Public Health Commons^™

Variation In Airborne Pollen Concentrations Among Five Monitoring Locations In A Desert Urban Environment, Tanviben Y. Patel, Mark P. Buttner, David Rivas, Chad L. Cross, Dennis A. Bazylinski, Joram S. Seggev

Environmental & Global Health Faculty Research

The urbanization of the Las Vegas Valley has transformed this part of the Mohave Desert into a green oasis by introducing many non-native plant species, some of which are allergenic. Typically, one monitoring station is established per city to obtain pollen counts for an entire metropolitan area. However, variations in pollen concentrations could occur among different microenvironments. The objective of this study is to measure and compare pollen concentrations in five locations in Las Vegas to determine if there are significant differences between microenvironments within the city. Air samples were collected from five sites across the Las Vegas Valley over …

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

School of Public Health Faculty Research

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Sex Moderates The Impact Of Diagnosis And Amyloid Pet Positivity On Hippocampal Subfield Volume, Jessica Z. K. Caldwell, Jody-Lynn Berg, Guogen Shan, Jeffrey L. Cummings, Sarah J. Banks

School of Public Health Faculty Research

We examined moderation effects of sex and diagnosis on the effect of positive florbetapir positron emission tomography (PET) amyloid-β (Aβ) scan (A+) on hippocampus subfield volumes in 526 normal control (NC) and early mild cognitive impairment (eMCI) participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI2; ADNI-GO). Regression moderation models showed that women— but not men— with NC designation did not show reduced subiculum volumes despite A+. At the eMCI stage, A+ was detrimental across sexes. Findings were significant while accounting for the effects of age, cognition at screening, education, and APOE4 carrier status. These findings suggest that women with A+ …

Variations In Institutional Review Board Processes And Consent Requirements For Trauma Research: An East Multicenter Survey, Jeffry Nahmias, Areg Grigorian, Scott Brakenridge, Randeep S. Jawa, Daniel N. Holena, John Varujan Agapian, Brandon Bruns, Paul J. Chestovich, Bruce Chung, Jonathan Nguyen, Carl I. Schulman, Kristan Staudenmayer, Rachel Dixon, Jason W. Smith, Andrew C. Bernard, Jose L. Pascual

School of Medicine Faculty Research

Oversight of human subject research has evolved considerably since its inception. However, previous studies identified a lack of consistency of institutional review board (IRB) determination for the type of review required and whether informed consent is necessary, especially for prospective observational studies, which pose minimal risk of harm. We hypothesized that there is significant inter-institution variation in IRB requirements for the type of review and necessity of informed consent, especially for prospective observational trials without blood/tissue utilization. We also sought to describe investigators’ and IRB members’ attitudes toward the type of review and need for consent. Eastern Association for the …

Provider Insight On Surmounting Specialty Practice Challenges To Improve Tdap Immunization Rates Among Pregnant Women, Arpita Mehrotra, Allison Kennedy Fisher, Jennifer Mullen, Leslie Rodriguez, Angela J. Jiles, Alison P. Albert, Laura A. Randall, Paula M. Frew

Environmental & Global Health Faculty Research

Background Pertussis, or “whooping cough,” is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27–36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16–61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women. Methods Our aim was to inform new strategies to increase …

An Evaluation Of Food Insecurity Rates And Its Correlates In A Filipino American Population Sample Residing In Clark County, Nevada, Prescott M. Cheong

UNLV Theses, Dissertations, Professional Papers, and Capstones

Filipino Americans comprise over half of the Asian American population in Clark County, Nevada. In 2016, 1.6% of Asian American households in Clark County reported being food insecure, which was considerably lower than food insecurity rates for White, non-Hispanic households (14.5%). Yet, Clark County demographic data reveals that 24% of Filipino-headed households report incomes at 200% or below the federal poverty level compared to 33% for Whites. Food insecurity rates specific to Filipino Americans in Clark County are lacking. Moreover, available food insecurity data aggregates Filipinos with other Asian American subgroups, which ignores the heterogeneity inherent to the Asian American …

