Community Health and Preventive Medicine Commons^™

Individual And Store Characteristics Associated With Brand Choices In Select Food Category Redemptions Among Wic Participants In Virginia, Qi Zhang, Chuanyi Tang, Patrick W. Mclaughlin, Leigh Diggs

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) often allows participants to redeem food benefits for various brands at different costs. To aid the program’s food cost containment efforts, it is important to understand the individual and store characteristics associated with brand choices. This study used the WIC Electronic Benefit Transfer (EBT) data for 239,062 Virginia WIC participants’ brand choices in infant fruits and vegetables (F&Vs) and whole grain bread in May 2014–February 2015, one of the first such data sets available in the U.S. for research purposes. Mixed effects logistic regression models were used to analyze …

The Social Income Inequality, Social Integration And Health Status Of Internal Migrants In China, Yanwei Lin, Qi Zhang, Wen Chen, Li Ling

Community & Environmental Health Faculty Publications

Background: To examine the interaction between social income inequality, social integration, and health status among internal migrants (IMs) who migrate between regions in China.

Methods: We used the data from the 2014 Internal Migrant Dynamic Monitoring Survey in China, which sampled 15,999 IMs in eight cities in China. The Gini coefficient at the city level was calculated to measure social income inequality and was categorized into low (0.2 < Gini <= 0.3), medium (0.3 < Gini <= 0.4), high (0.4 < x < = 0.5), and very high (Gini > 0.5). Health status was measured based upon self-reported health, subjective well-being, and perceptions of stress and mental health. Social integration was measured from four perspectives (acculturation and integration willingness, social insurance, economy, …

Assessment Of Current Occupational Safety And Health Regulations And Legislation In The Caribbean, Muge Akpinar-Elci, Myngoc Nguyen, Marvin Randall, Satesh Bidaisee, Omur Elci, Olaniyi Olayinka

Center for Global Health Publications

Neglecting occupational safety and health (OSH) can have adverse and even deadly consequences. While OSH is important in any nation, the issue is particularly concerning in developing countries, including ones in the Caribbean. The purpose of this study, which was carried out in 2012 and 2013, was to examine the reasons for an apparent fundamental lack of awareness of OSH in the Caribbean. We conducted a descriptive study, in which a questionnaire was administered, via telephone, to key policy-making representatives from six English-speaking Caribbean nations, in order to assess the current OSH environment in their countries. We also did a …

Physical Activity And Sedentary Behaviors In Urban Chinese Children: Grade Level Prevalence And Academic Burden Associations, Xihe Zhu, Justin A. Haegele, Yan Tang, Xueping Wu

Human Movement Studies & Special Education Faculty Publications

The objectives of this study were (a) to report grade level prevalence in physical activity and sedentary behaviors and (b) to examine academic burden associations with these behaviors. School-aged children (n = 48,118) reported their physical activity, perception of physical activity sufficiency, factors for activity insufficiency, homework hours, and screen time in a typical week. Data were analyzed using general linear models and logistic regression models of Complex Samples. Prevalence results showed that children had lower physical activity and lower screen viewing time, but higher homework time during transition grades (6th, 9th, and 12th) and high school years. Academic burden …

A Neighborhood-Wide Association Study (Nwas): Example Of Prostate Cancer Aggressiveness, Shannon M. Lynch, Nandita Mitra, Michelle Ross, Craig Newcomb, Karl Dailey, Tara Jackson, Charnita M. Zeigler-Johnson, Harold Riethman

School of Medical Diagnostics & Translational Sciences Publications

Purpose

Cancer results from complex interactions of multiple variables at the biologic, individual, and social levels. Compared to other levels, social effects that occur geospatially in neighborhoods are not as well-studied, and empiric methods to assess these effects are limited. We propose a novel Neighborhood-Wide Association Study(NWAS), analogous to genome-wide association studies(GWAS), that utilizes high-dimensional computing approaches from biology to comprehensively and empirically identify neighborhood factors associated with disease.

Methods

Pennsylvania Cancer Registry data were linked to U.S. Census data. In a successively more stringent multiphase approach, we evaluated the association between neighborhood (n = 14,663 census variables) and prostate …

Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling

Community & Environmental Health Faculty Publications

INTRODUCTION: Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China.

