Public Health Commons^™

Childhood Asthma In The Midwest, Tiffany Delane

Walden Dissertations and Doctoral Studies

In spite of the National Asthma Education and Prevention Program guidelines outlining how to diagnose, treat, and educate asthmatics, asthma morbidity and mortality rates are still mounting. Furthermore, the minority population has disproportionately higher rates of unfavorable outcomes from asthma, thereby diminishing their quality of life. The study's theoretical framework was based on the health belief model and explored associations of asthma control with self-efficacy and asthma education. Few studies focus on asthma inequity. The purpose of this quantitative study was to assess relationships between asthma control, race, asthma education, and healthcare utilization amongst asthmatic children residing in the Midwest. …

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …

Effects Of Menafrivac® Introduction In The African Meningitis Belt, 2010-2017, Andre Arsene Bita Fouda

Walden Dissertations and Doctoral Studies

Meningococcal meningitis is a burden in the African meningitis belt. Before 2010, Neisseria meningitidis serogroup A (N. meningitidis A) was the predominant pathogen causing deathly epidemics. MenAfriVac® vaccine protects against N. meningitidis A. It was introduced in 2010 into highest meningitis risk health districts. There was limited data on the effects of MenAfriVac®, mainly on the degree of relationship between N. meningitidis A and the MenAfriVac® immunization. The social ecological model was used as a theoretical framework for this study. The purpose of this quantitative study was to assess the effectiveness of MenAfriVac® from 2010 to 2017 in 21 out …

Evaluating Parents' Decisions Regarding Recommended Childhood Vaccinations, Jennifer Kline

Walden Dissertations and Doctoral Studies

Vaccinations are among the greatest accomplishments of public health. However, many parents are choosing not to vaccinate. The purpose of this study was to explore the association between social media influence and parents' decisions to vaccinate their children. The health belief model indicates that individuals' likelihood of engaging in a health-related behavior is determined by their perceptions of susceptibility, severity, benefits, and barriers. The research questions addressed whether there is an association between parents' perception of their children's disease susceptibility and their decisions about vaccination, and whether there is an association between exposure to messaging from social media and parents' …

Implementing Counseling African Americans To Control Hypertension Intervention In Louisville Metro, Raven Robbins

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hypertension disproportionately affects Africans Americans more than their White counterparts. Counseling African Americans to Control Hypertension (CAATCH) is an intervention program that is targeted at African American adults to decrease uncontrolled hypertension. The CAATCH intervention has three components, which includes 1) computerized hypertension education, 2) at home blood pressure monitoring, and 3) behavioral counseling. The CAATCH intervention will be implemented in three sites in the northwest portion of Jefferson County in Louisville, KY. The overall goals of the CAATCH intervention are to decrease the number of participants who suffer from uncontrolled hypertension, increase knowledge of hypertension among participants, increase the …

The Financial Impact Of A Healthy Eating Intervention In A Government Worksite Cafeteria, Andrew M. Wheeler

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Unhealthy eating habits are associated with a greater risk of obesity and many chronic diseases. Historically, public health nutrition interventions have focused on education of the individual to induce dietary behavior change. However, given that many factors influence food choices, more comprehensive interventions that address these multiple factors are needed. Worksite cafeterias provide a unique opportunity to intervene at multiple levels of influence on employees eating habits. In this paper we used cafeteria sales data to evaluate the changes in purchases and the financial impact of implementing a healthy eating intervention using an environmental change and various promotional efforts to …

Evaluation Of Anemia In Communities Served By Shoulder To Shoulder Global: A Cross-Sectional Study In Santo Domingo, Ecuador, Kevin Mercer

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND: Shoulder to Shoulder Global (STSG) recognizes anemia as a cause of morbidity among patients in Santo Domingo, Ecuador. Little research has been done to assess targetable anemia risk factors to serve as a foundation for future pharmacotherapeutic interventions. This study sought to identify risk factors for anemia in this population.

METHODS: Data obtained from existing patient records from January 1, 2010 to August 31, 2016 included hemoglobin/hematocrit, age, sex, pregnancy status, and presenting community. Chi-square tests compared means to examine risk factors associated with anemia. Poisson regression and incidence rate ratios (IRR) were used to estimate risk factors associated …

Statistical Analysis Of Rabies Submissions In Kentucky And Weather As A Potential Predictor Of Positive Cases, Hannah Free

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background

The rabies virus is a zoonotic pathogen that is nearly 100 percent fatal once symptoms occur. Because it is still active in wildlife populations in Kentucky, the need for preventive measures and surveillance is critical. Temperature and precipitation have been shown to affect rabies. This study examined rabies submissions in Kentucky, weather and geographical distribution to both describe and predict cases.

