Public Health Commons^™

Reducing Colorectal Cancer Incidence And Disparities: Performance And Outcomes Of A Screening Colonoscopy Program In South Carolina, Sudha Xirasagar, Yi-Jhen Li, James B. Burch, Virginie G. Daguisé, Thomas G. Hurley, James R. Hébert

Faculty Publications

This study evaluated the efficiency, effectiveness, and racial disparities reduction potential of Screening Colonoscopies for People Everywhere in South Carolina (SCOPE SC), a state-funded program for indigent persons aged 50–64 years (45–64 years for African American (AA)) with a medical home in community health centers. Patients were referred to existing referral network providers, and the centers were compensated for patient navigation. Data on procedures and patient demographics were analyzed. Of 782 individuals recruited (71.2% AA), 85% (665) completed the procedure (71.1% AA). The adenoma detection rate was 27.8% (males 34.6% and females 25.1%), advanced neoplasm rate 7.7% (including 3 cancers), …

Meal Pattern Of Male Rats Maintained On Amino Acid Supplemented Diets: The Effect Of Tryptophan, Lysine, Arginine, Proline And Threonine, Raghad Ayaso, Hala Ghattas Ph.D., Mohamad Abiad, Omar Obeid

Faculty Publications

The macronutrient composition of the diet has been shown to affect food intake, with proteins having distinct effects. The present study investigated the effect of diet supplementation with individual amino acids (tryptophan, lysine, arginine, proline and threonine) on meal pattern among male rats. Meal pattern and body weight were monitored for two weeks. Proline and threonine had minimal effects on meal pattern, while the most pronounced changes were observed in the tryptophan group. Both tryptophan and lysine decreased overall food intake, which was translated into a reduction in body weight. The reduced food intake of the tryptophan group was associated …

Conflict Translates Environmental And Social Risk Into Business Costs, Daniel M. Franks, Rachel Davis, Anthony J. Bebbington, Saleem H. Ali, Deanna Kemp, Martin Scurrah

Faculty Publications

Sustainability science has grown as a field of inquiry, but has said little about the role of large-scale private sector actors in socio-ecological systems change. However, the shaping of global trends and transitions depends greatly on the private sector and its development impact. Market-based and command-and-control policy instruments have, along with corporate citizenship, been the predominant means for bringing sustainable development priorities into private sector decision-making. This research identifies conflict as a further means through which environmental and social risks are translated into business costs and decision making. Through in-depth interviews with finance, legal, and sustainability professionals in the extractive …

Socioeconomic And Demographic Factors Modify The Association Between Informal Caregiving And Health In The Sandwich Generation, Elizabeth K. Do, Steven A. Cohen, Monique J. Brown Ph.D., Mph

Faculty Publications

Background

Nearly 50 million Americans provide informal care to an older relative or friend. Many are members of the “sandwich generation”, providing care for elderly parents and children simultaneously. Although evidence suggests that the negative health consequences of caregiving are more severe for sandwiched caregivers, little is known about how these associations vary by sociodemographic factors.

Methods

We abstracted data from the Behavioral Risk Factor Surveillance System to determine how the association between caregiving and health varies by sociodemographic factors, using ordinal logistic regression with interaction terms and stratification by number of children, income, and race/ethnicity.

Results

The association between …

Characterization Of Particle Emissions And Fate Of Nanomaterials During Incineration, Eric P. Vejerano, Elena C. Leon, Amara L. Holder, Linsey C. Marr

Faculty Publications

As the use of nanotechnology in consumer products continues to grow, it is inevitable that some nanomaterials will end up in the waste stream and will be incinerated. Through laboratory-scale incineration of paper and plastic wastes containing nanomaterials, we assessed their effect on emissions of particulate matter (PM) and the effect of incineration on the nanomaterials themselves. The presence of nanomaterials did not significantly influence the particle number emission factor. The PM size distribution was not affected except at very high mass loadings (10 wt%) of the nanomaterial, in which case the PM shifted toward smaller sizes; such loadings are …

Feasibility And Acceptability Of An Early Childhood Obesity Prevention Intervention: Results From The Healthy Homes, Healthy Families Pilot Study, Akilah Dulin Keita, Patricia M. Risica, Kelli L. Drenner, Ingrid Adams, Gemma Gorham, Kim M. Gans

