Community Health and Preventive Medicine Commons^™

The Role Of Relationship And Other Factors Associated With Condom Use Intention Among Young American Indian Men Ages 18 To 24 Years Old, Rebecca Dick, Elizabeth Rink, Kris Fourstar

Journal of Health Disparities Research and Practice

The purpose of this study was to investigate the heterosexual relationship factors that were associated with condom use intention for STI prevention in a purposive sample of American Indian men. The sample was drawn from the Fort Peck Reservations in northeastern Montana. The sample size included 122 American Indian men ages 18 to 24. The theory of planned behavior and interdependence theory provided the theoretical basis for the study. Seventy- seven percent of the young men reported being in a steady relationship with 60.3% agreeing that they were committed to maintaining their relationship with their current partner. Relationship duration and …

Perceptions Of Hiv Risk And Explanations Of Sexual Risk Behavior Offered By Heterosexual Black Male Barbershop Patrons In Brooklyn, Ny, Tonya N. Taylor, Michael A. Joseph, Kirk D. Henny, Angelo R. Pinto, Francis Agbetor, Brignel Camilien, Kim M. Williams, Ruth C. Browne, Marilyn White, Yolene Gousse, Humberto Brown, Raekiela D. Taylor, Tracey E. Wilson

Journal of Health Disparities Research and Practice

Objective: To describe HIV risk factors among adult heterosexual Black men recruited from four barbershops located in high HIV seroprevalent neighborhoods of Brooklyn, NY.

Methods: Data on HIV-risk related behaviors and other characteristics were collected from barbershop clients. All participants (n=60) completed brief risk assessments; and a subset (n=22) also completed focus groups and/or individual interviews.

Results: Of the subset of 22 men, 68% were US born, 59% had been in jail/prison, 32% were unemployed; and during the 3 months before the interviews, 68% reported at least two partners and 45% reported unprotected vaginal or anal sex with …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

Evaluation Of An Assertive Continuing Care Program For Hispanic Adolescents, Eric Strunz, Joanna Jungerman, Juliet Kinyua, Paula M. Frew

Environmental & Global Health Faculty Research

PURPOSE: This study evaluated an Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC) program targeting Hispanic adolescents at risk for substance abuse.

Socio-Economic And Cultural Determinants Of Health Care Services Utilization In Ghana, Vickita Akosua Antwiwaa Harvey

UNLV Theses, Dissertations, Professional Papers, and Capstones

The study examines the relationship between socio-economic and cultural determinants of health care service utilization in Ghana using Ghana Demographic and Health Survey (GDHS) 2008 data collected by Ghana Statistical Service (GSS) in which a two-stage sample design was used. The first stage involved a systematic sampling, with probability proportional to size, of 412 clusters using the 2000 Ghana Population and Housing Census as the sampling frame. At the second stage, systematic samples of 30 households from each cluster were selected, making a total of 12,360 sampled households. According to the GSS, data were not collected in some of the …

Application Of The Transtheoretical Model: Assessing Exercise Behavior In African Americans In A Church-Based Setting, Robin Marie White

UNLV Theses, Dissertations, Professional Papers, and Capstones

Sedentary behavior rates are higher among African-American men and women than in other American races and ethnicities, placing them at greater risk for chronic illness. Routine physical activity reduces the risk of chronic health problems such as: (a) overweight and obesity, (b) type 2 diabetes, (c) hypertension, (d) coronary artery disease, (e) stroke, (f) congestive heart failure, and (g) cancers. Assessment of African-Americans' exercise attitudes in a church-based setting may provide information with which to develop effective interventions to improve physical activity. This descriptive, cross-sectional study used components of the Transtheoretical Model (TTM) to assess whether any associations exist between …

Perspectives From Community-Based Doulas And Mothers: Neighborhood Context And Pregnancy, Dara D. Mendez, Jessica Burke, Jennifer Jones, Cynthia Salter

Journal of Health Disparities Research and Practice

Objectives: Limited research explores the potential pathways by which neighborhoods influence pregnancy or how community members conceptualize and interpret how neighborhood contexts and living environments influence pregnancy and birth.

Study Design: We applied participatory Concept Mapping and a series of focused discussions with community-based doulas and mothers.

Methods: We collaborated with a community-based doula program to investigate how mothers and community doulas perceived the neighborhood to influence reproductive health. We conducted a series of focused discussions including ‘Brainstorming’ to uncover key themes related to how neighborhood context influenced pregnancy, ‘Sorting and Rating’ of key themes in association with pregnancy and …

Internet Use For Health Information Among American Indians: Facilitators And Inhibitors, Melissa K. Filippi, