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Overview: Literature Review Of Linkage, Adherence, And Retention Interventions For Seropositive Children And Young People In Africa, Project Soar

HIV and AIDS

Various strategies have been implemented in countries around the world to reduce barriers to engagement in care and adherence to antiretroviral therapy among children and young people living with HIV. Despite these diverse programmatic strategies, a comprehensive understanding of what works best for children and adolescents in sub-Saharan Africa is lacking. To address this gap, Project SOAR conducted a systematic review of the peer-reviewed literature to: 1) document interventions that support engagement in care and ART adherence for infants, children, adolescents, and youth living with HIV in sub-Saharan Africa (SSA), including orphans and other vulnerable children; and 2) inform future …

Factors Influencing Hiv Care Outcomes Among Adolescents Living With Hiv In Rural South Africa, Lindsey M. Filiatreau, Audrey Pettifor, Jess Edwards, Nkosinathi Masilela, Rhian Twine, F. Xavier Gómez-Olivé, Nicole Haberland, Chodziwadziwa Whiteson Kabudula, Sheri A. Lippman, Kathleen Kahn

HIV and AIDS

In the Agincourt Health and Socio-Demographic Surveillance System (HDSS) site in rural Mpumalanga Province, South Africa the Project SOAR team hypothesized that HIV status disclosure, individuals’ prior healthcare seeking experiences, history of depression and overall emotional well-being, experiences with domestic and intimate partner violence, and substance use could contribute to poor levels of treatment adherence among adolescents living with HIV. The overall objective of this study was to better understand HIV care outcomes among HIV-positive adolescents in the Agincourt HDSS in the era of universal test and treat so we can better inform HIV care programs targeting this vulnerable population.

The Power And Process Of Shifting Gender Norms: Insights From A Randomized Controlled Trial In South Africa, Nicole Haberland, Julie Pulerwitz, Ann Gottert, Audrey Pettifor, Sheri A. Lippman, Dean Peacock, Lumbwe Chola, Ryan Wagner, Anna M. Leddy, Rebecca West, Mi-Suk Kang Dufour, Jennifer Hove, Rhian Twine, Rhandzekile Mathebula, Dumisani Rebombo, Angelica Pino, F. Xavier Gómez-Olivé, Chodziwadziwa Whiteson Kabudula, Nkosinathi Masilela, Aimée Julien, Kathryn Spielman, Kathleen Kahn

HIV and AIDS

This Project SOAR report summarizes findings from a randomized controlled trial of Tsima ra rihanyu (“working together for health”), a three-year community mobilization program for treatment as prevention that aimed to address the social barriers to HIV testing and treatment in Mpumalanga Province, South Africa. In this report, the authors explore the types of gender norms that are salient for women and men, how these relate to HIV testing and treatment, and the pathways through which gender norms operate to affect women’s and men’s HIV service use and experience and perpetration of intimate partner violence.

Improving Pmtct Outcomes For Mother-Infant Pairs Through Community-Facility Linkage: Results From A Mixed Methods Study In Malawi, Michael Herce, Jess Edwards, Stephanie M. Topp, Michael Eliya, Nicole Carbone, Lauren Zalla, Jennifer Tseka, Maga Chagomerana, Mina C. Hosseinipour, Innocent Mofolo

HIV and AIDS

To improve MIP care retention in Malawi, several prevention of mother-to-child transmission of HIV (PMTCT) care delivery models have emerged to strengthen community-facility linkage (CFL), a concept defined as any “formalized connection between a health facility and the communities it serves to support improved health outcomes.” Similar to other settings in sub-Saharan Africa, three models have been widely implemented to complement Malawi’s National PMTCT Programme: 1) mentor mothers; 2) expert clients; and 3) community health workers. While the rationale underpinning these models has been substantiated by evidence generated from general antiretroviral therapy and PMTCT programs across SSA, a clear and …

Addressing Hidden Barriers To Follow Up Healthcare: A Community Referral Pilot Project, Amber Williams

Doctor of Nursing Practice Projects

Objective: The project was aimed to reduce the number of participants lost to primary care follow-up following a mobile health unit screening event.

Design: A pilot study program screening tool implementation was utilized to address the hidden barriers of the Social Determinants of Health (SDoH) during a Winter 2021 event.

Sample: A group of 12 participants were screened during a mobile health unit event. Eight of the participants opted to be a part of the pilot study.

