Public Health Commons^™

Gender And Racial/Ethnic Disparities: Cumulative Screening Of Health Risk Indicators In 20-50 Year Olds In The United States, Alissa Cordner, Adrien A. Wilkie, Timothy J. Wade, Edward E. Hudgens, Rebecca J. Birch, Jane E. Gallagher

Journal of Health Disparities Research and Practice

This study explored potential gender and racial/ethnic disparities in overall health risk related to 24 health risk indicators selected across six domains: socioeconomic, health status and health care, lifestyle, nutritional, clinical, and environmental. Using the 2003-2006 National Health and Nutrition Examination Surveys (NHANES), it evaluated cross-sectional data for 5,024 adults in the United States. Logistic regression models were developed to estimate prevalence odds ratios (PORs) adjusted for smoking, health insurance status, and age. Analyses evaluated disparities associated with 24 indicator variables of health risk, comparing females to males and four racial/ethnic groups to non-Hispanic Whites. Non-Hispanic Blacks and Mexican Americans …

Stroke Quality Measures In Mexican Americans And Non-Hispanic Whites, Darin B. Zahuranec, Lynda D. Lisabeth, Jonggyu Baek, Eric E. Adelman, Nelda M. Garcia, Erin C. Case, Morgan S. Campbell, Lewis Morgenstern

Journal of Health Disparities Research and Practice

Mexican Americans (MAs) have been shown to have worse outcomes after stroke than non-Hispanic Whites (NHWs), but it is unknown if ethnic differences in stroke quality of care may contribute to these worse outcomes. We investigated ethnic differences in the quality of inpatient stroke care between MAs and NHWs within the population-based prospective Brain Attack Surveillance in Corpus Christi (BASIC) Project (February 2009- June 2012). Quality measures for inpatient stroke care, based on the 2008 Joint Commission Primary Stroke Center definitions were assessed from the medical record by a trained abstractor. Two summary measure of overall quality were also created …

Understanding The Support Needs Of Minority Women With Heart Disease, Everly Macario Sc.D., M.S., Ed.M., Heather Z. Montague Ph.D., Susan M. Campbell M.P.H., Yukari T. Schneider Ph.D., M.P.H., Jennifer H. Mieres M.D.

Journal of Health Disparities Research and Practice

Background. Cardiovascular disease (CVD) affects minority women disproportionately. WomenHeart: The National Coalition for Women with Heart Disease sought to determine effective ways to support non-Caucasian women with CVD. We surveyed women of color living with CVD to understand their unique CVD-related support needs.

Methods. 514 non-white women (100 Hispanic, 180 African American, 104 Asian, 107 Indigenous, 23 multiracial) with CVD from 46 states responded to a 55-question survey (online/telephone, English/Spanish) 8/28/15 through 9/11/15.

Results. Among respondents not currently attending support groups, 80% were interested in attending support groups. Of WomenHeart services, respondents were most interested in online message boards. Among …

The Impact Of The Patient-Centered Medical Home On Health Disparities In Adults: A Systematic Review Of The Evidence, J. Nwando Olayiwola 2062970, Sonali Sheth, Victor Mleczko, Anna L. Choi, Anjana E. Sharma

Journal of Health Disparities Research and Practice

Introduction: The objective of this study was to review the empirical evidence on Patient-Centered Medical Home (PCMH) impact on health disparities in adults.

Methods: We searched PubMed, Scopus, and Google Scholar to identify studies on PCMH/health homes and health disparities published in English between January 1, 2009 and December 31, 2014. Articles met inclusion criteria if they investigated at least one component of PCMH or health homes in vulnerable populations, defined by PROGRESS-PLUS criteria, and reported differences in one of five clinical quality measures.

Results: 964 articles were identified through database searching and subsequent snowballing. 60 articles underwent full text …

Knowledge And Beliefs About Cancer In African American Population, Rabindra P. Gautam Dhs, Deven Shah Phd, Eric Matthews Phd

Journal of Health Disparities Research and Practice

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, …

A Comparative Analysis Of Pregnancy Outcomes For Women With And Without Disabilities, Ari K. Mwachofi

Journal of Health Disparities Research and Practice

In 2010 in the US, there were 4.7 million childbearing age (15-44 years) women with disabilities (WWD) defined as, being limited in any way in any activities because of physical, mental, or emotional problems. Although their proportion and pregnancy rates are growing, there is little empirical evidence about their health, healthcare needs, pregnancy experiences and outcomes. We examined differences and predictors of pregnancy outcomes for women with and without disabilities. We used 2009 Pregnancy Risk Assessment Monitoring System (PRAMS) data from 15,585 Massachusetts and Rhode Island women. We conducted χ²- and t –tests of pregnancy outcome …

