Public Health Commons^™

Reference Guide: Factorial Focus Group Analysis Methods For Studying Social Norm Change, Bettina Shell-Duncan, Amadou Moreau, Katherine Wander, Sarah Smith

Reproductive Health

The factorial focus group methodology described in this guide provides a powerful means of illuminating the social norms that uphold female genital mutilation/cutting (FGM/C), and the ways in which meanings have at times become contested or rejected. The methods described here can be applied to the study of a wide range of behaviors influenced by social norms, such as early marriage, adoption of contraception, and more.

« More Than Brides Alliance (Mtba) » : Rapport D’Évaluation À Mi-Parcours Au Mali Et Au Niger, Andrea J. Melnikas, Grace Saul, Mouhamadou Gueye, Aissa Diarra, Sajeda Amin

Poverty, Gender, and Youth

L’Alliance « Plus qu’une épouse » (More Than Brides Alliance—MTBA) a été formée, rassemblant les forces d’une équipe diversifiée, compétente pour la mise en œuvre et la recherche de programmes destinés aux adolescents. Le volet recherche de l’Alliance MTBA vise à fournir des preuves et des connaissances sur ce qui fonctionne pour retarder le mariage des enfants en Inde, au Malawi, au Mali, au Niger et au Pakistan en évaluant le programme d’intervention de l’Alliance MTBA et en examinant les facteurs spécifiques du mariage des enfants dans chaque contexte. Dans ce rapport, nous visons à évaluer les succès du programme …

The Girl Roster: A Practical Tool For Strengthening Girl-Centered Programming, Population Council

Poverty, Gender, and Youth

This brief describes the Girl Roster^TM, a practical tool designed by the Population Council to help practitioners understand their program areas and elicit foundational information to intentionally link girls—especially highly marginalized adolescent girls—to the vital resources, facilities, and services to which they are entitled but often have limited or no access. The tool is a user-friendly, efficient, and cost-effective way to collect program-relevant information about girls in a community, using a mobile phone–based questionnaire (or, where resources do not permit, paper and pencil). The tool enables users to see a fuller view of girls’ lived realities in defined …

Examining Early Marriage In India: Qualitative Findings, Neelanjana Pandey, Komal Saxena, Andrea J. Melnikas

Poverty, Gender, and Youth

The More Than Brides Alliance (MTBA) implements the “Marriage: No Child’s Play” program (2016–20) in India, Malawi, Mali, Niger, and Pakistan. The MTBA is a holistic program that addresses early marriage through multiple strategies, including: sexual and reproductive health and rights, livelihoods, education, and prevalent community social norms around marriage. Furthermore, the program operates at multiple levels (girl, family, community, block, and district) to address individual, familial, and structural barriers to reducing child marriage in these communities. This report first looks at the legal environment in which programs operate by examining participants’ awareness of laws, acts, and programs related to …

Sexual Behaviours Of Adolescents In Creek Town, Cross River State, Nigeria, Kabiru K. Salami, Rowland E. Edet

Department of Sociology: Faculty Publications

Risky sexual behaviors of adolescents in Creek Town have not been fully profiled. This study investigated the sexual behaviors of adolescents and their various dimensions in Creek Town, in Cross River State, Nigeria. This cross-sectional survey design adopted multi-stage sampling procedure to administer a 112-items questionnaire to 422 adolescents, to elicit information on their sexual behaviors and practices. Four focus group discussion sessions were also conducted with in-school and out-of-school adolescents. The mean age of adolescents was 17 years. Majority (65.4%) of the adolescents were sexually active. The mean age at sexual debut was 15 years for both male and …

At Risk Alcohol Consumption With Smoking By National Background: Results From The Hispanic Community Health Study/Study Of Latinos, Frank C. Bandiera, Eliseo J. Pérez-Stable, Folefac Atem, Raul Caetano, Denise C. Vidot, Marc D. Gellman, Elena L. Navas-Nacher, Jianwen Cai, Gregory Talavera, Neil Schneiderman, Robert Kaplan

United States Food and Drug Administration: Publications

Introduction: Tobacco smoking and binge or excess drinking are unhealthy behaviors that frequently co-occur. Studies of Hispanics/Latinos have mostly been of Mexican Americans although there are substantial differences in smoking and drinking by heritage background. Associated with co-use by 5 subpopulations.