Measurements: A comparison ratio of Primary Care follow up was compared from the Winter of 2020 with Winter of 2021, where the screening …

Impact Of Social Barrier Removal On Primary Care Use By Managed Care Enrollees, Pamme Lyons-Taylor

Walden Dissertations and Doctoral Studies

Personal health represents a complex relationship among social, physical, and emotional factors that can be influenced by health-seeking behaviors. Prior research indicates that greater use of preventive services leads to longer life and lower healthcare costs. For some populations, evidence suggests that social barriers hinder access to preventive services. To better understand the relationship between social factors and the other personal-health factors, de-identified healthcare claims and social service encounter data for 4,480 low-income individuals enrolled in Medicare Advantage or Managed Medicaid at one national health insurance were examined using a retrospective, quasi-experimental design for services rendered between October 1, 2014 …

The Use Of Technology For Seeking Health Information In Persons With Cancer, Jasvir Zonobi

Walden Dissertations and Doctoral Studies

Cancer is a growing public health concern. The U.S. cancer prevalence nearly doubled from 8.1 million in 1996 to 15.5 million in 2016 and is expected to rise by an additional 68% from 2016 to 2040. Many cancer survivors use technology (e.g., smartphones) for health information seeking (HIS) for health-related self-efficacy (HRSE) to self-manage the health issues (e.g., physical impairment, chronic disease) they face. However, limited research exists regarding cancer survivors' use of HIS technology for HRSE. The self-efficacy theoretical framework, multiple logistic regression analyses, and the data from 2019 Health Information National Trends Survey were used in the current …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

Risk Factors Associated With Childhood Vaccination Coverage In Afghanistan, Iqbal Mawani

Walden Dissertations and Doctoral Studies

Globally, vaccination is among the most successful and cost-effective public health practices in the prevention of infectious diseases. The purpose of this study was to examine the child, parental, and geographical risk factors that influence childhood vaccination coverage in Afghanistan. The health belief model and socio-ecological model was used in this study as the theoretical framework to examine the effects of these risk factors on vaccination coverage among children in Afghanistan. Univariate, bivariate, and multivariate tests were conducted within the secondary data analysis of the 2015 Afghanistan national Demographic and Health Survey dataset. Of the 32,420 children aged 0 to …

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

Health Care Provider Program On The Management Of Obesity, Erlinda P. Bhat

Walden Dissertations and Doctoral Studies

Research has shown that educational programs have led to developing the professional skills and behaviors of front-line health care providers who care for overweight or at-risk obese patients. The purpose of this project was to provide an educational program on best practices for weight management to health care providers at a large military clinic. The project question was developed to assess whether the educational program increased the knowledge and confidence of health care providers in the management of obesity. Utilizing Pender's health promotion model, a quasi-experimental study was conducted in which 15 health care providers, including licensed and unlicensed personnel …

A Phenomenological Exploration Of How Nursing Experience Shapes The Transitional Performance Of Primary Care Nurse Practitioners, Helen Okeke

Walden Dissertations and Doctoral Studies

AbstractPoor access to healthcare and a shortage of primary care providers in underserved communities paved the way for reliance on advanced practice registered nurses (APRNs). This increased reliance on APRNs as primary care providers necessitates expanded public policy on APRN practice; however, information on APRN transitional experiences remains inadequate to inform policymakers effectively. Illinois’ Nurse Practice Act requires APRNs to incorporate the scope of practice of registered nurses into their practice but does not describe what that experience should be. Using Kanter’s theory of organizational structural empowerment and Benner’s novice to expert nursing model as theoretical lenses to ground the …

Human Immunodeficiency Virus And Homelessness Among U.S.-Born And Foreign-Born Tuberculosis Cases In Georgia, Semra Ramosevac

Walden Dissertations and Doctoral Studies

According to the Centers for Disease Control and Prevention, tuberculosis (TB) is an infectious disease caused by bacteria and can easily spread in the U.S. and worldwide. TB infections in the U.S. have been much lower compared to other countries around the world in the last 40 years, but with the recent increase in an immigrant foreign-born population, there is a serious risk of the spread of TB. The goal of the study was to look into U.S.-born vs. foreign-born populations among TB/HIV/homeless cases in the state of GA from 2014 to 2018. The quantitative study was performed using secondary …

Psychosocial Support During Pregnancy: A Narrative Inquiry Of Low-Income Unmarried Women In Iowa, Summer D. Parrott

Walden Dissertations and Doctoral Studies

Pregnant women who experience high levels of stress and who lack support are at higher risk for negative birth outcomes for themselves and their offspring including preterm labor, low birthweights, and a myriad of other short- and long-term health and behavioral consequences across the lifespan of the child. Unmarried or socioeconomically disadvantaged women lack the most common resources used to protect against the negative effects of stress during pregnancy. A research gap existed regarding the specific types of psychosocial support perceived by low-income unmarried women to be most beneficial at buffering their perceived prenatal stress. The ecological model and the …

Assessing The Risk Of Developing Liver Cancer Among Adults In The United States, Magbor Oben

