Public Health Commons^™

Circumcision Status Is Not Associated With Condom Use And Prevalence Of Sexually Transmitted Infections Among Young Black Msm, Richard A. Crosby, Cynthia A. Graham, Leandro Mena, William L. Yarber, Stephanie A. Sanders, Robin R. Milhausen, Angelica Geter

Health, Behavior & Society Faculty Publications

This study investigated whether intact young Black MSM differed from their circumcised counterparts regarding condom use behaviors and perceptions and HIV/Chlamydia/gonorrhea. Young Black MSM completed a self-interview, including a pictorial item assessing circumcision status and measures of condom use. Twenty-seven percent of 388 participants reported not being circumcised. With one exception, no associations tested approached significance. The mean frequency of unprotected insertive anal sex for circumcised men was about twice as high compared to those intact (P = .04). Intact young Black MSM did not differ from circumcised men relative to prevalence of STIs (including HIV) or condom use behaviors …

Toxic Environmental Exposures And Kidney Health In Children., Darcy K. Weidemann, Virginia M. Weaver, Jeffrey J. Fadrowski

Manuscripts, Articles, Book Chapters and Other Papers

High-level exposures to a number of agents are known to have direct nephrotoxic effects in children. A growing body of literature supports the hypothesis that chronic, relatively low-level exposure to various nephrotoxicants may also increase the risk for chronic kidney disease (CKD) or accelerate its progression. In this review we highlight several environmental nephrotoxicants and their association with CKD in children and adolescents. We also discuss unique epidemiological challenges in the use of kidney biomarkers in environmental nephrotoxicology.

Developing Novel Machine Learning Algorithms To Improve Sedentary Assessment For Youth Health Enhancement., Gowtham Kumar Golla, Jordan A. Carlson, Jun Huan, Jacqueline Kerr, Tarrah Mitchell, Kelsey Borner

Manuscripts, Articles, Book Chapters and Other Papers

Sedentary behavior of youth is an important determinant of health. However, better measures are needed to improve understanding of this relationship and the mechanisms at play, as well as to evaluate health promotion interventions. Wearable accelerometers are considered as the standard for assessing physical activity in research, but do not perform well for assessing posture (i.e., sitting vs. standing), a critical component of sedentary behavior. The machine learning algorithms that we propose for assessing sedentary behavior will allow us to re-examine existing accelerometer data to better understand the association between sedentary time and health in various populations. We collected two …

Adverse Childhood Experiences, Support, And The Perception Of Ability To Work In Adults With Disability, Sophia Miryam Schüssler-Fiorenza Rose, Jessica G. Eslinger, Lindsey Zimmerman, Jamie Scaccia, Betty S. Lai, Catrin Lewis, Eva Alisic

Psychiatry Faculty Publications

Objective To examine the impact of adverse childhood experiences (ACEs) and support on self-reported work inability of adults reporting disability.

Participants Adults (ages 18-64) who participated in the Behavioral Risk Factor Surveillance System in 2009 or 2010 and who reported having a disability (n = 13,009).

Design and Main Outcome Measures The study used a retrospective cohort design with work inability as the main outcome. ACE categories included abuse (sexual, physical, emotional) and family dysfunction (domestic violence, incarceration, mental illness, substance abuse, divorce). Support included functional (perceived emotional/social support) and structural (living with another adult) support. Logistic regression was …

A Technology-Mediated Behavioral Weight Gain Prevention Intervention For College Students: Controlled, Quasi-Experimental Study, Delia Smith West, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Beth Sundstrom, Chelsea Larsen, Karen Magradey, Sara Wilcox, Heather M. Brandt

Faculty Publications

BACKGROUND: Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. OBJECTIVE: This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. METHODS: Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral …

National Trends In Off-Label Use Of Atypical Antipsychotics In Children And Adolescents In The United States, Minji Sohn, Daniela C. Moga, Karen Blumenschein, Jeffery C. Talbert

Pharmacy Practice and Science Faculty Publications

The objectives of the study were as follows: to examine the national trend of pediatric atypical antipsychotic (AAP) use in the United States; to identify primary mental disorders associated with AAPs; to estimate the strength of independent associations between patient/provider characteristics and AAP use. Data are from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. First, average AAP prescription rates among 4 and 18-year-old patients between 1993 and 2010 were estimated. Second, data from 2007 to 2010 were combined and analyzed to identify primary mental disorders related to AAP prescription. Third, a multivariate logistic …

The Behavioral Addiction Indoor Tanning Screener (Baits): An Evaluation Of A Brief Measure Of Behavioral Addictive Symptoms, Jerod L. Stapleton, Joel J. Hillhouse, Rob Turrisi, Katie Baker, Sharon L. Manne, Elliot J. Coups

ETSU Faculty Works

No abstract provided.