Methods: Cross-sectional data of 16,412 Hispanics/Latinos from Miami, the Bronx, Chicago and San Diego collected between 2008 and 2011 as part of the HCHS/SOL were analyzed. Smoking and alcohol consumption and demographic data were measured by self-report. Prevalence of smoking and alcohol consumption and co-use were reported. Logistic regression models examined the odds of co-use of smoking and binge …

Comparing Methods For Clinical Investigator Site Inspection Selection: A Comparison Of Site Selection Methods Of Investigators In Clinical Trials, Nicholas Hein, Elena Rantou, Paul Schuette

United States Food and Drug Administration: Publications

Background During the past two decades, the number and complexity of clinical trials have risen dramatically increasing the difficulty of choosing sites for inspection. FDA’s resources are limited and so sites should be chosen with care.

Purpose To determine if data mining techniques and/or unsupervised statistical monitoring can assist with the process of identifying potential clinical sites for inspection.

Methods Five summary-level clinical site datasets from four new drug applications (NDA) and one biologics license application (BLA), where the FDA had performed or had planned site inspections, were used. The num- ber of sites inspected and the results of the …

Thymic Expression Of Il-4 And Il-15 After Systemic Inflammatory Or Infectious Th1 Disease Processes Induce The Acquisition Of"Innate" Characteristics During Cd8 + T Cell Development, Natalia S. Baez, Fabio Cerbán, Constanza Savid-Frontera, Deborah L. Hodge, Jimena Tosello, Eva Acosta-Rodriguez, Laura Almada, Adriana Gruppi, Maria Estefania Viano, Howard A. Young, Maria Cecilia Rodriguez-Galan

United States Public Health Resources

Innate CD8 + T cells express a memory-like phenotype and demonstrate a strong cytotoxic capacity that is critical during the early phase of the host response to certain bacterial and viral infections. These cells arise in the thymus and depend on IL-4 and IL-15 for their development. Even though innate CD8 + T cells exist in the thymus of WT mice in low numbers, they are highly enriched in KO mice that lack certain kinases, leading to an increase in IL-4 production by thymic NKT cells. Our work describes that in C57BL/6 WT mice undergoing a Th1 biased infectious disease, …

Implementation Of A Transcultural Nursing Education Program To Improve Nurses' Cultural Competence, Ann Marie Elizabeth Edwards

Walden Dissertations and Doctoral Studies

The exponential growth of culturally diverse populations in the United States has led to a multicultural patient population while the nursing workforce remains predominantly White. At the project site, managers identified that staff nurses struggled to deliver culturally competent care. The purpose of this project was to improve the cultural competence of registered nurses (RNs) through a transcultural nursing education program. Leininger's transcultural nursing theory guided the project. Sources of evidence used to develop a face-to-face educational program included peer-reviewed journals, credible websites, and the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-R tool. Aggregate pretest and …

Workers' Perception Of Hazards On Recycling Sorting Facilities In São Paulo, Brazil, Ana M. Moreira, Wanda M. Günther, Carlos Eduardo Siqueira

Gastón Institute Publications

This paper discusses views, perceptions, experiences, knowledge and behaviors related to occupational risks among recycling workers. Data collection involved field observation and two focus groups in each site. Narratives were recorded, transcribed, and analyzed for themes. Findings are presented according to the following topics: economic and environmental value of recycling; aspects of employment in the cooperative system; occupational hazards; and suggestions of improvements. Municipal programs of selective collection, as implemented in most Brazilian municipalities, still need improvements to achieve their goals and objectives. We learned that organizing recycling workers in cooperatives, despite its broad acceptance as a replacement to informal …

"I Don't Know If I Have The Courage" Reproductive Choices In Times Of Zika, Ana Rosa Linde, Grace Furtado, Elisa Tristán-Cheever, Carlos Eduardo Siqueira

Gastón Institute Publications

In this transnational study, we aimed at providing insights into women's views and attitudes towards their reproductive rights during the Zika epidemic. Women of distinct nationalities and ethnicities were recruited from various locations in Brazil, Puerto Rico, and the United States. We conducted semistructured interviews that suggest that participants reproductive decisions were intimately related to personal convictions and cultural beliefs, and their actions and thoughts were embedded in their sociocultural norms. The majority of women interviewed communicated that it takes courage to make the extreme, emotional, and overwhelming decision to have an abortion. The findings of this study suggest that …

Barriers Of Colorectal Cancer Screening In Rural Usa: A Systematic Review, Hongmei Wang, Shreya Roy, Jungyoon Kim, Evi A. Farazi, Mohammad Siahpush, Dejun Su

Journal Articles: Epidemiology

INTRODUCTION: Colorectal cancer (CRC) screening rates are lower in rural areas in the USA. To guide the design of interventions to improve CRC screening, a systematic review was conducted to identify CRC screening barriers for rural populations.

METHODS: A search was conducted in four literature databases - Medline, CINAHL, Embase, and Scopus - for articles from 1998 to 2017 that examine CRC screening barriers in rural areas. This review included a total of 27 articles reporting perceived CRC screening barriers by rural residents or providers or examining factors associated with CRC screening of rural populations in the USA.

RESULTS: The …

Differences In Access To Care Of Children With Intellectual Disability Versus Children With Autism Spectrum Disorder, Kelly J. Haller

Scholarship in Medicine - All Papers

Objective: With the increase in ASD awareness and diagnosis, concerns are raised as to whether children with ID have more unmet health care needs than children with ASD. The purpose of this study was to assess the unmet health care needs of children with ID compared to children with ASD and whether inconsistent health insurance coverage is associated with any differences. Methods: The 2016-2017 NSCH identified children with diagnoses of ID and ASD (with or without ID). Caregivers were asked if the child had an unmet need for health care during the past 12 months, and the type of care …

Public Health And Personal Choice: The Ethics Of Vaccine Mandates And Parental Refusal In The United States, Rebecca Horan

Undergraduate Honors Theses

No abstract provided.

Lived Experiences With Social Networking Technology To Improve Physical Activity, Paula Nobles Eubanks

Walden Dissertations and Doctoral Studies

Research suggests that Black women living in the United States are not engaging in sufficient physical activity, which is a major factor negatively impacting their health outcomes. Black Girls Run (BGR) is a targeted national health movement using the capacity of social networking technology as a tool to interact with and inspire Black women to live healthy through running. Literature lacked the voice and perspective of Black women who were embracing the innovation of technology to positively improve their health behaviors. The purpose of this qualitative phenomenological study was to gain a better understanding of the composite experiences of women …

Beliefs And Opinions Of Low-Income Residents Living In A Food Desert In A Gulf Coast State, Kimberly Lakeidra Willis

Walden Dissertations and Doctoral Studies

This study was an investigation of the access problem to fresh and affordable fruits and vegetables and how limited access influenced the beliefs and opinions of residents of a food desert as designated by United States Department of Agriculture. Many researchers have documented that price, availability, and transportation are barriers to fruit and vegetable consumption, particularly among low-income individuals. Researchers in other studies have concluded that these barriers are further exacerbated by an individual's distance from a supermarket or grocery store. However, much less information is available regarding the beliefs and opinions about life in a food desert and how …

Preventing Obesity And Type 2 Diabetes In Immigrant Populations, Maxwell K. Chikuta

Walden Dissertations and Doctoral Studies

Obesity-related diseases have been increasing in African immigrants throughout the United States. Although research has been done to identify risk factors associated with many ethnic groups in the United States, only a few studies exist that explore obesity and type 2 diabetes diseases among Central African immigrants. The conceptual framework for this qualitative case study was social constructivism and the health belief model. The primary research question addressed the potential underlying causes for an increase in obesity and type 2 diabetes among Central African Immigrants. The secondary research questions explored how culture, illiteracy, and religion contribute to the problem of …

