Community Health and Preventive Medicine Commons^™

Approaches To Mental Illness In Madagascar: A Case For Reconciling Reason With Faith, Raisa Tikhtman

Independent Study Project (ISP) Collection

This paper expounds the shortcomings of the mental health provisions inherent in the current primary health care system in Madagascar in light of its limited accessibility to the Malagasy. Integrating traditional medicine with allopathic psychiatric care is proposed, with attention to prevailing Malagasy beliefs in spiritual possession as the basis for mental illness, in order to accommodate the discrepant worldviews espoused by physicians and their Malagasy patients that inhibit the efficacy of public mental health care. Through an integrated system based on the model piloted at the Clinique de Manongarivo in northwestern Madagascar, the financial, physical, and epistemological barriers that …

Systematic Examination Of Infant Size And Growth Metrics As Risk Factors For Overweight In Young Adulthood, Andrew O. Odegaard, Audrey C. Choh, Ramzi W. Nahhas, Bradford Towne, Stefan A. Czerwinski, Ellen W. Demerath

Population and Public Health Sciences Faculty Publications

Objective:To systematically examine infant size and growth, according to the 2006 WHO infant growth standards, as risk factors for overweight status in young adulthood in a historical cohort. Specifically, to assess: Whether accounting for length (weight-for-length) provides a different picture of risk than weight-for-age, intervals of rapid growth in both weight-for-age and weight-for-length metrics, and what particular target ages for infant size and intervals of rapid growth associate most strongly with overweight as a young adult.Patients/Methods:Data analysis of 422 appropriate for gestational age white singleton infants enrolled in the Fels Longitudinal Study. Odds ratios (OR) for overweight and obesity in …

An Ethical Analysis Of Incentives As “Nudges” Toward Better Health Outcomes: A Case Study Of Seva Mandir’S Immunization Program In Rural Udaipur, Julika Kaplan

Independent Study Project (ISP) Collection

Seva Mandir, a non-governmental organization working on tribal development issues in the Udaipur District of India, offers pregnant women and mothers one kilogram of lentils for every visit they make to the organization’s monthly immunization camps. This study assesses whether it is ethical to use incentive-based systems, as opposed to empowerment through health education, to “nudge” the rural poor in Udaipur toward immunization. The information presented in this study is based on twenty-nine interviews with pregnant women and mothers of children less than two years old conducted during six field visits to Seva Mandir’s immunization camps. Through data obtained from …

Impact Of Water And Sanitation And Health Education Interventions On Health And Hygiene Behaviors: A Study From A Northern Pakistani Village, Aysha Zahidie, Fauziah Rabbani

Community Health Sciences

Introduction: Water and sanitation interventions were delivered in the northern areas of Pakistan as a joint venture of the Aga Khan University and the Aga Khan Health Systems Oshikhandass Diarrhea and Dysentery Project (1989-96) followed by the Aga Khan Water, Sanitation, Health and Hygiene Studies Program (WSHHSP). Through these interventions water treatment plants, new pit latrines along with a component of health education were introduced. Objectives: To explore perceptions, knowledge and practices of inhabitants of Oshikhandass village in Gilgit related to water quality, latrine use and hand washing following the intervention. Methods: Through a cross-sectional study during June-July 2012, six …

Future Competencies Needed For The Direct Service Workforce, William Spears, Carla Clasen, Katherine L. Cauley

Population and Public Health Sciences Faculty Publications

The aging of the baby boom generation and health care policy changes represented by the Affordable Care act create challenges for the long term care industry in America. In 2011 the first of the baby boomers turned 65 years old. By 2030 a total of 78 million baby boomers, 19% of the population, will be 65 or more years old and eligible for Medicare (U.S. Census Bureau 2010). Discussions of potential health care worker shortages often focus on the need for more physicians and nurses to care for an aging population. These changes are putting pressure on long term care …

The Hispanic Paradox And Older Adults’ Disabilities: Is There A Healthy Migrant Effect?, Esme Fuller Thomson, Amini Nuru-Jeter, Dawn M. Richardson, Ferrah Raza, Meredeth Minkler

