Public Health Commons^™

Examining The Relationships Between Religiosity, Spirituality, Internalized Homonegativity, And Sexual Risk Behaviors Among African-American Men Who Have Sex With Men: The Sexual Health In Faith Traditions (Shift) Study, Stacy Whichard Smallwood

Theses and Dissertations

Background: African-American men who have sex with men (AAMSM) are at disproportionate risk for HIV infection. Although the disparities in infection rates between AAMSM and MSM of other groups have been well-documented, little is known about the factors that contribute to the disparity, particularly psychosocial factors. One such factor, internalized homonegativity (IH), has been identified as a potential predictor of AAMSM engagement in risky sexual behaviors. However, little has been known about the ways in which IH manifests itself in the lives of AAMSM, or the role that sociocultural institutions, such as African-American faith communities, play in the development of …

A Preliminary Study Exploring Racial Differences In Triage, Hospitalization Status, And Discharge Medication In An Emergency Department In Graniteville, Sc, Clare Pollock

Theses and Dissertations

Purpose

This study seeks to identify any racial differences present in assigned triage scores, hospitalization status and discharge medications in a rural hospital likely experiencing a surge after a mass casualty incident involving chlorine gas as a result of a train derailment. Differences were examined between Non-Hispanic White and African American adults who were moderately ill and who presented to the emergency department of the closest hospital to the accident site within 24 hours of the incident.

Methods

Non-Hispanic White and African American adults who presented to the emergency department of the closest hospital to the accident site and who …

Understanding The Early Stages Of Development Of A Global Health Partnership, Wendy Raquel Gonzalez Navarrete

Theses and Dissertations

Maternal and child undernutrition contributes to more than one-third of child deaths. Global Health Partnerships (GHP) have emerged as a response to undernutrition and other pressing health problems. GHPs promote joint decision-making among donors, multilateral agencies, and country partners. Despite their positive impact on health problems, GHPs have generated unintended negative effects on country partners. This study aimed to understand the factors, strategies, and processes conducive to the establishment of an effective GHP in the context of a cooperative regional effort to reduce undernutrition and improve maternal and child health in eight countries in Latin America, Regional Health Initiative (RHI). …

Family-Focused Physical Activity, Diet, And Obesity Interventions In African-American Girls: A Systematic Review, Daheia J. Barr-Anderson, Alexis W. Adams-Wynn, Katherine I. Disantis, Shiriki Kumanyika

Faculty Publications

Obesity interventions that involve family members may be effective with racial/ethnic minority youth. This review assessed the nature and effectiveness of family involvement in obesity interventions among African-American girls aged 5-18 years, a population group with high rates of obesity. Twenty-six databases were searched between January 2011 and March 2012, yielding 27 obesity pilot or full-length prevention or treatment studies with some degree of family involvement and data specific to African-American girls. Interventions varied in type and level of family involvement, cultural adaptation, delivery format, and behavior change intervention strategies; most targeted parent-child dyads. Some similarities in approach based on …

Geographical Proximity To Health Facilities And Breast Cancer Morbidity And Mortality Among Women In South Carolina's Best Chance Network, Leepao Khang

Theses and Dissertations

Death rates for breast cancer have steadily decreased in women due to early detection, such as mammography, and improved treatments. Despite the benefit of mammography, many women are not up-to-date on screening and do not receive timely follow-up after abnormal mammogram finding. Breast cancer is a major contributor to morbidity and mortality among women in South Carolina. To reduce the disproportionate burden of breast cancer and cervical cancer among women in South Carolina, the South Carolina Best Chance Network (BCN) was established to provide service delivery and ensures timely and complete diagnostic follow-up and treatment initiation for underserved women.

The …

Association Between Breastfeeding And Infant Growth: A Probable Reverse Causality, Shraddha Vyas

Theses and Dissertations

Background: Much conflicting results exist in the association between breastfeeding and infant growth. One of these confusions is related to the temporal sequence between breastfeeding practice and infant growth.

Objective: This study aimed at examining the association and investigating a possible reverse causality between breastfeeding and infant growth.

