Public Health Commons^™

Deconstructing The Model Minority Myth: Exploring Health Risk Behaviors Of American Asian And Pacific Islander Young Adults, Todd M. Sabato

Journal of Health Disparities Research and Practice

The model minority stereotype describes Asian and Pacific Islanders (API) as the epitome of assimilation into U.S. culture using hard work, intelligence, high educational attainment, and economic success to overcome the challenges of discrimination and recent immigration. Adopted model minority pressures assume a life of their own, with origins in childhood that are amplified during adolescence and young adulthood. In response to evidence of increased vulnerability to HIV and other sexually transmitted infection exposure, the present study compared prevalence estimates of health risk behaviors of API and cross-ethnic college students (N = 1,880). Self-reported alcohol use and abuse tendencies, …

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Addressing Health Disparities And Cultural Competency In Reproductive Health Through Active Learning In The University Of Puerto Rico, School Of Medicine, Ines E. Garcia-Garcia, Kary M. Bouet Md, Lourdes Garcia-Fragoso, Juan Rivera-Gonzalez

Journal of Health Disparities Research and Practice

Introduction: Lesbian, gay, bisexual, transgender and queer (LGBTQ) individuals face health disparities linked to societal stigma, discrimination, and denial of their civil and human rights which impact reproductive health. Previous pregnancy, induced abortion, and hormonal contraceptive use are common among women who report sex with women, regardless of self-identification as lesbian. LGBTQ have higher risk of smoking, use illicit drugs or have alcohol related problems. Methods: A faculty development training addressed methods and skills for teaching cultural competence and eliminate health disparities. Faculty facilitated a small group active learning activity, including a vignette and a reflective self-evaluation, for medical students …

Effectiveness Of A Federal Healthy Start Program In Reducing Infant Mortality, Ronee E. Wilson, Hamisu M. Salihu, Jason L. Salemi, Priyanshi Patel, Rana Daas, Estrellita "Lo" Berry

Journal of Health Disparities Research and Practice

Objective: Infant mortality is an important indicator of the health status of a community. In this analysis, we aimed to evaluate temporal changes in infant mortality rates (IMR) in the Central Hillsborough Healthy Start (CHHS) program service area in Tampa, Florida compared to rates in the rest of Hillsborough County and the state.

Method: We conducted a five-year (2010-2014) trends analysis using birth and infant death data extracted from the Florida Community Health Assessment Resource Tool Set (CHARTS). The number of infant deaths and live births were used to calculate and compare IMRs in the CHHS catchment area to those …

Using Photovoice As A Tool For Community Engagement To Assess The Environment And Explore Environmental Health Disparities, Heather M. Brandt, Venice E. Haynes, Lashanta J. Rice, Dayna Campbell, Edith Williams, *Sacoby Wilson, Saundra H. Glover

Journal of Health Disparities Research and Practice

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Disparities In Breast Cancer Stage At Diagnosis: Importance Of Race, Poverty, And Age, Faustine Williams, Emmanuel Thompson

Journal of Health Disparities Research and Practice

This study investigated the association of race, age, and census tract area poverty level on breast cancer stage at diagnosis. The study was limited to women residing in Missouri, aged 18 years and older, diagnosed with breast cancer, and whose cases were reported to the Cancer Registry between 2003 and 2008. The risk, relative risk, and increased risk of late-stage at diagnosis by race, age, and census tract area poverty level were computed. We found that the odds of late-stage breast cancer among African-American women were higher when compared with their white counterpart (OR 1.433; 95% CI, 1.316, 1.560). In …

Persistence With Mammography Screening And Stage At Breast Cancer Diagnosis Among Elderly Appalachia-West Virginia Women, Ami Vyas, Suresh Madhavan, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

The objective of this study is to evaluate the association between persistence with mammography screening and stage at breast cancer diagnosis in elderly Appalachia-West Virginia women diagnosed with first incident breast cancer. The study utilized West Virginia Cancer Registry-Medicare linked database to identify women age 70 and above diagnosed with first incident breast cancer in 2007. Persistence to mammography screening was defined as having had at least three mammography screenings before breast cancer diagnosis. A multiple logistic regression was conducted to assess the association between persistence with mammography screening and stage at breast cancer diagnosis in these women. Of the …

Examining Differences In Hpv Awareness And Knowledge And Hpv Vaccine Awareness And Acceptability Between U.S. Hispanic And Island Puerto Rican Women, Daisy Y. Morales-Campos Phd, Robin Vanderpool

Journal of Health Disparities Research and Practice

Background: In 2015, only 42% of Puerto Rican (PR) girls aged 13-17 and 44% of U.S. Hispanic girls aged 13-17 were vaccinated with all three Human Papillomavirus (HPV) vaccine doses. These percentages were far lower than the Healthy People 2020 goal of 80% of girls aged 13-15 completing the vaccine series. The purpose of this study was to examine potential differences in HPV awareness and knowledge and HPV vaccine awareness and acceptability between a population-based sample of U.S. Hispanic and island Puerto Rican women.

