Public Health Commons^™

Estimates Of Burden And Consequences Of Infants Born Small For Gestational Age In Low And Middle Income Countries With Intergrowth-21(St) Standard: Analysis Of Cherg Datasets., Anne Cc Lee, Naoko Kozuki, Simon Cousens, Gretchen A Stevens, Hannah Blencowe, Mariangela F Silveira, Ayesha Sania, Heather E Rosen, Christentze Schmiegelow, Linda S Adair, Abdullah H Baqui, Fernando C Barros, Zulfiqar A Bhutta, Laura E Caulfield, Parul Christian, Siân E Clarke, Wafaie Fawzi, Rogelio Gonzalez, Jean Humphrey, Lieven Huybregts, Simon Kariuki, Patrick Kolsteren, John Lusingu, Dharma Manandhar, Aroonsri Mongkolchati, Luke C Mullany, Richard Ndyomugyenyi, Jyh Kae Nien, Dominique Roberfroid, Naomi Saville, Dianne J Terlouw, James M Tielsch, Cesar G Victora, Sithembiso C Velaphi, Deborah Watson-Jones, Barbara A Willey, Majid Ezzati, Joy E Lawn, Robert E Black, Joanne Katz

Global Health Faculty Publications

Objectives To estimate small for gestational age birth prevalence and attributable neonatal mortality in low and middle income countries with the INTERGROWTH-21st birth weight standard.

Design Secondary analysis of data from the Child Health Epidemiology Reference Group (CHERG), including 14 birth cohorts with gestational age, birth weight, and neonatal follow-up. Small for gestational age was defined as infants weighing less than the 10th centile birth weight for gestational age and sex with the multiethnic, INTERGROWTH-21st birth weight standard. Prevalence of small for gestational age and neonatal mortality risk ratios were calculated and pooled among these datasets at the regional level. …

On-The-Spot Mindfulness Based Practices For Addressing Behavior Challenges Among 3rd Graders, Christina Francis

Master's Projects and Capstones

Purpose: The purpose of this project was to introduce and implement a mindfulness based tool that will empower students to manage their stress which contributes to their classroom behavior and allow teachers to minimize the amount of classroom time spent addressing behavior challenges.

Methods: Observations of third grade classrooms, key informant interviews with third grade teachers and community observations were conducted at the Achieve Academy School while throughout the school day.

Results: Findings showed that students would benefit from the implementation of On-The-Spot Mindfulness Based Techniques and Practices by minimizing stress, increasing academic success and improving the overall behavior, …

Health Informatics Solution To Indoor Air Pollution: An Opportunity For Epidemiological Research, Rhys Fay Min Chua

Master's Projects and Capstones

Indoor air pollution accounts for the particulate matters and chemical compounds from outdoor sources that penetrate into the home environment. It also contains chemical particles from cleaning products, wall paints, personal care products, indoor combustion, and microbial agents. Mounting evidence links sources from indoor air pollution to sick building syndrome (SBS). SBS decreases human productivity, impacts learning abilities, and has the potential to trigger existing asthmatic symptoms, cause dizziness, nausea, fatigue, irritation to the lungs, etc. To improve the management of IAQ among population health and for environmental health to keep up with its technological counterpart, it is crucial to …

“Do You Think I Should Be Worried?” Building A Call Structure For Hiv(-) Callers To The Nightline, Ivy Epstein

Master's Projects and Capstones

Abstract

San Francisco Suicide Prevention’s HIV Nightline provides emotional support to those living with human immunodeficiency virus (HIV) as well as support and basic medical information around relative risk and testing for who may have been exposed to HIV. Nightline counselors use a harm-reduction model, active listening, reflection of emotions, and encouragement to promote health maintenance and mental health self-care behaviors. Until now, there has been no process to assess whether callers had disproportionate anxiety about HIV given their actual risk level. Consequently, HIV(-) anxious callers could receive inconsistent information. The goal of this improvement study was to develop a …

Mindful Mornings: Piloting A Meditation Group With Vulnerable Adults In A Drop-In Center, Iyo Kubota

Master's Projects and Capstones

An accumulation of stress and lack of coping resources can contribute to a higher incidence of mental and physical health disparities. Homeless adults are one of the most vulnerable subgroups who utilize Enterprise Resource Center, a peer-run day-center in Marin County. Because stress from multiple factors was identified in this transient and high-risk population, an intervention for stress reduction and management was explored. The findings from the needs assessment suggested that there was a need for an integrated approach for stress reduction and management. The challenge of sustaining a program was also highlighted during the needs assessment.