Family Predictive Factors Of Rural Malaria Prevalence In Nsukka, Eastern Nigeria, Gabriel Ugwuja Ugwu

Walden Dissertations and Doctoral Studies

Children in early childhood are still suffering from burdens of malaria-related morbidity and mortality. There have been insufficient studies on how family-level factors may predict the prevalence of malaria (PoM), and negatively impact the control of malaria in rural areas, especially among children. In this study, potential family factors were explored to address the challenges associated with the increase in PoM among the children in rural areas of Nsukka. Socioecological framework guided this study at the interpersonal level. The quantitative cross-sectional study used secondary data from Demographic and Health Surveys (DHS) of 2015 in Nsukka rural communities. Data were analyzed …

Globalization Of Clinical Research And Assessment Of Global Access To Treatments Approved Between 2006-2015, Rafael Duncan Escandon

Walden Dissertations and Doctoral Studies

Globalization in clinical research and development has increased since the 1990s. Products approved in the United States (U.S.) and European Union (EU) include increasing numbers of research participants from low- and middle-income countries. The purposes of this quantitative correlational study were to investigate the lag time, or drug lag, between U.S. approval and the approval of selected drugs in all countries that hosted their pivotal clinical trials. The study population was limited to products approved first in the U.S. between 2006 and 2015. The health capability model and research for health justice framework were the theoretical frameworks for the study. …

Connecticut Primary Care Physicians And Chronic Lyme Disease, Yvette P. Ghannam

Walden Dissertations and Doctoral Studies

The prevalence of chronic Lyme disease (CLD) remains relatively unknown in Connecticut because there is not an agreement on what CLD is and how it should be diagnosed in addition to which pathological agent causes CLD. The aim of this quantitative study was to assess whether there were significant differences between two groups of primary care physicians (PCP) working in Connecticut from two different points in time regarding their knowledge in the diagnosis, treatment, and management of CLD. A knowledge, attitude, and practice model was used as the underlying theoretical framework for this study. A random cross-sectional survey was mailed …

Parental Perception Of Physician Cultural Sensitivity And Adherence To Asthma Treatment, Narue Jaynelle Wright-Jegede

Walden Dissertations and Doctoral Studies

In the United States, asthma remains a major cause of frequent urgent care visits, hospitalizations, and preventable deaths among children. Nationwide, the chronic disease continues to fall disproportionately on minorities, mostly residing in urban localities. When a child is diagnosed with asthma, the parents are typically tasked with managing the child's condition. Establishing a collaborative partnership between parents and their child's primary physician is significant for improving asthma self-management among youth. Using the theory of reasoned action as a theoretical framework, this mixed-methods study examined whether a relationship exists between parental perceptions of physician cultural sensitivity and parental care in …

Better Health Through Vaping?, Janet Choongo, Delores Quasie-Woode, Jamie Cromley

Eagles Talking About the Public’s Health

No abstract provided.

Predictors Of Hospital Quality And Efficiency, Hoda Fotovvat

Electronic Theses and Dissertations

American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this …

Choosing A Second-Generation Antidepressant Using Demographic Characteristics And Clinical Symptoms Of Depression, Amanda Lin

Master of Public Health Program Student Publications

Depression is the sixth most costly health condition in the United States, and depression that does not respond to its first trial of antidepressant treatment adds an annual cost of $9,529 per person per year. Thus, choosing an effective starting antidepressant can decrease the overall cost of depression to society. A secondary analysis of data from the Collaborative Psychiatric Epidemiology Survey (CPES) was performed to create models that can predict the efficacy of second-generation antidepressants in treating sadness. Two sets of Principal Component Analyses (PCAs) and logistic regressions were performed on variables associated with patient demographics, clinical symptoms, past medical …

Description Of Race And Preterm Birth In Six Ohio Counties From 2013-2018, Kelly Trabue

Master of Public Health Program Student Publications

Objective: The purpose of this research was to describe preterm birth rates, and the risk of preterm birth among maternal race groups in Ohio, Cuyahoga County, Franklin County, Hamilton County, Lucas County, Montgomery County, and Summit County from 2013 to 2018. For the purpose of this study, preterm birth was defined as the live birth of a baby with a period of gestation less than 37 weeks. The maternal race groups were African American, White, and Other.

