Public Health Commons^™

Improving Influenza And Tdap Vaccination During Pregnancy: A Cluster-Randomized Trial Of A Multi-Component Antenatal Vaccine Promotion Package In Late Influenza Season, A. T. Chamberlain, K. Seib, K. A. Ault, E. S. Rosenberg, Paula M. Frew, M. Cortés, E. A. S. Whitney, R. L. Berkelman, W. A. Orenstein, S. B. Omer

Environmental & Global Health Faculty Research

Background Evidence-based interventions to improve influenza vaccine coverage among pregnant women are needed, particularly among those who remain unvaccinated late into the influenza season. Improving rates of antenatal tetanus, diphtheria and acellular pertussis (Tdap) vaccination is also needed.

The Impacts Of A Smoking Ban On Gaming Volume And Customers' Satisfaction In The Casino Industry In South Korea, Sojeong Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

A growing number of countries have legislated smoke-free policies in enclosed public areas and have extended the policies to hospitality facilities. However, some states and countries exempt gaming areas from the smoking law fully or partially. Anti-smoking policy is controversial for a number of reasons, such as smokers’ strong opposition, government ordinance, public health, and economic anxiety. Casino management may worry that a smoking ban policy will result in a significant decline of casino revenue because the break for smoking may interfere with continuing play.

This thesis examined a smoking ban impacts on gaming volume and customers’ satisfaction in the …

Slip, Trip And Fall Risk Among Elderly Men And Women Living In The Hawaii Adult Foster Care Home System, Michelle Echauz Ching

UNLV Theses, Dissertations, Professional Papers, and Capstones

Adults 65 years of age and older (hereby referred to as “elderly”) are one of the fastest growing populations in the United States (U.S.). A major public health concern affecting the elderly population is unintentional injuries, particularly slips, trips, and falls (STFs). While there is extensive research on STFs among the elderly living in the community and long-term health care facilities, little to no research is found on STFs among the elderly living in community-based health care facilities. Research has also shown that STFs are caused by the interaction between multiple risk factors. Therefore, the purpose of this quasi-experimental study …

Understanding Perceptions Of Genetically Modified Food Among Natural Food Shoppers In Southern Nevada, Christian Murua-Aceves

UNLV Theses, Dissertations, Professional Papers, and Capstones

Today, 85% of corn, 93% of soybeans, and 88% of cotton in the U.S. are genetically modified (GM). Using laboratory methods, genes from one species, such as a plant, can be transferred to an unrelated species, such as an animal. Genetically modified crops may lead to higher yields, have improved food quality, texture, and nutritional value, and have an increased shelf life.

Despite these promising benefits, the potential health risks relating to the consumption of GM food remain inadequately assessed. Genetically modified food is not subjected to rigorous safety testing, such as epidemiologic studies, to identify potential health risks. Two …

Partnering With The Community For Establishment Of Alternate Care Sites During Disasters Or Emergencies: A Staff Training Matrix, Jean Marie Roberts

UNLV Theses, Dissertations, Professional Papers, and Capstones

An approach to fulfill a need for additional hospital beds during emergency and disaster situations has been establishment of alternate care sites (ACS). Kern County, California, with a population of about 856,000 and approximately 1,500 hospital beds, is at significant risk for inability to care for the medical needs of its residents in the face of a disaster or an emergency. Even the most conservative estimates of additional hospital beds requirements in a disaster or emergency would indicate the need for nine to ten ACSs accommodating up to 50 patients each in Kern County.

Recognizing the need for alternatives to …

Lead Hazard Control In Henderson, Nevada: Identifying Critical Areas And The Associated Costs, Khaye Gerazel Arcilla Rufin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Lead poisoning is a common, yet preventable childhood health problem in the United States today. Studies show statistically significant (p < .05) associations between higher childhood lead exposure and subsequent negative developmental outcomes. Since 1993, the U.S. Department of Housing and Urban Development (HUD) Lead Hazard Control (LHC) Grant Program has devoted more than $1 billion in funding to several cities.

