Public Health Commons^™

Formative Development Of A Culturally Appropriate Mammography Screening Campaign For Low-Income African-American Women., Kimberly D. Leeks, Ingrid J. Hall, C. Ashani Johnson-Turbes, Ngozi Kamalu, Yasmine Zavahir

Journal of Health Disparities Research and Practice

The purpose of this qualitative study was to conduct a formative evaluation of messages and materials to inform the development of a promotional, health campaign designed to increase breast cancer screening awareness and utilization among low-income, uninsured African American women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Savannah and Macon, Georgia (GA). A priority of CDC is to understand why women eligible for screening through the NBCCEDP do not participate in NBCCEDP screening services as well as to identify effective strategies for increasing enrollment among NBCCEDP-eligible women who have never received breast cancer screening. As …

Ethnic And Gender Differences In Psychosocial Factors In Native Hawaiian, Other Pacific Islanders, And Asian American Adults With Type 2 Diabetes, Jillian Inouye, Dongmei Li, James Davis, Richard Arakaki

Journal of Health Disparities Research and Practice

This study examined the differences between 207 Asians and Native Hawaiian, other Pacific Islanders (NHOPI) with type 2 diabetes among various psychosocial measures. Responses to five multivariable regression models including the Diabetes Quality of Life Questionnaire (DQOL) and Short Form -36® Health Survey (SF-36) were analyzed. Differences were determined by linear contrasts in the multivariate linear regression models after adjusted for multiple demographic and socioeconomic variables. Compared to Asians, NHOPIs perceived a lower impact of diabetes on their quality of life; highlighting differences in perceptions of self-efficacy and self-care activities. Females did better on their diet while males perceived better …

Housing, The Neighborhood Environment, And Physical Activity Among Older African Americans, Lonnie Hannon Iii, Patricia Sawyer, Richard M. Allman

Journal of Health Disparities Research and Practice

Abstract

This study examines the association of neighborhood environment, as measured by housing factors, with physical activity among older African Americans. Context is provided on the effects of structural inequality as an inhibitor of health enhancing neighborhood environments. The study population included African Americans participating in the UAB Study of Aging (n=433). Participants demonstrated the ability to walk during a baseline in-home assessment. The strength and independence of housing factors were assessed using neighborhood walking for exercise as the outcome variable. Sociodemographic data, co-morbid medical conditions, and rural/urban residence were included as independent control factors. Homeownership, occupancy, and length of …

Racial Disparities In Pain Management In Primary Care, Miriam Ezenwa

Journal of Health Disparities Research and Practice

This descriptive, cross-sectional, secondary data analysis was conducted to examine racial disparities in pain management of primary care patients with chronic nonmalignant pain using chronic opioid therapy. Data from 891 patients, including 201 African Americans and 691 Caucasians were used to test an explanatory model for these disparities. We predicted that: (1) African American patients would report worse pain management and poor quality of life (QOL) than Caucasians; (2) the association between race and pain management would be mediated by perceived discrimination relating to hopelessness; and (3) poor pain management would negatively affect QOL. Results revealed significant differences between African …

Parallel Ngo Networks For Hiv Control: Risks And Opportunities For Ngo Contracting., Shehla Zaidi, Xaher Gul, Noureen Aleem Nishtar

Community Health Sciences

Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO …

The 'Art' Of Medicine: Building A Caring Relationship With Clients, Lisa Barkley

UCF Forum

On the first day of school each year at the UCF College of Medicine, Dean Deborah German asks our incoming class of students what they think makes a “good doctor.”