Prostate Cancer Survival Among Hispanics: A Surveillance, Epidemiology, And End Results (Seer) Population-Based Cohort Study, David Rivas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hispanics are now the youngest, largest, and fastest growing minority group in the U.S. Prostate cancer (PC) is the most commonly diagnosed cancer in men and is the second-leading cause of cancer deaths among Hispanics. For the first time, we examined PC-specific survival among distinct Hispanic groups that include Mexicans, Cubans, Dominicans, Puerto Ricans, as well as Central and South Americans. We compared these groups to the main reference population in the U.S., non-Hispanic Whites (NHW), after adjustment for prognostic factor risk categories (prostate-specific antigen (PSA) level, Gleason score, and tumor stage), as well as sociodemographic covariates (e.g., health insurance, …

An Examination Of The Community And Environmental Impact Of A Las Vegas Convention Food Rescue Program, Samantha H. To

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity affects millions of Americans each year, inflicting negative consequences on the physical and mental health outcomes at all ages. Concurrently, millions of tons of leftover edible foods are sent to landfill each year. Not only does this pose a question of ethics, but increasingly harms the environment by misusing resources and increasing the release of

greenhouse gases.

Food rescue advisory meetings highlighted the need for more focused research to be conducted that assessed the impacts of donating rescued convention food on local environmental and community health. A mixed-method approach was used to detail the food rescue process between …

Hiv Mortality Difference Between Black And White Women, Carlos O. Nesbeth, Rajiv Kandala, Syed Najeeb, Ruksana Nazneen, Banglore Murthy

Journal of Health Disparities Research and Practice

OBJECTIVE

In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups^². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.

METHODS

Information was accessed through public data, the US Census, and the US Compressed Mortality File.

RESULTS

In these descriptive data from 1987 through 2015, including reliable HIV …

Asian Americans’ Cancer Information Seeking, Fatalistic Belief, And Perceived Risk: Current Status And Relationships With Cancer Prevention And Detection Behaviors, Jungmi Jun, Xiaoli Nan

Journal of Health Disparities Research and Practice

This study pursues four research goals: (1) to examine Asian Americans and Asian ethnic groups’ (i.e., Chinese, Filipinos, Japanese, Koreans, Vietnamese) information seeking, fatalistic belief, and perceived risk of cancer, in comparison to non-Hispanic Whites; (2) to identify characteristics of Asian Americans who seek cancer information, hold fatalistic cancer belief, and perceive cancer risk; (3) to assess cancer prevention and detection behavior gaps between Asian Americans and Whites, and (4) to explore whether such gaps can be explained by cancer information seeking, fatalistic belief, and perceived risk. Data from 2011-2014 Health Information National Trends Surveys (HINTS) were analyzed. Asian Americans …

Household Financial Assets Inequity And Health Disparities Among Young Adults: Evidence From The National Longitudinal Study Of Adolescent To Adult Health, Shiyou Wu, Xiafei Wang, Qi Wu, Kathleen Mullan Harris

Journal of Health Disparities Research and Practice

Introduction: Research has established a strong relationship between financial resources and health outcomes. Yet, little is known about the effects of assets disparities on health outcomes, especially during the critical period when adolescents transition to adults.

Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health (n = 10,861), this study investigated the relationships between three household total assets value groups (low, moderate, and high assets) and three net worth groups (negative, neutral, and positive) on young adults’ general health, obese, and depression.

Results: Both assets and debts were related to young adults’ health status, …

Graduating Into Lower Risk: Chlamydia And Trichomonas Prevalance Among Community College Students And Graduates, Janet E. Rosenbaum

Journal of Health Disparities Research and Practice

Background: Community colleges enable youth from economically disadvantaged and minority populations to access college and may enable social mobility including improved health outcomes. However, educational health disparities studies rarely assess the health outcomes for community college graduates.

Methods: Chlamydia and trichomonas prevalence were assessed with nucleic acid based tests in a nationally representative sample of 6233 high school graduates (ages 18–25) from five educational levels: young adults without post-secondary credentials who were not enrolled in college, community college students, 4-year college students, associate’s degree, and bachelor’s degree. To reduce confounding between educational attainment and STI status, we used full matching …

A Cohort Study Of Public Health Insurance Coverage Loss Among Oregon Adolescents, Heather Angier Mph, Carrie Tillotson Mph, Lorraine Wallace Phd, Miguel Marino Phd, Jean O'Malley Mph, Aleksandra Sumic Mph, Lynn Baker Bsee, Christine Nelson Phd, Rn, Nathalie Huguet Phd, Andrew Suchocki Md, Mph, Heather Holderness Mph, Jennifer E. Devoe Md, Dphil

Journal of Health Disparities Research and Practice

ABSTRACT

Introduction: Churning on and off and/or experiencing coverage gaps is common among public health insurance recipients. Although the Affordable Care Act (ACA) provisions to extend parental coverage for adolescents transitioning to young adulthood on private insurance plans were implemented in 2010, no such protection was mandated for adolescents with public health insurance.