A brief mindfulness …

Community-Based Asthma Intervention Programs And Their Impact On Childhood Health Outcomes And Burdens On The Healthcare System, Danika Ng

Master's Projects and Capstones

Since 1997, asthma prevalence rates have increased by 3% annually, leading to a current rate of 18.4 million adults and 6.2 million children with asthma, high hospitalization and emergency department visit rates, and an overall healthcare spending of 50 billion dollars. However, this increase in prevalence is disproportionately impacting children. Asthma is the third leading cause for hospitalization in children, have higher proportions of children being hospitalized with asthma symptoms, and have higher rates of asthma attacks. Recent literature shows that perceived lack of adequate education in areas such as medication adherence, medical device usage, asthma trigger avoidance, lack of …

A Roundtable On Cross-Sector Collaboration And Resource Alignment For Health Equity: Meeting Summary, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Cross-sector collaboration is a highly recommended strategy to eliminate health inequities nationally and globally. In the federal sector, it is evolving into an important approach for solving complex social problems, as evidenced by its steady proliferation the past few decades. Despite the increased adoption of cross-sector collaboration, it is still not a default strategy or preeminent option for managing complex social problems. In September 2015, the Federal Interagency Health Equity Team (FIHET) hosted a Roundtable event to discuss opportunities and strategies to foster widespread adoption of cross-sector collaboration and resource alignment. The Roundtable featured several expert panelists and participants from …

An Assessment Of Funding And Other Capacity Needs For Health Equity Programming Within State-Level Chronic Disease Programs, Tiffany Pertillar, Ann Pobutsky, Phd, Gail Brandt, Edd, Mph, Marisa New, Otr, Mph, Jamielou Delavan, Ba, Robyn Taylor, Mba, Amishi Shah, Mpa, Ma, Folasaya Adunola, Dds, Mph, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

Background: Chronic diseases are an important contributor to morbidity and mortality among racial/ethnic minority, low-income, and other under-resourced populations. Given that state health departments (and their chronic disease programs) play a significant role in providing population and preventive health services, their capacity to promote health equity is an important consideration in national efforts to address chronic diseases. The purpose of this study was to examine capacity needs of state chronic disease programs with respect to promoting health equity.

Methods: In 2015, the National Association of Chronic Disease Directors (NACDD) conducted a survey of its members that work within a …

Achieving Health Equity For Indian Country, Jamie Ishcomer

Journal of Health Disparities Research and Practice

The essence of health equity is giving resources where they are needed most. American Indians and Alaska Natives (AI/AN) continue to have the worst health outcomes, live in some of the most desperate of conditions, and lack access to even basic amenities that many other Americans could not survive without. Although Tribes have been plagued with social, economic and political injustice for centuries, there is an opportunity to put a stop to the systematic oppression and build up the first peoples of this country. A partnership between the National Indian Health Board (NIHB) and the National Partnership for Action to …

Rhode Island’S Health Equity Zones: Addressing Local Problems With Local Solutions, Nicole Alexander-Scott, Md, Mph, Ana P. Novais, Ma, Carol Hall-Walker, Mpa, Angela B. Ankoma, Mph, Msw, John P. Fulton, Phd

Journal of Health Disparities Research and Practice

The Rhode Island Department of Health (RIDOH) describes the strategies and infrastructure it has developed to fund its placed-based initiatives to address the social determinants of health to eliminate health disparities. Using a data driven and community-led approach, RIDOH funded 10 local collaboratives, each with its own, geographically-defined “Health Equity Zone,” or “HEZ,” and, to support the collaboratives, created a new “Health Equity Institute,” a “HEZ Team” of 9 seasoned project managers, and direct lines of communications between these assets and the Office of the Director of Health.