Community Health Faculty Publications and Presentations

The “Hispanic Paradox” suggests that despite rates of poverty similar to African Americans, Hispanics have far better health and mortality outcomes, more comparable to non-Hispanic White Americans. Three prominent possible explanations for the Hispanic Paradox have emerged. The “Healthy Migrant Effect” suggests a health selection effect due to the demands of migration. The Hispanic lifestyle hypothesis focuses on Hispanics’ strong social ties and better health behaviors. The reverse migration argument suggests that the morbidity profile in the USA is affected when many Hispanic immigrants return to their native countries after developing a serious illness. We analyzed data from respondents aged …

Tailoring A Physical Activity Promotion Program For A Rural Area, Gavin T. Colquitt, Moya L. Alfonso, Ashley Walker, Vanessa Dunmore

Community Health: Faculty Presentations (1993-2018)

Background/Purpose: VERBTM Summer Scorecard (VSS) has used social marketing to successfully promote physical activity for urban and suburban youth. The purpose of this study was to adapt the program to meet the needs of a minority, rural population.

Method: Qualitative marketing research methods including focus groups were used to gather data from parents (N = 12) and their children (N =12) in April 2012. A structured, open-ended focus group guide was developed specific to parents and youth and based on the social marketing framework. Marketing topics covered included Product, Price, Place and Promotion. Attention was given to testing two previously …

Using Photovoice In Pete Programs To Initiate Positive Change, Gavin T. Colquitt, Jody Langdon, Tony A. Pritchard, Starla Mccollum

Community Health: Faculty Presentations (1993-2018)

The purpose of this presentation will be to provide teacher educators with an overview of the Photovoice methodology and its potential utility in curricular change. The National Association for Sport and Physical Education’s ([NASPE], 2008) PETE standards state educators should allow diversity to drive instructional related decision-making. Photovoice, a participatory action research methodology, is a tool teacher educators can use to be responsive to the continuously changing contexts of public schools.

Conflict Situation For Health Care Workers: A Case Study Of The Occupational Challenges In Kasangati Health Centre Iv And Their Implications For Patient Care., Shannon Mcdowell

Independent Study Project (ISP) Collection

Many factors influence a country’s ability to provide quality health services for its people. Particularly, quality health care hinges upon the availability of properly trained and equipped health care workers (HCWs) to deliver effective care. Resource-strained countries committed to the Millennium Development Goals are confronting the reality that shortages and uneven distribution of HCWs threaten their capacities to encourage and establish healthy communities. A scarcity in HCWs is one challenge of public health initiatives and places stress on existing HCWs. Other challenges faced by HCWs severely affect performance, motivation, and overall care-giving ability.

This study aims to examine the particular …

Prevention Education Effects On Fundamental Memory Processes, Susan L. Ames, Marvin D. Krank, Jerry L. Grenard, Steve Sussman, Alan W. Stacy

CGU Faculty Publications and Research

This study evaluated effects of a key session from a nationally recognized drug abuse prevention program on basic memory processes in 211 high-risk youth in Southern California. In a randomized, between-subject design, the authors manipulated assignment to a Myth and Denial program session and the time of assessment (immediate vs. 1-week delay). The authors examined program decay effects on memory accessibility and judgment errors. Those participants exposed to the program session generated more myths and facts from the program than those in the control group, suggesting that even a single program session influenced students’ memory for program information and this …

Creating A Patient Navigation Model To Address Cervical Cancer Disparities In A Rural Hispanic Farmworker Community, Kristen Wells, Maria Rivera, Sara Proctor, Gloria Arroyo, Shalanda A. Bynum, Gwendolyn Quinn, John S. Luque, Marlene Rivera, Dinorah Martinez-Tyson, Cathy Meade

Community Health: Faculty Publications

This report describes the implementation of a pilot patient navigation (PN) program created to address cervical cancer disparities in a predominantly Hispanic agricultural community. Since November 2009, a patient navigator has provided services to patients of Catholic Mobile Medical Services (CMMS). The PN program has resulted in the need for additional clinic sessions to accommodate the demand for preventive care at CMMS.