Methods: Oregon public health insurance enrollment and electronic health record data from community health centers were used to conduct a retrospective, observational cohort study of Oregon adolescents (17-19 years of age) with public coverage [January 1, 2011-December 31, 2013 (n=51,988)] to assess loss. Time-to-event methods determined the …

Food Insecurity And Pre-Hypertension, Pre-Diabetes In Adult Women: Results From The 2007-2010 National Health And Nutrition Examination Survey, Michelle L. Redmond, Phd, Ms, Fanglong Dong, Phd, Philip Twumasi-Ankrah, Phd, Robert B. Hines, Phd, Mph, Lisette T. Jacobson, Phd, Mpa, Ma, Elizabeth Ablah, Phd, Mph, Judy Johnston, Ms, Rd/Ld, Tracie C. Collins, Md, Mph, Mhcds

Journal of Health Disparities Research and Practice

Background

Being food insecure is generally defined as the limited or uncertain availability of safe and nutritious foods and is linked to poor nutrition and fully progressed diet-sensitive chronic diseases. However, little is known about the association between food insecurity and pre-clinical disease such as pre-hypertension and pre-diabetes. This study sought to examine the associations between food insecurity and pre-clinical disease among a racially/ethnically diverse population of women.

Methods

Using data from 2007-2010 NHANES, we examined associations between food security and pre-clinical disease among women 18-65 years. Chi-square tests were used to examine differences in demographic variables. Bivariate and multivariable …

Nativity Differences In Stress Among Asian And Pacific Islander American Women, Brittany N. Morey, Gilbert C. Gee, Salma Shariff-Marco, Gem M. Le, Alison J. Canchola, Juan Yang, Laura Allen, Sandra Lee, Roxanna Bautista, Trish Quema La Chica, Winston Tseng, Pancho Chang, Scarlett Lin Gomez

Journal of Health Disparities Research and Practice

According to the Stress Process Theory, people who are marginalized in society encounter more stress than those in more advantaged positions. Immigrants are one such marginalized group in the United States (US) who may experience greater psychological stress than their US-born counterparts due to (1) severing of social ties; (2) social disadvantage and marginalization; and (3) adaptation to a new environment. This study examines the disparity in stress by nativity, and how social factors contribute to this disparity for Asian and Pacific Islander (API) women. Data come from the Asian Community Health Initiative, which included a sample of 291 foreign-born …

Application Of The Imb Model To The Reported Intake Of Fruits And Vegetables Of Native American Children, Rachel C. Sinley, Julie A. Albrecht

Journal of Health Disparities Research and Practice

The purpose of this study was to evaluate the applicability of the Information-Motivation-Behavioral Skills (IMB) model to identify variables that are associated with fruit and vegetable intake among Native American children. A cross-sectional study design was employed with a convenience sample of 92 English-speaking caregivers of Native American children between the ages of 2 and 5 from several tribes representing the Midwest, including Omaha, Santee Sioux, Ponca and Winnebago. Caregivers completed an IMB model survey, fruit and vegetable food frequency questionnaire and demographic survey. Multivariate linear regression and path analysis were conducted to assess association between model constructs and fruit …

Are Parent Activation And Health Literacy Distinct Concepts? A Study In Low Income Urban Populations, Harita S. Shah, Kate Leifheit, Sarah Polk, Elizabeth Sloand, Tina L. Cheng, Lisa Decamp

Journal of Health Disparities Research and Practice

Patient activation (the knowledge, confidence, willingness, and skills to manage one’s healthcare) and health literacy have well-established associations with health and healthcare outcomes in adults. However, little is known about parent activation on behalf of children and its relation to health literacy. Our objective was to examine relations between parent activation, health literacy, and parent-provider relationship quality. We surveyed 316 Spanish- or English-speaking parents of publicly-insured patients of a general pediatrics clinic. Surveys included the Parent-Patient Activation Measure (P-PAM), the Newest Vital Sign (NVS), and parent-provider relationship measures. We used chi-square analyses and logistic regression to explore associations stratified by …