Mapping The Alignment Of Programmatic Mission, Functions And Outcomes With The Attainment Of Health Equity: An Overview Of The Approach And Initial Outcomes Through The Lens Of The Usda’S Cyfar Scp Program, Onyemaechi Nweke, Kara Ryan, Mpp, Bonita Williams, Phd

Journal of Health Disparities Research and Practice

Eliminating health disparities is a priority across national agenda and initiatives such as the National Partnership for Action to End Health Disparities (NPA), the National Prevention Strategy, and Healthy People 2020. To advance this priority under the NPA, the Federal Interagency Health Equity Team (FIHET), which is an NPA federal cross-sector and collaborative platform, initiated a voluntary pilot “health equity mapping” exercise in 2014. This exercise served as a strategy to clarify the strategic alignment between participant federal partner program missions, goals, and activities, and the goal to end health disparities and promote health equity. The mapping process included an …

Implementation Of The National Partnership For Action To End Health Disparities: A Three-Year Retrospective, Oscar Espinosa, Brandon Coffee-Borden, Mpp Coffee-Borden, Mpp, Alexis Bakos, Phd, Mph, Rn, D. Bakos, Phd, Mph, Rn, Onyemaechi Nweke

Journal of Health Disparities Research and Practice

In April 2011, the U.S. Department of Health and Human Services’ (HHS) Office of Minority Health (OMH) launched the National Partnership for Action to End Health Disparities (NPA) to increase the effectiveness of efforts to eliminate health disparities by coordinating partners, leaders, and stakeholders committed to action. At its core, the NPA is an experiment in collaboration that relies heavily on those on the front line who are actively engaged in minority health work at multiple levels. It gives them the responsibility of identifying and helping to define core actions, new approaches, and new partnerships that ultimately will help to …

The Guide To Community Preventive Services Review Of Interventions To Promote Health Equity In The United States, Robert Hahn, Jonathan E. Fielding, M.D., M.P.H., M.A., M.B.A, Robert L. Johnson, M.D., Carles Muntaner, M.D., Ph.D., M.H.S., Benedict I. Truman, M.D., M.P.H., Tracy Orleans

Journal of Health Disparities Research and Practice

The optimal approach to eliminating health inequities is through evidence-based interventions. In 2009, the non-federal Community Preventive Services Task Force launched a series of systematic reviews of interventions to promote health equity. Topics to be considered include education, employment, housing, and transportation. Thus far, reviews have focused on educational interventions: center-based early childhood education, full-day kindergarten programs, out-of-school time academic programs, high school completion programs, and school-based health centers. These reviews demonstrate the benefits of diverse educational interventions in advancing health equity. Here, we summarize the strategy of Community Guide health equity reviews, first findings and challenges.

Improving Access And Utilization Of Data To Support Research And Programs Intended To Eliminate Disparities And Promote Health Equity, Rosaly Correa-De-Araujo

Journal of Health Disparities Research and Practice

Numerous Federal initiatives are addressing health and health care disparities. The ultimate goal is to achieve “a nation free of disparities in health and health care.” Social determinants of health remain mostly responsible for health/health care disparities among population groups within and between countries. In the United States, there is little evidence that disparities associated with such determinants are decreasing, with only 10% of those associated with race/ethnicity and income having demonstrated improvement in recent years. A variety of data sources are available from the Federal and private sectors to support research on disparities, but no single national survey seems …

Racial And Socioeconomic Disparities Are More Pronounced In Inflammatory Breast Cancer Than Other Breast Cancers, Ryan A. Denu, John M. Hampton, Adam Currey, Roger T. Anderson, Rosemary D. Cress, Steven T. Fleming, Joseph Lipscomb, Xiao-Cheng Wu, J. Frank Wilson, Amy Trentham-Dietz