This study investigated a total of n=75 homes enrolled into the Henderson Lead Hazard Control and Healthy Homes Program (HLHCHHP) from December 2013 – February 2015. A logistic regression was performed to ascertain the frequency of lead-based paint (LBP) found in homes based on the year it was constructed. Of the 75 enrolled and tested for LBP, 58 homes (77.3%) were found to contain LBP and 17 homes (22.7%) did not contain LBP. The significance value of p=0.013 shows that …

Sleep Duration Associated With Cardiovascular Conditions Among Adult Nevadans, Brianna Pergola

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cardiovascular disease (CVD) is the leading cause of mortality in the United States accounting for 1 out of every 3 deaths. Additionally, 43.9% of the population is expected to have some form of cardiovascular disease by the year 2030, with direct and indirect costs expected to rise upwards of 58 percent. To successfully prevent cardiovascular disease conditions such as myocardial infarction, coronary heart disease, and stroke, research must be done to identify risk factors, both modifiable and non-modifiable. In the existing literature, sleep duration as a risk factor for cardiovascular disease conditions has shown inconsistent associations. According to the National …

The Effects Of Adverse Childhood Experiences On Subsequent Injury In Young Adulthood: Findings From The National Longitudinal Study Of Adolescent And Adult Health, Michelle M. Sotero

UNLV Theses, Dissertations, Professional Papers, and Capstones

The objective of this study is to examine the association between adverse childhood experiences (ACEs) in the context of family and community and the likelihood of subsequent unintentional and intentional, nonfatal injury in young adulthood (ages 24-32 years). Using a cross sectional study design, data from Waves I and IV of the National Longitudinal Study of Adolescent and Adult Health, a nationally representative sample (n = 14,800) was used to examine the relationship between 16 types of ACEs and a cumulative ACE score and the odds of seven injury outcomes in young adulthood. Over a third (37.6%) of young adults …

The Feasibility Of Delivering A Home-Based Motivational Exercise Program To African-American Breast Cancer Survivors, Denise Spector, Claudio Battaglini

Journal of Health Disparities Research and Practice

Most African-American breast cancer survivors do not meet current exercise recommendations for cancer survivors, which include both aerobic and strength-training exercises. This pilot study tested the feasibility of delivering a home-based exercise intervention to African-American breast cancer survivors. Sedentary African-American breast cancer survivors were recruited for a 16-week motivational home-based progressive aerobic and strength-training exercise pilot study. Participants completed weekly exercise logs and received weekly phone calls. To assess feasibility, we evaluated recruitment, retention, and adherence rates, as well as participant acceptance and safety. 17 women enrolled; 13 completed the intervention (76%). Participants had moderately-high adherence (70%) to walking goals, …

Racial/Ethnic Disparities Related To Health Insurance Coverage, Access To Care And Ease In Health Care Services Among Children In 2012 Cchaps Data, Jacquelynn Meeks, Sweety Baidhya

Journal of Health Disparities Research and Practice

nObjective:The aim of this study was to examine racial/ethnic disparities in unmet medical care, dental care and prescription medications and ease of using heath care services.

Methods:This is a cross sectional study of households in a six-county service region in Texas (Tarrant, Johnson, Hood, Parker, Wise and Denton Counties). The participants included the parents/guardians of children aged 1-15 years. In 2012, a total of 8,439 parents completed the survey. In 2012, 4194 completed the version containing the health insurance type and unmet medical, prescription and dental health care and ease/difficulty in access to health care questions.The dependent variables …

Psychosocial Correlates Of Perceived Stress And Depressive Symptoms Among Help-Seeking Hispanic Smokers, Monica Webb Hooper Phd

Journal of Health Disparities Research and Practice

Objectives: Research has demonstrated robust associations between perceived stress, depressive symptoms, and cigarette smoking. The extent to which these findings from the general population generalize to Hispanic smokers is unknown. The present study examined (a) correlates of perceived stress and depressive symptoms among help-seeking Hispanic smokers and (b) whether maladaptive coping and social support were related to stress and depressive symptoms. Design: Hispanic smokers (N=123) enrolled in an RCT completed demographic and smoking history, perceived stress, depressive symptoms, perceived social support, and maladaptive coping measures. Results: Bivariate associations indicated that perceived stress was positively correlated with depressive symptoms …

Reducing Health Disparities Through The 2015 Mcat: A Bold Goal Requiring On-Going Assessment, Aliya G. Feroe, Stephen F. Loebs

Journal of Health Disparities Research and Practice

There is broad consensus that reduction in health care disparities is an important and multi-faceted challenge. One possible approach, among many others, starts with the attraction of women and men to the field of medicine who have a broad based education and who can demonstrate cultural understanding and sensitivity. In this context, the Medical College Admissions Test (MCAT) has been revised, effective in 2015, to include many additional questions concerning the psychological, social, and behavioral sciences. There are important assumptions fueling the revised Medical College Admissions Test (MCAT) and these will need to be tested. These assumptions range from influencing …

