Public Health Commons^™

Family Centred Approach For Hiv Services: Pilot Study In South Africa, Meredith Sheehy, Nomtandazo Patricia Mini, Tonicah Maphanga, Scott E. Kellerman

HIV and AIDS

In 2003, UNICEF estimated that nearly 250,000 children were infected with HIV in South Africa. While scale-up of prevention of mother-to-child transmission (PMTCT) programs has improved testing and care for perinatally infected infants, uptake of these services remains low in much of sub-Saharan Africa and few HIV infected children are diagnosed and receive services through PMTCT programs. With support from USAID/PEPFAR, the Horizons Program adapted a family-centered model for children and families in need of broader-reaching HIV diagnostic services in South Africa. The Family Centered Approach (FCA) pilot intervention was designed to expand access to HIV testing for family members …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Cambodia 2005, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Cambodia 2005” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

Ensuring Education For All In Bihar: Highlighting The Obstacles, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

The extent to which India will be able to successfully harness its demographic dividend depends significantly on the situation of its youth, notably on the levels of education and market-oriented skills they attain. While many states have made progress on the education front, many other states, including Bihar, have lagged behind. Looking at the current educational situation of youth in Bihar, this policy brief argues that significant investments in terms of appropriate policies and programs are required to enable the state to: achieve the Millennium Development Goals of universal primary education and elimination of gender disparity in primary and secondary …

Adolescent Girls In Urban Ethiopia: Vulnerability And Opportunity, Abebaw Ferede, Annabel Erulkar

Poverty, Gender, and Youth

In 2008, the Population Council undertook a survey of out-of-school, adolescent girls (aged 10 to 19) in slum areas of urban Ethiopia—a population that is highly vulnerable to HIV infection. The survey serves as a baseline for HIV prevention programs designed and implemented jointly by the Ministry of Youth and Sports, Regional Bureaus of Youth and Sports, and the Population Council. This study provided valuable direction for programmers interested in supporting adolescent girls, particularly early adolescent (10 to 14 years old) and out-of-school girls who are highly vulnerable and in need of dedicated attention. Special efforts are needed to support …

Variables In Health Care Policy Making: Resolving A Quandary, George P. Smith Ii

Scholarly Articles

Contemporary debate in health care resource management is tied to a central moral issue: how to achieve the optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failure to tackle and resolve this issue in a confident and forthright manner ensures that the present approach to health care decision-making will continue in a state of indecisiveness if not, indeed, lethargy. Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Crafting a just solution to an equitable distribution of finite health care resources is, indeed, …

Using Motivational Interviewing In Public Health Practice To Prevent Fetal Alcohol Syndrome, Lisa J. Ficker, Cheryl Lauber, Sandra L. King, Jewell Akins, Dranoel Knox, William Ridella

Michigan Journal of Public Health

Background: Surveys of women in prenatal care at busy clinics in Detroit, Michigan have reported 12.5% continue to drink during pregnancy (Flynn et al, 2003) and women in substance abuse treatment programs in Wayne County, MI have an incidence rate for Fetal Alcohol Syndrome (FAS) of 4 in 1,000 births, double the national prevalence rate of FAS. The goal of the current study was to intervene with women at high risk for an alcohol-exposed pregnancy using techniques of Brief Motivational Interviewing (BMI) in a verbal and written format. Methods: One third (33%) of 1,784 women screened at Detroit Department of …

Analyzing Adherence To Prenatal Supplements: Does Pill Count Measure Up?, Kristie Elizabeth Appelgren

MUSC Theses and Dissertations

Background: Results of a trial of prenatal Vitamin D supplementation are analyzed for associations of pill count data with serum-based measures of adherence. Obiective: It is hypothesized that adherence as measured by pill count will have a significant association with serum-based measures of adherence. Design: The study from which the data for this analysis were derived is a large randomized, controlled, and double-blinded trial of vitamin D supplements in pregnant women. The women have been stratified by race and randomized into three groups, which receive a 400IU (control), 20001U, or 40001U dose of vitamin D[subscript 3] once daily. Women enter …

Childhood Obesity: The Law's Response To The Surgeon General's Call To Action To Prevent And Decrease Overweight And Obesity, Leah Loeb

Journal of Health Care Law and Policy

No abstract provided.