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Similarities And Differences In Sexual Risk Behaviors Between Young Black Msm Who Do And Do Not Have Sex With Females, Richard A. Crosby, Leandro Mena, Angelica Geter, Demarc Hickson

Health, Behavior & Society Faculty Publications

The objective of this study is to determine whether young Black MSM who also have sex with females report similar levels of sexual risk behaviors as those not having sex with females. YBMSM (N = 400) were recruited from an STI clinic, located in the Southern U.S. Men completed an audio-computer assisted self-interview and donated specimens for STI/HIV testing. Forty-three percent recently engaged in penile-vaginal sex. They were less likely to report having concurrent partners (P = .01), unprotected fellatio (P = .04), multiple partners as a bottom (P < .02), any unprotected anal sex as a bottom (P < .013), and any anal sex (P = .007). They were equally likely …

Urgent Care And Emergency Department Visits In The Pediatric Medicaid Population., Amanda Montalbano, Jonathan Rodean, Juhi Kangas, Brian R. Lee, Matt Hall

Manuscripts, Articles, Book Chapters and Other Papers

Background: Urgent care (UC) is one of the fastest growing venues of health care delivery. We compared clinical and cost attributes of pediatric UC and emergency department (ED) visits that did not result in admission.

Methods: Our study examined 5 925 568 ED and UC visits of children under 19 years old in the 2010 through 2012 Marketscan Medicaid Multi-State Database. Basic demographics, diagnoses, severity, and payments were compared. Between ED and UC visits, χ(2) tests were used for proportions and Wilcoxon rank-sum tests were used for continuous variables.

Results: The UC and ED had the same most common diagnoses. …

Demographic And Socioeconomic Factors Associated With Hpv Vaccination In Georgia’S South Central Health District, Sydney Ekeledo, Candace Best, Stephanie Norman, Jodi Bazemore, Jessica Smith Schwind

Journal of the Georgia Public Health Association

Background: Human Papillomavirus (HPV) subtypes are the primary cause of cervical cancer. Despite introduction of the HPV vaccine in 2006, vaccination percentages remain low across Georgia counties. The primary objective of this research was to conduct a descriptive epidemiological study of HPV vaccination coverage among individuals in the South Central Health District (SCHD) to provide guidance for targeted vaccination campaigns aimed at adolescents residing in rural communities.

Methods: Data from the Georgia Registry of Immunization Transactions and Services and AEGIS.net, Inc. were used to analyze demographic and socioeconomic factors associated with HPV vaccine uptake among individuals visiting county health departments …

Depressive And Anxiety Symptoms Predict Sustained Quality Of Life Deficits In Hiv-Positive Ugandan Adults Despite Antiretroviral Therapy: A Prospective Cohort Study., Amara E. Ezeamama, Makhabele N. Woolfork, David Guwatudde, Danstan Bagenda, Yukari C. Manabe, Wafaie W. Fawzi, Mary C. Smith Fawzi

Journal Articles: Epidemiology

The impact of psychosocial status at onset of antiretroviral therapy on changes in quality of life (QOL) and subjectively rated health (SRH) among adults on highly active antiretroviral therapy (HAART) in resource-limited settings is poorly understood. Therefore, we evaluate the association between stigma, anxiety, depression, and social support and change in QOL and SRH in HIV-infected Ugandan adults during an 18-month period.Psychosocial indicators were assessed at enrollment using structured questionnaires. QOL and SRH measures were assessed at months 0, 6, 12, and 18 using the Medical Outcomes Survey-HIV. Linear mixed models determined risk estimated differences in QOL and SRH in …

Development Of A Spirometry T-Score In The General Population, Sei Won Lee, Hyun Kuk Kim, Seunghee Baek, Ji-Ye Jung, Young Sam Kim, Jae Seung Lee, Sang-Do Lee, David M. Mannino, Yeon-Mok Oh

Preventive Medicine and Environmental Health Faculty Publications

Background and objective: Spirometry values may be expressed as T-scores in standard deviation units relative to a reference in a young, normal population as an analogy to the T-score for bone mineral density. This study was performed to develop the spirometry T-score.