Faculty Publications

Background. This study examined the feasibility and acceptability of a home-based early childhood obesity prevention intervention designed to empower low-income racially/ethnically diverse parents to modify their children’s health behaviors. Methods. We used a prospective design with pre-/posttest evaluation of 50 parent-child pairs (children aged 2 to 5 years) to examine potential changes in dietary, physical activity, and sedentary behaviors among children at baseline and four-month follow-up. Results. 39 (78%) parent-child pairs completed evaluation data at 4-month follow-up. Vegetable intake among children significantly increased at follow-up (0.54 cups at 4 months compared to 0.28 cups at baseline, 𝑃 …

Text 4 Health: Addressing Consumer Health Information Needs Via Text Reference Service, Van M. Ta Park

Faculty Publications

This study seeks to provide empirical evidence about how health-related questions are answered in text reference service in order to further the understanding of how to best use texting as a reference service venue to fulfill people’s health information needs. Two hundred health reference transactions from My Info Quest, the first nation-wide collaborative text reference service, were analyzed identify the types of questions, length of transactions, question-answering behavior, and information sources used in the transactions. Findings indicate that texting-based health reference transactions are usually brief, and cover a wide variety of topics. The most popular questions are those seeking general …

Strategies Employed By Inner-City Activists To Reduce Alcohol-Related Problems And Advance Social Justice, Laurie Drabble, Denise Herd

Faculty Publications

This study explored strategies employed by activists engaged in efforts to change policies and laws related to selling and promoting alcoholic beverages based on in-depth interviews with 184 social activists in seven U.S. major cities. Nine strategies aimed at improving local conditions and influencing policy were described by activists across regional contexts. Grassroots mobilization was central to all other strategies, which included the creation or enforcement of laws, meeting with elected officials, media advocacy, working with police/law enforcement, education and training, direct action, changing community norms, and negotiating with store owners.

State Responses To Alcohol Use And Pregnancy: Findings From The Alcohol Policy Information System, Laurie Drabble, Sue Thomas, Lisa O'Connor, Sarah Roberts

Faculty Publications

This article describes U.S. state policies related to alcohol use during pregnancy, using data from the National Institute on Alcohol Abuse and Alcoholism Alcohol Policy Information System. Specifically, this study examines trends in policies enacted by states over time and types of policies enacted across states in the United States, with a focus on whether laws were supportive or punitive toward women. Findings revealed substantial variability in characteristics of policies (19 primarily supportive, 12 primarily punitive, 12 with a mixed approach, and 8 with no policies). Findings underscore the need to examine possible consequences of policies, especially of punitive policies …

Impaired Fasting Glucose Level And Diabetes In Kaoma And Kasama Rural Districts Of Zambia: Prevalence And Correlates In 2008-2009 Population Based Surveys, Olesegun A. Babaniyi, Peter Songolo, Emmanuel Rudatsikira, Adamson S. Muula, David Mulenga, Mazyanga L. Mazaba-Liwewe, Idah Ndumba, Freddie Masaninga, Seter Siziya

Faculty Publications

Background: Impaired fasting glucose level has been associated with increased incidence of Type 2 Diabetes mellitus, and diabetes is becoming a major public health problem in developing countries. The objective of the study was to determine the prevalence and correlates for impaired fasting glucose level/diabetes in Kaoma and Kasama rural districts of Zambia. Methods and Findings: A cross sectional study using modified World Health Organization (WHO) global non communicable diseases (NCD) surveillance initiative NCD STEPwise approach was used in the study. Proportions were compared using the Yates’ corrected Chi-square test, and a result yielding a p value of less than …

Primary Care And Youth Mental Health In Ireland: Qualitative Study In Deprived Urban Areas, Dorothy Leahy, Elisabeth Schaffalitzky, Claire Armstrong, Gerard Bury, Paula Cussen-Murphy, Rachel Davis, Barbara Dooley, Blanaid Gavin, Rory Keane, Eamon Keenan, Linda Latham, David Meagher, Pat Mcgorry, Fiona Mcnicholas, Ray O'Connor, Ellen O'Dea, Veronica O'Keane, Tom P. O'Toole, Edel Reilly, Patrick Ryan, Lena Sanci, Bobby P. Smyth, Walter Cullen

Faculty Publications

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people's unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

The Influence Of Family Dynamics On Contraceptive Use In Madagascar And The Ensuing Impact On Family Well-Being, Joel Zafitandra Hajason, Kayla Piña, Joel L. Raveloharimisy

Faculty Publications

While studies have shown a relationship between family dynamics and contraceptive use and between contraceptive use and family well-being, no empirical study has been conducted to test whether a relationship exists between family influence on contraceptive use and family wellbeing. The objective of this study is to explore whether there is such a relationship between family influence on contraceptive use and family well-being.

