcomes among persons living with HIV infection.

OBJECTIVES: The objective of this study was to determine whether linkage of clinical cohort data and routinely collected HIV surveillance data would enhance the completeness and accuracy of each database and improve the understanding of care patterns and clinical outcomes.

METHODS: We linked data from the District of Columbia (DC) Cohort, a large HIV observational clinical cohort, with Washington, DC, Department …

Combining Community Engagement And Scientific Approaches In Next-Generation Monitor Siting: The Case Of The Imperial County Community Air Network., Michelle Wong, Esther Bejarano, Graeme Carvlin, Katie Fellows, Galatea King, Humberto Lugo, Michael Jerrett, Dan Meltzer, Amanda Northcross, Luis Olmedo, Edmund Seto, Alexa Wilkie, Paul English

Environmental and Occupational Health Faculty Publications

Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities. By engaging community residents in the project design, monitor …

Use Of Placebo In Supplementation Studies-Vitamin D Research Illustrates An Ethical Quandary., Leigh A. Frame, Jonathan P. Fischer, Gail Geller, Lawrence J Cheskin

Clinical Research and Leadership Faculty Publications

History has shown that without explicit and enforced guidelines, even well-intentioned researchers can fail to adequately examine the ethical pros and cons of study design choices. One area in which consensus does not yet exist is the use of placebo groups in vitamin supplementation studies. As a prime example, we focus on vitamin D research. We aim to provide an overview of the ethical issues in placebo-controlled studies and guide future discussion about the ethical use of placebo groups. Research in the field of vitamin D shows variation in how placebo groups are used. We outline four types of control …

Tobacco Dependence Treatment In The Emergency Department: A Randomized Trial Using The Multiphase Optimization Strategy., Steven L Bernstein, James Dziura, June Weiss, Ted Miller, Katrina A Vickerman, Lauretta E Grau, Michael V Pantalon, Lorien Abroms, Linda M Collins, Benjamin Toll

Prevention and Community Health Faculty Publications

Background

Tobacco dependence remains the leading preventable cause of death in the developed world. Smokers are disproportionately from lower socioeconomic groups, and may use the hospital emergency department (ED) as an important source of care. A recent clinical trial demonstrated the efficacy of a multicomponent intervention to help smokers quit, but the independent contributions of those components is unknown.

Methods

This is a full-factorial (16-arm) randomized trial in a busy hospital ED of 4 tobacco dependence interventions: brief motivational interviewing, nicotine replacement therapy, referral to a telephone quitline, and a texting program. The trial utilizes the Multiphase Optimization …

Qualitative Evaluation Of The Saleema Campaign To Eliminate Female Genital Mutilation And Cutting In Sudan., Andrea C Johnson, W Douglas Evans, Nicole Barrett, Howida Badri, Tamador Abdalla, Cody Donahue

Prevention and Community Health Faculty Publications

BACKGROUND: Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being "whole", healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants' information sources, values, and suggestions for the campaign broadly. …

The Association Of Long-Term Exposure To Particulate Matter Air Pollution With Brain Mri Findings: The Aric Study., Melinda C Power, Archana P Lamichhane, Duanping Liao, Xiaohui Xu, Clifford R Jack, Rebecca F Gottesman, Thomas Mosley, James D Stewart, Jeff D Yanosky, Eric A Whitsel

Epidemiology Faculty Publications

BACKGROUND: Increasing evidence links higher particulate matter (PM) air pollution exposure to late-life cognitive impairment. However, few studies have considered associations between direct estimates of long-term past exposures and brain MRI findings indicative of neurodegeneration or cerebrovascular disease.

OBJECTIVE: Our objective was to quantify the association between brain MRI findings and PM exposures approximately 5 to 20 y prior to MRI in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: ARIC is based in four U.S. sites: Washington County, Maryland; Minneapolis suburbs, Minnesota; Forsyth County, North Carolina; and Jackson, Mississippi. A subset of ARIC participants underwent 3T brain MRI in …

Long-Term Exposure Of Fine Particulate Matter Causes Hypertension By Impaired Renal D1 Receptor-Mediated Sodium Excretion Via Upregulation Of G-Protein-Coupled Receptor Kinase Type 4 Expression In Sprague-Dawley Rats., Xi Lu, Zhengmeng Ye, Shuo Zheng, Hongmei Ren, Jing Zeng, Xinquan Wang, Pedro A Jose, Ken Chen, Chunyu Zeng

Medicine Faculty Publications

BACKGROUND: Epidemiological evidence supports an important association between air pollution exposure and hypertension. However, the mechanisms are not clear.

METHODS AND RESULTS: Our present study found that long-term exposure to fine particulate matter (PM2.5) causes hypertension and impairs renal sodium excretion, which might be ascribed to lower D1 receptor expression and higher D1 receptor phosphorylation, accompanied with a higher G-protein-coupled receptor kinase type 4 (GRK4) expression. The in vivo results were confirmed in in vitro studies (ie, PM2.5 increased basal and decreased D1 receptor mediated inhibitory effect on Na+-K+ ATPase activity, decreased D1 receptor expression, and increased D1 receptor phosphorylation …

Reducing Stigma Among Healthcare Providers To Improve Mental Health Services (Reshape): Protocol For A Pilot Cluster Randomized Controlled Trial Of A Stigma Reduction Intervention For Training Primary Healthcare Workers In Nepal., Brandon A Kohrt, Mark J D Jordans, Elizabeth L Turner, Kathleen J Sikkema, Nagendra P Luitel, Sauharda Rai, Daisy R Singla, Jagannath Lamichhane, Crick Lund, Vikram Patel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services …

Surgical Management Of Symptomatic Intraluminal Duodenal Diverticulum In An Adolescent, Vivian Lam Saavedra, Timothy D. Kane, Stefany Garrity

Surgery Faculty Publications

No abstract provided.

