Public Health Commons^™

Characterizing The Vaccine Knowledge, Attitudes, Beliefs, And Intentions Of Pregnant Women In Georgia And Colorado, Matthew Z. Dudley, Rupali J. Limaye, Saad B. Omer, Sean T. O’Leary, Mallory K. Ellingson, Christine I. Spina, Sarah E. Brewer, Allison T. Chamberlain, Robert A. Bednarczyk, Fauzia Malik, Paula M. Frew, Daniel A. Salmon

School of Public Health Faculty Research

Vaccine coverage for maternal vaccines is suboptimal; only about half of pregnant women received influenza and Tdap vaccines in 2018. We explored knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines among pregnant women. Between June 2017 and July 2018, we surveyed 2196 pregnant women recruited from geographically and socio-demographically diverse prenatal care practices in Georgia and Colorado (56% response rate). Fifty-six percent of pregnant women intended to receive both influenza and Tdap vaccines during pregnancy and 68% intended to vaccinate their baby with all recommended vaccines on time. Attitudinal constructs associated with intention to vaccinate include confidence …

Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Research

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American …

Estimating The Costs And Cost-Effectiveness Of Promoting Mammography Screening Among Us-Based Latinas, Yamilé Molina, Catherine M. Pichardo, Donald L. Patrick, Scott D. Ramsey, Sonia Bishop, Shirley A.A. Beresford Phd, Gloria Coronado

Journal of Health Disparities Research and Practice

Purpose: We characterize the costs and cost-effectiveness of a community health worker (CHW)-based intervention to promote screening mammography among US-based non-adherent Latinas.

Methods: The parent study was a randomized controlled trial for 536 Latinas aged 42-74 years old who had sought care within a safety net health center in Western Washington. Participants were block-randomized within clinic to the control arm (usual care) or intervention arm (CHW-led motivational interviewing intervention). We used the perspective of the organization implementing promotional activities to characterize costs and cost-effectiveness. Cost data were categorized as program set-up and maintenance (initial training, booster/annual training) program implementation (administrative …

Discrimination, Coping, And Depression Among Black Men Who Have Sex With Men, Andre L. Brown, Jordan Sang, Leigh Bukowski, Steven Meanley, Byron D. Brooks, Cristian Chandler

Journal of Health Disparities Research and Practice

Black men who have sex with men (BMSM) have elevated risk for depression compared to the general population. BMSM’s capacity to cope with these experiences is not well understood. Increased understanding of how multiple forms of discrimination contribute to depression and how BMSM cope with discrimination can better inform interventions. Data come from 3,510 BMSM who attended Black Pride events in six U.S. cities from 2015-2017. Participants completed a health survey that ascertained their psychosocial health and resiliency profiles. Using multivariable logistic regression models, we tested the associations between type-specific discrimination (race, sexuality, HIV status) and depression. We then conducted …

Improving Community Advisory Board Engagement In Precision Medicine Research To Reduce Health Disparities, Erin Connors, Rebecca Selove, Juan Canedo, Maureen Sanderson, Pamela Hull, Marilyn Adams, Ila Mcdermott, Calvin Barlow, Denice Johns-Porter, Caree Mcafee, Karen Gilliam, Oscar Miller, Nora Cox, Mary Kay Fadden, Stephen King, Hilary Tindle

Journal of Health Disparities Research and Practice

Community Advisory Boards (CABs) are used in efforts to reduce health disparities; however, there is little documentation in the literature regarding their use in precision medicine research. In this case study, an academic-CAB partnership developed a questionnaire and patient educational materials for two precision smoking cessation interventions that involved use of genetic information. The community-engaged research (CEnR) literature provided a framework for enhancing benefits to CAB members involved in developing research documents for use with a low-income, ethnically diverse population of smokers. The academic partners integrated three CEnR strategies: 1) in-meeting statements acknowledging their desire to learn from community partners, …

Rural Primary Care And The Diagnostic Resolution Of Abnormal Screening Mammograms: A Mixed Methods Study In Rural Missouri, Jean Hunleth, Julia Maki, Amanda Lee, Aimee James, Rebecca Lobb