Emergency Department Utilization Among Recently Released Prisoners: A Retrospective Cohort Study, Suyanpeng Zhang, Allie Silverman, Sze Chaun Suen, Christina Andrews, Brian Chen

Faculty Publications

Background: The population of ex-prisoners returning to their communities is large. Morbidity and mortality is increased during the period following release. Understanding utilization of emergency services by this population may inform interventions to reduce adverse outcomes. We examined Emergency Department utilization among a cohort of recently released prisoners.

Methods: We linked Rhode Island Department of Corrections records with electronic health record data from a large hospital system from 2007 to 2009 to analyze emergency department utilization for mental health disorders, substance use disorders and ambulatory care sensitive conditions by ex-prisoners in the year after release from prison in comparison to …

Trauma History And Depression Predict Incomplete Adherence To Antiretroviral Therapies In A Low Income Country, Kathryn Whetten, Kristen Shirey, Brian Wells Pence, Jia Yao, Nathan Thielman, Rachel Whetten, Julie Adams, Bernard Agala, Jan Ostermann, Karen O'Donnell, Amy Hobbie, Venance Maro, Dafrosa Itemba, Elizabeth Reddy, Chat Research Team

Faculty Publications

Background: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. Methodology: The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV …

District Specific Correlates For Hypertension In Kaoma And Kasama Rural Districts Of Zambia, Seter Siziya, Emmanuel Rudatsikira, Victor M. Mukonka, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula

Faculty Publications

Introduction: Hypertension a major risk factor for cardiovascular disease and is the most widely recognized modifiable risk factor for this disease. There is little information on the prevalence and risk factors for hypertension in Zambia, and in particular in rural areas of the country. In order to contribute to the existing global literature on hypertension, particularly in rural Zambia, this study was conducted to determine the prevalence of hypertension and its correlates in two rural districts of Zambia, namely Kaoma and Kasama. Methods: A cross-sectional study using a modified World Health Organization (WHO) global non communicable diseases (NCD) surveillance initiative …

Parental Height And Child Growth From Birth To 2 Years In The Who Multicentre Growth Reference Study, Cutberto Garza, Elaine Borghi, Adelheid W. Onyango, Mercedes De Onis, Edward A. Frongillo Jr.

Faculty Publications

inear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to …

What Attributes Of Patients Affect Their Involvement In Safety? A Key Opinion Leaders’ Perspective, Stephen Buetow, Rachel E. Davis, Kathleen Callaghan, Susan Dovey

Faculty Publications

OBJECTIVE: Little is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders. DESIGN: Delphi study involving indirect group interaction through a structured two-round survey. SETTING: International electronic survey. PARTICIPANTS: 11 (65%) of the 17 invited internationally recognised experts on patient safety completed the study. OUTCOME MEASURES: 50 patient attributes were rated by the Delphi panel for their ability to contribute maximally to safe health care. RESULTS: The panellists agreed that 13 attributes are important for patients who …

Alcohol In The Life Narratives Of Women: Commonalities And Differences By Sexual Orientation, Laurie A. Drabble, K. Trocki

Faculty Publications

Aim: The aim of this study was to explore social representations of alcohol use among women, with a focus on possible differences between sexual minority and heterosexual women. Methods: This qualitative study was part of a larger study examining mediators of heavier drinking among sexual minority women (lesbian identified, bisexual identified, and heterosexual identified with same sex partners) compared to heterosexual women based on the National Alcohol Survey. Qualitative in-depth life history interviews were conducted over the telephone with 48 women who had participated in the 2009–2010 National Alcohol Survey, including respondents representing different sexual orientation groups. Questions explored the …