Methods

Data from the University of Kentucky Veterinary Diagnostics laboratory were used to assess rabies submissions from 2005 through 2015. These submissions were anonymously submitted by the public and the Florescent Antibody Test was used to determine infection …

Exploring Disaster Preparedness For The Aging Population, Gladysmarie W.R. Harris

Walden Dissertations and Doctoral Studies

Older adults are encountering harsh recovery after disasters, and compounding this problem is the lack of research on older adults' perceptions on disaster preparedness as aging affects the ability to react to emergency situations. To partially address that gap, the purpose of this general qualitative research study was to use Rotter's spectrum of locus of control theory to examine the level of preparation regarding disaster preparation of older adults who were living independently in single-family homes in a state affected by Hurricane Sandy. Data were collected through a qualitative survey distributed to adults aged 65 to 80-years (N=88) and publicly …

Predictors Of Nutritional Counseling Among Adolescents By Physicians In California, Jean Kigozi

Walden Dissertations and Doctoral Studies

The prevalence of obesity in the United States was stable at 17% from 2011-2014 among approximately 13 million children and adolescents 12-19 years of age, according to the Centers for Disease Control and Prevention. Nutritional counseling has been recommended, and while most physicians agree that it is necessary, it is not happening consistently. The purpose of this study was to examine the association between dietary intake, physical activity, and body mass index (BMI) characteristics of youth 12-17 years old in California and the receipt of nutritional counseling. Social cognitive theory guided this quantitative cross-sectional analysis of archived data from 814 …

Stress Reduction Strategies For Improving Private Security Officer Performance, Khalil Ibrahim Al-Mulla

Walden Dissertations and Doctoral Studies

The impact of occupational stress on employees' health and work performance costs U.S. companies $300 billion annually; work-related stress is an issue for private security organizations all over the world. The purpose of this single case study was to explore strategies private security organizational leaders used to mitigate private security officers' occupational stress. The study participants were 4 leaders of a private security organization in Bahrain who had a minimum of 5 years of experience in the private security field and had addressed occupational stress successfully. The human capital theory was the conceptual framework used for this study. Data were …

The U.S. Science And Technology “Triple Threat”: A Regulatory Treatment Plan For The Nation’S Addiction To Prescription Opioids, Michael J. Malinowski

Journal Articles

No abstract provided.

Infant Feeding Practices In China And Ireland - Ireland Chinese Mother, Qianling Zhou, Katherine Younger, John Kearney

Articles

Introduction: Migration to another country may induce changes in infant feeding practices especially where such practices differ considerably between the two countries. This study was undertaken to compare the infant feeding practices between Chinese mothers who gave birth in Ireland (CMI) with immigrant Chinese mothers who gave birth in China (CMC), and to examine the factors that influence these practices. Methods: A cross-sectional self-administrated survey was conducted among a convenience sample of 322 Chinese mothers living in Ireland. Data were obtained from mailed questionnaires. Infant feeding practices between CMC and CMI were compared by Chi-square or independent sample t-test. Binary …

Reducing Arsenic Exposure From Private Well Water In The United States: The Use, Effect, And Potential Of Testing Requirements, Sara Flanagan

Dissertations and Theses

Over 45 million Americans drink from unregulated private well water of unknown quality. Arsenic is the most concerning groundwater contaminant for health because of its toxicity and widespread natural occurrence. Most residential wells in arsenic-affected areas have not been tested for arsenic; the success of community programs and efforts to motivate testing is limited by a range of psychological, situational, and socioeconomic barriers. However, testing only acts as screening and does not reduce exposure without effective and consistent actions to follow. Given the limitations in relying on individual well owners to be aware, willing, and capable of testing their water, …

Acceptability Study And Pilot Rct Of A Guide To Understanding Reproductive Health For Ladeez (Gurhl) Code: An Hiv Risk Reduction App Intervention For Black And Latina Young Women In New York City, Sonia K. Gonzalez Gladstein

Dissertations and Theses

Background: Young Black and Latina women suffer from higher sexually transmitted disease (STD) incidences than White women, increasing their susceptibility to contracting human immunodeficiency virus (HIV). The adoption and widespread usage of mobile devices has contributed to the public’s ability to access available information at all hours, including information on sexual and reproductive health (SRH). Despite a growing body of mobile health literature, there is limited understanding of how mobile-based sexual and reproductive health interventions for use by young adult Black and Latina women could improve sexual health knowledge and connection to clinical care.

Methods: This pilot randomized controlled trial …

Pediatric In-Patient Days Predictive Model, Dana Nicholson Bledsoe

MUSC Theses and Dissertations

The study objective is to develop a predictive model for pediatric inpatient days based on ambulatory outpatient visits and emergency department visits. This model aims to study the relationship between ambulatory visits and inpatient days, and determine if in-patient days can be predicted based on sub-specialty practice. Such a model does not currently exist, and when created and validated such a model could be utilized for various important management decisions, including refined insight into inpatient capacity and operational efficiency for self-governing children’s hospitals with large sub-specialty practices. The data set was a sample of convenience from one health system in …

Adolescent Girls Empowerment Program (Agep), Population Council

Poverty, Gender, and Youth

For Zambian girls, social isolation, economic vulnerability, and lack of appropriate health information and services are critical problems that prevent a healthy transition from girlhood to womanhood. The challenges that girls are confronted with—high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, lack of agency and participation—are linked together through their root causes. Through the Adolescent Girls Empowerment Program (AGEP), the Population Council and partners implemented a social, health, and economic asset-building program for vulnerable adolescent girls in Zambia. This brief summarizes …

Medication Education In The Pediatric Rheumatology Clinic, Ashley M. Cooper, Julia G. Harris

Posters

No abstract provided.

Adolescent Girls Empowerment Program (Agep): Sexual And Gender-Based Violence, Karen Austrian, Erica Soler-Hampejsek, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Acceptability and experience of sexual and gender-based violence is alarmingly high among adolescent girls in Zambia. Even more striking is the very young age from which notions of violence are ingrained and experience with violence begins. This brief summarizes the Adolescent Girls Empowerment Program (AGEP) evaluation which demonstrated that in the Zambian context, a program focused on changing norms among girls themselves is not enough to impact attitudes toward and experience of violence. Social and cultural norms are shaped by households, schools, communities, and all of the adults that girls interact with in these places—even the mentors of their own …

Child Domestic Work And Transitions To Commercial Sexual Exploitation: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

There are an estimated 17.2 million child domestic workers in the world, and the vast majority are girls. Domestic work keeps children out of school, confined to the home, socially isolated, and burdened with excessive domestic duties. Furthermore, evidence is emerging that domestic work is a feeder profession for sex work. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in Ethiopia. The domestic work conditions described in this brief create unbearable conditions for girls who enter into commercial sex work as an alternative, hoping for an improvement in their work situation. The study found that a …

Forced Child Unions: From Legal Reform To Social Disruption—Formative Research In Five Communities In Chisec, Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

Evidence has shown that child early and forced marriage/unions (CEFM/U) are harmful to the rights and development of girls and adolescents. It has also shown that increasing the minimum marriage age is not enough to eradicate this phenomenon because of the underlying practices of social institutions at the community level. This report details an investigation undertaken when a modification to the Civil Code was approved, then modified, in order to increase the minimum age of marriage in Guatemala. The investigation aimed to identify the norms, practices, and attitudes prevailing in the school, family, religion, government, and economy with regard to …

Girlsread! E-Reader Curriculum, Natalie Jackson Hachonda, Nicole Haberland, Abdul-Kahad Alhassan, Beatrice Ani-Asamoah, Pamela Nyirenda, Barbara Mensch

Poverty, Gender, and Youth

Zambian adolescent girls are at risk for premature school leaving and HIV infection due to a host of contextual factors including child marriage, early childbearing, harmful gender norms, and intimate partner violence. This report describes the GirlsRead! program, whose overall goal is to enhance learning and increase progression to secondary school among Zambian adolescent girls in grade 7, the last year of primary school. Through GirlsRead!, the Population Council, together with FAWEZA and Worldreader are aiming to improve school retention by bolstering girls’ learning outcomes, furthering social connections, improving critical thinking skills, increasing agency, and fostering community norms supportive of …

Migration And Child Domestic Work: Evidence From Ethiopia, Annabel Erulkar

Poverty, Gender, and Youth

Domestic work is frequently the initial survival strategy for rural Ethiopian girls migrating to urban areas. Following migration from rural areas, most girls enter the workforce as domestic workers, because it is a readily available form of work requiring little or no education. In 2015–16, the Population Council undertook a study of migrant, out-of-school girls in urban and rural areas in six Ethiopian regions which demonstrated that this is a common phenomenon. Originating from poor rural areas and armed with little in the way of education, domestic workers receive low pay and frequently work in abusive situations, including sexual abuse. …

Nisitu (Nisikilize Tujengane): Listen To Me, Let’S Grow Together, Population Council

Poverty, Gender, and Youth

Evidence from several studies, including in Kenya, supports the idea that empowerment and asset-building interventions targeting multiple levels of the socio-ecological environment can improve education, health, economic and social capital, gender-equitable attitudes, and violence outcomes for girls. This brief describes efforts by researchers to test the effects of engaging boys and men alongside girl-centered programming to improve the lives of adolescent girls. In 2017, the Population Council and partners undertook formative research to understand from girls: 1) what are the most influential types of males in their lives; 2) how and what they influence; and 3) what behavior changes among …

Building Resilience In Communities Most Vulnerable To Environmental Stressors, Jessie Pinchoff

Poverty, Gender, and Youth

Evidence suggests that the frequency and intensity of environmental hazards such as floods, cyclones, and droughts may be increasing, leading to high volatility in many parts of the world. The impact of these events falls unequally on the most vulnerable individuals, households, and communities. To fully understand and address the needs of vulnerable communities, the Population Council is building on its existing research, deep global research expertise, and proven approaches in reaching and working with vulnerable populations to examine how humans interact with their environments and explore how to test and develop successful strategies for building resilience. This report presents …

Accelerating Action To End Child Marriage In Bangladesh, Sajeda Amin, Jyotirmoy Saha, Masuma Billah, Nargis Sultana, Eashita Haque, Surojit Kundu

Poverty, Gender, and Youth

Despite considerable social and economic progress in Bangladesh, child marriage remains the norm. The Population Council is partnering with UNFPA and the Ministry of Women and Children Affairs to empower girls with gender, life, and livelihood skills, and to engage communities to address fundamental normative drivers of child marriage. The objective of the baseline study is to generate a set of indicators against which change can be measured, and to provide specific information about the status of adolescents in the study area in ways that can guide intervention strategies and inform programs and policies. Baseline findings will provide a benchmark …

Las Uniones Infantiles Forzadas: De La Reforma Legal A La Disrupción Social—Investigación Formativa En Cinco Comunidades En Chisec Alta Verapaz, Paola Broll, Cecilia Garcés

Poverty, Gender, and Youth

La evidencia ha demostrado que el matrimonio y las uniones infantiles forzadas (M/UIF) son nocivos a los derechos y el desarrollo de las niñas y adolescentes. También se ha demostrado que aumentar la edad mínima del matrimonio no es suficiente para erradicar este fenómeno que subyace en la práctica de las instituciones sociales a nivel comunitario. Se ha realizada esta investigación en el momento en que se aprobó la modificación al Código Civil, seguido de una modificación para aumentar la edad mínima para el matrimonio en Guatemala, con el propósito de identificar las normas, prácticas, y actitudes vigentes en la …

What Works To Improve Outcomes For Kenya's Adolescent Girls?, Population Council

Poverty, Gender, and Youth

This fact sheet outlines results from the Adolescent Girls Initiative–Kenya, a study that evaluates the long-term impact of a multi-sectoral intervention targeted at adolescent girls aged 11 to 15 years from Kibera and rural Wajir. The intervention consists of four different components: a community-based violence-prevention program, an education conditional cash transfer (CCT), health-focused girls' empowerment clubs, and wealth creation for girls via financial education and savings. Results indicate that the approach was a cost-effective way to create positive change across a range of well-being factors for young adolescent girls, including education, health, and economic outcomes.

Community-Level Assessment Of Heatwaves In Odisha State, India: Effects, Resilience And Implications, Sangram Kishor Patel

Poverty, Gender, and Youth

Heatwaves constitute a potential threat to many of India’s states, including Odisha, and their impact could become acute without adaptive capacity. This research brief explores the perceived causes and experiences of climate change and heatwave by stakeholders in the district. It summarizes reported effects on livelihoods, food security, and livestock; water and sanitation; and health, and reviews coping strategies offered by respondents. The report includes a number of recommendations to meet the needs of the population as indicated by the findings.

Adolescent Girls Initiative–Kenya: Midline Results Report, Karen Austrian, Erica Soler-Hampejsek, Joyce Mumah, Beth Kangwana, Yohannes Dibaba Wado, Benta Abuya, Valsa Shah, John A. Maluccio

Poverty, Gender, and Youth

Many adolescent girls in Kenya face considerable risks and vulnerabilities that affect their education status, health, and general well-being. In addition to low educational attainment and health risks, other factors that impact education and health outcomes include household poverty, lack of economic independence, limited income-earning opportunities, illiteracy, violence, and social isolation. Younger adolescent girls who live in environments laden with these vulnerabilities are at risk of experiencing negative outcomes such as school dropout, early sexual initiation, unintended pregnancy, early marriage, and sexual and gender-based violence. The Adolescent Girls Initiative–Kenya (AGI-K) delivered multisectoral interventions to over 6,000 girls aged 11–15 in …