Methods: A descriptive analysis of retrospective data was conducted on 798,957 live births in Ohio over six years. The data was further divided …

Cost-Effectiveness Of A Weight Loss Intervention: An Adaptation Of The Look Ahead Lifestyle Intervention In The Us Military, Karina Manz

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

Objective: To assess whether a counselor-initiated adaptation (CI) of the Look AHEAD Intensive Lifestyle Intervention (ILI) in a military setting was cost-effective relative to a self- paced adaptation (SP).

Methods: We performed cost-effectiveness analysis from a payer perspective alongside a 2014- 2017 randomized behavioral weight loss trial among 248 active-duty military personnel stationed at a US Air Force Base in Texas. We calculated incremental cost-effectiveness ratios (ICERs) for weight loss, reductions in waist circumference, and quality-adjusted life years (QALYs).

Results: After 12 months, the CI adaptation cost more per participant compared to the SP adaptation ($1,081 vs. $120), but achieved …

School-Based Hpv9 Vaccination Clinic In The Cumberland Valley Area Development District Of Kentucky, Eryne Wirthorn

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

Human Papillomavirus (HPV) is a group of more than 150 virus that can cause genital warts and cancers of the oropharynx, cervix, vagina, vulva, penis, and anus. A preventive vaccine currently exists that protects against seven oncogenic HPV strands and two strands that cause genital warts. Current guidelines for HPV9 vaccination consist of a 2-dose series delivered at 0 and 6 months for males and females ages 9-14, and a 3-dose series delivered at 0, 2, and 6 months for those ages 15-26.

While up-to-date (UTD) vaccination rates have increased across the Unites States, in 2017, only about 52.4% of …

Deputizing Family: Loved Ones As A Regulatory Tool In The “Drug War” And Beyond, Matthew B. Lawrence

Faculty Articles

Many laws use family members as a regulatory tool to influence the decisions or behavior of their loved ones, i.e., they deputize family. Involuntary treatment laws for substance use disorder are a clear example; such laws empower family members to use information shared by their loved ones to petition to force their loved ones into treatment without consent. Whether such deputization is helpful or harmful for a patient’s health is a crucial and dubious question discussed in existing literature, but use of family members as a regulatory tool implicates important considerations beyond direct medical impacts that have not been as …

Factors Associated With Utilization Of Maternal Health Services In Myanmar, Myint Kyaw Swar

Chulalongkorn University Theses and Dissertations (Chula ETD)

One of the significant causes of maternal deaths during pregnancy is low utilization of maternal health services, particularly in limited-resource settings. Proper utilization of these services can help reduce the rate of maternal mortality. Utilization of maternal health services is currently being promoted in Myanmar, however, the factors which influence on the use of these services have not been explored broadly. This present study aimed to explore the levels and patterns of utilization of maternal health services among Myanmar mothers, as well as the factors which could influence their utilization including general characteristics, mass media exposure, and woman decision making …

Environmental Health Needs Assessment Base On Priority Need Index Corresponding With Health Effects From Flood For Improving Local Government Action Plans: A Case Study Of Nakhon Si Thammarat Province, Thailand, Jariya Matrongduang

Chulalongkorn University Theses and Dissertations (Chula ETD)

Flooding is considered as one of disaster that affect more people than any other natural disaster. The effects of flooding are extremely dangerous in developing countries due to low level flood protection. Initiatives in the development of response to floods need to create responses and support from stakeholders to identify causes, decision makers and local solutions. However, there’s limited studies on environmental health needs assessment for local government flood response. The purposes of this study are access environmental health needs of flooding action plan among affected people and compare environmental health needs between people who have and non-have health related …