Methods: T-scores were calculated from lambda-mu-sigma-derived Z-scores using a young, normal age reference. Three outcomes of all-cause death, respiratory death, and COPD death were evaluated in 9,101 US subjects followed for 10 years; an outcome of COPD-related health care utilization (COPD utilization) was evaluated in 1,894 Korean subjects followed for 4 years.

Results: The …

The Association Between Graduated Driver Licensing Laws And Travel Behaviors Among Adolescents: An Analysis Of Us National Household Travel Surveys, Motao Zhu, Peter Cummings, Songzhu Zhao, Thomas Rice

Faculty & Staff Scholarship

Background: Young novice drivers have crash rates higher than any other age group. To address this problem, graduated driver licensing (GDL) laws have been implemented in the United States to require an extended learner permit phase, and create night time driving or passenger restrictions for adolescent drivers. GDL allows adolescents to gain experience driving under low-risk conditions with the aim of reducing crashes. The restricted driving might increase riding with parents or on buses, which might be safer, or walking or biking, which might be more dangerous. We examined whether GDL increases non-driver travels, and whether it reduces total travels …

Social Disparities In Exposure To Point-Of-Sale Cigarette Marketing, Mohammad Siahpush, Evi A. Farazi, Jungyoon Kim, Tzeyu L. Michaud, Aaron Yoder, Ghada Soliman, Melissa Tibbits, Minh N. Nguyen, Raees A. Shaikh

Journal Articles: Epidemiology

While most ecological studies have shown that higher levels of point-of-sale (POS) cigarette marketing are associated with larger proportions of residents from lower socioeconomic and minority backgrounds in neighborhoods, there are no studies that examine individual-level social disparities in exposure to POS cigarette marketing among smokers in the United States. Our aim was to examine these disparities in a Midwestern metropolitan area in the United States. We conducted a telephone survey to collect data on 999 smokers. Cigarette marketing was measured by asking respondents three questions about noticing advertisements, promotions, and displays of cigarettes within their respective neighborhoods. The questions …

Effect Of Anthelminthic Treatment On Helminth Infection And Related Anaemia Among School-Age Children In Northwestern Ethiopia, Yonas Yimam, Abraham Degarege, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Information about improvements in the health status of population at-risk of helminth infection after anthelminthic treatment helps to evaluate the effectiveness of the large scale deworming program. The objectives of this study were to assess the impact of anthelminthic treatment on the prevalence and intensity of intestinal helminth infection, haemoglobin level and prevalence of anaemia among school-age children.

METHODS: A total of 403 children attending Tikur Wuha Elementary School in Jiga, northwestern Ethiopia were enrolled in this study between February and March 2011. Formol-ether concentration and Kato-Katz methods were used to examine stool for intestinal helminth infections at baseline …

Locations Of Physical Activity As Assessed By Gps In Young Adolescents., Jordan A. Carlson, Jasper Schipperijn, Jacqueline Kerr, Brian E. Saelens, Loki Natarajan, Lawrence D. Frank, Karen Glanz, Terry L. Conway, Kelli L. Cain, James F. Sallis, J E. Chapman

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To compare adolescents' physical activity at home, near home, at school, near school, and at other locations.

METHODS: Adolescents (N = 549) were ages 12 to 16 years (49.9% girls, 31.3% nonwhite or Hispanic) from 447 census block groups in 2 US regions. Accelerometers and Global Positioning System devices assessed minutes of and proportion of time spent in moderate to vigorous physical activity (MVPA) in each of the 5 locations. Mixed-effects regression compared MVPA across locations and demographic factors.

RESULTS: Forty-two percent of adolescents' overall MVPA occurred at school, 18.7% at home, 18.3% in other (nonhome, nonschool) locations, and …

Dog Walking Among Adolescents: Correlates And Contribution To Physical Activity., Jessa K. Engelberg, Jordan A. Carlson, Terry L. Conway, Kelli L. Cain, Brian E. Saelens, Karen Glanz, Lawrence D. Frank, James F. Sallis

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: To assess the association of dog walking with adolescents' moderate-to-vigorous physical activity (MVPA) and body mass index (BMI), and identify correlates of dog walking.