Methods: We restricted our analyses to female respondents from the Health Information National Trends Survey (HINTS) …

Demographics And Cardiovascular Risk Factors In A Bi-Ethnic Church-Based Intervention: Baseline Results Of The Stroke Health And Risk Education (Share) Project, Lesli Skolarus

Journal of Health Disparities Research and Practice

Objectives: Hispanics have a higher incidence of cardiovascular disease (CVD) than non-Hispanic whites (NHWs). Despite proven benefits in other minority populations, few interventions have been conducted in partnership with Churches with substantial Hispanic membership. In this context, we describe the baseline demographics and CVD risk factors among participants of a bi-ethnic Catholic Church-based CVD prevention trial.

Methods: The Stroke Health and Risk Education (SHARE) project was a cluster-randomized, multi-component, faith-based, behavioral intervention that enrolled Mexican Americans (MAs) and NHWs from Catholic Churches in Corpus Christi, Texas. Strategies to ensure MA recruitment included bilingual staff and materials and partnership with Catholic …

Randomized Trial To Reduce Air Particle Levels In Homes Of Smokers And Children, Suzanne C. Hughes, John Belletierre, Benjamin Nguyen, Sandy Liles, Neil E. Klepeis, Penelope J.E. Quintana, Vincent Berardi, Saori Obayashi, Savannah Bradley, C. Richard Hofstetter, Melbourne F. Hovell

Psychology Faculty Articles and Research

Introduction

Exposure to fine particulate matter in the home from sources such as smoking, cooking, and cleaning may put residents, especially children, at risk for detrimental health effects. A randomized clinical trial was conducted from 2011 to 2016 to determine whether real-time feedback in the home plus brief coaching of parents or guardians could reduce fine particle levels in homes with smokers and children.

Design

A randomized trial with two groups—intervention and control.

Setting/participants

A total of 298 participants from predominantly low-income households with an adult smoker and a child aged <14 years. Participants were recruited during 2012–2015 from multiple sources in San Diego, mainly Women, Infants and Children Program sites.

Intervention

The multicomponent intervention consisted of continuous lights and …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Determining The Barriers To Prenatal Care Entry Within The First Trimester By Evaluation Of Prenatal Care Surveys And Questionnaires, Joycelyn Akamune

Master of Public Health Program Student Publications

Background: Prenatal care (PNC) within the first trimester is associated with improved fetal and maternal health outcomes. Improved PNC is necessary to prevent negative birth outcomes such as low birth weight and infant mortality, which have significant impact on birth outcome rates. Improving access to PNC in the first trimester involves removing barriers to care. A brief survey distributed to expectant mothers is a simple way to define these barriers. Many small community health centers do not use surveys to gather patient information. By reaching this population, barriers to PNC can be better understood and mitigated using community resources decreasing …

Data Analytics And Modeling For Appointment No-Show In Community Health Centers., Iman Mohammadi, Huanmei Wu, Ayten Turkcan, Tammy Toscos Phd, Bradley N Doebbeling

Mirro Center Articles

OBJECTIVES: Using predictive modeling techniques, we developed and compared appointment no-show prediction models to better understand appointment adherence in underserved populations.

METHODS AND MATERIALS: We collected electronic health record (EHR) data and appointment data including patient, provider and clinical visit characteristics over a 3-year period. All patient data came from an urban system of community health centers (CHCs) with 10 facilities. We sought to identify critical variables through logistic regression, artificial neural network, and naïve Bayes classifier models to predict missed appointments. We used 10-fold cross-validation to assess the models' ability to identify patients missing their appointments.

RESULTS: Following data …

Reducing Stigma Among Healthcare Providers To Improve Mental Health Services (Reshape): Protocol For A Pilot Cluster Randomized Controlled Trial Of A Stigma Reduction Intervention For Training Primary Healthcare Workers In Nepal., Brandon A Kohrt, Mark J D Jordans, Elizabeth L Turner, Kathleen J Sikkema, Nagendra P Luitel, Sauharda Rai, Daisy R Singla, Jagannath Lamichhane, Crick Lund, Vikram Patel