Journal of Health Disparities Research and Practice

Rural health clinics (RHCs) and federally qualified health centers (FQHCs) play a vital role in initiating cancer screening in underserved, rural settings. Yet there is limited information about their involvement in diagnostic tests when a mammogram result is abnormal. Diagnostic resolution of abnormal mammograms varies widely by geographic location and resources, and timely resolution is important for addressing rural-urban cancer disparities. This mixed methods study in a rural region of Missouri with high rates of cancer mortality examined the roles of primary care providers during follow-up after an abnormal mammogram, the processes they used, and the clinic specific variations among …

The Right To Vote, The Right To Health: Voter Suppression As A Determinant Of Racial Health Disparities, Anna K. Hing

Journal of Health Disparities Research and Practice

Civic participation is beneficial to one’s health. Conversely, being unable to participate, such as being unable to vote, may be detrimental for health. Barriers that prevent voting and civic participation, which constitute voter suppression, disproportionately impact people of color. Therefore, voter suppression may explain intractable racial health disparities. However, few studies have examined the connection between voter suppression and health. In consideration of the frequent, and increasing, reports of voter suppression in recent elections, including the rise in voter identification laws, the reduction in early voting opportunities, and the closing of polling places, the field of public health should address …

Factors Contributing To Domestic Violence Among Hindu Asian Indian Immigrant Women In Allegheny County, Pennsylvania: A Feasibility Study, Chelsea Pallatino, Todd Bear, Martha A. Terry

Journal of Health Disparities Research and Practice

While there is research on survivors of domestic violence in India and the United States (U.S.), little is known about the sociocultural factors related to domestic violence among Hindu Asian Indian immigrant women (AIIW) in the U.S. The objectives of this study were to a) test the feasibility of conducting domestic violence research among Hindu AIIW; b) investigate domestic violence prevalence and correlations with other characteristics; and c) test the cultural appropriateness of completed measures on social support, acculturation status, and domestic violence. Over 50% of respondents had experienced abuse, often perpetrated by family. Participants had high levels of social …

Accessing Young Black Stroke Survivors For Secondary Prevention, Mellanie V. Springer, James F. Burke, Devin L. Brown, Lesli E. Skolarus

Journal of Health Disparities Research and Practice

ABSTRACT

Background- Stroke rates and risk factors may be increasing in young adults aged 18-64, especially black individuals. We sought to identify whether young high risk stroke survivors could be found at community health centers.

Methods- This was a cross-sectional analysis of the National Ambulatory Medical Care Survey from 2006-2011. We used chi-square analyses, t-tests, and proportions to compare and describe stroke survivor visits at community health centers and private offices.

Results- Young stroke survivor visits comprise 48% of stroke survivor visits at community health centers compared to 31% of stroke survivor visits at the private office setting. Among young …

A Health Disparity Action Plan: Achieving Equity Through Clinical Trials, Affordable Care, And Professional Development, Daniel Schafer, Shefa Moten, Ayesha Khan, Mauro Ferrari, Boris Lushniak, Edwin Burkett, Asad Moten

Journal of Health Disparities Research and Practice

Given the threatened nature of affordable care in the United States, it is crucial to underscore its importance. What is more, the reason such care is so important is the presence of an oft-unacknowledged disparity in access to quality care in this country and, indeed, around the world. A world without health disparities can be achieved and will be characterized by prompt and quality care available to all and at all stages of the care continuum. Further insurance reform is needed beyond the Affordable Care Act, while local care must be more accessible in rural, urban, and other underserved areas. …

Condom Use And Related Factors Among Rural And Urban Men Who Have Sex With Men In Western China: Based On Information-Motivation-Behavioral Skills Model, Ling Hu, Yetao Luo, Xiaoni Zhong, Rongrong Lu, Yang Wang, Manoj Sharma, Mengliang Ye

Environmental & Global Health Faculty Research

This study aimed to determine the differences in condom use and related factors among rural–urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information–motivation–behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom …

Is The Coronavirus A Pandemic, And Does That Matter? 4 Questions Answered, Brian Labus

Environmental & Global Health Faculty Research

Editor’s note: The new coronavirus has now affected more than 20,000 people in China and claimed more lives as of Feb. 4 than the SARS epidemic from 2002 to 2004. Hong Kong has reported its first death. Some public health officials have said the outbreak is likely to soon be a pandemic, but the World Health Organization said Feb. 4 that it isn’t, yet. Just what is a pandemic anyway? An epidemiologist and public health researcher explains.