METHODS: Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Association Between Social Integration And Health Among Internal Migrants In Zhongshan, China, Yanwei Lin, Qi Zhang, Wen Chen, Jingrong Shi, Siqi Han, Xiaolei Song, Yong Xu, Li Ling

Community & Environmental Health Faculty Publications

Internal migrants are the individuals who migrate between regions in one country. The number of internal migrants were estimated at 245 million in China in 2013. Results were inconsistent in the literature about the relationship between their health statuses and social integration. The main difference exists on how to measure the social integration and whether health statuses of internal migrants improve with years of residence. To complement the existing literature, this study measured social integration more comprehensively and estimated the internal migrants' health statuses with varying years of residence, and explored the associations between the migrants' social integration and health. …

Pesticide Exposure In The Caribbean: A Case From Nutmeg Processing, Muge Akpinar-Elci, My Ngoc Thuy Nguyen, Satesh Bidaisee, Omur Cinai Elci

Community & Environmental Health Faculty Publications

Many developed countries around the world have implemented regulations to phase out or greatly restrict the use of pesticides. Pesticides are still utilized with minimal restrictions, however, in fumigating agricultural commodities in developing countries such as Grenada. This special report presents the case of a nutmeg factory worker in Grenada who worked with various pesticides including methyl bromide, magnesium phosphide (magtoxin), and aluminum phosphide (phostoxin) without the proper awareness and utilization of health and safety measures. The nutmeg factory worker later developed metastatic bladder cancer, which may have been triggered by a combination of individual risk factors along with long-term …

Caribbean Heat Threatens Health, Well-Being, And The Future Of Humanity, Cheryl C. Macpherson, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to …

An Exploratory Study Of Generational Differences In Health Information Seeking And Smoking Behaviors In Bulgaria, Iva Stoyneva

Communication & Theatre Arts Theses

Smoking is a serious global public health threat that causes more than 6 million deaths annually (WHO, 2013). Smoking is also the single, most preventable cause of death (CDC, 2014). According to a recent study, Bulgaria was ranked as one of onlyl 1 countries in the world, in which half of the adult male population smokes, as well as one of 11 countries in which more than one-quarter of the adult female population smokes. Research suggests that the most significant predictors of smoking behavior in Bulgaria were age and geographic location (Balabanova, Bobak & McKee, 1998). Contributing to these finings, …

Associations Between U.S. Adult Obesity And State And County Economic Conditions In The Recession, Qi Zhang, Rajan Lamichhane, Youfa Wang

Community & Environmental Health Faculty Publications

This study examines the association between state and county unemployment rates and individuals' body weight status during the latest recession in the U.S. We used the U.S. Behavioral Risk Factor Surveillance System (BRFSS) data in 2007, 2009 and 2011, which were collected from 722,692 American adults aged 18 or older. Overweight and obesity were defined as body mass index (BMI) ≥25, and ≥30, respectively. Multivariate linear and logistic regressions were applied to assess the association between BMI, risks of overweight and obesity, and state and county unemployment rates. State unemployment rates were negatively associated with individual BMI across years, while …

Measuring The Effectiveness Of The Leave No Trace Peak Program, Jennifer Miller, Eddie Hill, Amy Shellman, Ron Ramsing, Ben Lawhon

Human Movement Studies & Special Education Faculty Publications

The Leave No Trace Center for Outdoor Ethics developed the Promoting Environmental Awareness in Kids (PEAK) program to teach children the seven Leave No Trace principles. The purpose of this study was to assess the effectiveness of the PEAK program. A significant increase was found between the pre-test (M = 3.41, SD = .34) and the post-test (M = 3.61, SD = .36) with the post-test scores being significantly higher, F(1, 140) = 11.15, p<.01. No significant difference was found between the pre-test (M = 3.48, SD = .35), post-test (M = 3.63, SD = .35), and 8-month post-test (M = 3.38, SD = .41). The 8-month post-test indicated a drop in scores, though not statistically significant, below the pre-test. Results supported the PEAK program’s effectiveness, in the short-term, in teaching children the Leave No Trace principles. However, longer-term retention was not supported.

Vitamin D And Biomarkers Of Sex Steroid Hormones Are Non-Linearly And Inversely Related To All-Cause Mortality: Results From Nhanes Iii, Hind A. Beydoun, Shaker M. Eid, Hueiwang Anna Jeng, Alan B. Zonderman, May A. Beydoun

Community & Environmental Health Faculty Publications

Background: In men, hypovitaminosis D as well as high and low testosterone levels have been linked to adverse events, including death. A biological interaction has been previously suggested between vitamin D and androgens. In a cohort study using Third National Health and Nutrition Examination Survey data, we simultaneously investigated circulating vitamin D and biomarkers of sex steroid hormones as predictors of all-cause mortality.

Methods: Age-adjusted and fully-adjusted Cox regression models were constructed to estimate hazard ratios (HR) and their 95% confidence intervals (CI). Whereas the vitamin D sufficient group (25(OH)D3 ≥30 ng/ml) was selected as a referent, biomarkers of sex …

Identifying Environmental Health Priorities In Underserved Populations: A Study Of Rural Versus Urban Communities, M. C. Bernhard, M. B. Evans, S. T. Kent, E. Johnson, S. L. Threadgill, S. M. Becker

Community & Environmental Health Faculty Publications

Objectives- Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members' concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities: defined the term environment; their perceptions of environmental exposures as affecting their health; specific priorities in their communities; and differences in urban versus rural populations.

Study design- A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities.

Methods- A total of eight …

Victimization From Bullying Among School-Attending Adolescents In Grades 7 To 10 In Zambia, Seter Siziya, Emmanuel Rudatsikira, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background:

Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying.

Methods:

The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also …

Prevalence And Correlates For School Truancy Among Pupils In Grades 7-10: Results From The 2004 Zambia Global School-Based Health Survey, Adamson S. Muula, Emmanuel Rudatsikira, Olusegun Babaniyi, Peter Songolo, Seter Siziya

Community & Environmental Health Faculty Publications

Background

There are limited data on the prevalence and associated factors of truancy in southern Africa. Yet truancy should attract the attention of public health professionals, educators and policy makers as it may be associated with adolescent problem behaviours. The objectives of the study were to estimate the prevalence and determine correlates of school truancy among pupils in Zambia.

Findings

We used data collected in 2004 in the Zambia Global School-based Health Survey. Logistic regression analysis was conducted to identify factors associated with truancy. A total of 2257 pupils participated in the survey of whom 53.9% were male. Overall 58.8% …

Analyzing The Effects Of Policy Options To Mitigate The Effect Of Sea Level Rise On The Public Health And Medically Fragile Population: A System Dynamics Approach, Rafael Diaz, Joshua Behr, Anna Jeng, Hua Liu, Franceso Longo

VMASC Publications

A critical question related to climate change concerns to how rising sea level will affect underserved populations and medically fragile population in coastal zones and floodplains. As sea levels rise, coastal waters will regain near-tidal areas and co-mingle with human-made pollutants, resulting from decades of industrial and commercial activity. This poses potential threat and risks to public health and the environment. It is critical that decision makers will initiate a process of parsing resources to the mitigation and management of these issues. The purpose of this research is to model the inherent dynamics of this process and understand how near-term …

Decomposing The Intergenerational Disparity In Income And Obesity, Qi Zhang, Buhong Zheng, Ning Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Intergenerational disparity in income and health violates the norm of equal opportunity and deserves the attention of researchers and policy makers. To understand changes in intergenerational disparity, we created the intergenerational mobility index (IMI), which can simultaneously measure changes in income rankings and in health outcomes across two generations. We selected obesity as one health outcome to illustrate the application of IMI due to its severe health and financial consequences for society and the significant changes in the distribution of obesity across income groups. Although obesity has increased in all income groups in the last four decades, higher income groups …

Review Of The Multi-Level Factors Contributing To Fruit And Vegetable Consumption In The U.S., Qi Zhang, Liuliu Fu

Community & Environmental Health Faculty Publications

The consumption of fruits and vegetables (F&V) has a significant protective effect in reducing various cardiometabolic diseases. In recent years, the U.S. government has made a lot of effort to promote F&V consumption through different projects and programs, including the MyPyramid food guidance system supported by the USDA’s Center for Nutrition Policy and Promotion, and the Fruits & Veggies More Matters program (previously called the 5-A-Day for Better Health program), supported by the Centers for Disease Control and Prevention (CDC) and other public and private agencies. However, modest success has been achieved in promoting healthy diets among the American public. …

Alcohol Consumption In Lusaka Urban District, Zambia: A Population Based Survey, 2007, Selestine H. Nzala, Olusegun Babaniyi, Peter Songolo, Adamson S. Muula, Emmanuel Rudatsikira, Seter Siziya

Community & Environmental Health Faculty Publications

Alcohol use is an important preventable risk factor for several non-communicable diseases (NCDs) and injuries that is related to lifestyle choices. The objective of the study was to determine the prevalence of alcohol consumption and its correlates. A cross sectional study utilizing a WHO stepwise approach to surveillance of NCDs was conducted in Lusaka district, Zambia. Current alcohol consumption was defined as having consumed alcohol in the previous 30 days to the survey. Complex samples logistic regression was used to determine independent predictors. A total of 1928 individuals participated in the survey. A third of the participants were males and …

Prevalence Of Hypertension And Its Correlates In Lusaka Urban District Of Zambia: A Population Based Survey, Fastone M. Goma, Selestine H. Nzala, Olusegun Babaniyi, Peter Songolo, Cosmos Zyaambo, Emmanuel Rudatsikira, Seter Siziya, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background

Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia.

Methods

A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables.

Results

A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% …

Increasing The Use Of Booster Seats: A Community-Based Research Project, Michelle Gallina, Amanda Jones, Jane Kim, Habibullah Muhiddin, Natasha Singletary

OUR Journal: ODU Undergraduate Research Journal

The aim of this project was to increase booster seat usage and knowledge of booster seat safety by implementing population-based interventions in the community. To aid in accomplishing the goal, the nursing students utilized the performance of an educational puppet show, educational handouts, and aggregate height and age screening as the interventions. Pre and post tests data were obtained. As a result, there was an increase of the aggregates‟ desire to be in a booster seat. Nurses who take more action in a leadership role by implementing interventions based on the educational needs of the community increased booster seat awareness. …

A Benefits-Based Study Of Appalachian Trail Users: Validation And Application Of The Benefits Of Hiking Scale, Barbara Freidt, Eddie Hill, Edwin Gomez, Marni Goldenberg

Human Movement Studies & Special Education Faculty Publications

Lack of exercise has been linked to poor health issues (e.g., obesity) in American society. National (e.g., Appalachian Trail) and local trails are a potential resource for championing physical activity. To challenge sedentary lifestyle choices and promote more active ones, an understanding of the benefits perceived to be associated with physical and outdoor activities is needed. A total of 454 Appalachian Trail user surveys were collected. Validity analyses and reliability analyses showed the Benefits of Hiking Scale to be an accurate and consistent measure of the dimensions of recreation benefits. Within the improved condition dimension of Benefits, significant differences were …

The Cultural Production Of Health Inequalities: A Cross-Sectional, Multilevel Examination Of 52 Countries, Carol L. Mansyur, Benjamin C. Amick Iii, Ronald B. Harrist, Luisa Franzini, Robert E. Roberts

Community & Environmental Health Faculty Publications

In a 2001 report, the U.S. National Institutes of Health called for more integration of the social sciences into health-related research, including research guided by theories and methods that take social and cultural systems into consideration. Based on a theoretical framework that integrates Hofstede's cultural dimensions with sociological theory, the authors used multilevel modeling to explore the association of culture with structural inequality and health disparities. Their results support the idea that cultural dimensions and social structure, along with economic development, may account for much of the cross-national variation in the distribution of health inequalities. Sensitivity tests also suggest that …

Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

Childhood Obesity In Minority Populations In The United States, Qi Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Obesity became a public health crisis in the United States, which affects both adults and children.^1,2,24,25 Approximately 31% of U.S. children and adolescents aged 2-19 years were overweight or obese, and almost 17% were obese in 1999-2004.^3-5,24 Studies suggest that increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have contributed to the rising obesity epidemic among children.^6,21,28 Childhood obesity increased the risk of many diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension, stroke, and certain forms of cancers.⁷ It is important to …

Dental Hygienists' Contributions To Improving The Nation's Oral Health Through School-Based Initiatives From 1970 Through 1999: A Historical Review, Gayle B. Mccombs, Cynthia C. Gadbury-Amyot, Rebecca S. Wilder, Karen O. Skaff, Margaret Lappan Green

Dental Hygiene Faculty Publications

PURPOSE: The purpose of this literature review is to document the contributions dental hygienists have made over the past 3 decades to improve the nation's oral health. This historical review encompasses selected literature that acknowledged dental Hygienists' direct involvement in U.S. school-based or school-linked oral health programs from 1970-1999.

METHODS: Five researchers independently searched MEDLINE, PubMed, and other electronic databases to identify relevant literature for the years 1970-1999. The search aimed to locate articles authored by or that documented dental Hygienists' involvement as "service provider" in U.S. school-based oral health programs. For the purpose of this review, service provider was …

Oral Cancer Prevalence In Virginia, Karin C. Loftin, Michele Darby, Stacey Plichta, Sophie Thompson, Shreeram Kumar, Louis Abbey

Dental Hygiene Faculty Publications

Purpose. Oral and pharyngeal cancer affects 30,000 Americans a year and kills one fourth of those diagnosed. The primary risk factors for oral cancer are past or present cigarette and tobacco usage, and alcohol consumption in conjunction with tobacco use. Even though the prevalence of oral cancer is relatively low in the younger age groups, this group is most likely to benefit from intervention programs designed to change risky behavior such as smoking, and to prevent oral cancer in the later years. The goal of the study was to identify high-risk target areas for an oral cancer prevention program in …

Factors That Influence Mammography Use Of Community Health Workers, Cynthia M. Kratzke

Health Services Research Dissertations

Community health worker (CHW) interventions promote early detection of breast cancer and mammography use to help eliminate health disparities for minority and low-income women. Data trends show lower mammography use among this population although CHW interventions have been shown to promote mammography use. However, CHW interventions have not been tested sufficiently to examine the factors that influence mammography use of CHWs.

This cross-sectional study examined the factors that influence mammography use of CHWs and the relationship of self-efficacy, social norms, and mammography use of CHWs. The PRECEDE model served as the framework combining social factors, beliefs, attitudes, behaviors, and accessibility …