Adults With Greater Weight Satisfaction Report More Positive Health Behaviors And Have Better Health Status Regardless Of Bmi, Christine E. Blake Ph.D., Rd, James R. Hébert Scd, Duck Chul Lee, Swann A. Adams, Susan E. Steck Phd, Mph, Rd, Xuemei Sui M.D., M.P.H., Ph.D., Jennifer L. Kuk, Meghan Baruth, Steven N. Blair

Faculty Publications

Background. Prior studies suggest that weight satisfaction may preclude changes in behavior that lead to healthier weight among individuals who are overweight or obese. Objective. To gain a better understanding of complex relationships between weight satisfaction, weight-related health behaviors, and health outcomes. Design. Cross-sectional analysis of data from the Aerobics Center Longitudinal Study (ACLS). Participants. Large mixed-gender cohort of primarily white, middle-to-upper socioeconomic status (SES) adults with baseline examination between 1987 and 2002 (n = 19,003). Main Outcome Variables. Weight satisfaction, weight-related health behaviors, chronic health conditions, and clinical health indicators. Statistical Analyses Performed. Chi-square test, t-tests, and linear and …

Association Between Adverse Childhood Experiences And Diagnosis Of Cancer, Monique J. Brown, Leroy R. Thacker, Steven A. Cohen

Faculty Publications

Objective: Adverse childhood experiences (ACEs) are linked to multiple adverse health outcomes. This study examined the association between ACEs and cancer diagnosis.

Methods: Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) survey were used. The BRFSS is the largest ongoing telephone health survey, conducted in all US states, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands, and provides data on a variety of health issues among the non-institutionalized adult population. Principal component analysis (PCA) was used to derive components for ACEs. Multivariable logistic regression models were used to provide adjusted odds ratios (OR) and …

Correlates Of Diarrhoea Among Children Below The Age Of 5 Years In Sudan, Seter Siziya, Adamson S. Muula, Emmanuel Rudatsikira

Faculty Publications

Background

The Millennium Development Goals recognise child health and survival as an important socio-development issue.

Objectives

To determine the correlates of diarrhoea among children aged below 5 years in north Sudan.

Methods

We conducted secondary data analysis of the Sudan Multiple Cluster Indicators Survey II.

Results

Altogether, 23,295 children were included in the survey. Half (50.0%) of the children were males, and 22.5% of them were of age less than one year. Boys were 3% (p=0.044) more likely to have diarrhoea compared to girls. Compared with the oldest age group (48–59 months), children less than 6 months of age and …

Prevalence And Predictors Of Smoking In A Mining Town In Kitwe, Zambia: A 2011 Population-Based Survey, Cosmas Zyaambo, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Faculty Publications

Smoking is one of the major preventable causes of death and non-communicable diseases which include hypertension, cardiovascular diseases and cancers. The aim of the study is to establish prevalence and predictors of smoking so that interventions specific to these communities can be executed to prevent smoking. A cross sectional study was conducted using a modified World Health Organizations Global Non Communicable Diseases (NCD) Surveillance Initiative NCD-STEPs 1 and 2. Multivariate logistic regression was used to examine the determinants of tobacco smoking. A total of 1627 individuals participated in the survey, of which 42.3% were males. About half of the participants …

Early Prenatal Food Supplementation Ameliorates Thenegative Association Of Maternal Stress With Birth Size In A Randomised Trial, Amy L. Frith, Ruchira T. Naved, Lars Ake Persson, Edward A. Frongillo Jr.

Faculty Publications

Low birthweight increases the risk of infant mortality, morbidity and poor development. Maternal nutrition and stress influence birth size, but their combined effect is not known.We hypothesised that an early-invitation time to start a prenatal food supplementation programme could reduce the negative influence of prenatal maternal stress on birth size, and that effect would differ by infant sex. A cohort of 1041 pregnant women, who had delivered an infant, June 2003–March 2004, was sampled from among 3267 in the randomised controlled trial, Maternal Infant Nutritional Interventions Matlab, conducted in Matlab, Bangladesh. At 8 weeks gestation, women were randomly assigned an …

Overweight And Obesity In Kaoma And Kasama Rural Districts Of Zambia: Prevalence And Correlates In 2008-2009 Population Based Surveys, Chola Besa, David Mulenga, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Faculty Publications

Background: Overweight and obesity (overweight/obesity) is associated with hypertension. Low- and middleincome countries are experiencing an obesity epidemic. There is growing evidence that the epidemic is on the increase in urban settings of developing countries. However, there is scanty information on the magnitude of this epidemic and its correlates in rural settings. The objective of the current study was to establish levels of overweight/obesity and its correlates in rural areas of Zambia. Designing interventions based on the correlates for overweight/obesity to reduce its prevalence may in turn lead to a reduction in the prevalence of hypertension.