Factors Associated With Immunization Opinion Leadership Among Men Who Have Sex With Men In Los Angeles, California, Ian W. Holloway, Robert Bednarczyk, Vincent L. Fenimore, Cameron Goldbeck, Elizabeth Wu, Rebecca Himmelstein, Diane Tan, Laura Randall, Chelsea S. Lutz, Paula M. Frew

Environmental & Global Health Faculty Research

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B …

Lagged Influence Of Fine Particulate Matter And Geographic Disparities On Clinic Visits For Children’S Asthma In Taiwan, Lung-Chang Chien, Yu-An Chen, Hwa-Lung Yu

School of Public Health Faculty Research

Recent studies have revealed the influence of fine particulate matter (PM2.5) on increased medication use, hospital admission, and emergency room visits for asthma attack in children, but the lagged influence of PM2.5 on children’s asthma and geographic disparities of children’s asthma have rarely been discussed simultaneously. This study investigated the documented diagnosis of children’s asthma in clinic visits for children aged less than 15 years old that were associated with PM2.5 in two counties located in west-central Taiwan during 2005–2010. The result shows that PM2.5 had a significant lagged effect on children’s asthma for up to 6 days. A significantly …

Disparity Of Imputed Data From Small Area Estimate Approaches – A Case Study On Diabetes Prevalence At The County Level In The U.S, Lung-Chang Chien, Ge Lin, Xiao Li, Xingyou Zhang

School of Public Health Faculty Research

This paper assesses concordance and inconsistency among three small area estimation methods that are currently providing county-level health indicators in the United States. The three methods are multi-level logistic regression, spatial logistic regression, and spatial Poison regression, all proposed since 2010. Diabetes prevalence is estimated for each county in the continental United States from the 2012 sample of Behavioral Risk Factor Surveillance System. The mapping results show that all three methods displayed elevated diabetes prevalence in the South. While the Pearson correlation coefficients among three model-based estimates were all above 0.60, the highest one was 0.80 between the multilevel and …

Sling Complications, David L. Howard, Andrea Mcglynn, Joy A. Greer

Research Briefs

No abstract provided.

Jail, An Unappreciated Medical Home: Assessing The Feasibility Of A Strengths-Based Case Management Intervention To Improve The Care Retention Of Hiv-Infected Persons Once Released From Jail, Anne C. Spaulding, Ana Drobeniuc, Paula M. Frew, Tiffany L. Lemon, Emeli J. Anderson, Colin Cerwonka, Chava Bowden, John Freshley, Carlos Del Rio

Environmental & Global Health Faculty Research

Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection …

Biomarker And Clinical Trial Design Support For Disease-Modifying Therapies: Report Of A Survey Of The Eu/Us: Alzheimer's Disease Task Force, Jeffrey Cummings, Nick Fox, Bruno Vellas, Paul Aisen, Guogen Shan

Environmental & Global Health Faculty Research

BACKGROUND: Disease-modifying therapies are urgently needed for the treatment of Alzheimer’s disease (AD). The European Union/United States (EU/US) Task Force represents a broad range of stakeholders including biopharma industry personnel, academicians, and regulatory authorities. OBJECTIVES: The EU/US Task Force represents a community of knowledgeable individuals who can inform views of evidence supporting disease modification and the development of disease-modifying therapies (DMTs). We queried their attitudes toward clinical trial design and biomarkers in support of DMTs. DESIGN/SETTING/PARTICIANTS: A survey of members of the EU/US Alzheimer’s Disease Task Force was conducted. Ninety-three members (87%) responded. The details were analyzed to understand what …

Effects Of Index Client And Geo-Targeting On Hiv Case Identification: An Observational Study, E. Oladele, William Menson, O-O Badejo, E. Onwasigwe, I. Iyamu, A. Olarinoye, C. Agbakwuru, T. Bruno, H. Khamofu, Ee Ezeanolue

School of Public Health Faculty Research

Background Despite huge investments in HIV prevention, treatment, and care in sub-Saharan Africa, fewer than one in 10 individuals knows their HIV status, and 40% of individuals living with HIV are not cognisant of their positive status. Efforts to improve and strengthen HIV service delivery, particularly in HIV testing, are necessary to increase efficiency in HIV case finding and optimise service delivery. Standard approaches to HIV testing have not been effective in addressing this gap. Our objective was to evaluate a targeted approach for HIV case identification in a PEPFAR-supported HIV programme in Nigeria. Methods Between October, 2016, and June, …