Formative Research On Hpv Vaccine Acceptability With Latina Farmworkers, John S. Luque, Heide Castañeda, Dinorah Martinez Tyson, Natalia Vargas, Meade

Community Health: Faculty Publications

The purpose of this study was to identify the barriers and benefits to human papillomavirus (HPV) vaccination in a low-income, Latina farmworker population in central Florida. This study reports on formative qualitative research conducted on perceptions of benefits, barriers, costs, place, and promotion related to the HPV vaccine from surveys and interviews with a sample of 46 low-income, Latina farm workers and 19 health care workers serving this population. It was found that Latina farmworkers hold many misperceptions about the HPV vaccine and the potential links between HPV infection and cervical cancer. In addition, it was observed that HPV vaccination …

Ethics Of Clear Health Communication: Applying The Clean Look Approach To Communicate Biobanking Information For Cancer Research, Alexis Koskan, Mariana Arevalo, Gwen Quinn, Shalwea Noel-Thomas, John S. Luque, Kristen Wells, Cathy Meade, Clement K. Gwede

Community Health: Faculty Publications

Cancer innovations, such as biobanking technologies, are continuously evolving to improve our understanding and knowledge about cancer prevention and treatment modalities. However, the public receives little communication about biobanking and is often unaware about this innovation until asked to donate biospecimens. It is the researchers’ ethical duty to provide clear communications about biobanking and biospecimen research. Such information allows the public to understand biobanking processes and facilitates informed decision making about biospecimen donation. The aims of this paper are 1) to examine the importance of clear communication as an ethical imperative when conveying information about cancer innovations and 2) to …

Refinement Of An Educational Toolkit To Promote Cervical Cancer Screening Among Hispanic Farmworker Women In Southeast Georgia, Lisa C. Watson-Johnson, Jigar Bhagatwala, Claudia Reyes-Garcia, Andrea Hinojosa, Mondi Mason, Cathy Meade, John S. Luque

Community Health: Faculty Publications

Cervical cancer incidence and mortality continue to affect Hispanic women in the U.S. disproportionately. Our project sought to refine a cervical cancer intervention designed for use by community health workers, or promotoras, in rural southern Georgia. We collaborated with Hispanicpromotoras to refine a Spanish language educational flipchart featuring cervical cancer topic areas for use in screening promotion.

Formative Research On Perceptions Of Biobanking: What Community Members Think, John S. Luque, Gwendolyn P. Quinn, Francisco A. Montel-Ishino, Mariana Arevalo, Shalanda A. Bynum, Shalewa Noel-Thomas, Kristen J. Wells, Clement K. Gwede, Cathy D. Meade, Tampa Bay Community Cancer Network Partners

Community Health: Faculty Publications

Preparing healthy community members with timely communications prior to engaging them in a request to donate biospecimens promises to improve the experience of biobanking participation. To this end, a qualitative study was conducted to assess community member knowledge, attitudes, beliefs, and informational needs about cancer-related biospecimen collection in a large metropolitan area in southwest Florida. The study utilized purposive sampling techniques to recruit a total of 95 participants to participate in 12 focus groups, segmented by race/ethnicity and language preference (mixed race, African American only, and Spanish speaking) and age (18–29, 30–54, and 55 and older). Focus group interviews were …

Colostrum Avoidance, Prelacteal Feeding And Late Breast-Feeding Initiation In Rural Northern Ethiopia, Nikki Lynn Rogers, Jemilla Abdi, Dennis Moore, Sarah Nd'iangui, Linda J. Smith, Andrew J. Carlson, Dennis Carlson

Population and Public Health Sciences Faculty Publications

Objective

To identify specific cultural and behavioural factors that might be influenced to increase colostrum feeding in a rural village in Northern Ethiopia to improve infant health.

Design

Background interviews were conducted with six community health workers and two traditional birth attendants. A semi-structured tape-recorded interview was conducted with twenty mothers, most with children under the age of 5 years. Variables were: parental age and education; mother's ethnicity; number of live births and children's age; breast-feeding from birth through to weaning; availability and use of formula; and descriptions of colostrum v. other stages of breast milk. Participant interviews were …

A Silent Storm: Hepatitis C In Pakistan, Noureen Jiwani, Raisa B. Gul

School of Nursing & Midwifery

No abstract provided.