Chronic Physical Health Conditions Among Homeless, Nooshin Nikoo, Marjan Motamed, Mohammad Ali Nikoo, Verena Strehlau, Erika Neilson, Sahoo Saddicha, Michael Krausz

Journal of Health Disparities Research and Practice

ABSTRACT

Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a …

Evaluation Of The Nci’S Community Cancer Centers’ Program (Ncccp): Impact On Disparities In Quality Of Cancer Care, Michael T. Halpern, Pamela Spain, Debra J. Holden, Andrew K. Stewart, Erica J. Mcnamara, Greer Gay, Steven B. Clauser, Irene Prabhu Das

Journal of Health Disparities Research and Practice

This study examined the effects of the NCCCP pilot on breast or colon cancer quality of care for patients from underserved populations and those treated at disparities-focused hospitals (NCCCP sites having fewer oncology resources or in communities with greater proportions of underserved populations). Data on five quality of care measures were collected using the Commission on Cancer’s Rapid Quality Reporting System. Following NCCCP initiation, we observed improvements in all five quality of care measures. There were similar quality of care improvements for Black vs. White patients, privately insured vs. Medicaid or uninsured patients, and men vs. women. Patients treated at …

Impact Of Social And Cultural Factors On Teenage Pregnancy, Devi Akella, Melissa Jordan

Journal of Health Disparities Research and Practice

United States has the highest level of teenage pregnancy amongst the industrialized nations. Further, the level of teenage pregnancy is highest amongst the minority population. This research study examines the reasons behind high rates of early childbirth amongst African American teenagers. This study uses Bandura’s (1977) Social Learning Theory to deconstruct the factors, which influence and manipulate the overall behavior of the teenagers and initiates them to choose early motherhood over education and career. To ensure better quality of empirical data, the authors collaborated with the pregnant teenagers and a local non-profit community agency using a phenomenological analysis.

Gathering Perspectives On Extended Family Influence On African American Children's Physical Activity, Natasha A. Brown, Katherine Clegg Smith, Rachel L.J. Thornton, Janice V. Bowie, Pamela J. Surkan, Darcy A. Thompson, David M. Levine

Journal of Health Disparities Research and Practice

Background: The family environment is a key determinant of children’s physical activity. The importance of the extended African American family is well established, but there is little research on its influence on school age children’s physical activity. Methods: We recruited eight families in which grandparents and other adult relatives played a central role in child supervision. Semi-structured interviews with parents, other adult relatives, and children revealed various perspectives on the influences of culture and families on children’s weight-related behaviors. Results: Children were between the ages of 6 and 11, and five of the families resided in neighborhoods in which at …

American Muslim Health Disparities: The State Of The Medline Literature, Aasim I. Padela, Afrah Raza

Journal of Health Disparities Research and Practice

Background: While religious beliefs and values influence health behaviors, conventional health disparities research rarely examines health outcomes by religious affiliation particularly within multi-ethnic minority communities.

Methods: Using a systematic strategy we searched the Medline literature to identify empiric studies that report on health disparities between American Muslims and non-Muslim groups residing in America. In addition to use religious affiliation descriptors for Muslim groups we utilized geographic and ethnicity terms such as “South Asian” or “Pakistani” as proxy terms to help uncover studies of American Muslims.

Results: 171 empirical studies were captured. South Asians and Arabs were the most commonly studied …

Factors Associated With Intention To Receive Influenza And Tetanus, Diphtheria, And Acellular Pertussis (Tdap) Vaccines During Pregnancy: A Focus On Vaccine Hesitancy And Perceptions Of Disease Severity And Vaccine Safety, Allison T. Chamberlain, Katherine Seib, Kevin A. Ault, Walter A. Orenstein, Paula M. Frew, Fauzia Malik, Marielysse Cortés, Pat Cota, Ellen A. S. Whitney, Lisa C. Flowers, Ruth L. Berkelman, Saad B. Omer