Method: Infant Feeding Practices Survey II, a national longitudinal database with repeated measurements, following women prenatally and until one year postpartum (N=2914) was used. Mixed linear model assessed the impact of breastfeeding from the 2nd, 4th, 6th and 9th months on infant growth at the 3rd, 5th, 7th and 12th months, respectively. …

Understanding Online And Offline Sex Seeking Behavior Among Young Men Who Have Sex With Men: Implications For Hiv/Aids Interventions, Winston Eromosele Abara

Theses and Dissertations

Men who have sex with men (MSM), especially in the southeastern US are disproportionately impacted by the HIV/AIDS epidemic. Young MSM and African American MSM are particularly burdened accounting for a greater proportion of HIV/AIDS diagnoses. Factors such as risky sexual behavior, perception of sexual risk, ignorance about HIV sero-status, internalized homonegativity/homophobia (IH), stigma, and alcohol and illegal drug use have been advanced as reasons for this disproportionate burden. HIV/AIDS prevention efforts aimed at stemming the epidemic among MSM have focused on locations where MSM meet other men for sex such as parks, beaches, bathhouses, adult book stores, clubs, and …

Smokers' Neurological Responses To Imagery From Cigarette Package Warning Labels, Johann Fridrik Fridriksson

Theses and Dissertations

Tobacco use is the leading cause of preventable death in the United States. The Family Smoking Prevention and Tobacco Control Act was signed into law in 2009 and gave the U.S. Food and Drug Administration (FDA) the authority to implement pictorial health warning labels (HWLs) on cigarette packages. Multiple studies investigating self-reported affective, cognitive and behavioral impacts of HWLs suggest that the most effective warnings include imagery that depicts physical damage to the body due to smoking. However, self-report methods of assessment used in these studies may be biased. Far less is known about how HWLs directly modulate brain activity. …

Exploring African American And White 18-19 Year Old Males' Communication Experiences With Their Parents And Partners About Sex And Contraception, Charlotte Toole Galloway

Theses and Dissertations

Background: Increasing parent-child and partner communication about sex and contraception have been identified as protective factors that are amenable to change by teen pregnancy prevention programs.

Purpose and Methods: From June through July 2012, a total of six focus groups (N=30) were conducted with African American and White 18-19 year old males to retrospectively explore their communication experiences with parents and partners about sex and contraception, and their attitudes and beliefs about sex, pregnancy, and contraception.

Results: Most participants felt that parent-child sexual risk communication would be more effective when parents had a history of open communication and a good …

Investigating Developmental Patterns Of Symptom And Impairment Change Among Youth With Adhd, Subthreshold Adhdand Youth Without Adhd, Lorie Love Geryk

Theses and Dissertations

Introduction. Despite a substantial prevalence of subthreshold Attention-Deficit/Hyperactivity Disorder (ADHD) and research indicating that many youth with this disorder have impaired functioning and negative outcomes, few studies have considered patterns of symptom and functioning change for youth with probable ADHD, subthreshold ADHD and youth without ADHD transitioning from childhood to adolescence. Additionally, we are not aware of any studies examining predictors of impairment severity among youth with subthreshold ADHD, and few studies have examined predictors of treatment utilization and patterns of symptom and functioning change based on medication status for youth with subthreshold ADHD compared to youth with ADHD. Methods. …

A Qualitative Study Of An Urban Community Garden: Creating Healthier Neighborhood Environments, Lauren Workman

Theses and Dissertations

Neighborhoods influence population level health; the places where people live, work, and grow are an essential setting for health promotion interventions. In efforts to create healthier neighborhood environments, there is a movement to better understand neighborhood social characteristics. The neighborhood social environment potentially includes social relationships (including trust and cohesion), networks, norms, and the resources that may be generated from relationships. In addition, more work is needed to learn about how people may become engaged in neighborhood initiatives. Community gardens are a 1) potential strategy to promote health at community and individual levels 2) mechanism to involve community members in …

Bmi At Diagnosis And Its Association With Markers Of Hiv Disease Progression And Cardiovascular Disease Risk., Kelly Deshon Johnson

Theses and Dissertations

Highly active antiretroviral treatment (HAART) has transformed the state of human immunodeficiency virus (HIV) from acute to chronic. As a result, the long-term effect of HAART has caused weight gain among HIV-infected individuals, leading to an increased prevalence of overweight and obesity. Increased Body Mass Index (BMI) has been associated with adverse health outcomes in non-HIV and HIV populations, yet among HIV-infected individuals, a higher BMI at diagnosis offers a slower progression from HIV to AIDS. Pre-HAART, studies reported that obese HIV-infected individuals have higher increases in CD4 count over time. However post-HAART, some report that overweight HIV-infected individuals with …

The Relationship Between Electronic Health Record Implementation And Outcomes Of Care For Three Cardiovascular Procedures, Deshia Ann Leonhirth

Theses and Dissertations

Background. The U.S. healthcare movement to improve quality and patient outcomes has prompted investigations into tools that can assist in these aims. Electronic health records (EHRs) are one tool proposed by the Institute of Medicine (IOM). The objective of this original dissertation research was to examine the relationship between electronic health record functionalities and two outcomes of care as proxies for quality: risk-adjusted mortality for abdominal aortic aneurysm (AAA) repair, coronary artery bypass grafting (CABG), and percutaneous coronary intervention (PCI) and log estimated cost-per-discharge. Methods. This study used 2009-2010 hospital inpatient administrative discharge data from the Nationwide Inpatient Sample (NIS), …

Food Environment And Birth Outcomes In South Carolina, Xiaoguang Ma

Theses and Dissertations

An increasing number of studies examined the association between neighborhood characteristics and birth outcomes. However, the results can be difficult to compare because of the variety of indicators used to characterize the neighborhood. As an important neighborhood characteristic, the food environment is associated with residents' nutrition status, diet quality, and related health outcomes. In addition, the food environment has been found to influence women's diet quality during pregnancy, which is a key factor in predicting birth outcomes. However to date, studies on food environment and birth outcomes are extremely limited.

This study examined the association between food environment (evaluated by …

Differential Effects Of The Great Recession On Minority Populations, Samuel Towne

Theses and Dissertations

Times of severe economic flux may burdend individuals at differing levels. The Great Recession affected individuals differently by racial group. Vulnerable individuals who may already be burdened by economic strains and health disparities may benefit from state policies that work to improve the health and health care access of individuals. Medicaid Generosity for parents or childless adults is associated with differences in individuals' health status and reporting forgone medical care. Individuals in states that have higher levels of Medicaid eligibility defined as eligibility in relation to the percent of the Federal Poverty Level report lower levels of poor or fair …

An Assessment Of Injury Presentation To Determine Elder Abuse Prevalence In South Carolina, Brittani L. Harmon

Theses and Dissertations

As the number of individuals age 60 years of age and older continues to rise in the United States, the care and safety of this population will be a growing issue. There are many contributing factors and reasons why elder abuse occurs. Elder abuse is an emerging issue; however there is limited research and understanding in the area. There are barriers to the detection and prevention of the issue. Emergency department staff is essential to the identification and detection of possible abuse, and it is important that these providers understand the risk factors and physical manifestations of abuse and neglect …

Promoting Early Childhood Development Through Community Health Worker Interventions: Implementation And Measurement Issues In Rural Pakistan, Zaeem Haq

Theses and Dissertations

Appropriate nutrition and psychosocial stimulation during the first three years of life can have long-lasting effects on a child's health and development. However, not all children in the world receive adequate nutrition and psychosocial stimulation during this period. There has been enormous interest in developing the evidence on the most effective ways of implementing and assessing early childhood development (ECD) promotion interventions in resource poor settings. Despite the interest, the integration of ECD interventions into pre-existing public health programs, and assessment of these interventions in extended family, rural household environment have not been addressed.

The dissertation research presented here was …

Postnatal Depression In Mexico: Healthcare Provider Conceptualizations And Policies In The Public Health Sector, Jean Marie Sims Place

Theses and Dissertations

Background: The World Health Organization (WHO) and the United Nations Population Fund (UNFPA) highlight education and training for healthcare providers and the development of a policy framework as core strategies to address maternal mental health in low- and middle-income countries. This research critically examines these strategies with respect to postnatal depression in Mexico. The research 1) addresses how healthcare providers in Mexico conceptualize postnatal depression, and 2) assesses the policies that exist in Mexico regarding postnatal depression, which will inform the next steps for policy development. The research informs appropriate healthcare provider education and training, as well as the next …

Race, Ethnicity, And Differential Perceptions Of Sexual Victimization (Assault), Kaleea Regina Lewis

Theses and Dissertations

The purpose of this pilot study is to ascertain how a sample of female college students perceives a hypothetical victim of a fabricated sexual assault. Participant perceptions of the sexual assault were explored through three distinct parameters: (1) victim responsibility attributes, (2) levels of trauma suffered due to the experience, and (3) levels of social support. This study addressed the two following research questions: (1) how does the hypothetical sexual assault victim's race and ethnicity affect how the study parameters are assessed and (2) how do participants perceive a hypothetical sexual assault victim, when presented in different races and ethnicities, …

Early Invitation To Food And/Or Multiple Micronutrient Supplementation In Pregnancy Does Not Affect Body Composition In Offspring At 54 Months: Follow-Up Of The Minimat Randomized Trial, Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Sophie Hawkesworth, Eva‐Charlotte Ekström, Shams Arifeen, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

Growth patterns in early life are associated with later health.The effect of nutrition duringin uterodevelopmenton later body composition is unclear. We evaluated whether prenatal early invitation to food and/or multiplemicronutrient supplementation (MMS) in pregnancy has an effect on offspring body composition at 54 monthsof age. In Maternal and Infant Nutrition Interventions in Matlab trial (ISRCTN16581394) in Bangladesh, 4436pregnant women were randomised into six equally sized groups: double-masked supplementation with capsulesof either 30 mg Fe and 400mg folic acid, or 60 mg Fe and 400mg folic acid, or MMS (15 micronutrients), wascombined with a randomised early invitation (around 9 weeks) or …

Prevalence And Predictors Of Giving Birth In Health Facilities In Bugesera District, Rwanda, Shahrzad Joharifard, Stephen Rulisa, Francine Niyonkuru, Andrew Weinhold, Felix Sayinzoga, Jeffrey Wilkinson, Jan Ostermann, Nathan M. Thielman

Faculty Publications

Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda.

Methods Using census data …

Elite Athletes' Survival Advantage: Could Be Shared By All Through Physical Activity, Adrian E. Bauman, Steven N. Blair

Faculty Publications

No abstract provided.

Prevalence And Correlates Of Receiving Cigarettes As Gifts And Selecting Preferred Brand Because It Was Gifted: Findings From The Itc China Survey, Li-Ling Huang, Jim Thrasher, Yuan Jiang, Qiang Li, Geoffrey T. Fong, Anne Ck Quah

Faculty Publications

Background: Giving cigarettes as gifts is a common practice in China, but there have been few systematic studies of this practice. The present study was designed to estimate the incidence of receiving cigarettes as gifts, correlates of this practice, and its impact on brand selection in a representative sample of urban adult smokers in China.

Methods: Data were analyzed from Wave 2 of the International Tobacco Control (ITC) China Survey, where 4843 adult urban smokers were interviewed in six major Chinese cities between October 2007 and January 2008. The incidence of most recent cigarette acquisition due to gifting and the …

Maternal Pre‐Pregnancy Body Mass Index Is Not Associated With Infant And Young Child Feeding In Low‐Income Mexican Children 1–24 Months Old, Eva C. Monterrosa, Edward A. Frongillo Jr., Lynnette M. Neufeld, Kelsey A. Egan, Usha Ramakrishnan, Kathleen M. Rasmussen

Faculty Publications

Pre-pregnancy overweight and obesity is associated with shorter breastfeeding (BF) duration. Whether pre-pregnancy overweight and obesity is associated with other aspects of infant and young child feeding (IYCF) hasnot been investigated. We used data from 370 children born January 1999–September 2001 in a semi-urbancommunity in Morelos, Mexico, where information on how they were fed was available at 1, 3, 6, 9, 12, 18 and 24months of age. We modified the World Health Organization’s dietary diversity indicator to assess the quality ofthe complementary foods. An index that included BF, quality of complementary foods and other behaviours wasconstructed to measure IYCF. We …

The Potential Impact Of Plain Packaging Of Cigarette Products Among Brazilian Young Women: An Experimental Study, Christine M/ White, David Hammond, Jim Thrasher, Geoffrey T. Fong

Faculty Publications

Background: Tobacco use is responsible for 5.4 million deaths every year worldwide and is a leading cause of preventable death. The burden of these deaths is rapidly shifting to low and middle-income countries, such as Brazil. Brazil has prohibited most forms of tobacco advertising; however, the cigarette pack remains a primary source of marketing. The current study examined how tobacco packaging influences brand appeal and perceptions of health risk among young women in Brazil.

Methods: A between-subjects experiment was conducted in which 640 Brazilian women aged 16–26 participated in an online survey. Participants were randomized to view 10 cigarette packages …

Body Mass Index Trajectories From Adolescence To Midlife: Differential Effects Of Parental And Respondent Education By Race/Ethnicity And Gender, Katrina M. Walsemann, Jennifer A. Ailshire, Bethany A. Bell, Edward A. Frongillo

Faculty Publications

Objectives: Race/ethnicity and education are among the strongest social determinants of body mass index (BMI) throughout the life course, yet we know relatively little about how these social factors both independently and interactively contribute to the rate at which BMI changes from adolescence to midlife. The purpose of this study is to 1) examine variation in trajectories of BMI from adolescence to midlife by mothers' and respondents' education, and 2) determine if the effects of mothers' and respondents' education on BMI trajectories differ by race/ethnicity and gender.

Design: We used nationally representative data from the National Longitudinal Survey of Youth …

The Effect Of Exercise Training Modality On Serum Brain Derived Neurotrophic Factor Levels In Individuals With Type 2 Diabetes, Damon L. Swift, Neil M. Johannsen, Valerie H. Myers, Conrad P. Earnest, Jasper A. J. Smits, Steven N. Blair, Timothy S. Church

Faculty Publications

Introduction: Brain derived neurotrophic factor (BDNF) has been implicated in memory, learning, and neurodegenerative disease. However, the relationship of BDNF with cardiometabolic risk factors is unclear, and the effect of exercise training on BDNF has not been previously explored in individuals with type 2 diabetes.

Methods: Men and women (N=150) with type 2 diabetes were randomized to an aerobic exercise (aerobic), resistance exercise (resistance), or a combination of both (combination) for 9 months. Serum BDNF levels were evaluated at baseline and follow-up from archived blood samples.

Results: Baseline serum BDNF was not associated with fitness, body composition, anthropometry, glucose control, …

Dose-Response Effects Of Exercise Training On The Subjective Sleep Quality Of Postmenopausal Women: Exploratory Analyses Of A Randomised Controlled Trial, Christopher E. Kline, Xuemei Sui, Martica H. Hall, Shawn D. Youngstedt, Steven N. Blair, Conrad P. Earnest, Timothy S. Church

Faculty Publications

Objective: To investigate whether a dose-response relationship existed between exercise and subjective sleep quality in postmenopausal women. This objective represents a post hoc assessment that was not previously considered.

Design: Parallel-group randomised controlled trial.

Setting: Clinical exercise physiology laboratory in Dallas, Texas.

Participants: 437 sedentary or overweight/obese postmenopausal women.

Intervention: Participants were randomised to one of four treatments, each of 6 months of duration: a non-exercise control treatment (n=92) or one of three dosages of moderate-intensity exercise (50% of VO_2peak), designed to meet 50% (n=151), 100% (n=99) or 150% (n=95) of the National Institutes of Health Consensus Development …

Omega-3 Fatty Acid Supplementation Appears To Attenuate Particulate Air Pollution-Induced Cardiac Effects And Lipid Changes In Healthy Middle-Aged Adults, Haiyan Tong, Ana G. Rappold, David Diaz-Sanchez, Susan E. Steck, Jon Berntsen, Wayne E. Cascio, Robert B. Devlin, James M. Samet

Faculty Publications

BACKGROUND: Air pollution exposure has been associated with adverse cardiovascular health effects. Findings of a recent epidemiological study suggest that omega-3 fatty acid (fish oil) supplementation blunted cardiac responses to air pollution exposure.

OBJECTIVES: We conducted a randomized, controlled exposure study to evaluate the efficacy of fish oil supplements in attenuating adverse cardiac effects of exposure to concentrated ambient fine and ultrafine particulate matter (CAP).

METHODS: Twenty-nine healthy middle-aged participants (mean 58 ± 1 years of age) were supplemented in a randomized, double-blinded manner with 3 g/day of either fish oil or olive oil for 4 weeks before sequential chamber …

Correlates Of Poor Health Among Orphans And Abandoned Children In Less Wealthy Countries: The Importance Of Caregiver Health, Nathan Thielman, Jan Ostermann, Kathryn Whetten, Rachel Whetten, Karen O’Donnell, Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background: More than 153 million children worldwide have been orphaned by the loss of one or both parents, and millions more have been abandoned. We investigated relationships between the health of orphaned and abandoned children (OAC) and child, caregiver, and household characteristics among randomly selected OAC in five countries.

Methodology: Using a two-stage random sampling strategy in 6 study areas in Cambodia, Ethiopia, India, Kenya, and Tanzania, the Positive Outcomes for Orphans (POFO) study identified 1,480 community-living OAC ages 6 to 12. Detailed interviews were conducted with 1,305 primary caregivers at baseline and after 6 and 12 months. Multivariable logistic …