The Believe In All Your Possibilities Campaign: Updating A Social Marketing Campaign On A Shoe String Budget, Moya L. Alfonso, H. Woodcum, Sherri Reynolds, John S. Luque

Community Health: Faculty Presentations (1993-2018)

The purpose of this presentation is to provide participants with an understanding of how to revamp or refresh a brand on a limited budget using a case study approach. The ‘Believe in All Your Possibilities’ community-based prevention marketing campaign, which was targeted at reducing alcohol and tobacco use among middle school youth, was the result of a long term school-community-university partnership in Southeast Florida. This alcohol campaign has been continuously implemented for eight years. Encouraging evaluation results combined with recently acquired alcohol prevention funding served as the impetus for conducting research to determine if ‘Believe’: a) was still relevant to …

Substance Abuse In Georgia, The Burruss Institute Of Public Service And Research

Georgia Journal of Public Policy

In order to create a snapshot of substance use and abuse in Georgia, the Burruss Institute of Public Service and Research requested access to data from the National Survey on Drug Use and Health conducted on behalf of the Substance Abuse and Mental Health Services Administration (SAMHSA), a unit of the Department of Health and Human Services (HHS).  SAMHSA would not provide access to the raw data; instead, the Institute was given a series of tables with estimates of the average annual number of users of various substances among Georgians ages 12 and older between the years 2002 and 2008. …

Long-Term Effects Of Self-Control On Alcohol Use And Sexual Behavior Among Urban Minority Young Women, Kenneth W. Griffin, Lawrence M. Scheier, Bianca Acevedo, Jerry L. Grenard, Gilbert J. Botvin

CGU Faculty Publications and Research

High risk alcohol use and sexual behaviors peak in young adulthood and often occur in the same individuals. Alcohol use has been found to impair decision-making and contribute to high risk sexual activity. However, the association between alcohol use and risky sexual behavior may also reflect enduring individual differences in risk taking, sociability, self-control, and related variables. Both behaviors can serve similar functions related to recreation, interpersonal connection, and the pursuit of excitement or pleasure. The present study examined the extent to which high risk drinking and sexual behavior clustered together in a sample of urban minority young adult women, …

Ethical Issues In Global Health Education, David Barnard, T. Thuy Bui, Jack Chase, Evaleen Jones, Scott Loeliger, Anvar Velji, Mary T. White

Population and Public Health Sciences Faculty Publications

No abstract provided.

Increasing Cervical Cancer Screening In A Hispanic Migrant Farmworker Community Through Faith-Based Clinical Outreach, John S. Luque, Dinorah Martinez-Tyson, Talar Markossian, Ji-Hyun Lee, Rachel Turner, Sara Proctor, Janelle Menard, Cathy D. Meade

Community Health: Faculty Publications

Objective: Partnerships between academic medical centers and faith-based community organizations have been associated with increased screening rates in low-income minority women. We describe clinical outcomes of an outreach partnership between a cancer center and a faith-based outreach clinic offering gynecologic screening services in central Florida to increase cervical cancer screening adherence in a priority population of primarily Hispanic farmworker women.

Methods: Data sources included a retrospective chart review. This descriptive study examined patterns of cervical cancer screening behavior among the patient population of the faith-based outreach clinic.

Results: Findings suggest that among this group of patients, the demographic factors that …

Salud Es Vida: Development Of A Cervical Cancer Education Curriculum For Promotora Outreach With Latina Farmworkers In Rural Southern Georgia, Kristen J. Wells, John S. Luque, Branko Miladinovic, Natalia Vargas, Yasmin Asvat, Richard G. Roetzheim, Ambuj Kumar

Community Health: Faculty Publications

Methods: A systematic review was conducted to synthesize evidence from all prospective controlled studies on effectiveness of CHW programs in improving screening mammography rates. Studies reported in English and conducted in the United States were included if they: (i) evaluated a CHW intervention designed to increase screening mammography rates in women 40 years of age or older without a history of breast cancer; (ii) were a randomized controlled trial (RCT), case-controlled study, or quasi-experimental study; and (iii) evaluated a CHW intervention outside of a hospital setting.