Environmental & Global Health Faculty Research

BACKGROUND: Improving influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccine coverage among pregnant women is needed. PURPOSE: To assess factors associated with intention to receive influenza and/or Tdap vaccinations during pregnancy with a focus on perceptions of influenza and pertussis disease severity and influenza vaccine safety. METHODS: Participants were 325 pregnant women in Georgia recruited from December 2012 – April 2013 who had not yet received a 2012/2013 influenza vaccine or a Tdap vaccine while pregnant. Women completed a survey assessing influenza vaccination history, likelihood of receiving antenatal influenza and/or Tdap vaccines, and knowledge, attitudes and beliefs about influenza, …

Impact Of Hiv Testing And Counseling (Htc) Knowledge On Hiv Prevention Practices Among Traditional Birth Attendants In Nigeria, Alice Osuji, Jennifer R. Pharr, Uche Nwokoro, Anulika Ike, Christiana Ali, Ogheneaga Ejiro, John Osuyali, Michael Obiefune, Kevin Fiscella, Echezona E. Ezeanolue

Environmental & Global Health Faculty Research

Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess …

Delivering A “Dose Of Hope”: A Faith-Based Program To Increase Older African Americans’ Participation In Clinical Trials, Paula M. Frew, Saad B. Omer, Kimberly Parker, Marcus Bolton, Jay Schamel, Eve Shapiro, Lauren Owens, Diane Saint-Victor, Sahithi Boggavarapu, Nikia Braxton, Matthew Archibald, Ameeta S. Kalokhe, Takeia Horton, Christin M. Root, Vincent L. Fenimore, Aaron M. Anderson

Environmental & Global Health Faculty Research

Background: Underrepresentation of older-age racial and ethnic minorities in clinical research is a significant barrier to health in the United States, as it impedes medical research advancement of effective preventive and therapeutic strategies. Objective: The objective of the study was to develop and test the feasibility of a community-developed faith-based intervention and evaluate its potential to increase the number of older African Americans in clinical research. Methods: Using a cluster-randomized design, we worked with six matched churches to enroll at least 210 persons. We provided those in the intervention group churches with three educational sessions on the role of clinical …

Recognizing The Influence Of Social Determinants On Hiv Risk Behaviors And The Need For Structural Interventions To Prevent Hiv In Women, Arlene Edwards

Journal of Health Disparities Research and Practice

The design and implementation of structural interventions may provide for simultaneous and longitudinal responses to prevention needs in multiple contexts as defined by social determinants, thus varied opportunities exist to respond to the HIV prevention needs of women. According to the CDC, in 2010, the rate of new HIV infections among black women was 20 times that of white women, and the rate among Hispanic/Latino women was 4 times the rate of white women. Additionally, 86% of HIV infections in women were attributed to heterosexual contact and 14% to injection drug use (CDC, 2012). These numbers are reflected outside the …

Common Threads: An Integrated Hiv Prevention And Vocational Development Intervention For African American Women Living With Hiv/Aids, Liza Marie Conyers, Yung-Chen Chiu, Aisha Shamburger-Rousseau, Vanessa Johnson, Mark Misrok

Journal of Health Disparities Research and Practice

Current policies and initiatives call for the integration of social determinants of health into HIV/AIDS prevention and care interventions. According to the World Health Organization’s Commission on Social Determinants of Health, the lower a person’s socioeconomic status, the worse the health outcomes. One way to alleviate poverty among African American women with HIV/AIDS is to help foster their vocational development and economic empowerment. The National HIV/AIDS Strategy Implementation Plan specifically directs federal agencies to find ways to integrate people living with HIV/AIDS into broader employment initiatives. The purpose of this manuscript is to examine medical, psychosocial, financial/legal and vocational social …

A Comparison Of Sexual Health And Sexual Pressure Among Young African American And Caucasian Women, Ann Gakumo

Journal of Health Disparities Research and Practice

Introduction. Condom self-efficacy, positive attitudes toward condom use, condom negotiation skills, HIV knowledge, and self-esteem have been associated with decreased HIV risk behavior among young women, but few studies have examined racial disparities that may exist in these social health indicators. Moreover, sexual pressure (inclusive of both coercive and non-coercive pressures to engage in unwanted or unprotected sex) has been understudied in women of different racial groups.