The Responses Of Bamenda Disability Organizations To Hiv And Aids: A Multiple Case Study, Lynn Cockburn

Walden Dissertations and Doctoral Studies

In Cameroon, many disabled people (an estimated 10-20% of the population) have inadequate access to education and health care, and disabled people's organizations (DPOs) are advocating for social change. Yet, there is a scarcity of information regarding how African DPOs address HIV and AIDS. The purpose of this study was to assess how DPOs in Cameroon have responded to AIDS in the disabled population and to identify strategies to enable DPOs to manage AIDS issues. This study was guided by the complex adaptive systems theory as the theoretical framework. The research questions focused on what DPOs have done to develop …

Foodborne Or Pandemic: An Analysis Of The Transmission Of Norovirus-Associated Gastroenteritis And The Role Of Food Handlers, M. S. Dreyfuss

Walden Dissertations and Doctoral Studies

This study examined the strength of association between food workers and food to norovirus in comparison to bacteria associated with foodborne-related gastroenteritis by whether norovirus had a direct (physical evidence), indirect (statistical evidence), or suspect (neither of the two) association with food or food handlers. The Centers for Disease Control and Prevention considers norovirus to cause the largest number of foodborne-related gastroenteritis cases in the United States. The association of norovirus with foodborne outbreaks through its information data collection form focuses on the food worker as the typical source. Yet, many outbreaks are not foodborne in nature. The gap in …

Beliefs And Attitudes Regarding Health -Enhancing Behaviors In African American And Caucasian Women, Cassaundra Murray

Walden Dissertations and Doctoral Studies

A disproportionate number of African American (AA) women are overweight, obese, and more likely to have weight related health concerns compared with Caucasian (C) women. Previous research indicates perception about health-enhancing behaviors influences AA females' health behavior. A gap exists in the current literature regarding AA women's perception of eating and exercise behavior and the impact social support has on AA women's adherence to USDA recommendations. The purpose of this study was twofold: (1) to examine AA women's weight locus of control, perceived susceptibility to weight related diseases, and perceived barriers to healthy eating and exercise relative to C women; …

Download Full Pdf Issue Of Thomas Jefferson University Mph Public Health Link Newsletter, Vol. 5, Iss. 1, Winter 2009

Public Health Link

This issue includes a spotlight on alumnae—Meghan Gannon, along with recaps of the Oxfam Hunger banquet, SAPHE Students Participate in AIDS Walk Philly, the Annual APHA: Public Health Without Borders conference and program announcements.

Violence Against Women Raises Risk Of Cervical Cancer, Ann L. Coker, Claudia Hopenhayn, Christopher P. Desimone, Heather M. Bush, Leslie Crofford

CRVAW Faculty Journal Articles

Background: An emerging literature suggests that violence against women (VAW), particularly sexual violence, may increase the risk of acquiring a sexually transmitted infection (STI) and, therefore, may be associated with cervical cancer development. The purpose of this cross-sectional analysis was to determine if women who had experienced violence had higher prevalence rates of invasive cervical cancer.

Methods: Women aged 18–88 who joined the Kentucky Women’s Health Registry (2006–2007) and completed a questionnaire were included in the sample. Multivariate logistic regression analyses were used to adjust odds ratio (OR) for confounders (e.g., age, education, current marital status, lifetime illegal drug use, …

Hpv Vaccine Acceptance Among Latina Mothers By Hpv Status, Maureen Sanderson, Ann L. Coker, Katherine S. Eggleston, Maria E. Fernandez, Concepcion D. Arrastia, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objective: We investigated whether Latina mothers who were and were not human papillomavirus (HPV) positive differed in their knowledge and acceptance of the HPV vaccine for their children.

Methods: We conducted a cross–sectional survey among women aged 18–64 years between April 2007 and April 2008. Data collectors conducted in-person interviews in community clinics with 215 HPV-negative women and 190 HPV-positive women (with respective response rates of 64% and 84%). Most (83%) HPV-positive women were recruited at dysplasia clinics. Although no HPV-negative women were recruited at dysplasia clinics, they were recruited at other low-income public and private clinics.

Results: After adjustment …

Breast Cancer Screening In Women Exposed In Utero To Diethylstilbestrol, Elizabeth A. Camp, Ann L. Coker, Stanley J. Robboy, Kenneth L. Noller, Karen J. Goodman, Linda T. Titus-Ernstoff, Elizabeth E. Hatch, Arthur L. Herbst, Rebecca Troisi, Raymond H. Kaufman, Ervin Adam

CRVAW Faculty Journal Articles

Purpose: To determine if women exposed in utero to diethylstilbestrol (DES) are more likely than unexposed women to receive recommended or additional breast cancer screening examinations.

Methods: 1994 Diethylstilbestrol-Adenosis (DESAD) cohort data are used to assess the degree of recommended compliance of breast cancer screenings found in 3140 DES-exposed and 826 unexposed women. Participants were enrolled at four sites: Houston, Boston, Rochester, and Los Angeles. Logistic regression modeling was used to analyze mailed questionnaire data that included reported frequency over the preceding 5 years (1990–1994) of breast-self examinations (BSEs), clinical breast examinations (CBEs), and mammograms.