Integrated Services Post (Posyandu) As Sociocultural Approach For Primary Health Care Issue, Oedojo Soedirham

Kesmas

Kelahiran posyandu pada tahun 1980-an merupakan usaha pemerintah Indonesia untuk meningkatkan status kesehatan masyarakat, mengikuti panggilan internasional, Deklarasi Alma Ata (Kazakhstan) tentang kesehatan masyarakat tahun 1978. Konsep kunci deklarasi tersebut adalah partisipasi masyarakat. Di Indonesia, partisipasi masyarakat disebut “gotong royong”. Masyarakat memainkan peran penting dalam meningkatkan kesehatan masing-masing. Untuk melibatkan masyarakat dalam kesehatan masyarakat, relawan harus direkrut dan dilatih untuk mengenal isu-isu kesehatan masyarakat dasar. Gagasan mengenai relawan yang disebut kader (village health worker) tersebut diajukan agar relawan sebagai bagian dari masyarakat dapat lebih mudah menyampaikan program-program kesehatan karena lebih dekat dibandingkan pejabat kesehatan masyarakat. Di dalam artikel ini dibahas …

Kondisi Sosial Ekonomi Dan Stres Pada Wanita Hipertensi Anggota Majelis Taklim, Anna Fitriani

Kesmas

Proporsi hipertensi pada wanita selalu lebih tinggi dengan peningkatan usia populasi. Penelitian ini membahas hipertensi dan faktor risiko pada 105 wanita dewasa anggota Majelis Taklim Al-Amin Cilandak, Jakarta Selatan. Penelitian observasional dengan desain studi potong lintang ini dilatarbelakangi oleh hasil Riset Kesehatan Dasar (Riskesdas) 2007 dengan metode analisis uji Chi Square. Populasi target adalah seluruh anggota majelis taklim di Jakarta Selatan dengan sampel anggota Majelis Taklim Al-Amin di Kecamatan Cilandak yang datang pada saat pengambilan data. Hasil penelitian menunjukkan bahwa prevalensi hipertensi sebesar 41,7% lebih tinggi daripada provinsi DKI Jakarta (28,6%) dan angka nasional 2007 (31,7%). Hipertensi pada penelitian ini …

Perbedaan Gender Pada Kejadian Sindrom Metabolik Pada Penduduk Perkotaan Di Indonesia, Krisnawaty Bantas, Hari Koesnanto Yoseph, Budi Moelyono

Kesmas

Sindrom Metabolik (SM) merupakan faktor risiko penting penyakit kardiovaskuler yang merupakan penyebab utama kematian di Indonesia. Perbedaan gender pada SM berkontribusi terhadap perbedaan gender pada penyakit kardiovaskuler. Penelitian ini bertujuan mengetahui prevalensi dan risiko SM berdasarkan gender di perkotaan Indonesia menggunakan data Riset Kesehatan Dasar 2007 dan menggunakan rancangan penelitian potong lintang. Populasi penelitian terdiri dari 13.262 orang pria dan wanita yang tidak hamil berusia lebih dari 15 tahun yang bermukim di daerah perkotaan. Variabel penelitian meliputi variabel dependen sindrom metabolik. Variabel independen utama adalah gender dan variabel kovariat yang lain adalah level 1 (umur, status perkawinan, pendidikan, stres, merokok, …

Use Of The County Health Rankings By Local Health Departments In Florida, 2010 - 2011, Nancy L. Winterbauer, Bonita Sorensen, James B. Tidwell

Frontiers in Public Health Services and Systems Research

This paper describes how local health departments (LHDs) in Florida used the County Health Rankings over the first two years of their release (2010 – 2011). We surveyed LHD leadership to describe if, how and to what extent the Rankings were used by Florida’s 67 LHDs to improve the health of their communities and describe changes in use from the 2010 to the 2011 release. Our results indicate substantial use of the Rankings by Florida’s LHDs, particularly as applied to community health assessments, staff education, as a starting point for examining other indicators and databases, and in grant applications. From …

Effectiveness And Challenges For Implementing Quality Improvement Activities In Nebraska’S Local Health Departments, Li-Wu Chen, Anh Nguyen, Janelle J. Jacobson, Diptee Ojha, David Palm

Frontiers in Public Health Services and Systems Research

What is already known on this topic? Although the implementation strategies and effectiveness of quality improvement (QI) activities have been examined extensively for many industries, including the health care sector, very few studies have focused on QI activities in the public health context.