Medicaid Managed Care And The Health Care Utilization Of Foster Children, Makayla Palmer, James Marton, Aaron Yelowitz, Jeffery Talbert

Molasky Family Department of Economics and Real Estate Faculty Research

A recent trend in state Medicaid programs is the transition of vulnerable populations into Medicaid managed care (MMC) who were initially carved out of such coverage, such as foster children or those with disabilities. The purpose of this article is to evaluate the impact of the transition of foster children from fee-for-service Medicaid coverage to MMC coverage on outpatient health care utilization. There is very little empirical evidence on the impact of managed care on the health care utilization of foster children because of the recent timing of these transitions as well as challenges associated with finding data sets large …

The Role Of Functional, Social, And Mobility Dynamics In Facilitating Older African Americans Participation In Clinical Research, Eve T. Shapiro, Jay T. Schamel, Kimberly A. Parker, Laura A. Randall, Paula M. Frew

Environmental & Global Health Faculty Research

Purpose: Older African Americans experience disproportionately higher incidence of morbidity and mortality related to chronic and infectious diseases, yet are significantly underrepresented in clinical research compared to other racial and ethnic groups. This study aimed to understand the extent to which social support, transportation access, and physical impediments function as barriers or facilitators to clinical trial recruitment of older African Americans. Methods: Participants (N=221) were recruited from six African American churches in Atlanta and surveyed on various influences on clinical trial participation.

Readyvax: A New Mobile Vaccine Information App, Robert A. Bednarczyk, Paula M. Frew, Daniel A. Salmon, Ellen Whitney, Saad B. Omer

Environmental & Global Health Faculty Research

Vaccine information of varying quality is available through many different sources. We describe the creation, release and utilization of ReadyVax, a new mobile smartphone app providing access to trustworthy, evidence-based vaccine information for a target audience of healthcare providers, pharmacists, and patients (including parents of children). We describe the information content and technical development of ReadyVax. Between the hard launch of the app on February 12, 2015 and October 8, 2016, the app has been downloaded by 5,142 unique users, with 6,841 total app sessions initiated, comprising a total of 15,491 screen views (2.3 screens/session on average). ReadyVax has been …

Demographic Differences And Annual Trends In Childhood And Adolescent Cancer Incidence And Mortality In Michigan During The Period 1999-2012, Gergana Kodjebacheva, Jeremy Blankenship, Lenwood Hayman, Shan Parker

Journal of Health Disparities Research and Practice

Background. Michigan has declining economic conditions and factories that release pollutants. During the period 1999-2012, only 10 out of 50 states had an overall cancer incidence rate that was higher than that in Michigan. It is not known how children’s cancer rates in Michigan vary by age, gender, race/ethnicity, and year as well as how these rates compare to those in the U.S.

Method: The Center for Disease Control and Prevention WONDER database obtained cancer incidence and mortality data from cancer registries and death certificates. We compared age-adjusted incidence and mortality cancer rates by gender, race/ethnicity, and year for children …

Sociocultural Risk Factors For Elevated Perceived Stress Among African American Smokers, Monica Webb Hooper, Noella A. Dietz, Joseph C. Wilson

Journal of Health Disparities Research and Practice

Introduction: African Americans experience unique stressors that may inhibit smoking cessation and enhance relapse rates. Few studies, however, have focused on risk factors for perceived stress among treatment seekers. Because African Americans are less likely to quit compared to the larger community, understanding factors associated with perceived stress among smokers has the potential to improve intervention outcomes. This study examined psychosocial and cultural correlates of stress in a sample of African American participants in a randomized controlled trial.

Methods: At baseline, participants reported demographic factors and completed assessments of smoking history, alcohol use, friend and household smoking, weight concerns, acculturation, …

Exploring Sexual And Behavioral Health Inequities Among College Students: A Need For Lgb-Specific Risk Reduction, Todd M. Sabato

Journal of Health Disparities Research and Practice

Many studies have examined differences in sexual behavior based upon self-identified sexual orientation, with results often indicating that those with same-sex partners engage in greater risk behaviors than those with opposite sex partners. However, few of those studies consisted of large, national sample studies. To address that gap, the present study examined the relationship between sexual orientation and both behavioral and sexual health outcomes in a national sample of U.S. college students. The Fall 2012 through Spring 2014 American College Health Association National College Health Assessment was used to examine behavioral and sexual health related responses from self-identified heterosexual, gay, …

The Effects Of Patient Characteristics On Clinician’S Adherence To Preventive Practice Guidelines, Deshana A. Collett Ph.D,Pa-C, Kenneth M. Tyler Ph.D.