Results: DES-exposed women exceeded annual …

Ethnic Disparities In Cervical Cancer Survival Among Medicare Eligible Women In A Multiethnic Population, Ann L. Coker, Katherine S. Eggleston, Xianglin L. Du, Lois Ramondetta

CRVAW Faculty Journal Articles

To determine predictors of cervical cancer survival by socioeconomic status (SES), urbanization, race/ethnicity, comorbid conditions, and treatment among elderly Medicare-eligible women whose conditions were diagnosed with cervical cancer in a multiethnic population.

Methods: A total of 538 women with cervical cancer aged 65 years or older were identified from 1999 to 2001 from the Texas Cancer Registry and were linked with the state Medicare data and Texas Vital Records to determine survival times. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of SES was created using census tract-level data as was urbanization. Treatment and …

The Effects Of Aerosolized Brevetoxin Exposure On The Human Respiratory System, Katie M. Spaulding

International Journal of Global Health and Health Disparities

While much information has been collected about the effects of brevetoxin ingestion in contaminated seafood, there has been very little research conducted and little is known about the effects of these toxins when inhaled in aerosols (Backer et al., 2003). The effects of brevetoxins are of great public health concern because not only are harmful algal blooms increasing in frequency and duration of occurrence, they are also expanding their area of distribution (Sellner et al., 2003; Kirkpatrick, 2004). Since a significant proportion of the world's population live within 75 miles of an ocean coast and this density of human coastal …

Mrsa In Animals And The Risk Of Infection In Humans, Shannon Tucker

International Journal of Global Health and Health Disparities

MRSA infection is a major concern in animals and, as in humans, animals can also become carriers. It is suspected that most animals acquire MRSA from humans (reverse zoonosis) (Heot & Hough, 2008). In 1959, Mann was one of the first to culture the nostrils of cats and dogs for Staphylococcus sp. and he "proposed that the common house pet can serve as an important reservoir or carrier of staphylococci infective for man" (Mann, 1959). In the 1970's MRSA strains were isolated in milk samples in Belgium (Devriese, Van Damme, & Fameree, 1972) (Devriese & Hommez, 1975). Humans can be …

Animal Source Foods And Adolescent Nutrition, Abbey J. Canon

International Journal of Global Health and Health Disparities

Due to a variety of production, processing, or preservation limitations, or because of household economic, cultural or religious factors, many children, especially those in developing countries, do not consume an adequate amount of animal source foods (ASF). While little to no animal products are consumed in many developing countries, they are nonetheless essential to a healthy diet, especially for a growing child. The majority of low income households in developing countries base their diets on cereal grains or starchy tubers. These typical diets pose many threats to the nutritional health of children. Grains and starches lack many essential micronutrients, and …

Hospice Africa Uganda: End-Of-Project Evaluation Of Palliative Care Services, Annette Bongiovanni, Mary Alexis Greenan

HIV and AIDS

Hospice Africa Uganda (HAU) is a nongovernmental organization that provides palliative care services to people living with HIV/AIDS (PHA) and cancer. Based in Kampala, HAU aims to scale-up palliative care within and beyond the nation’s borders. From 2005–08, HAU sought to achieve the following objectives: 1) Increase coverage and scope of palliative care services available to PHA and their families; 2) Train health workers and other HIV/AIDS care providers to integrate pain management, symptom control, and end-of-life care into their existing HIV/AIDS support programs; 3) Build the capacity of families, communities, and community-based organizations in palliative care provision; 4) Integrate …

Freedom To Live, Freedom To Die: Health Disparities In El Salvador, Shaina Elizabeth Rose

Senior Honors Theses and Projects

No abstract provided.

Using Decision Analysis To Improve Malaria Control Policy Making, Jonathan B. Wiener, Randall A. Kramer, Katherine L. Dickinson, Richard M. Anderson, Vance G. Fowler, Marie Lynn Miranda, Clifford M. Mutero, Kathryn A. Saterson

Faculty Scholarship

Malaria and other vector-borne diseases represent a significant and growing burden in many tropical countries. Successfully addressing these threats will require policies that expand access to and use of existing control methods, such as insecticide-treated bed nets (ITNs) and artemesinin combination therapies (ACTs) for malaria, while weighing the costs and benefits of alternative approaches over time. This paper argues that decision analysis provides a valuable framework for formulating such policies and combating the emergence and re-emergence of malaria and other diseases. We outline five challenges that policy makers and practitioners face in the struggle against malaria, and demonstrate how decision …

Health Belief Model Of Breast Cancer Screening For Female College Students, Kirsten M. Frankenfield

Master's Theses and Doctoral Dissertations

No abstract provided.