Epidemiology and Environmental Health Faculty Publications

Inflammatory breast cancer (IBC) is a rare yet aggressive form of breast cancer. We examined differences in patient demographics and outcomes in IBC compared to locally advanced breast cancer (LABC) and all other breast cancer patients from the Breast and Prostate Cancer Data Quality and Patterns of Care Study (POC-BP), containing information from cancer registries in seven states. Out of 7,624 cases of invasive carcinoma, IBC and LABC accounted for 2.2% (N = 170) and 4.9% (N = 375), respectively. IBC patients were more likely to have a higher number (P = 0.03) and severity (P …

Interleukin-6 (Il-6) Rs1800796 And Cyclin Dependent Kinase Inhibitor (Cdkn2a/Cdkn2b) Rs2383207 Are Associated With Ischemic Stroke In Indigenous West African Men, Rufus Akinyemi, Donna K. Arnett, Hemant K. Tiwari, Bruce Ovbiagele, Fred Sarfo, Vinodh Srinivasasainagendra, Marguerite Ryan Irvin, Abiodun Adeoye, Rodney T. Perry, Albert Akpalu, Carolyn Jenkins, Lukman Owolabi, Reginald Obiako, Kolawole Wahab, Emmanuel Sanya, Morenikeji Komolafe, Michael Fawale, Philip Adebayo, Godwin Osaigbovo, Taofiki Sunmonu, Paul Olowoyo, Innocent Chukwuonye, Yahaya Obiabo, Onoja Akpa, Sylvia Melikam, Raelle Saulson, Raj Kalaria, Adesola Ogunniyi, Mayowa Owolabi

Epidemiology and Environmental Health Faculty Publications

Background—Inherited genetic variations offer a possible explanation for the observed peculiarities of stroke in sub – Saharan African populations. Interleukin–6 polymorphisms have been previously associated with ischemic stroke in some non-African populations.

Aim—Herein we investigated, for the first time, the association of genetic polymorphisms of IL-6 and CDKN2A- CDKN2B and other genes with ischemic stroke among indigenous West African participants in the Stroke Investigative Research and Education Network (SIREN) Study.

Methods—Twenty-three previously identified single nucleotide polymorphisms (SNPs) in 14 genes of relevance to the neurobiology of ischemic stroke were investigated. Logistic regression models adjusting for known …

Exploring The Role Of Nutrition Education In Reducing Obesity Among The U.S. Adult Population, Nikitha Reddy Ravula

Master's Projects and Capstones

Obesity is a major concern among the low-income groups, yet the problem lacks adequate awareness. It is observed that the prevalence of obesity in the United States is increasing in the U.S., this paper is focused on obtaining information on low-income participants’ knowledge about consumption of nutritious food and its contribution in preventing obesity. This paper focuses on identifying the steps that participants have been taking to prevent obesity. To reach the goal of this qualitative study two surveys were designed by the researcher. From the study, it was found that majority of the participants were aware that consumption of …

Influence Of Socioeconomic Status On Event-Free Survival In Children Diagnosed With Acute Lymphoblastic Leukemia, Jordan L. Chester

Masters Theses

Acute lymphoblastic leukemia (ALL) is the most common type of cancer diagnosed in children. However, little is known about how socioeconomic status (SES) influences the outcomes of children diagnosed with ALL. The goal of the research study was to understand how SES impacted the outcomes of children diagnosed with ALL, with a particular interest in children living in West Michigan. Children ages 0-14 years who received treatment for ALL at Spectrum Health’s Helen DeVos Children’s Hospital’s Pediatric Hematology and Oncology program between the years 2002-2011 were considered for this study. Eligible participant’s zip codes and dates of relapse/death were obtained …

Gulf States Health Policy Center Community Research Fellows Birmingham, Al Evaluation Report, Candace Bright, Braden Bagley

Faculty Publications

The Gulf States Community Research Program (GSCRP) program took place in Birmingham between January 10th, 2017 and May 16th, 2017. This report reflects the implementation and evaluation of a community based participatory training (CBPR) program for this cohort of community members. The report provides data on the assessment of the program’s effectiveness in promoting the role of underserved populations in research by enhancing the capacity for CBPR. In assessing the social network development of the cohort, we seek to understand effectiveness in bridging many community roles to serve the purpose of addressing health disparities. Specifically, the report assesses if the …

Alternative Healthy Eating Index 2010, Dietary Inflammatory Index And Risk Of Mortality: Results From The Whitehall Ii Cohort Study And Meta-Analysis Of Previous Dietary Inflammatory Index And Mortality Studies, Nitin Shivappa, James R. Hébert, Mika Kivimaki, Tasnime Akbaraly

Faculty Publications

We aimed to examine the association between the Alternative Healthy Eating Index updated in 2010 (AHEI-2010), the Dietary Inflammatory Index (DIITM) and risk of mortality in the Whitehall II study. We also conducted a meta-analysis on the DII-based results from previous studies to summarise the overall evidence. Data on dietary behaviour assessed by self-administered repeated FFQ and on mortality status were available for 7627 participants from the Whitehall II cohort. Cox proportional hazards regression models were performed to assess the association between cumulative average of AHEI-2010 and DII scores and mortality risk. During 22 years of follow-up, 1001 participants died …

Gulf States Health Policy Center Community Research Fellows Mobile, Al Evaluation Report, Candace Bright, Braden Bagley

Faculty Publications

The Gulf States Community Research Program (GSCRP) program took place in Mobile between January 10th, 2017 and May 9, 2017. This report reflects the implementation and evaluation of a community based participatory training (CBPR) program for this cohort of community members. The report provides data on the assessment of the program’s effectiveness in promoting the role of underserved populations in research by enhancing the capacity for CBPR. In assessing the social network development of the cohort, we seek to understand effectiveness in bridging many community roles to serve the purpose of addressing health disparities. Specifically, the report assesses if the …

Understanding The Blogging Practices Of Women Undergoing In Vitro Fertilization (Ivf): A Discourse Analysis Of Women’S Ivf Blogs, Elizabeth Orr, Susan M. Jack, Wendy Sword, Sandra Ireland, Lois Ostolosky

The Qualitative Report

Infertility and its associated treatments, including in vitro fertilization (IVF), can have a profound impact on the emotional health and well-being of women desiring to become mothers. Researchers have measured the impact of infertility and described the experience of infertility and its treatment, leaving the rich descriptions of the IVF experience as captured in women’s blogs to be explored. This discourse analysis describes the blogging practices of women undergoing IVF, exploring both the content and function of the IVF blog discourse. Data were collected from the text of seven women’s blogs (n=1,149 blog posts) and resulted in four main functions …

Mountain Biking As A Means To Encourage Public Health And Wellbeing, Scott C. Dillard

Master of Public Health Program Student Publications

Mountain biking is a popular form of outdoor exercise. There are 8.3 million riders in the U.S., 2.8% of the population (The Outdoor Foundation, 2016). The National Survey on Recreation and the Environment (https://www.srs.fs.usda.gov/trends/nsre-directory/) places the number of participants much higher at 42.7 million riders, but their definition is less restrictive (Cordell, 2012). The National Survey includes anyone who has ridden a mountain or hybrid bicycle in the last twelve months, regardless of riding surface, while Outdoor Recreation Participation Top Line Report (The Outdoor Foundation, 2016) estimates are based on riding surface. Therefore, to avoid confirmation bias, the lower Outdoor …

The Fight Against Breast Cancer: A Policy And Programmatic Approach, Nandi Robinson

Master's Projects and Capstones

Abstract

Breast cancer continues to remain a significant health issue for women. Previously thought to only occur among postmenopausal women, breast cancer has impacted women of different ages; and rates of breast cancer have various impacts among different ethnic groups. For women living in a toxic environment, many of them have become the new wave of breast cancer cases. Screening and detection have succeeded in decreasing mortality rates. However, more research is needed in finding an efficient method of treatment. In the effort to assist in the fight against breast cancer through a policy and programmatic angle, I am fulfilling …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Assessing The Potential Benefits Of Recreational Therapy On Functioning Outcomes, Samantha R. Lamkin