What is added by this report? The study results indicated that Nebraska’s LHDs still face significant barriers for QI implementation, including low capacity, knowledge gaps, inadequate resources, and low institutional QI maturity.

What are the implications for public health practice/policy/research? Policy makers and LHDs should provide QI training and external QI expertise to LHD staff and better …

Building Capacity To Support And Study Qi In Local Georgia Public Health Systems, William C. Livingood, Nandi Marshall, Angela Peden, Ketty Gonzales, Gulzar H. Shah, Russ Toal, Kellie Penix, Dayna Alexander, Kay Davis, Sylvester Nixon, Purity Cummings, William Riley, Lynn Woodhouse

Frontiers in Public Health Services and Systems Research

The study of quality improvement within Georgia’s local public health systems provides important insight into the use of regional bodies as quality improvement (QI) collaboratives and multijurisdictional entities. This report describes QI initiatives following a RWJF funded quick strike research grant to assess health district capacity to conduct QI in Georgia’s local public health systems. These QI initiatives use QI to improve public health outcomes including: Adolescent pregnancy and Sexually Transmitted Infection prevention, HIV prevention and control, and HIV Management.

Tax Levy Financing For Local Public Health: Relationships Between Fiscal Allocation, Fiscal Effort And Fiscal Capacity, William Riley, Kim J. Gearin, Carmen D. Parrotta, Jill Briggs, M. Elizabeth Gyllstrom

Frontiers in Public Health Services and Systems Research

This study examines property tax levy (local tax levy) as a source of local health department (LHD) funding during a five year period (2006-2010) in all Minnesota counties by assessing fiscal effort, fiscal allocation and fiscal capacity. Local health departments rely on pluralistic funding from local, state, federal and private sources. However, local tax levy funding is unexplored and little is known regarding the extent of fiscal allocation (tax levy used for LHD), fiscal effort (potential amount of tax levy available for LHD), and fiscal capacity (wealth of community). More important it is not known to what extent variation between …

Mandated Activities And Limited Decision-Making Authority Among Local Public Health Officials, Betty Bekemeier, Anthony L-T Chen, Nami Kawakyu

Frontiers in Public Health Services and Systems Research

Local public health department leaders face difficult decisions regarding the allocation of increasingly scarce resources, yet existing evidence for public health decision making, while still limited, is underutilized by public health officials. Participants in this study described processes regarding resource allocation in response to local budget cuts as based largely on legally mandated activities and categorical funding and perceived these factors as limiting much of their agency-level decision making to a relatively small portion of flexible funding. In the limited areas in which they perceived themselves to have flexibility, they generally considered their agencies to have very little capacity for …

Evidence-Based Decision Making In Local Health Departments, Linda Weiss, Collette Sosnowy, Christopher M. Maylahn, Nancy J. Katagiri, Sylvia Pirani

Frontiers in Public Health Services and Systems Research

Evidence-based decision making (EBDM) represents an important strategy to increase efficacy and efficiency of public health programs and practice. There is insufficient information on the application of EBDM among local health departments (LHDs). This qualitative study examined use of EBDM in New York State (NYS) LHDs and factors facilitating and impeding its adoption through interviews and focus groups with 47 LHD commissioners, health directors, and other upper-level staff. Findings suggest variability in application of EBDM in NYS LHDs. A number of internal factors (e.g., staff capacity, organizational culture) and external factors (e.g., policy environment, appropriate and …