Developing An Indicator System For A Healthy City: Taking An Urban Area As A Pilot, Tingting Li, Yong Fang, Dewei Zeng, Zumin Shi, Manoj Sharma, Huan Zeng, Yong Zhao

Environmental & Global Health Faculty Research

Purpose: The Healthy Cities Project is an important strategy for global health. This study aimed to develop a scientific and appropriate indicator system for the evaluation of a Healthy City in Chongqing, China. Methods: Data were collected via a review of government documents, focus group discussions, and in-depth interviews. A total of 34 government documents were reviewed to build the indicator database based on our previous studies. The first round of focus group discussions, which involved eight health-related experts, was conducted to form the indicator system framework. In-depth interviews with 15 experts from government departments were conducted to design the …

Educational Needs Assessment Among 10-14-Year-Old Girls About Puberty Adolescent Health Of Ardebil, Arosh Ziapour, Manoj Sharma, Nazila Nejhaddadgar, Afrouz Mardi, Sedigheh S. Tavafian

Environmental & Global Health Faculty Research

Background: This study aimed to investigate the educational needs of 10–14-year-old girls about adolescent puberty health in Ardabil City in Iran, the matter of adolescent puberty health is one of the most important health priorities, especially for girls. Methods: This cross-sectional descriptive-correlational study was performed on girl students through stratified-cluster sampling in Ardabil city. The data gathering tool was a self-reported researcher-designed questionnaire consisting of 10 demographic questions and 35 self-care questions in 5 domains of self-care awareness, self-efficacy, enablers, enhancers and behaviors, based on the reviewed articles and resources. Descriptive statistics and chi-square test, correlation coefficient and regression were …

Spirituality And Prayer On Teacher Stress And Burnout In An Italian Cohort: A Pilot, Before-After Controlled Study, Francesco Chirico, Manoj Sharma, Salvatore Zaffina, Nicola Magnavita

Environmental & Global Health Faculty Research

Introduction: Teaching is a stressful profession that exposes workers to the risk of burnout. Techniques involving higher mental functions, such as transcendental meditation and prayer, have been used in stress and burnout prevention programs. In this study, we report the results of an experience conducted in a group of teachers of a religious institute, in which prayer was used as a technique to prevent burnout. Methods: Fifty teachers and support staff employed at a Catholic school of a Congregation of nuns volunteered for this study. They were randomized into two groups: prayer treatment (n = 25) or control group (n …

Spatiotemporal Epidemiology Of Varicella In Chongqing, China, 2014-2018, Hua Zhu, Han Zhao, Rong Ou, Qing Zeng, Ling Hu, Hongfang Qiu, Manoj Sharma, Mengliang Ye

Environmental & Global Health Faculty Research

Although immunization against varicella using vaccines has been proven to be significant and effective in the past decades, varicella remains a major public health concern for many developing countries. Varicella vaccination has not been introduced into routine immunization programs in China, and varicella outbreaks have continued to occur. Taking the city of Chongqing, which has a high prevalence of varicella, as an example, this study explored the spatiotemporal epidemiology of varicella. Based on the reported data of varicella cases from 1 January 2014 to 31 December 2018 in Chongqing, hot spots and space-time clusters of varicella were identified using spatial …

Factors Associated With Initiation And Sustenance Of Stress Management Behaviors In Veterinary Students: Testing Of Multi-Theory Model (Mtm), Vinayak K. Nahak, Julia K. Wells, Robert E. Davis, Elizabeth C. Johnson, Jason W. Johnson, Manoj Sharma