The Effects Of Childhood Social Support And Family Resiliency On Mental Health In Adulthood, Korede K. Adegoke, Chukwudi Ufondu, Dania Al Agili, Estrellita L Berry L. Berry, Hamisu M. Salihu

Journal of Health Disparities Research and Practice

The effect of social support on the overall health and quality of life in adulthood has been well documented particularly in chronic disease populations. Very few studies examined the relationships between childhood social support, family resiliency and mental health in adulthood in the community and among disadvantaged minority populations. We examined the role of social support and family resilience during childhood on subsequent mental health-related quality of life (HRQoL) in adulthood among racial/ethnic minorities.

A needs assessment survey which was designed to explore health determinants and quality of life indicators using a community-based participatory research (CBPR) approach in a low-income …

American Indian Youth: A Residential Camp Program For Wellness, Francine C. Gachupin, Jennie R. Joe

Journal of Health Disparities Research and Practice

The American Indian Youth Summer Wellness Camp strives to increase physical activity and healthful eating among at-risk southwest American Indian youth. The Wellness Camp is one week in duration and involves youth, aged 10-15 years. Youth who attend camp are self-selected or referred by local tribal health programs. In any given summer, 35-60 youth attend camp. Approximately 20%-33% of youth return from one year to the next. We describe our program to increase healthy lifestyles among American Indian youth at risk for overweight, obesity, diabetes and cardiovascular disease. The Wellness Camp Program includes five primary components: (1) cultural capital, (2) …

Health Insurance Enrollment Of Children And Young Adults In Wayne County, Michigan: A Qualitative Evaluation, Kristin Kan, Richard Lichtenstein, Michelle Famulare, Alison Jensen, Theresa Kowalski-Dobson, Joslyn Pettway, Erminia Ramirez, Madiha Tariq, Minal Patel

Journal of Health Disparities Research and Practice

Since the Affordable Care Act went into effect, community outreach to increase health insurance enrollment of young adults and children in low-income families of color has been a priority in Wayne County, Michigan. Our objective was to inform community efforts for improved outreach, we explored perceptions around the importance of health insurance and barriers to enrollment for children and young adults through a qualitative research study. We conducted a focus group with enrollment assisters and nine focus groups with Arab American, Latino/Hispanic, and African American community members. Several themes emerged about community members’ perceptions and experiences: they believe that children …

Disparities In Healthcare Coverage And Utilization After Expanded Dependent Coverage, Tina Hernandez-Boussard, Doug E. Morrison, Lu Tian, Sanjay Basu

Journal of Health Disparities Research and Practice

Background. A goal of expanding insurance coverage is reducing racial disparities in healthcare utilization, however the effects of such expansions under the affordable care act (ACA) on disparities remain unclear. The 2010 dependent coverage expansion provided an opportunity to evaluate disparities following a major coverage expansion.

Objectives. We sought to understand changes in emergency department (ED)utilization following a major insurance expansion, the 2010 dependent coverage expansion.

Research Design. We present changes in coverage and utilization among young adults (19-25 years old) before and after the dependent coverage expansion, compared to a control group (26-31 years old) unaffected …

Situating Food Insecurity In A Historic Albuquerque Community: The Whorled Relationship Between Food Insecurity And Place, Janet Page-Reeves, Maurice Moffett, Molly Bleecker, Katharine Linder, Jeannie Romero, Carol Krause

Journal of Health Disparities Research and Practice

This article examines conceptualizations of the relationship between food insecurity and place. We use an ethnographically inspired and community-engaged approach to situate our analysis of fluid dynamics at work in a community with high levels of food insecurity. We propose that the relationship between place and people’s experience of food insecurity is recursive, dialectical, and “whorled.” This relationship reflects complex, interconnected, and multidimensional processes with consequences for the health of residents. Our research demonstrates the key nature of the health-place nexus by exploring how food insecurity articulates with place in unexpected ways that go beyond discussions of food, …

Patient-Provider Race And Sex Concordance: New Insights Into Antibiotic Prescribing For Acute Bronchitis, Jake R. Morgan, Mari-Lynn Drainoni, Cindy Christiansen, Tamar F. Barlam

Journal of Health Disparities Research and Practice

Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis.

Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital.

Study design: We used a logistic model of prescribing as a function of race and sex concordance.

Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010.

Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive …