Public Health Commons^™

Test Site Predicts Hiv Care Linkage And Antiretroviral Therapy Initiation: A Prospective 3.5 Year Cohort Study Of Hivpositive Testers In Northern Tanzania, Elizabeth A. Reddy, Chris Bernard Agala, Venance P. Maro, Jan Ostermann, Brian W. Pence, Dafrosa K. Itemba, Donna Safley, Jia Yao, Nathan M. Thielman, Kathryn Whetten

Faculty Publications

Background: Linkage to HIV care is crucial to the success of antiretroviral therapy (ART) programs worldwide, loss to follow up at all stages of the care continuum is frequent, and long-term prospective studies of care linkage are currently lacking.

Methods: Consecutive clients who tested HIV-positive were enrolled from four HIV testing centers (1 health facility and 3 community-based centers) in the Kilimanjaro region of Tanzania as part of the larger Coping with HIV/AIDS in Tanzania (CHAT) prospective observational study. Biannual interviews were conducted over 3.5 years, assessing care linkage, retention, and mental health. Bivariable and multivariate logistic regression analyses were …

Infant And Young Child Feeding Practices Differ By Ethnicity Of Vietnamese Mothers, Tuan T. Nguyen, Phuong H. Nguyen, Nemat Hajeebhoy, Huan V. Nguyen, Edward A. Frongillo Jr.

Faculty Publications

Background: Limited studies have examined ethnic variation in breastfeeding and complementary feeding practices in developing countries. This study investigated ethnic variation in feeding practices in mothers with children 0–23 months old in Vietnam.

Methods: We used data on 1875 women who came from the ethnic majority, Kinh (n = 989, randomly sampled from 9875 surveyed Kinh mothers, 10 % from each province) and three ethnic minorities: E De-Mnong (n = 309), Thai-Muong (n = 229) and Tay-Nung (n = 348). Ethnic minorities were compared with the Kinh group using logistic regression model.

Results: Prevalence of breastfeeding initiation within an hour …

Does Reactance Against Cigarette Warning Labels Matter? Warning Label Responses And Downstream Smoking Cessation Amongst Adult Smokers In Australia, Canada, Mexico And The United States, Yoo Jin Cho, Jim Thrasher, Kamala Swayampakala, Hua-Hie Yong, Robert Mckeever, David Hammond, Dien Anshari, K. Michael Cummings, Ron Borland

Faculty Publications

Objective

Some researchers have raised concerns that pictorial health warning labels (HWLs) on cigarette packages may lead to message rejection and reduced effectiveness of HWL messages. This study aimed to determine how state reactance (i.e., negative affect due to perceived manipulation) in response to both pictorial and text-only HWLs is associated with other types of HWL responses and with subsequent cessation attempts.

Methods

Survey data were collected every 4 months between September 2013 and 2014 from online panels of adult smokers in Australia, Canada, Mexico, and the US were analyzed. Participants with at least one wave of follow-up were included …

Book Review: Madness In Civilization: A Cultural History Of Insanity From The Bible To Freud, From The Madhouse To Modern Medicine, Edward Cohen

Faculty Publications

A review of: Scull, Andrew. (2015). Madness in civilization: A cultural history of insanity from the Bible to Freud, from the madhouse to modern medicine. Princeton, NJ: Princeton University Press. 448 pp. $39.50 (Hardback), ISBN 978-0-691-16615-5.

Exposure To Mass Media And Interpersonal Counseling Has Additive Effects On Exclusive Breastfeeding And Its Psychosocial Determinants Among Vietnamese Mothers, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Nemat Hajeebhoy, Lan M. Tran, Silvia Alayon, Marie T. Ruel, Rahul Rawat, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

The pathways through which behavior change interventions impact breastfeeding practices have not been well studied. This study aimed to examine: (1) the effects of exposure to mass media and interpersonal counseling on exclusive breastfeeding (EBF) and hypothesized psychosocial determinants (i.e. knowledge, intention, beliefs, social norms, and self-efficacy); and (2) the pathways through which exposure to mass media and interpersonal counseling are associated with EBF. We used survey data from mothers with children< 2 year (n = 2045) from the 2013 process evaluation of Alive & Thrive’s program in Viet Nam. Multiple linear regression analyses and structural equation modeling were used to estimate effects. Exposure to mass media only, interpersonal counseling only, both or neither was 51%, 5%, 19% and 25%, respectively. Exposure to both mass media and interpersonal counseling had additive effects on EBF as well as on related psychosocial factors, compared with no exposure. For example, EBF prevalence was 26.1 percentage points (pp) higher in the group that received interpersonal counseling only, 3.9 pp higher in the mass media group and 31.8 pp higher in the group that received both interventions. As hypothesized, more than 90% of the total effect of the two interventions on EBF was explained by the psychosocial factors measured. Our findings suggest that combining different behavior change interventions leads to greater changes in psychosocial factors, which in turn positively affects breastfeeding behaviors.

A Technology-Mediated Behavioral Weight Gain Prevention Intervention For College Students: Controlled, Quasi-Experimental Study, Delia Smith West, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Beth Sundstrom, Chelsea Larsen, Karen Magradey, Sara Wilcox, Heather M. Brandt

Faculty Publications

BACKGROUND: Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. OBJECTIVE: This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. METHODS: Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral …

Progress In Improving Provincial Plans For Nutrition Through Targeted Technical Assistance And Local Advocacy In Vietnam, Jody Harris, Phuong H. Nguyen, Quyen To, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Oliver, Chaza Akik, Hala Ghattas Ph.D.

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Syrian Refugees And Digital Health In Lebanon: Opportunities For Improving Antenatal Health, Reem Talhouk, Sandra Mesmar, Anja Thieme, Madeline Balaam, Patrick Olivier, Chaza Akik, Hala Ghattas Ph.D

Faculty Publications

There are currently over 1.1 million Syrian refugees in need of healthcare services from an already overstretched Lebanese healthcare system. Access to antenatal care (ANC) services presents a particular challenge. We conducted focus groups with 59 refugees in rural Lebanon to identify contextual and cultural factors that can inform the design of digital technologies to support refugee ANC. Previously identified high utilization of smartphones by the refugee population offers a particular opportunity for using digital technology to support access to ANC as well as health advocacy. Our findings revealed a number of considerations that should be taken into account in …

Perceptions And Experiences Of Human Papillomavirus (Hpv) Infection And Testing Among Low-Income Mexican Women, Leith León-Maldonado, Emily Wentzell, Brandon Brown, Betania Allen-Leigh, Leticia Torres-Ibarra, Jorge Salmerón, Deborah L. Billings, Jim Thrasher, Eduardo Lazcano-Ponce

Faculty Publications

Background

HPV infection causes cervical cancer, a major contributor to morbidity and mortality among low-income Mexican women. Human papillomavirus (HPV) DNA testing is now a primary screening strategy in Mexico’s early cervical cancer detection program (ECDP). Research on Mexican women’s perceptions of HPV and testing is necessary for establishing culturally appropriate protocols and educational materials. Here, we explore perceptions about HPV and HPV-related risk factors among low-income Mexican ECDP participants.

Methods

We conducted semi-structured interviews with 24 ECDP participants from two primary care health clinics in Michoacán state, Mexico. Interviews addressed women’s understandings of and experiences with HPV and HPV …

Stigma Against People Living With Hiv/Aids In China: Does The Route Of Infection Matter?, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Liying Zhang, Yuejiao Zhou, Zhenzhu Tang, Zhiyong Shen, Yi Chen

Faculty Publications

In the current study, we tested the hypothesis that people who contracted HIV from “blameless” routes (e.g., blood transfusion, sex with stable partners) are less stigmatized compared to people who contracted HIV from “blamable” routes (e.g., injection drug use, sex with sex workers). A cross-sectional study was conducted among 2,987 participants in Guangxi province, China, between 2012 and 2013. We employed both explanatory and predictive modeling strategy by using multivariate linear regression models. In the explanatory models, we assessed the association between routes of infection and three types of stigma (perceived, internalized, and enacted). From identified routes of infection that …

Supply- And Demand-Side Factors Influencing Utilization Of Infant And Young Child Feeding Counselling Services In Viet Nam, Phuong H. Nguyen, Sunny S. Kim, Tuan T. Nguyen, Lan M. Tran, Nemat Hajeebhoy, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Adequate utilization of services is critical to maximize the impact of counselling on infant and young child feeding (IYCF), but little is known about factors affecting utilization. Our study examined supply- and demand-side factors associated with the utilization of IYCF counselling services in Viet Nam. We used survey data from mothers with children <2y >(n = 1,008) and health staff (n = 60) from the evaluation of a program that embedded IYCF counseling into the existing government health system. The frequency of never users, one-time users, repeat users, and achievers of the recommended minimum number of visits at health facilities were …

An Increasing Trend Of Illicit Drug Use Among Romanian University Students From 1999 To 2011, Lucia Maria Lotrean, Edna Arillo Santillan, Jim Thrasher, Valeria Laza

Faculty Publications

Aim

The present study investigates the evolution of illicit drug use among Romanian university students from 1999 to 2011.

Methods

The study was performed in Cluj-Napoca, Romania, in three phases: in 1999 (T1), in 2003 (T2) and in 2011 (T3).The study was carried out by means of anonymous questionnaires among university students aged 19-24.

Results

The results show that among girls the lifetime illicit drugs use increased statistically significantly from 2.5% in 1999 to 7.5% in 2003 and to 15% in 2011. Among boys the trend was also increasing, the prevalence of illicit drug use was 14.2% at T1, 18.1% …

Waterpipe Tobacco Smoking And Susceptibility To Cigarette Smoking Among Young Adults In The United States, 2012–2013, Ramzi G. Salloum, M. Rifat Haider, Tracey E. Barnett, Yi Guo, Kayla R. Getz, Jim Thrasher, Wasim Maziak

Faculty Publications

INTRODUCTION:

Waterpipe tobacco smoking, also known as hookah and shisha, has surged in popularity among young people in the United States. Waterpipe is also increasingly becoming the first tobacco product that young people try. Given the limited access to and limited portability of waterpipes, waterpipe smokers who become more nicotine dependent over time may be more likely to turn to cigarettes. This study examined the relationship between waterpipe tobacco smoking and susceptibility to cigarette smoking among young adults in the United States.

METHODS:

Using data from the 2012-2013 National Adult Tobacco Survey, a nationally representative sample of US adults, we …

Surgical Complications And Their Impact On Patients’ Psychosocial Well-Being: A Systematic Review And Meta-Analysis, Anna Pinto, Omar Faiz, Rachel E. Davis, Alex Almoudaris, Charles Vincent

Faculty Publications

Objective Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients’ recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients’ postoperative well-being and the duration of this impact.

Methods The primary data sources were ‘PsychINFO’, ‘EMBASE’ and ‘MEDLINE’ through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult …

Estimates Of The Quality Of Complementary Feeding Amongvietnamese Infants Aged 6-23months Varied By Howcommercial Baby Cereals Were Classified In 24-H Recalls, Nguyen T. Tuan, Mellissa Withers, Edward A. Frongillo Jr., Nemat Hajeebhoy

Faculty Publications

The World Health Organization's (WHO) standardized questionnaire for assessing infant and young child feeding practices does not include commercial baby cereals (CBC), which are derived from several food groups and are fortified with micronutrients. We examined how different scenarios for classifying CBC affect estimates of the quality of complementary feeding in children ages 6−23 months in Vietnam in 2014 (n = 4811). In addition to the WHO standardized 24‐h recall questionnaire for infant and young child feeding, we asked mothers about the consumption of CBC. The five resulting scenarios were S1 – omitted CBC; S2 – CBC classified as grains; …

Attention And Recall Of Point-Of-Sale Tobacco Marketing: A Mobile Eye-Tracking Pilot Study, Maansi Bansal-Travers, Sarah E. Adkison, Richard J. O’Connor, Jim Thrasher

Faculty Publications

Introduction: As tobacco advertising restrictions have increased, the retail ‘power wall’ behind the counter is increasingly invaluable for marketing tobacco products.

Objective: The primary objectives of this pilot study were 3-fold: (1) evaluate the attention paid/fixations on the area behind the cash register where tobacco advertising is concentrated and tobacco products are displayed in a real-world setting, (2) evaluate the duration (dwell-time) of these fixations, and (3) evaluate the recall of advertising displayed on the tobacco power wall.

Methods: Data from 13 Smokers (S) and 12 Susceptible or non-daily Smokers (SS) aged 180–30 from a mobile eye-tracking study. Mobile-eye tracking …

Clinically Relevant Behavioral Endpoints In A Recurrent Nitroglycerin Migraine Model In Rats, Kenneth J. Sufka, Stephanie M. Staszko, Ainslee P. Johnson, Morgan E. Davis, Rachel E. Davis, Todd A. Smitherman

Faculty Publications

BACKGROUND: This research sought to further validate the rat nitroglycerin (NTG) migraine model by comparing the effects of single versus recurrent NTG episodes on behavioral endpoints that mirror ICHD-3 diagnostic criteria for migraine, and to determine if the altered behavioral endpoints are reduced after administration of sumatriptan. METHODS: Separate cohorts of rats were administered NTG (10 mg/kg/2 ml) or saline (Experiment 1: single injection; Experiment 2: repeated injections; Experiment 3: repeated injections with sumatriptan [0.0, 0.3 and 1.0 mg/kg/ml] rescue. Behavioral endpoints were assessed 2 h after final NTG administration and included time in light/dark chambers for photophobia and activity, …

Conducting Qualitative Interviews By Telephone: Lessons Learned From A Study Of Alcohol Use Among Sexual Minority And Heterosexual Women, Laurie Drabble, Karen Trocki, Brenda Salcedo, Patricia Walker, Rachael Korcha

Faculty Publications

This study explored effective interviewer strategies and lessons learned based on collection of narrative data by telephone with a subsample of women from a population-based survey, which included sexual minority women. Qualitative follow-up, in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey. Questions explored the lives and experiences of women, including use of alcohol and drugs, social relationships, identity, and past traumatic experiences. Strategies for success in interviews emerged in three overarching areas: (1) cultivating rapport and maintaining connection; (2) demonstrating responsiveness to interviewee content, concerns; and (3) …

Filter Presence And Tipping Paper Color Influence Consumer Perceptions Of Cigarettes, Richard J. O’Connor, Maansi Bansal-Travers, K. Michael Cummings, David Hammond, Jim Thrasher, Cindy Tworek

Faculty Publications

Background: Cigarettes are marketed in a wide array of packaging and product configurations, and these may impact consumers’ perceptions of product health effects and attractiveness. Filtered cigarettes are typically perceived as less hazardous and white tipping paper (as opposed to cork) often conveys ‘lightness’.

Methods: This study examined cigarette-related perceptions among 1220 young adult (age 18-35) current, ever, and never smokers recruited from three eastern U.S. cities (Buffalo NY, Columbia SC, Morgantown WV). Participants rated three cigarette sticks: two filtered cigarettes 85 mm in length, differing only in tipping paper color (cork versus white), and an unfiltered 70 mm cigarette. …

Human Immunodeficiency Virus, Syphilis And Hepatitis C Virus Prevalence Trends Among Cross-Border Migrant Vietnamese Female Sex Workers In Guangxi, China, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhenzhu Tang, Zhiyong Shen

Faculty Publications

Background: Global literature indicates the burden of human immunodeficiency virus (HIV), syphilis and hepatitis C virus (HCV) has disproportionately affected cross-border migrant female sex workers (FSW). However, few studies reported the HIV risk among Vietnamese FSW at borderline areas in China. We examined five consecutive years of HIV, syphilis, and HCV prevalence and corresponding risk factors among this group in Guangxi Province of China in the current study. Method: Demographic and behavioral data as well as test results of blood samples for HIV/syphilis/HCV testing were collected from the annual National Sentinel Surveillance (NSS) from the year of 2010 to 2014. …

Successive 1-Month Weight Increments In Infancy Can Be Used To Screen For Faltering Linear Growth, Adelheid W. Onyango, Elaine Borghi, Mercedes De Onis, Edward A. Frongillo Jr., Cesar G. Victora, Kathryn G. Dewey, Anna Lartey, Nita Bhandari, Anne Baerug, Cutberto Garza

Faculty Publications

Background: Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention.

Objective: This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life.

Methods: By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for …

Experiences With Food Insecurity And Risky Sex Among Low-Income People Living With Hiv/Aids In A Resource-Rich Setting, Henry J. Whittle, Kartika Palar, Tessa Napoles, Lee Lemus Hufstedler, Irene Ching, Frederick M. Hecht, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Background: Forty-nine million individuals are food insecure in the United States, where food insecurity and HIV/AIDS are prevalent among the urban poor. Food insecurity is associated with risky sexual behaviours among people living with HIV/AIDS (PLHIV). No qualitative studies, however, have investigated the mechanisms underlying this relationship either in a resource-rich setting or among populations that include men who have sex with men (MSM).

Methods: Semi-structured in-depth interviews were conducted with 34 low-income PLHIV receiving food assistance in the San Francisco Bay Area. The interviews explored experiences with food insecurity and perceived associations with sexual risk behaviours. Interviews were conducted …

Comparison Of Tobacco And Alcohol Use In Films Produced In Europe, Latin America, And The United States, Inti Barrientos-Gutierrez, Christy Kollath-Cattano, Raul Mejía, Edna Arillo-Santillán, Reiner Hanewinkel, Matthis Morgenstern, James D. Sargent, Jim Thrasher

Faculty Publications

Background: Studies that have evaluated tobacco and alcohol portrayals in films have mainly focused on US films. Our aim is to describe tobacco and alcohol portrayals in nationally produced films from six European and two Latin American countries, and compare them with US produced films.

Methods: A sample of 337 nationally produced and 502 US produced films, consisting of top grossing films from 2004 to 2009 in each country, was content coded for presence of tobacco or alcohol and seconds of tobacco or alcohol use. Logistic and linear regression models were estimated for all films and youth-rated films (Ages 0–14) …

A Noise Delivery System For Multi-Animal Multi-Level Whole Body Ototoxicity Studies, John E. Stubbs, Jeremy M. Slagley, James E. Reboulet

Faculty Publications

The Naval Medical Research Unit Dayton (NAMRU-D) at Wright-Patterson Air Force Base, Ohio, in conjunction with the U.S. Air Force, studied ototoxic effects of JP-8 in rats. NAMRU-D used a multi-chamber whole body exposure facility for up to 96 test animals and 32 control animals at different exposure levels. The objective was to design a noise delivery system that could provide a white noise source one octave band wide, centered at 8 kHz frequency, delivered from outside the exposure chambers. Sound pressure levels were required to be within ±2 dB at all exposure points within each chamber and within ±2 …

Phosphorus Ingestion Improves Oral Glucose Tolerance Of Healthy Male Subjects: A Crossover Experiment, May Khattab, Christelle Abi-Rashed, Hala Ghattas Ph.D., Sani Hlais, Omar Obeid

Faculty Publications

Background:

Fasting serum phosphorus (P) was reported to be inversely related to serum glucose and insulin, while the impact of P ingestion is not well documented. The effect of P intake with or before glucose ingestion on postprandial glucose and insulin statuses was investigated.

Method:

Two cross over experiments using healthy male subjects were conducted. Experiment 1: Overnight fasted subjects (n∈=∈7) randomly received: 500 mg of P tablets, glucose (75 g) solution with placebo or 500 mg of P tablets. Experiment 2: Overnight fasted subjects (n∈=∈8) underwent similar procedures to those of experiment 1, except that placebo or 500 mg …

Using Height-For-Age Differences (Had) Instead Of Height-For-Age Z-Scores (Haz) For The Meaningful Measurement Of Population-Level Catch-Up In Linear Growth In Children Less Than 5 Years Of Age, Jef L. Leroy, Marie Ruel, Jean-Pierre Habicht, Edward A. Frongillo Jr.

Faculty Publications

Background: Evidence from studies conducted in nutritionally deprived children in low- and middle-income countries (LIMC) in past decades showed little or no population-level catch-up in linear growth (mostly defined as reductions in the absolute height deficit) after 2 years of age. Recent studies, however, have reported population-level catch-up growth in children, defined as positive changes in mean height-for-age z-scores (HAZ). The aim of this paper was to assess whether population-level catch-up in linear growth is found when height-for-age difference (HAD: child’s height compared to standard, expressed in centimeters) is used instead of HAZ. Our premise is that HAZ is inappropriate …

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

#Aulivewholly, Patricia Spangler

Faculty Publications

Andrews University officially launched its new University Health & Wellness initiative on Wednesday, September 23. The initiative will integrate five deeply connected pillars: physical, spiritual, mental, relational and professional wellness, but mainly focus on physical health and wellness to address the gaps that have been identified.

The Impact Of Changing Lake Levels On Property Values: A Hedonic Model Of Lake Thurmond, Lori Dickes, Elizabeth L. Crouch

Faculty Publications

This study uses hedonic pricing models to examine the relationship between lake levels and property values for properties adjacent to Lake Thurmond. Lake Thurmond is located along the Savannah River Basin, bordering Georgia and South Carolina. Of the 1,030 properties from 2000-2009 for which data was reliable and available, 388 were lake front homes. The model of the effect of lake level on sales prices also includes home characteristics, home condition variables, lake attributes, and macroeconomic control variables. Results reveal a statistically significant change in sales price when the lake is closer to full pool. Results confirm that declining Lake …