Environmental & Global Health Faculty Research

Veterinary students across the United States face the challenge of stress during school every day. When managed improperly, stress can become chronic and manifest in physical and emotional consequences. The purpose of this study was to examine the utility of the multi-theory model (MTM) of health behavior change in predicting the initiation and sustenance of stress management behaviors among veterinary students. A cross-sectional design was used to study the efficacy of the MTM in predicting initiation and sustenance of stress management behaviors among veterinary students at a private College of Veterinary Medicine in the Southeast United States. Researchers collected data …

Does Age Affect The Association Between Race/Ethnicity And Hpv Screening: A Retrospective Cohort Study Of United States Women, Keila L. Marlin, Mph, Larissa R. Brunner Huber, Ph.D.

Journal of Health Disparities Research and Practice

Many studies have demonstrated disparities in awareness of and knowledge about human papillomavirus (HPV) among young, immigrant, and minority populations. Yet, there is a lack of existing research that has investigated the role of race/ethnicity and HPV screening, and how it varies by age. The purpose of this study was to evaluate this association using 2016 Behavioral Risk Factor Surveillance System (BRFSS) data. This study included 120,646 women who self-reported information on race/ethnicity, HPV screening, and age. Logistic regression was used to obtain odds ratios (OR) and 95% confidence intervals (CIs). A stratified analysis was conducted to determine if age …

The Prevalence Of Physical Health Problems Among Youth In The Juvenile Justice System: A Systematic Review., Wadiya A. Udell, Selina Mohammed

Journal of Health Disparities Research and Practice

Justice-involved youth suffer from a range of health problems. Using health and social science databases, we summarize findings from studies reporting rates of physical health problems among youth in the juvenile justice system published between 2006 and 2017. A total of 23 were identified, with the majority examining sexual health problems and focusing on youth confined to correctional facilities. Although fewer studies focused on non-sexual health problems and non-detained youth, findings suggest disparities across some physical health problems impacting youth within various levels of justice system involvement. Given the health risks faced by justice-involved youth and their long-term consequences, more …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Substance Abuse Treatment In Correctional Versus Non-Correctional Settings: Analysis Of Racial/Ethnic And Gender Differences, George Pro, Ricky Camplain, Samantha Sabo, Julie Baldwin, Paul A. Gilbert

Journal of Health Disparities Research and Practice

Background

Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants …

Trends In Mental Well-Being Of Non-Hispanic White Children Of Midlife Parents With Low Education, Neeraj Bhandari

School of Public Health Faculty Research

Background: It is unknown whether recent increase in mortality and morbidity linked to mental despair (eg, suicide, opioid addiction, alcoholism) in midlife non-Hispanic whites (NHWs) was accompanied by declines in mental well-being of NHW children. The author examined aggregate trends in the mental well-being of NHW children between 2003 and 2018. Methods: The author used linear (unadjusted) regression to generate estimates of long period (ie, between 2003-2005 and 2016-2018) and annual change in mental well-being and self-assessed health from the National Health Interview Survey data on 68 057 NHW children (aged 4-17 years). Results: The NHW children showed no significant …

2017 Statewide Child Death Report, Nevada Institute For Children's Research And Policy, Dawn L. Davidson, Elizabeth Holka

Nevada Institute for Children's Research and Policy Reports

The purpose of this report is to provide comprehensive information regarding the circumstances by which children die in Nevada in order to prevent future child deaths and improve the health and safety of children in the state.