Study Purpose. The purpose of this study was to compare racial similarities and disparities in indicators of sexual health and sexual pressure in an urban sample of young African American and Caucasian women …

Project Thanks: A Socio-Ecological Framework For An Intervention Involving Hiv Positive African American Women With Comorbidities, Meena Mahadevan, Ndidiamaka Amutah, Lauren Juliette Ramos, Emily Rose Raines, Jerome King, Jodyann Mcintosh, Constance Leverett

Journal of Health Disparities Research and Practice

HIV-positive individuals are living longer today as a result of continuing advances in treatment but are also facing an increased risk for chronic diseases such as diabetes, and hypertension. These conditions result in a larger burden of hospitalization, outpatient, and emergency room visits. Impoverished African American women may represent an especially high-risk group due to disparities in health care, racial discrimination, and limited resources. This article describes an intervention that is based on the conceptual framework of the socio-ecological model. Project THANKS uses a community-based participatory, and empowerment building approach to target the unique personal, social, and environmental needs of …

Sexual Decision Making In The Absence Of Choice: The African American Female Dating Experience., Michele Peake Andrasik, Hong V. Nguyen, William H. George, Kelly F. Kajumulo

Journal of Health Disparities Research and Practice

Although links between low mate availability and increased HIV and STI risk for African American women have been documented in the literature, we know little about the impact of limited mate choices on the quality of relationships between Black men and women and how these relationship dynamics impact risk for young Black women. We conducted a qualitative study with African American female young adults (N=12) to explore the perceived impact of structural forces on African American female young adults’ dating and sexual behavior. Participants reported (1) perceptions of Black men as untrustworthy and manipulative, (2) the limited and often negative …

Lessons Learned: Exploratory Study Of A Hiv/Aids Prevention Intervention For African American Women Who Have Experienced Intimate Partner Violence, Michele A. Rountree

Journal of Health Disparities Research and Practice

Given the prevalence and co-occurring nature of HIV and intimate partner violence among African American women there is a need for a risk reduction intervention. This study explored the results from an exploratory study of an HIV/AIDS prevention intervention for African-American women who have experienced intimate partner violence. The emphasis of this study is to identify lessons learned to guide future research.

Recruitment for the feasibility study was done in two waves over a period of three months. During the first wave, 22 participants were recruited for the intervention group, and in the second wave, 25 participants were in the …

Is Race A Factor In Disparate Health Problems Associated With Violence Against Women?, Gabriel M. Garcia, Marny Rivera

Journal of Health Disparities Research and Practice

Research studies examining the health correlates of violence against women have consistently demonstrated associations between violence and poor health outcomes, but have not examined a disparate impact on racial minorities. Alaska Victimization Survey data (2010) was used to examine whether a disparate relationship between victimization and health problems exists for minority women relative to White women. The Alaska Victimization Survey (AVS) is a cross-sectional survey designed to provide baseline estimates of intimate partner and sexual violence for Alaskan women. Logistic regression was used to assess the odds of experiencing various health problems given race and exposure to violence status while …

Dramatic Plays As A Tool To Educate Young African-American Females About Hiv/Aids, Jonathan N. Livingston, James Merryweather, Jessica Mohabir, Che' Smith, Nina Smith, Jacqueline Madry, Travis Knight, Dorothy M. Singleton, Seronda A. Robinson, Lisa Cothran, Dwayne Brandon, Alexis L. Slay, Camille Brown

Journal of Health Disparities Research and Practice

Rates of HIV/AIDS transmission have increased substantially, particularly among young African American women. According to the Centers for Disease Control and Prevention (CDC), HIV/AIDS is the number one killer for African American women aged 25 to 34. Given that many of these young women are contracting the disease in their late teens and early twenties, there is a need to develop interventions that directly address the needs of this group. The current study sought to assess the effectiveness of theater in increasing knowledge of HIV/AIDS and the likelihood of healthier sexual behavior and choices among 219 young African American women …

Editors' Notes-Women Of Color Sexual Health Across The Lifespan, Marya Shegog, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

No abstract provided.

Parental Discussions About Sexual Risk With African American Sons: The Role Of Religiosity., Wadiya A. Udell, Geri R. Donenberg

Journal of Health Disparities Research and Practice

The current study investigated the relationship between parental religiosity (i.e., parent church attendance), and frequency of parent-youth communication about sexual risk (i.e., discussion about sex, and discussion about condom use) with African American boys. Participants were 65 parents of African American boys between the ages of 11 and 17 years. Results indicated no relationship between age and parent-son discussion about sexual risk. However, parental religiosity was negatively associated with frequency of communication with sons about sex and condom use. Parents who attended church more frequently reported fewer discussions about sex and condom use than parents who attended church less frequently. …