From The Frontier: Translating Research To Practice, Paul C. Erwin

Frontiers in Public Health Services and Systems Research

The purpose of this invited article is to describe the process of translating research into public health practice. An example is provided, showing how questions arose in the practice setting, a researcher was identified to help answer the questions, and findings from the research were applied in the practice setting. In this example, Dr. Lea LaFave (Community Health Institute/JSI in New Hampshire) worked with Dr. Danielle Varda (Assistant Professor at the University of Colorado/ Denver, School of Public Affairs) to use social network analysis to better understand a network of coalitions focused on underage substance abuse. The social network analysis …

Stimulating Public Health Improvement In Complex And Constrained Delivery Systems: Findings From The Public Health Pbrns, Glen P. Mays

Frontiers in Public Health Services and Systems Research

The Robert Wood Johnson Foundation’s Public Health Practice-Based Research Networks Program sponsored a series of studies to examine how public health decision-makers are responding to accreditation, quality improvement, and public reporting initiatives amid the ongoing fiscal pressures. Overall, the evidence to date indicates that these initiatives represent promising strategies for strengthening evidence-based decision-making and expanding the delivery of evidence-tested programs and policies in local public health settings. Continued, comparative research and evaluation activities are needed to provide more definitive evidence about which combination of strategies work best, for which population groups, in which community and organizational settings, and why.

Changes In Latitudes, Changes In Attitudes: Fqhcs And Community Clinics In A Reformed Health Care Market, Jessamyn Taylor

National Health Policy Forum

The Patient Protection and Affordable Care Act of 2010 and the Supreme Court’s related decision have significantly shifted the health care landscape for safety net providers. Federally qualified health centers (FQHCs) are a mainstay of primary care for the uninsured and those with limited access to care. This paper focuses on the impact of health reform on FQHCs given the significant federal investment in them through grants, Medicaid, and Medicare reimbursement. Where noteworthy, the effect on non-FQHC community clinics is also discussed. The implications of Medicaid coverage expansions (or lack thereof in states that choose not to expand), Medicaid disproportionate …

Evaluation Of Heat Stress In Migrant Farmworkers, Stephen L. Mcqueen

Electronic Theses and Dissertations

The rate of heat-related fatalities in crop production workers is almost 20 times that of other industries. Heat stress was investigated in migrant tomato workers in July, 2012, using measurements of body temperature, heart rates, body weight loss, evaluation of the thermal environment, and survey data. Using occupational safety criteria, these workers were found to work in an environment that should require protective measures to prevent heat strain. Increases in body temperature, heart rate, and physiological strain correlated with heat exposure. One third of workers had body weight percentage losses that indicated dehydration. However, working in hot environments appears to …

The Face Of Cancer In Montgomery County Ohio: A Look At The Population At Risk, Chika E. Okere

Master of Public Health Program Student Publications

The purpose of this study was to identify the population in Montgomery County Ohio who are at the greatest risk for cancer based on age, sex, and race/ethnicity, family history and demographics. The research will also look at modifiable behaviors such as use of tobacco products, physical inactivity, obesity, poor nutrition and heavy drinking of alcohol that increase the risk and identify areas of improvement in data collection for reporting purposes. During 1996-2006, cancer was the second-leading cause of death for residents of Montgomery County.

Methods: Age, sex, race/ethnicity of people in Montgomery County with cancer were examined and using …

A Practical Scale For Multi-Faceted Organizational Health Climate Assessment, Zandra M. Zweber

Master's Theses

The current study sought to develop a practical scale to measure workplace health climate in a way that has not previously been conceptualized – as a three-faceted approach from the employee perspective serving as an indicator of a healthy organization. The goal was to create a short, useable yet comprehensive scale that could translate into practical use by organizations and occupational health professionals planning workplace interventions. To accomplish this, the proposed multi-faceted organizational health climate scale (MOHCA) assesses three-facets which match up with three organizational levels: 1) organization 2) supervisor and 3) workgroup. Ten items were developed and tested on …

Evaluation Of The Survival Effect For Various Treatment Modalities Among Stage Ii And Iii Rectal Cancer Patients In California, 1994-2009, Myung Mi Cho

Loma Linda University Electronic Theses, Dissertations & Projects

Background: European trials evaluating the effect of preoperative (PreOP) versus postoperative chemoradiotherapy (PostOP CRT) found no survival benefit. However, the effect of a change from PostOP to PreOP CRT has not been evaluated in a population-based setting. We sought to evaluate multimodal treatment changes and overall survival for perioperative (PeriOP) CRT versus surgery alone and for PreOP versus PostOP CRT from 1994 through 2009 among patients receiving radical surgery for stage II and III rectal cancer (RC).