Walden Dissertations and Doctoral Studies

The risk of developing liver cancer among adults in the United States remains asignificant threat due to an increasing prevalence of the disease. Despite the identification of some biological, environmental, and socioeconomic risk factors, uncertainty exists as to the role of sociodemographic factors. In this study, participants (N=27,804), age 18 and over, were assessed for liver cancer outcome specific to three factors liver disease, insurance coverage, and access to healthcare. With the person-centered care model as the framework, data from the 2016 National Health and Interview Surveys were subjected to the selection criteria and quantitatively analyzed using binary logistic regression. …

Primary Care Providers’ Perceptions Of Adolescent Friendly Health Services In Relationship To Adolescent Pregnancy, Jill Marie Ensminger

Walden Dissertations and Doctoral Studies

According to recent research, adolescent health continues to be a public health concern. The purpose of this qualitative research was to identify the perceptions of primary care providers regarding adolescent friendly health services and the relationship to adolescent pregnancy. The theoretical and conceptual framework used for this research included the social ecological model and the recommendations of the World Health Organization (WHO) for providing adolescent friendly health services. Using a phenomenological qualitative research approach, interviews were conducted over the telephone. Data analysis included hand coding with emerging themes and subthemes in relationship to each research question. The results of the …

Examining Clinicians' Perspectives Screening For Depression In Patients With Type 2 Diabetes Mellitus, Vickie Lavette Bland

Walden Dissertations and Doctoral Studies

The United States has a significant diabetes problem. This chronic disease affects the body physically and mentally. One of the emotional effects of diabetes is depression. Depression is often present in individuals with diabetes, chiefly in those with type 2 diabetes mellitus (T2DM). While depression is common in T2DM and can interfere with treatment adherence, clinician screening for depression in T2DM patients is low. The purpose of this study was to examine clinicians' attitudes, behaviors, and perceptions concerning screening patients with T2DM for depression. Through a qualitative case study approach centered on reasoned action theory, 3 physicians and 5 nurse …

Predictors Of Depression Screening Among Cancer Patients In U.S. Ambulatory Settings, Joseph Oluyinka Fawole

Walden Dissertations and Doctoral Studies

Depression is a common mental health comorbidity in cancer diagnoses, affecting 8-24% of cancer patients. Despite the high prevalence of depression among cancer patients, it is often unrecognized and untreated, thereby representing an enormous psychological distress source among the cancer patient population. The purpose of this study was to explore and establish the factors that predict depression screening among cancer patients in the ambulatory care setting in the United States. The health belief model guided the study. Secondary data from the National Ambulatory Medical Care Survey were analyzed to evaluate the predictors of depression screening in patients diagnosed with cancer. …

Carbon Dioxide And Particulate Matter Concentration On Hampton Roads Air Quality, Gregory Hubbard

OUR Journal: ODU Undergraduate Research Journal

Hampton Roads has been a maritime crossroads for the last 400 years. Industrialization has impacted the coastal region for the last 250 years. The expansion of the Port of Virginia in 2019 has created dense traffic in the region resulting in impacts to air quality. Two waste products that affect humans are particulate matter and carbon dioxide. Both respective emissions can cause adverse effects on humans, such as asthma, some lung cancers, and other respiratory distress. Scientists and health practitioners are studying the effects of particulate matter on human health. Hampton Roads, in particular, because of its unique location on …

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

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

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

Patient Engagement In Patient Portals In Appalachia Versus Surrounding Us Census Regions: An Analysis Of Hints (Health Information National Trends Survey) Data, 2017 - 2020, Heather Lea Tudor

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

OBJECTIVE: Those living in the Appalachian regions face more significant healthcare disparities than those in the US. Patient portals can decrease disparities and increase health outcomes and health literacy. The purpose of this study was to determine if those living in the Appalachian region were offered access to and used their patient portals differently than the surrounding US Census region. Additionally, we aimed to determine if there was a difference in reported reasons for non-use of patient portals.

METHODS: This was a descriptive study using data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) data (2017-2020) to …

Racial Disparities In Syringe Exchange Program Access In Kentucky, Ankur Bhargava

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

Non-white Kentuckians use syringe exchange programs (SEPs) at lower rates than white Kentuckians. This analysis begins by documenting this disparity and then explores several potential causes. Access to SEPs is limited by law as only health departments may operate them. Areas of the state in which SEPs face political opposition are therefore underserved. A consequence of this legal limitation is distance to a SEP may be a barrier to access. Analysis of publicly available data indicates non-white drug users in Kentucky are located closer to syringe exchange programs in urban areas but farther away in rural areas. Proximity to a …