Journal of Health Disparities Research and Practice

ABSTRACT

BACKGROUND: The existence of health disparities confirms that not all patients, regardless of differences in patient demographics, are provided quality healthcare (Agency of Health Care Research and Quality, 2003). Moreover, research suggests that health disparities may be present due to the inadequate delivery of medical services (S. Haist, J. Wilson, M. Lineberry, & C. Griffith, 2007; Van Ryn, Burgess, Malat, & Griffin, 2006). The differences in the delivery of care and services to ethnic minorities and those of low socioeconomic status warrant examining the role healthcare providers play in the causation of these health disparities (Smedley, Stith, & Nelson, …

Emergency Department Utilization: A Qualitative Analysis Of Illinois Medical Home Network Patients., Crystal M. Glover, Yanina A. Purim-Shem-Tov

Journal of Health Disparities Research and Practice

Background

Inappropriate emergency department (ED) use continues to plague healthcare in terms of disease management and costs. In 2012, the State of Illinois implemented Medical Home Network (MHN) where Medicaid recipients were assigned to primary care providers to, in part, reduce overreliance on EDs. However, MHN patients have continued to use EDs.

Objective

The purpose of this study is to provide a qualitative analysis of Medicaid patient-identified barriers to primary care, facilitators of emergency use, and related mental health and psychosocial factors.

Methods

Patients who presented themselves at the ED located at an urban, academic medical center participated in one-time, …

A Comparison Of Measured And Self-Reported Blood Pressure Status Among Low-Income Housing Residents In New York City, James H. Williams Ab, Dustin T. Duncan Scd, Jonathan Cantor Ms, Brian Elbel Phd Mph, Gbenga Ogedegbe Md Ms Mph, Joseph Ravenell Md Ms

Journal of Health Disparities Research and Practice

Self-report is widely used to measure hypertension prevalence in population-based studies, but there is little research comparing self-report with measured blood pressure among low-income populations. The objective of this study was to compare self-reported and measured blood pressure status among a sample of low-income housing residents in New York City (n=118). We completed a cross-sectional analysis comparing self-report with measured blood pressure status. We determined the sensitivity, specificity, and positive predictive value (PPV) of each self-report metric. Of the sample, 68.1% was Black, 71.1% had a household income under $25,000/year, and 28.5% did not complete high school. In our study, …

Healthcare Reform In Latino Rhode Island: Perspectives Of Spanish Speakers And Insurance Navigators, Haiyan Ramírez Batlle, Roberta E. Goldman, Amed Logroño, Joseph A. Diaz

Journal of Health Disparities Research and Practice

Latinos have the highest uninsurance rates of any ethnic or racial group in the US despite recent health insurance expansion reform. In addition to immigration and language barriers, health literacy and attitudes may impact coverage disparities. Focus groups with Spanish-speaking community members and semi-structured interviews with health insurance navigators were conducted to explore knowledge, awareness, and attitudes towards healthcare reform among Latinos in Rhode Island. Sessions were audio recorded, transcribed, and analyzed employing standard qualitative methods. Thirty-two focus group participants and six navigators were enrolled in the study. Spanish-speaking participants demonstrated limited knowledge of the cost implications of the Medicaid …

Child-Mediated Health Communication: A Conceptual Framework For Increasing Stroke Literacy In Hard To Reach Populations, Olajide Williams, Ellyn Leighton-Herrmann, Mindy F. Hecht, Alexandra Desorbo, William Gerin, Monique Hedmann, Rachel Shelton, Benjamin Tolchin, James Noble

Journal of Health Disparities Research and Practice

Effectively engaging economically-disadvantaged ethnic minority communities for promoting health has proved to be challenging for a variety of reasons, including factors related to healthcare access, literacy, inadequate or ineffective cultural appropriateness of materials, and the relatively low priority for health due to competing demands related to economic hardship. We have developed a framework of Child-Mediated Health Communication (CMHC), which focuses on children as channels for carrying out health promotion interventions to parents and other caregivers. CMHC is an innovative, alternative strategy for engaging this underserved population, where traditional methods of health promotion have not been successful. We discuss the theoretical …

Identifying Outcomes And Gaps Impacting Tobacco Control And Prevention In African American Communities, Leah M. Ranney, Hannah M. Baker, Delmonte Jefferson, Adam O. Goldstein