Masters Theses

Background: The aim of recreational therapy, like all rehabilitation therapies, is to promote the functionality and well-being of a person with disability. However, unlike other forms of therapy, recreational therapy utilizes a unique approach to rehabilitation by incorporating meaningful daily life activities into the patient’s individualized rehabilitation plan. Gains in functionality can be quantified using a Likert scale measurement Functional Independence Measures (FIM®). Previously conducted research shows a positive association between recreational therapy services and functionality gains in specific populations of persons with disability with stroke, traumatic brain injury, and spinal cord injury being most heavily represented. Problem: Research gaps …

Teen, Parent, And Clinician Expectations About Obesity And Related Conditions During The Annual Well-Child Visit, Andrew S. Bossick, Charles Barone, Gwen L. Alexander, Heather A. Olden, Tanya Troy, Andrea E. Cassidy-Bushrow

Journal of Patient-Centered Research and Reviews

Purpose: This study aimed to examine family (patient, parent/guardian) and clinician preferences for identification and management of obesity and obesity-related conditions during the well-child visit.

Methods: Four focus groups with teen patients (n = 16), four focus groups with parents (n = 15) and one focus group with providers (n = 12) were conducted using a structured moderator guide tailored to each population. Eligible patients had a well-child visit during the past 12 months and a diagnosis of overweight, obesity, hyperlipidemia or elevated blood pressure. Parents who attended their child’s well-child visit and whose child met the diagnostic …

The Value In Verifying Medical Folklore, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Citing a related article published within this issue of the Journal of Patient-Centered Research and Reviews, the author opines on why traditional ideas regarding human health can persist over decades, and even centuries, despite a lack of scientifically accumulated evidence. It is important to keep in mind that some commonly accepted truths are supported by little to no factual data, and that occasionally patients may benefit from clarification on what is (or, often, is not) actually known about longstanding “rules of thumb” (eg, certain home remedies, disease-prevention measures or behavioral concerns). On the flip side, traditions that are shown …

Maternal Intuition Of Fetal Gender, Michael Mcfadzen, David P. Dielentheis, Ronda Kasten, Maharaj Singh, Joe Grundle

Journal of Patient-Centered Research and Reviews

Purpose: Fetal gender speculation is a preoccupation of many expecting parents, and pregnant women commonly profess to intuitively know the gender of their unborn babies. This study objectively compared pregnant mothers’ perceptions of fetal gender to sonographically proven gender determinations. Also, success rates from previously published studies, noninvasive prenatal testing and a myriad of gender determination methods were observed and reported for context.

Methods: All pregnant women presenting for second-trimester screening ultrasound (at 17–23 weeks gestation) in the obstetrics department of a single health center were asked to participate. A medical sonographer described the ultrasound examination, obtained appropriate consent and …

Multiple Myeloma Baseline Immunoglobulin G Level And Pneumococcal Vaccination Antibody Response, Michael A. Thompson, Martin K. Oaks, Maharaj Singh, Karen M. Michel, Michael P. Mullane, Husam S. Tarawneh, Angi Kraut, Kayla J. Hamm

Journal of Patient-Centered Research and Reviews

Infections are a major cause of morbidity and mortality in multiple myeloma (MM), a cancer of the immune system. Vaccination clinical efficacy endpoints have not been demonstrated, and there are limited data on surrogate markers of efficacy. This pilot study evaluated sequential immunologic markers after standard pneumococcal vaccination (PV) in patients with MM and non-MM controls. Vaccination was standard for PV (PCV13 or PPV23), with laboratory testing at baseline and at 2, 4, 12 and 24 weeks after vaccination. Immunoglobulin G (IgG) antibodies to pneumococcal antigens were detected by ELISA. Prevaccination total IgG levels and IgG subclass levels were also …