Results: Participation in a CHW intervention was associated with a statistically significant …

Barbershop Communications On Prostate Cancer Screening Using Barber Health Advisers, John S. Luque, Brian M. Rivers, Clement K. Gwede, Maisha Kambon, B. Lee Green, Cathy D. Meade

Community Health: Faculty Publications

Objective: The authors report the outcomes of a community-based, barber health adviser pilot intervention that aims to develop customized educational materials to promote knowledge and awareness of prostate cancer (CaP) and informed decision making about prostate cancer screening (PCS) among a predominantly African American clientele.

Method: First, the authors implemented a series of learner verification processes with barbershop clients (n=15) to adapt existing CaP health promotion materials. Following intervention implementation in the barbershop, they conducted structured surveys with barbershop clients (n=40) to evaluate the intervention. Results: Findings from the posttest showed both a significant increase in barbershop clients' …

La Correlación Entre El Autoestima Y La Intención De Cambiar En Seis Ámbitos De La Vida De Un Fumador Adolescente., Aaron Picus

Independent Study Project (ISP) Collection

Background: According to a study in 2008 by the National Agency for the Control of Narcotics, 26.1% of Chilean adolescents between the ages of 12-18 had used tobacco at least once during the month of the study and 13% used tobacco daily. Even though smoking has negative health effects, many adolescents in Chile still smoke. Since the 1970s, low self-esteem has been proposed as a risk factor for the development of poor health behaviors. Recent investigations have shown that, when measured in the social, school, family, self-body image, sports and physical activity, and global realms of the life of an …

Las Percepciones De La Salud Mental Y Su Evolución, Rebecca Gourevitch

Independent Study Project (ISP) Collection

Background: Previous literature has identified a strong stigma against mental health patients in many parts of Latin America, which can serve as a deterrent to seeking help for mental health (Acuña 2005; López 2008; Vicente 2007). The resulting lack of attention to one’s mental health can not only exacerbate mental illnesses but also impede proper attention to one’s physical health (Prince 2007). Therefore, combating this stigma is an important step to improving the health of a population. Some of the most effective strategies for combating the stigma are education, social interaction, and integrating mental health services into primary care (López …

Athlete And Coach Knowledge, Attitudes, And Perceptions Of Sickle Cell Trait And National Collegiate Athletic Association Mandated Testing: Recommendations For Intervention, Raymona Holloway Lawrence

College of Graduate Studies: Theses & Dissertations

Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete …

Initial Assessment Of Community Midwives In Rural Pakistan, Abdul Wajid, Zubaida Rashid, Ali M. Mir

Reproductive Health

The goal of this Population Council study, funded by USAID through the Pakistan Initiative for Mothers and Newborns (PAIMAN) project, was to assess the potential of community midwifery services in rural Pakistan in order to provide necessary evidence for future decisions regarding the training, practice, and placement of community midwives (CMWs). The introduction of a new cadre of skilled birth attendants is significant, especially at a time when Pakistan is working toward achieving the Millennium Development Goals. The report makes the following recommendations: 1) opportunities for practical training should be followed meticulously; 2) selection criteria should be revised especially for …

Training Institutions For Community Midwives In Pakistan: An Initial Assessment, Zakir Hussain Shah, Momina Salim, Mumraiz Khan

Reproductive Health

This study focuses on the training of community midwives (CMWs) in Pakistan, to specifically look at the institutions providing CMW training to see what resources (both physical and human resources) they had available and how these resources were being utilized. This study served as an early evaluation of the trainings and upgrades by the PAIMAN project, to assess how their interventions fared, and provides documentation for future decisions regarding the management, training, and practice of CMWs in Pakistan. As Pakistan transitions from a country with a high level of home births to a country where most births take place in …

Process Evaluation Of Community Mobilization Activities, Zakir Hussain Shah

Reproductive Health

This report presents the findings of a process evaluation by the Population Council of community mobilization (CM) activities implemented under the PAIMAN project in Pakistan. PAIMAN developed a comprehensive communication, advocacy, and mobilization (CAM) strategy to increase knowledge and awareness of harmful practices among women and their family and to improve their health-seeking behaviors. The CAM roadmap acknowledges the importance of engaging communities in order to achieve behavior change and links clients with providers and services. The main objective of this evaluation was to assess the process of CM implementation and to identify its gaps in order to develop corrective …