Changes In Immunization Practices, Knowledge And Beliefs Of Michigan Obstetrician-Gynecologists Since 2000, Meaghan A. Leddy, Bernard Gonik, Stanley A. Gall, Britta A. Anderson, Jay Schulkin

Michigan Journal of Public Health

No abstract provided.

Kenya's Fertility Transition: Trends, Determinants And Implications For Policy And Programmes, Ian Askew, Alex C. Ezeh, John Bongaarts, John Townsend

Reproductive Health

In Africa, fertility rates in the 1990s declined less rapidly than had been projected, and in a few cases the fertility transition appears to have stalled. This development has serious implications for future population growth because projected population size is sensitive to minor variations in current fertility trends. The 16 countries with three DHS surveys in sub-Saharan Africa can be divided into three subgroups: stalled transitions, insignificant declines, and significant declines. Half of the 16 countries experienced a stall, and an additional two experienced insignificant declines. The Population Council prepared a series of demographic and policy analyses that drew from …

Kwazulu-Natal Department Of Health Policy And Guidelines For Integrated Ante And Postnatal Care At District Hospital Community Health Centre And Clinic Level, Population Council

Reproductive Health

A 2006 baseline survey conducted by CARE Kenya indicated that sexual and gender-based violence (SGBV) is widespread throughout Kenya’s North Eastern Province. Other findings revealed that high levels of stigma and gender imbalances are associated with sexual violence and female genital mutilation (FGM) and that a coordinated approach to responding to the service needs of survivors is missing. As noted in this report, there is limited awareness of the legal mechanisms available to survivors. The Population Council’s study in Wajir District ascertained the need for and possible components of an integrated and comprehensive services model that could meet the needs …

A Look At Customer Attitudes, Influences Of Subjective Norms, And Behavioral Intention Regarding Second Hand Smoke And Smoking In Public, Tanya Marie Dubay

Master's Theses and Doctoral Dissertations

This study is an assessment of customer’s attitudes, influences of subjective norms, and behavioral intention regarding exposure to secondhand smoke and smoke free policy at a small family owned and operated restaurant. Research questions address relationships between customer attitudes and smoke free policy as well as likelihood of customers supporting a smoke free policy in an establishment where there is currently no law that prohibits smoking. Methodology included a voluntary self administered survey questionnaire given to a convenience sample of patrons who were dining out. The results show; (a) a significant relationship between attitude about second hand smoke and choosing …

Examining Conversational Constraints In Vietnamese Patient-Doctor Communication: A Case Study, Kimberly Tran

XULAneXUS

The purpose of this study was to determine the use of conversational constraints among older members of the New Orleans Vietnamese community within the primary healthcare context. A purposive sample of seven Vietnamese male and five Vietnamese female immigrants between the ages of 47 and 80 was interviewed. Conversational constraints were evident in the responses relating to communication with physicians. The respondents emphasized relational conversational constraints such as minimal imposition on the physician’s autonomy, prevention of hurting the physician’s feelings, and prevention of negative evaluation by the physician. Conversely, task-oriented conversational constraints such as concern for clarity and effectiveness were …

Integration Of Services: Making Integrated Services A Reality, Frontiers In Reproductive Health

Reproductive Health

Programs seeking to provide a more comprehensive RH service may establish or strengthen referrals between related yet separately provided services that enable a client to receive the range of needed services. There are two main rationales for integrating services. First, many clients have needs for several services; and second, there is an expectation that providing integrated or linked services can be more efficient programmatically. Little empirical evidence exists to support these underlying rationales, or to guide policies and programs in organizing services effectively and efficiently. Lessons from FRONTIERS have demonstrated not only the demand for multiple services, but also the …

A Religious Oriented Approach To Addressing Female Genital Mutilation/Cutting Among The Somali Community Of Wajir, Kenya, Maryam Sheikh Abdi, Ian Askew

Reproductive Health

The Somali ethnic community, in Kenya as well in Somalia, Djibouti, and Ethiopia, has practiced genital cutting for centuries and the practice appears to have remained largely unchanged. The community practices the severest form of FGM/C, type III or infibulation. The Population Council’s FRONTIERS program, with support from USAID/Kenya, carried out two studies to better understand the practice of FGM/C among the Somalis in North Eastern Province so as to inform the design and implementation of interventions that would encourage abandonment of the practice. Both studies collected data through in-depth interviews and focus group discussions with community and religious leaders, …