The Witness Project In Whitehall, Oh, Freda Allyson Hucek

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

Abstract

The Witness Project (WP) is an evidence-based breast cancer screening intervention that will be implemented in Whitehall, Ohio, at three different churches by the Franklin County Health Department. The WP will target African American women 50-74 years old who are non-compliant with current United States Preventative Services Task Force (USPSTF) breast cancer screening recommendations. African American women face disproportionately higher mortality rates from breast cancer when compared to other racial and ethnic groups in the United States and in Whitehall. African American women are less likely to discuss breast cancer and preventive screening services within their community. The WP …

When Disparities Become Deadly: Spatial Differences In Pm2.5 Levels Within The City Of Pomona, California, Pauline Bekkers

Pomona Senior Theses

This thesis discusses the disparities in particulate matter concentrations between different neighborhoods in the city of Pomona, California, and explores the historical, political and social factors that have shaped these spatial patterns. I argue that urban growth patterns in Pomona, which are historically marked by race and class segregation as a consequence of past discriminatory housing practices, have led to the disproportionate concentrations of air pollutants in low-income, Latino communities in South Pomona.

Due to the absence of a local air quality monitoring system, there is a lack of information about and understanding of how poor air quality may be …

Parental Educational And Engagement Through Positioning And Play, Gaile E. Seay

Occupational Therapy Doctorate Capstone Projects

Background: This project is to increase the confidence of parents/caregivers via education about their infants that may not otherwise be provided by other health care professionals. This project also provides early intervention to the infants in efforts to facilitate their maximum development through proper positioning for sleeping and play. Purpose: The purpose of this project was a parental education class for parents/primary caregivers of babies ages 0-6 months. They were educated about their child’s development, and how to engage their baby through play and positioning for optimal cognitive, communication, and social-emotional development. This class and project sought to enhance parents’ …

The Occupational Depression Inventory—A Solution For Estimating The Prevalence Of Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We are concerned about researchers’ reliance on the burnout construct and the MBI-GS to estimate the prevalence of job-related distress. In this paper, we first describe some of the problems plaguing the burnout construct and its measures. Then, we present the Occupational Depression Inventory, a new instrument designed to help occupational health specialists get a clearer view of the mental health status of the workforce (Bianchi and Schonfeld, 2020).

Barriers And Facilitators To Pre-Exposure Prophylaxis Uptake Among Black Women: A Qualitative Analysis Guided By A Socioecological Model, Alexa B. D'Angelo, Leah N. Davis Ewart, Juline Koken, David Bimbi, Justin Brown, Christian Grov

Publications and Research

Background This study included Community Health Workers and their supervisors from HIV clinical care teams who participated in the Healthy Choices intervention program. Healthy Choices is a Motivational Interviewing-based intervention aimed at improving medication adherence and reducing alcohol use for adolescents and emerging adults ages 16—24 living with HIV. In this study, the intervention was “scaled up” for delivery by local HIV care providers in real-world clinic settings. Methods Providers (N = 21) completed semi-structured interviews (N = 29) about their experiences with intervention scale-up. Rigorous thematic analyses were conducted within discussions of barriers and facilitators of intervention implementation. Results …

Impact Of The 2018 European Drought On Microbial Groundwater Quality In Private Domestic Wells: A Case Study From A Temperate Maritime Climate, Jean O'Dwyer, Carlos Chique, John Weatherill, Paul Hynds

Articles

A significant volume of research over the past two decades has highlighted both direct and indirect links between climate change and groundwater quality. However, to date, few studies have sought to explore the relationship(s) between drought conditions and groundwater quality in i) private (unregulated) groundwater sources, or ii) temperate maritime climates not commonly prone to drought events. The Republic of Ireland (ROI) represents an appropriate case-study due to its’ high reliance on private groundwater supplies, and while the region is largely unaffected by climatological extremes, modelling studies indicate that drier summers and drought conditions will increase in frequency. Accordingly, the …

Digging Deeper: Improving Health Communication With Patients, Jennifer Ko, Miranda Steinkopf, Abby A. Kahaleh, Sharon Connor

Pharmacy Faculty Books and Book Chapters

At the end of this activity, students will be able to:

• Identify five theories and models that can be used to facilitate the patient-provider health communication process
• Describe opportunities to optimize communication with patients in healthcare settings
• Apply health communication theories within patient care, providing specific approaches and language to utilize

Optimizing Maternal, Newborn, And Child Health Outcomes Through Use Of Multidisciplinary 'Improve' Teams In Lesotho: Costing Component, Adebiyi Adesina, Rachael Linder, Lori Bollinger

HIV and AIDS

This study builds on the USAID-funded prevention of mother-to-child transmission service delivery program (IMPROVE) already being implemented by Elizabeth Glaser Pediatric AIDS Foundation in Lesotho. Rather than designing a suite of entirely new services and delivery platforms, the intervention (conducted under Project SOAR) focused on improving existing services and strengthening the connection between facility- and community-based care. This brief describes the approach and key quantitative findings of the costing component of the IMPROVE intervention from the service provider perspective.