METHODS/DESIGN: Participants were 12-17year-olds (n=925) from the Baltimore, MD and Seattle, WA regions. Differences in accelerometer-assessed minutes/day of MVPA and self-reported BMI (percentile) were compared among adolescents (1) without a dog (n=441) and those with a dog who (2) did (≥1days/week, n=300) or (3) did not (n=184) walk it. Correlates of (1) dog walking (any vs. none) among adolescents with dogs (n=484), and (2) days/week of dog walking among dog walkers (n=300) were investigated. Potential …

An Ecological Approach To African American Adolescent Food Choices In Low Income Neighborhoods, Clarence E. Mcmillan

Walden Dissertations and Doctoral Studies

Childhood obesity remains prevalent among African American (AA) adolescents in low income neighborhoods with limited access to a variety of foods from stores. Guided by the ecological framework, the purpose of this study was to examine the impact of neighborhood stores on food choices, and physical activity among AA adolescents in a low income neighborhood. A quantitative research design with cross sectional primary and secondary surveys was used. Participants included 176 high school students and 42 store merchants. Data sources were the 2011 New Jersey Student Health Survey with core questions from the Youth Risk Behavior Survey and the Hmong …

Contraceptive Provision To Adolescent Females Prescribed Teratogenic Medications., Stephani L. Stancil, Melissa K. Miller, Holley Briggs, Daryl Lynch, Kathy Goggin, Gregory Kearns

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND OBJECTIVES: Rates of adult women receiving contraceptive provision when simultaneously prescribed a known teratogen are alarmingly low. The prevalence of this behavior among pediatric providers and their adolescent patients is unknown. The objective of this study was to describe pediatric provider behaviors for prescribing teratogens concurrently with counseling, referral, and/or prescribing of contraception (collectively called contraceptive provision) in the adolescent population.

METHODS: A retrospective review was conducted examining visits in 2008-2012 by adolescents aged 14 to 25 years in which a known teratogen (US Food and Drug Administration pregnancy risk category D or X) was prescribed. The electronic …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Cost Effectiveness Analysis Of Year 2 Of An Elementary School-Located Influenza Vaccination Program-Results From A Randomized Controlled Trial., Byung-Kwang Yoo, Sharon Humiston, Peter G. Szilagyi, Stanley J. Schaffer, Christine Long, Maureen Kolasa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: School-located vaccination against influenza (SLV-I) has the potential to improve current suboptimal influenza immunization coverage for U.S. school-aged children. However, little is known about SLV-I's cost-effectiveness. The objective of this study is to establish the cost-effectiveness of SLV-I based on a two-year community-based randomized controlled trial (Year 1: 2009-2010 vaccination season, an unusual H1N1 pandemic influenza season, and Year 2: 2010-2011, a more typical influenza season).

METHODS: We performed a cost-effectiveness analysis on a two-year randomized controlled trial of a Western New York SLV-I program. SLV-I clinics were offered in 21 intervention elementary schools (Year 1 n = 9,027; …

Sexual Health Education In Georgia: A Role For Reducing Sexually Transmitted Infections Among Adolescents, Madison L. Gates, Veronica Walker, Nancy C. Webb

Journal of the Georgia Public Health Association

Background: In Georgia, sexually transmitted infections (STIs) are a substantial health issue, particularly among young adults in vulnerable and minority populations. The United States Preventive Services Task Force recommends that sexually active adolescents and at-risk adults receive behavioral counseling and education in primary care settings, community organizations, departments of health, and schools.

Methods: The present approach used in Georgia for educating adolescents at high risk for STIs about these diseases was assessed. The data collected included standards for sexual health education, survey results from educators and students, and observations from a pilot study with adolescents detained by the juvenile justice …

The Effect Of Standard Dose Multivitamin Supplementation On Disease Progression In Hiv-Infected Adults Initiating Haart: A Randomized Double Blind Placebo-Controlled Trial In Uganda., David Guwatudde, Molin Wang, Amara E. Ezeamama, Danstan Bagenda, Rachel Kyeyune, Henry Wamani, Yukari C. Manabe, Wafaie W. Fawzi

Journal Articles: Epidemiology

BACKGROUND: Efficacy trials investigating the effect of multivitamin (MV) supplementations among patients on Highly Active Antiretroviral Therapy (HAART) have so far been inconclusive. We conducted a randomized, double blind, placebo controlled trial to determine the effect of one recommended daily allowance (RDA) of MV supplementation on disease progression in patients initiating HAART.