Methods: Cross sectional studies …

Prevalence And Correlates Of Being Bullied Among In-School Adolescents In Malawi: Results From The 2009 Global School-Based Health Survey, H. W. Kubwalo, Adamson S. Muula, Seter Siziya, S. Pasupulati, Emmanuel Rudatsikira

Faculty Publications

Background

Physical and emotional violence against adolescents is a neglected, but growing problem globally. Violence against adolescents negatively affects the victim in terms of physical health, school attendance and performance and social adjustment. The literature on the prevalence and associated factors of bullying against adolescents is sparse in southern Africa outside South Africa. Such data are even sparser for Malawi. The current study was conducted to estimate the prevalence of self-reported bullying and its personal and social correlates.

Methods

A secondary analysis of the Malawi School-Based Student Health Survey (2009) was done. Descriptive analyses were done to describe the sample …

Confronting Myths About Household Food Insecurity And Excess Weight, Edward A. Frongillo Jr.

Faculty Publications

No abstract provided.

Indicators Of Family Care For Development For Use In Multicountry Surveys, Patricia Kariger, Edward A. Frongillo Jr., Patrice Engle, Pia M. Rebello Britto, Sara M. Sywulka, Purnima Menon

Faculty Publications

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of …

The Children And Parents In Focus Project: A Population-Based Cluster-Randomised Controlled Trial To Prevent Behavioural And Emotional Problems In Children, R. Salari, H. Fabian, Ron Prinz, S. Lucas, I. Feldman, Amanda Fairchild, A. Sarkadi

Faculty Publications

Background: There is large body of knowledge to support the importance of early interventions to improve child health and development. Nonetheless, it is important to identify cost-effective blends of preventive interventions with adequate coverage and feasible delivery modes. The aim of the Children and Parents in Focus trial is to compare two levels of parenting programme intensity and rate of exposure, with a control condition to address impact and cost-effectiveness of a universally offered evidence-based parenting programme in the Swedish context. Methods/Design: The trial has a cluster randomised controlled design comprising three arms: Universal arm (with access to participation in …

Alcohol Consumption And Its Correlates Among Residents Of Mining Town, Kitwe, Zambia: 2011 Population Based Survey, Cosmas Zyaambo, Olesegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Faculty Publications

Alcohol consumption is a risk factor for non-communicable diseases such as cardiovascular diseases, liver cirrhosis and cancers. It has also been associated with risky sexual behaviors, hence, attributed as a factor in the increase of HIV incidence and prevalence. A cross sectional study was conducted using a modified World Health Organizations Global Non Communicable Diseases (NCD) Surveillance Initiative NCD-STEPs 1and 2. Multivariate logistic regression was used to examine the determinants of alcohol consumption. A total of 1627 individuals participated in the survey, of which 42.3% were males. Some 22.3% (36.2% of male and 12.1% of female; p<0.001) participants reported to have consumed alcohol during the 30 days preceding the survey. The factors considered to be associated with alcohol consumption were age, sex and smoking. Compared to respondents age 25-34 years, respondents of age 35-44 years were 38% (AOR = 1.38, 95%CI [1.11, 1.70]) more likely to report having consumed alcohol and those aged 45 years or older were 26% (AOR = 0.74, 95%CI [0.60, 0.93]) less likely to report having consumed alcohol. Female respondents were 47% (AOR = 0.53, 95%CI [0.46, 0.60]) less likely to report consuming alcohol compared to male respondents. Compared to respondents who reported smoking cigarettes, those who did not smoke cigarettes were 51% (AOR = 0.49, 95%CI [0.40, 0.59]) less likely to consume alcohol. The rate of alcohol consumption is high in this mining town. Factors identified in this study as associated with alcohol consumption, i.e., male sex, age, cigarette smoking, should be considered in designing interventions to curtail the level of alcohol consumption.