Journal of Health Disparities Research and Practice

Great racial disparities exist in smoking and related health outcomes in the United States. African American (AA) smokers start smoking later and smoke less than white smokers but are less likely to quit. In 2008, the CDC’s Office on Smoking and Health funded the National African American Tobacco Prevention Network (NAATPN) to focus tobacco control leadership, expertise and promotion in the AA community. In 2012, NAATPN sought to determine significant outcomes of tobacco control efforts impacting Black and AA communities by conducting a qualitative document search and series of interviews with experts in the field. Thirteen identified outcomes were categorized …

Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck

Journal of Health Disparities Research and Practice

BACKGROUND: Breast cancer is known to be a heterogeneous disease across women, and even within individual tumors. However, relatively little is known about heterogeneity across cultures. There has been some evidence to suggest that Asian women are more likely to have HER2+ breast cancer than their Caucasian counterparts.

PURPOSE: The aim of this study was to further investigate the unique pattern of breast cancer incidence and subtype in the Vietnamese population.

METHODS: We retrospectively collected data on all Vietnamese women diagnosed with invasive breast cancer at the Lester & Sue Smith Breast Center in Houston, Texas over a four year …

Hiv Treatment Outcome Disparities: Using Web-Based Technology To Promote Adherence And Engagement With Care Among African American Patients, Eric Houston, Brenda Wolfe, Alexander K. Tatum, Monique Rucker, Norma Rolfsen, Maryanne Williams, Nancy Glick

Journal of Health Disparities Research and Practice

Ethnic minorities continue to be disproportionately affected by the HIV epidemic and those individuals living with the virus experience differential outcomes in treatment. Technology-based approaches have been used to address a variety of health problems, but few studies have focused on the application of these approaches in addressing HIV treatment disparities. Using a sample of African-American patients identified as lost to follow-up for HIV treatment (n=33), this study examined the feasibility and acceptability of a web-based program designed to assess and improve treatment engagement. Participants were randomly assigned to either the web-based assessment program or the control group. Measures of …

Overcoming Recruitment Challenges: A Pilot Study In Arab Americans, Nawar M. Shara, Sayf A. Yassin, Soleman H. Abu-Bader, Asqual Getaneh, Shaunagh Browning, Alexander Zeymo, Barbara V. Howard, Zeid Abudiab, Anas Shahrour, Jason G. Umans

Journal of Health Disparities Research and Practice

While diabetes prevalence and cardiovascular risk factors have been increasing among Arab populations worldwide, few studies of Arab Americans have been conducted because of the difficulty in recruiting Arab American participants. Cultural sensitivity and social awareness of different immigrant groups could ensure successful recruitment and retention in clinical studies. While the primary objective of our overall research project was to determine the prevalence of metabolic syndrome in Arab Americans, the focus of this article is to describe the methodology used to overcome challenges in recruiting and enrolling Arab Americans for a community-based study. We used novel methods, including open houses, …

Relationship Of Associated Cardiovascular Risk Factors And Chronic Kidney Disease With Participants Enrolled In The National Kidney Foundation Of Hawai'i Kidney Early Detection Screening (Keds) Program, Merle R. Kataoka-Yahiro, Victoria Page, Dongmei Li

Journal of Health Disparities Research and Practice

Objective The objective of this study was to further examine the relationship of associated cardiovascular risk factors and chronic kidney disease (CKD) with a large cross-sectional sample of Native Hawaiians, Japanese, Chinese, Filipino, and White participants who were enrolled in the National Kidney Foundation of Hawai'i Kidney Early Detection Screening (KEDS) program.

Methods Data for this cross-sectional study was collected between 2006 and 2009 from the National Kidney Foundation of Hawaii (NKFH). Nine hundred and fifteen participants who attended the NKFH KEDS program were 18 years and older, and residents of the State of Hawaii. Data included demographic information, clinical …

Race, Age, And Neighborhood Socioeconomic Status In Low Birth Weight Disparities Among Adolescent Mothers: An Intersectional Inquiry, Sheryl L. Coley, Tracy R. Nichols

Journal of Health Disparities Research and Practice

Introduction: Few studies examined socioeconomic contributors to racial disparities in low birth weight outcomes between African-American and Caucasian adolescent mothers. This cross-sectional study examined the intersections of maternal racial status, age, and neighborhood socioeconomic status in explaining these disparities in low birth weight outcomes across a statewide sample of adolescent mothers.