Community Health Worker Interventions To Promote Psychosocial Outcomes Among People Living With Hiv—A Systematic Review, H Han, K Kim, Jeanne Murphy, J Cudjoe, P Wilson, P Sharps, J Farley

Nursing Faculty Publications

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the …

Fusion, 2018, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Relative Roles Of Race Versus Socioeconomic Position In Studies Of Health Inequalities: A Matter Of Interpretation, Amani Nuru-Jeter, Elizabeth Michaels, Marilyn D. Thomas, Alexis Reeves, Roland Thorpe, Thomas A. Laveist

Health Policy and Management Faculty Publications

An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common …

Planned Social Network Change And Modern Contraceptive Use In A Rural Ethiopian Community, Mark Edberg, Erica Sedlander, Rajiv Rimal, Jeffrey Bingenheimer, Hina Shaikh, Wolfgang Munar, Lakew Gebretsadik Abebe, Fira Abamecha, Abraham Tamirat Gizaw, Sudhakar Morankar

Prevention and Community Health Faculty Publications

No abstract provided.

Risk Behaviors And Hiv Care Continuum Outcomes Among Criminal Justice-Involved Hiv-Infected Transgender Women And Cisgender Men: Data From The Seek, Test, Treat, And Retain Harmonization Initiative., Curt G Beckwith, Irene Kuo, Rob J Fredericksen, Lauren Brinkley-Rubinstein, William E Cunningham, Sandra A Springer, Kelsey B Loeliger, Julie Franks, Katerina Christopoulos, Jennifer Lorvick, Shoshana Y Kahana, Rebekah Young, David W Seal, Chad Zawitz, Joseph A Delaney, Heidi M Crane, Mary L Biggs

Epidemiology Faculty Publications

BACKGROUND: Transgender persons are highly victimized, marginalized, disproportionately experience incarceration, and have alarmingly increased rates of HIV infection compared to cis-gender persons. Few studies have examined the HIV care continuum outcomes among transgender women (TW), particularly TW who are involved with the criminal justice (CJ) system.

METHODS: To improve our understanding of HIV care continuum outcomes and risk behaviors among HIV-infected TW who are involved with the CJ system, we analyzed data from the National Institute on Drug Abuse-supported Seek, Test, Treat, Retain (STTR) Data Harmonization Initiative. Baseline data were pooled and analyzed from three U.S. STTR studies to examine …

Better Bone Health: Health Community Clinic, Naijah Hughes, Dakota Turnage, Kintara Williams, Christopher Fangna

DC Health and Academic Prep Program (DC HAPP)

Osteoporosis affects the quality of life, the ability to work, and basic activities of daily living. Osteoporosis is a disease marked by reduced bone strength leading to an increase in fractures. Every day, our body breaks down old bone and puts new bone in its place. As we get older, our bones break down more bone than they put back. If you do not take the steps to keep your bones healthy, you may lose too much bone and osteoporosis may develop. Men and women are both affected by osteoporosis. In the United States, an estimated 5.3 million people aged …

Teen Pregnancy Prevention: Nine Minutes To Avoid Nine Months, Natalie Custodio, Ronaldo Gomez, Katherine Mejicanos-Portillo, Jalen Templeman

DC Health and Academic Prep Program (DC HAPP)

The United States is one of the most developed nations with one of the highest rates of teen pregnancy. Although there has been a reduction in teen pregnancy nationally, areas in DC such as Wards 5, 7 and 8 still have teen birth rates above the national rate. The objective for our project is to provide a targeted-intervention to decrease teen pregnancy rates by increasing awareness of safe sex practices, contraceptive methods and STIs/HIV. Our program will provide a 9-minute session on sexual health at chosen schools and youth organizations in Wards 5, 7 and 8 to target 11 to …

Project Anacostia, Lapoldeon Williams, Abenezer Lemma, Janae Thomas, Kafoued Ouedraogo

DC Health and Academic Prep Program (DC HAPP)

Objectives Project Anacostia aims to [1] help meet the Healthy People 2020 goal of reducing the disease burden of diabetes mellitus (DM) and improving the quality of life for all persons who have, or are at risk for, DM as outlined by the U.S. Department of Health and Human Services. [2] To increase community awareness of the social determinants of health related to obesity and diabetes. [3] Increase access to recreational facilities and healthy food options in Wards 7 &8 and [4] promote healthy lifestyle choices among youth in the Anacostia community.

Methods Our intervention is comprised of three progressive …

Pre- And Post-Diagnosis Physical Activity, Television Viewing, And Mortality Among Hematologic Cancer Survivors., Daniela Schmid, Gundula Behrens, Hannah Arem, Christina Hart, Wolfgang Herr, Carmen Jochem, Charles E Matthews, Michael F Leitzmann

Epidemiology Faculty Publications

PURPOSE: The associations of physical activity and television (TV) viewing with mortality risk among individuals with hematologic malignancies remain unclear.

METHODS: We examined the relations of physical activity and TV viewing time before and after diagnosis with mortality among 5182 U.S. adults aged 50-71 years from the NIH-AARP Diet and Health Study cohort who survived a first primary hematologic cancer between 1995-1996 and 2011.

RESULTS: For the pre- and post-diagnosis analyses, we confirmed 2606 and 613 deaths respectively. In multivariable-adjusted Cox proportional hazard regression models, comparing high (≥4 hrs/wk) versus low (/wk) activity levels, pre-diagnosis physical activity was associated with …