Psychiatry and Behavioral Sciences Faculty Publications

Background

Non-specialist healthcare providers, including primary and community healthcare workers, in low- and middle-income countries can effectively treat mental illness. However, scaling-up mental health services within existing health systems has been limited by barriers such as stigma against people with mental illness. Therefore, interventions are needed to address attitudes and behaviors among non-specialists. Aimed at addressing this gap, REducing Stigma among HealthcAre Providers to ImprovE mental health services (RESHAPE) is an intervention in which social contact with mental health service users is added to training for non-specialist healthcare workers integrating mental health services …

Metabolic Obesity Phenotypes And Risk Of Colorectal Cancer In Postmenopausal Women., G. C. Kabat, M. Y. Kim, M. Stefanick, G. Y. F. Ho, D. S. Lane, A. O. Odegaard, M. S. Simon, J. W. Bea, J. Luo, T. E. Wassertheil-Smoller

Journal Articles

Obesity has been postulated to increase the risk of colorectal cancer by mechanisms involving insulin resistance and the metabolic syndrome. We examined the associations of body mass index (BMI), waist circumference, the metabolic syndrome, metabolic obesity phenotypes and homeostasis model-insulin resistance (HOMA-IR-a marker of insulin resistance) with risk of colorectal cancer in over 21,000 women in the Women's Health Initiative CVD Biomarkers subcohort. Women were cross-classified by BMI (18.5-

The Influence Of Insurance Type On Stage At Presentation, Treatment, And Survival Between Asian American And Non-Hispanic White Lung Cancer Patients, A. Tantraworasin, E. Taioli, B. Liu, R. M. Flores, A. J. Kaufman

Journal Articles

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. The effect of insurance type on lung cancer diagnosis, treatment, and survival in Asian patients living in the United States is still under debate. We have analyzed this issue using the Surveillance, Epidemiology, and End Results database. There were 102,733 lung cancer patients age 18–64 years diagnosed between 2007 and 2013. Multilevel regression analysis was performed to identify the association between insurance types, stage at diagnosis, treatment modalities, and overall mortality in Asian and non-Hispanic White (NHW) patients. Clinical characteristics were significantly different between Asian and NHW …

Liver Cancer Disparities In New York City: A Neighborhood View Of Risk And Harm Reduction Factors, G. R. Kamath, E. Taioli, N. N. Egorova, J. M. Llovet, P. V. Perumalswami, J. J. Weiss, M. Schwartz, S. Ewala, N. A. Bickell

Journal Articles

© 2018 Kamath, Taioli, Egorova, Llovet, Perumalswami, Weiss, Schwartz, Ewala and Bickell. Introduction: Liver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions. Materials and methods: Publicly available data were collected on adult NYC residents (n = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the …

Prevalence, Comorbidity, And Correlates Of Psychiatric And Substance Use Disorders And Associations With Hiv Risk Behaviors In A Multisite Cohort Of Women Living With Hiv, J. A. Cook, J. K. Burke-Miller, P. J. Steigman, R. M. Schwartz, N. A. Hessol, J. Milam, D. J. Merenstein, K. Anastos, E. T. Golub, M. H. Cohen

Journal Articles

© 2018, The Author(s). We used the World Health Organization’s Composite International Diagnostic Interview to determine the prevalence, comorbidity, and correlates of lifetime and 12-month behavioral health disorders in a multisite cohort of 1027 women living with HIV in the United States. Most (82.6%) had one or more lifetime disorders including 34.2% with mood disorders, 61.6% with anxiety disorders, and 58.3% with substance use disorders. Over half (53.9%) had at least one 12-month disorder, including 22.1% with mood disorders, 45.4% with anxiety disorders, and 11.1% with substance use disorders. Behavioral health disorder onset preceded HIV diagnosis by an average of …

Controversies On Lung Cancers Manifesting As Part-Solid Nodules., R. Yip, K. Li, L. Liu, D. Xu, K. Tam, D. F. Yankelevitz, E. Taioli, B. Becker, C. I. Henschke

Journal Articles

PURPOSE: Summarise survival of patients with resected lung cancers manifesting as part-solid nodules (PSNs).

METHODS: PubMed/MEDLINE and EMBASE databases were searched for all studies/clinical trials on CT-detected lung cancer in English before 21 December 2015 to identify surgically resected lung cancers manifesting as PSNs. Outcome measures were lung cancer-specific survival (LCS), overall survival (OS), or disease-free survival (DFS). All PSNs were classified by the percentage of solid component to the entire nodule diameter into category PSNs

RESULTS: Twenty studies reported on PSNs

CONCLUSION: A clear definition of the upper limit of solid component of a PSN is needed to avoid …

Teens As Teachers In The Garden: Cultivating A Sustainable Model For Teaching Healthy Living, Virginia Bolshakova, John Gieng, C. Sheena Sidhu, Mary Vollinger, Lorena Gimeno, Jessica Guild