Methods: Using data from the North Carolina State Center of Health Statistics for 2010-2011, birth cases for 16,472 adolescents were geocoded by street address and linked to census-tract information from the 2010 United States Census. Multilevel models with interaction terms were used to identify significant associations between maternal racial …

Emergency Department Use Among Asian Adults Living In The United States: Results From The National Health Interview Survey (2006 – 2013), Kathleen M. Sullivan, James Davis, Angela Sy

Asian/Pacific Island Nursing Journal

This paper presents secondary analyses of the National Health Interview Survey data focused on emergency department (ED) utilization among Asian adults residing in the United States. National Health Interview Survey data provided from survey years 2006-2013 was pooled and disaggregated by single-race Asian ethnic subgroups (Filipino, Chinese, Asian Indian, other Asian). We explored trends in reports of an ED visit over the survey years for the purpose of determining whether reports of an ED visit increased or decreased over survey years. We also explored background/biologic, environment, access to care, and behavior factors and their associations with having an ED visit. …

Secondary Data Analysis: A Non-Pharmacology Treatment For Individuals Living With Hiv/Aids, Joseph Jean, Carolee Dodge-Francis Ed.D

McNair Poster Presentations

At the end of 2015, 36.7 million people were living with HIV/AIDS world wide (WHO, 2017). Living with this disease puts individuals at increased risk for mental and physical health complications. Opportunistic infections and increased serious mental health conductions are common (NIH, 2016). Advances in antiretroviral therapies have been made to increase life expectancy but often times can adversely affect the individuals quality of life. Complementary and alternative medicine (CAM) is one way to help improve quality of life. One form of CAM, massage therapy may offer benefits to PLWHA in terms of ability to cope with stress.

Moving Public Health Learners To The Skeptical Edge With Information Creation As A Process, Xan Goodman

Library Faculty Research

No abstract provided.

Connecting Culturally And Spiritually To Healthy Eating: A Community Assessment With Native Hawaiians, Mary Frances Oneha, Joan Dodgson, Mabel Ho`Oipo Decambra, Carol Titcomb, Rachelle Enos, Sandie Morimoto-Ching

Asian/Pacific Island Nursing Journal

Many of the chronic illnesses disproportionately experienced by Native Hawaiians are directly related to poor diets and long-standing obesity beginning in childhood. We report on the findings of in-depth key informant interviews (N = 14) that took place in two Native Hawaiian communities as part of a larger, community-based participatory research study that included a community assessment through individual interviews and focused group discussions, and a pilot intervention targeting pregnant women, their infants, and families. Four categories emerged from the qualitative analysis of interview transcripts that described an understanding of “healthy eating”: family roles and responsibilities, aspects of community …

Phase I Dose-Escalation Trial Of Intravaginal Curcumin In Women For Cervical Dysplasia, Leda Gattoc, Paula M. Frew, Shontell N. Thomas, Kirk A. Easley, Laura Ward, H-H Sherry Chow, Chiemi A. Ura, Lisa Flowers

Environmental & Global Health Faculty Research

Background: This is a Phase I trial demonstrating safety and tolerability of intravaginal curcumin for future use in women with cervical neoplasia. Objective: The objective of this study was to assess the safety, tolerability, and pharmacokinetics of intravaginal curcumin in healthy women. Study design: We conducted a 3+3 dose-escalation Phase I trial in a group of women aged 18–45 years. Thirteen subjects were given one of four doses of curcumin powder (500 mg, 1,000 mg, 1,500 mg, and 2,000 mg) packed in gelatin capsules, which was administered intravaginally daily for 14 days. The primary end point for this study was …

Assessing The Impact Of The Sunwise Program On Youth Sun Safety Knowledge, Attitudes, And Behaviors In Clark County, Nevada, Sabina Malik

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Skin Cancer rates in Nevada continue to increase and remain above the

national average. One important method to combat rising rates is education related to the

prevention of sunburns, the main risk factor for developing skin cancer. This study aimed

to assess the impact of the SunWise Program, a sun safety education program developed

by the Environmental Protection Agency, to increase knowledge, improve attitudes, and

change behaviors of participants based on constructs of the Health Belief Model.

Methods: Participants included youth from ages 7-18 years old who attended 6 Boys and

Girls Clubs of Southern Nevada. Boys and Girls …

The Relationship Between Pediatric Asthma And Obesity In Nevada, Jennifer Anne Lucas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Asthma and obesity are two of the most common comorbid health problems in the U.S. Currently nearly 8% of Nevada youth are affected by asthma and more than 30% are overweight or obese. Obesity is a risk factor for asthma, yet asthma-related factors such as decreased physical activity and use of oral corticosteroids for asthma control can lead to obesity. This study examined the relationship between asthma and obesity in two pediatric populations in Nevada. It was hypothesized that children with asthma and elevated BMI would have more severe asthma symptoms, decreased lung function, poorer quality-of-life measures, and different atopic …