Patients and Methods: We conducted a nonconcurrent cohort study evaluating demographic predictors of multimodal therapy for stage II and III RC using …

Elevated Cardiovascular Risk Among Adults With Obstructive And Restrictive Airway Functioning In The United States: A Cross-Sectional Study Of The National Health And Nutrition Examination Survey From 2007-2010, Earl S. Ford, Anne G. Wheaton, David M. Mannino, Letitia Presley-Cantrell, Chaoyang Li, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

METHODS: We used data from adults aged 20-79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria.

RESULTS: Among 7249 participants, 80.9% had …

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 …

Role And Effectiveness Of Community Health Workers Among Underserved Us Populations, Hibo H. Noor

Master of Public Health Program Student Publications

The role of the Community Health Workers (CHWs) in the health care system has great value both domestically and internationally. CHWs have training in healthcare; they are members of the community in which they serve. They have in depth understanding of the barriers to health care the community faces; they can speak the same language, and can promote and improve health status, quality of care and assist managing chronic disease. This paper focuses on the role and documented effectiveness of CHWs in terms of quality, health care services, cost health services, as well as health behaviors and knowledge about the …

A Regionalized National Universal Kriging Model Using Partial Least Squares Regression For Estimating Annual Pm2.5 Concentrations In Epidemiology, Paul D. Sampson, Mark Richards, Adam A. Szpiro, Silas Bergen, Lianne Sheppard, Timothy V. Larson, Joel Kaufman

UW Biostatistics Working Paper Series

Many cohort studies in environmental epidemiology require accurate modeling and prediction of fine scale spatial variation in ambient air quality across the U.S. This modeling requires the use of small spatial scale geographic or “land use” regression covariates and some degree of spatial smoothing. Furthermore, the details of the prediction of air quality by land use regression and the spatial variation in ambient air quality not explained by this regression should be allowed to vary across the continent due to the large scale heterogeneity in topography, climate, and sources of air pollution. This paper introduces a regionalized national universal kriging …

Long-Term Effects Of Alcohol Consumption [Annotated Bibliography], Polly Cowan

Undergraduate Research Award

No abstract provided.

Public Health Return On Investment: Making The Case, Glen P. Mays

Health Management and Policy Presentations

Fiscal pressures and policy imperatives have created a need for rigorous economic analyses of public health programs and policies. ROI analyses can reveal whether the benefits of public health strategies justify their costs, who realizes these benefits and costs, and under what circumstances.

Comparative Effectiveness Research And Patient Centered Outcomes Research In Public Health Settings: Design, Analysis, And Funding Considerations, Glen P. Mays

Health Management and Policy Presentations

The principles and methods of CER and PCOR have developed primarily with therapeutics in mind, but they must also be applied to the study of public health programs, policies, and delivery systems. This session surveys the emerging field, and provides examples of CER/PCOR methods applied in public health settings using practice-based research networks (PBRNs).

Health & Wellness Page, Ilana A. Mesnard

Blogging the Library

Where is health on your priority list? Good health is crucial for all people, but especially for musicians (or athletes) who need their bodies in top performance shape. Musicians in the conservatory need to be aware of how to stay healthy. The purposes of the Health and Wellness Page are to promote good health, and to create awareness of reliable resources on healthy lifestyle choices as musicians. [excerpt]