Faculty Publications

School gardens are an ideal space to deliver a healthy living curriculum, such as nutrition and physical activity education, to elementary school youth. However, public schools often lack the resources and support to establish sustainable garden-based programming. We created the Healthy Living Ambassador program, a collaborative after-school garden program in low-income communities that brought together resources from schools, community programs, and University of California Cooperative Extension. This school garden program featured culturally competent teens as teachers to serve as near-peer educators and mentors to elementary school youth. The program development model incorporated lessons from sustainable community-based health program interventions and …

Surgical Management Of Symptomatic Intraluminal Duodenal Diverticulum In An Adolescent, Vivian Lam Saavedra, Timothy D. Kane, Stefany Garrity

Surgery Faculty Publications

No abstract provided.

Community Health Worker Interventions To Promote Psychosocial Outcomes Among People Living With Hiv—A Systematic Review, H Han, K Kim, Jeanne Murphy, J Cudjoe, P Wilson, P Sharps, J Farley

Nursing Faculty Publications

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the …

Fusion, 2018, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Relative Roles Of Race Versus Socioeconomic Position In Studies Of Health Inequalities: A Matter Of Interpretation, Amani Nuru-Jeter, Elizabeth Michaels, Marilyn D. Thomas, Alexis Reeves, Roland Thorpe, Thomas A. Laveist

Health Policy and Management Faculty Publications

An abundance of research has documented health inequalities by race and socioeconomic position (SEP) in the United States. However, conceptual and methodological challenges complicate the interpretation of study findings, thereby limiting progress in understanding health inequalities and in achieving health equity. Fundamental to these challenges is a lack of clarity about what race is and the implications of that ambiguity for scientific inquiry. Additionally, there is wide variability in how SEP is conceptualized and measured, resulting in a lack of comparability across studies and significant misclassification of risk. The objectives of this review are to synthesize the literature regarding common …

Lebanon: Cholera Outbreak, Muhammad Naqvi

Global Public Health

Lebanon is a country that has always been tangled with the ever looming threat of a growing health crisis. With a failing government and massive influx of refugees, mostly the victim of their war torn economy, it seemed inevitable that sanitation procedures would run short. Now the Lebanese people and government face the challenge of the spread of Cholera, a water-borne disease, within the countries vicinity as a result of mass pollution from the formation of informal settlements as well as the country being a hotbed for political instability. These have resulted in limited success in controlling the outbreak engulfing …

Guinea : Malaria, Madeleine Jacobson

Global Public Health

This brief analyzes malaria in Guinea and its impacts on individuals and the society. It consists of a geographic and demographic presentation of Guinea which includes information about its location, climate, natural resources, ethnic groups, politics and social internal and external challenges where human trafficking, lack of healthcare and refugees are discussed. The brief analyzes malaria´s transmission, diagnosis, preventions and a suggestion for an intervention.

Malaria is a vector-borne disease, which means that living organisms that can transmit infectious diseases between humans or from animals to humans, spread malaria. 70 percent of all malaria deaths occur in age years, but …

Chile: Air Pollution, Kara Eder

Global Public Health

Chile faces a constant issue of air pollution, reaping respiratory health problems for citizens in urban areas. While the many cases over the past century have increased officials to take action on the issue, the growing infrastructure and economy of the country makes it difficult to regulate harmful emissions. Wood-burning heaters within urban residential areas also contribute to the unhealthy smog. Ingestion of these forms of matter in the air causes respiratory symptoms such as bronchitis and cardiovascular disease. Bans on such heaters and taxes on vehicle emissions were placed in order to prevent the severity of pollutants in the …

Canada: Obesity, Marissa Olson

Global Public Health

Canada is a country with a relatively healthy population of approximately 37 million people. Canada has few major public health problems; however, Canada has experienced a rise of obesity in its population with a higher rise in the adult population than childhood. The male population is at a greater risk of becoming obese than the female population, and people 35 years old and over than below 35 years old. This brief discusses the effects of obesity, Canada’s interventions to obesity such as surgery, drugs, and healthier school lunches, and a possible new method of health counseling or more convenient healthier …

Czech Republic: Diabetes, Alejandra Martinez

Global Public Health

The prevalence of diabetes mellitus, a life-threatening disease, continues to grow annually in the Czech Republic and the accessibility of care is at stake. Most of the information and statistics compiled in this brief are derived from insurance companies in the Czech Republic, rather than governmental records, which reflects the need for mass data collection of diabetes accessibility and treatment. In order to understand the public health issue, the public must also be informed and encouraged to visit their doctor for checkups to prevent diabetes and its various complications. The healthcare system could better care for Czechs not only to …