METHODS: Eligible subjects were randomized to receive placebo or MV supplementation including vitamins B-complex, C and E. Participants were followed for up to 18 months. Primary endpoints were: change in CD4 cell count, weight and quality of life (QoL). Secondary endpoints were: i) development of a new or …

The Effect Of An Antenatal Breastfeeding Intervention On Breastfeeding Self-Efficacy And Intention Among Inner City Adolescents, Jamie El Harit

Evidence-Based Practice Project Reports

According to Healthy People 2020, infants who are breastfed have improved nutritional, immunological, developmental, and social outcomes (USDHHS, 2014). Despite the benefits of breastfeeding and the focused international efforts to increase levels of breastfeeding, adolescents remain largely unaware and continue to have among the lowest levels of breastfeeding initiation (CDC, 2013; Spear, 2006). The purpose of this EBP project was to reduce the disparities of breastfeeding initiation by increasing breastfeeding self-efficacy and intention in an inner city specialty high school. Synthesis of the evidence demonstrated that needs-based, repeated antenatal education delivered by a lactation expert including breastfeeding peer counselor supports …

Comparison Of Individual And Pooled Urine Samples For Estimating The Presence And Intensity Of Schistosoma Haematobium Infections At The Population Level, Abraham Degarege, Berhanu Erko, Zeleke Mekonnen, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Bruno Levecke

Journal Articles: Epidemiology

BACKGROUND: There is a lack of cost-effective diagnostic strategies to evaluate whether mass drug administration (MDA) programmes to control Schistosoma haematobium progress as anticipated. The purpose of this study is to provide a proof-of-principle for examination of pooled urine samples as a strategy for rapid assessment of presence and intensity of Schistosoma haematobium infections at the population level.

METHODS: A total of 640 urine samples were collected from 520 school-aged children (520 at baseline and 120 at follow-up) during a clinical trial that was designed to assess the efficacy of praziquantel against Schistosoma haematobium infections in Ethiopia. Individual and pooled …

High School Teacher And Administrator Perceptions Of Student Health Promotion: An Exploratory Study, Sarah B. Conklin

Theses and Dissertations

The current study explored the high school health promotion environment with regards to physical activity, nutrition, and sedentary behaviors from the perspective of high school health and physical education teachers and administrators. Specifically, potential strategies for a prevention program to promote student physical activity participation and healthy eating, and decrease student sedentary time were explored.

Individual semi-structured interviews were conducted with physical education teachers to explore potential strategies to promote student health behaviors. Next, interviews were conducted with high school administrators to determine the feasibility of recommended strategies. Teachers and administrators in the current study expressed a need for strategies …

Age-Related Factors Influencing The Occurrence Of Undernutrition In Northeastern Ethiopia, Abraham Degarege, Elifaged Hailemeskel, Berhanu Erko

Journal Articles: Epidemiology

BACKGROUND: Undernutrition is a major public health problem on the globe particularly in the developing regions. The objective of the current study was to assess the prevalence of undernutrition in different age groups and examine the relationship of the disease to parasitic and socioeconomic factors among communities in Harbu Town, northeastern Ethiopia.

METHODS: Stool samples of the study participants were examined for intestinal helminth infections using the Kato-Katz method. Blood specimens were diagnosed for Plasmodium infection using CareStartTM Malaria Pf/Pv Combo test. The blood type was determined from blood samples using antisera A and antisera B. In addition, the height …

Prevalence Of Schistosoma Haematobium Infection Among School-Age Children In Afar Area, Northeastern Ethiopia, Abraham Degarege, Zeleke Mekonnen, Bruno Levecke, Mengistu Legesse, Yohannes Negash, Jozef Vercruysse, Berhanu Erko

Journal Articles: Epidemiology

In this study, the prevalence and intensity of Schistosoma haematobium infection was determined among school-age children living in the Middle and Lower Awash Valley, Afar Regional State of Ethiopia. Between February and May 2014, urine samples were collected from 885 school-age children (5-16 years of age) from the Middle (n = 632; 4 villages) and Lower (n = 253; 3 villages) Awash Valley. All samples were processed using urine filtration to detect and quantify S. haematobium eggs. In addition, a subset of the urine samples was tested for hematuria using a urine dipstick (n = 556). The overall prevalence was …

Youth Assault-Injury Variation Patterns And Their Dimensional Structure, Diana Faissal Wilkerson

Walden Dissertations and Doctoral Studies

Youth assault-injury is 1 of the 5 leading causes of adolescents' death in the United States. Despite public health efforts, the prevalence rates of youth assault-injury and almost all its risk factors have remained consistent in the past 10 years. The purpose in conducting this cross-sectional quantitative study using archival data of the Add Health Wave II in-home survey was to examine the underlying-multidimensional structure of youth assault-injury. Problem behavior theory (PBT) lens and a multidimensional model were used and a structural equation model was conducted to examine the relationships between 22 risk and protection variables, 3 unobserved latent factors, …