Exploring Factors Influencing Whether Residents Participate In Square Dancing Using Social Cognitive Theory: A Cross-Sectional Survey In Chongqing, China, Feng Peng, Hongjia Yan Bs, Manoj Sharma Phd, Ying Liu Bs, Ying Lu Bs, Shijie Zhu Bs, Peiqian Li Bs, Nianyong Ren Bs, Ting Li Bs, Yong Zhao Md

Environmental & Global Health Faculty Research

Physical inactivity is a worldwide public health problem, and it is a risk factor for several chronic diseases. Square dancing nightly may be an efficient way to promote physical activity among Chinese residents. This study aims to explore factors that affect resident participation in square dancing on the basis of social cognitive theory constructs (outcome expectations, outcome expectancies, self-efficacy, self-control, and environment) that may provide a scientific basis for designing interventions to promote physical activity in the future. Forty squares near neighborhood communities in Chongqing were randomly selected. A sample of 1732 residents who came to these squares at 18:00–21:00 …

Carbon Management And Volatile Fatty Acid Production In Primary Clarifiers At A Wastewater Treatment Plant, Brittany Nicole Radke

UNLV Theses, Dissertations, Professional Papers, and Capstones

An increasing number of treatment plants are required to remove nutrients from domestic wastewater to lessen the impact of nutrient loading to water bodies. Enhanced Biological Phosphorus Removal (EBPR) is one of the processes commonly used to remove phosphorus from domestic wastewater. The presence of an adequate quantity of volatile fatty acids (VFA) in the wastewater influent to EBPR is important for process efficiency and stability. The objective of this research was to investigate the production of VFAs through fermentation of sludge in primary clarifiers as it related to improving nutrient removal, primarily targeting phosphorus.

The research tested, in full-scale, …

Community Exposure To Particulate Matter And Its Impact For Students And Residents Near A Construction Asphalt Plant: A Case Study, Aman Gebremariam Gebreselassie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Particulate matter (PM) consists of various small particles in the atmosphere that has been associated with environmental health risk factors for many deadly diseases. PM2.5 is particulate matter 2.5 micrometers or less in diameter, PM10 is particulate matter 10 micrometers or less in diameter and are both respirable particles that can penetrate the lungs and increase risk of cardiovascular problems and respiratory illness, among other health issues. Exposure to particulate pollution in the environment tends to cause lost income from work absence, students’ absences from school, hospital admissions as well as emergency and doctor room visits.

Although asphalt plants are …

An Evaluation Of Factors Associated With The Perceptions Of Diabetes In A Filipino American Sample Residing In Clark County, Nevada, Lawrence Nartatez Sagadraca

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study assessed beliefs about the contribution of the Filipino diet and genetics to diabetes burden and its ability to control it without medical interventions. The data from a need’s assessment survey of 200 Filipino Americans residing in Clark County, Nevada, were analyzed by using the logistic regression model. A significant proportion of the participants believed that diabetes is a problem in the Filipino community (79%) and is related to the Filipino diet (75%) and genetics (69.0%), and that it can be controlled without medical intervention (52.4%). In univariate analyses, age (Odds ratio [OR]: 1.03, 95% confidence interval [CI]: 1.01 …

A Retrospective Survey Of Exercise Habits In Low-Income Female Senior Citizens, Kelly L. Bumgarner

UNLV Theses, Dissertations, Professional Papers, and Capstones

American adults spend at least 50% of their time sedentary with the most inactive demographic being low-income women over 60. This is detrimental because routine physical activity benefits for senior women include balancing hormones, maintaining bone mineral density, and decreasing the risk of breast cancer. Statements like “good exercise habits begin during youth; children should play sports to establish healthy habits they’ll continue throughout their lives” are common, but not clearly supported by literature. Objective: The purpose of this retrospective, cross-sectional study was to identify whether physical activity/exercise habits during youth and young adulthood predict old age physical activity/exercise habits …

Disparities In Administrative Pediatric Asthma Prevalence In Clark County, Aaliyah Goodie

UNLV Theses, Dissertations, Professional Papers, and Capstones

Objective: Asthma is one of the most common chronic diseases affecting young children nationally and globally. Asthma affects more than 25 million people in the nation, of which 6

million are children. Lifetime asthma prevalence for children in Nevada is 11.5% (CDC, 2016). This is likely an underestimate due to a large undocumented Hispanic population. In Clark County School District (CCSD) during the 2016-2017 school year, 20,235 students (8%) listed asthma in school records as a health concern. Asthma burden varies by sociodemographic group with highest rates documented among Black/African American, Hispanic/Latino, and pediatric populations. The Centers for Disease Control …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …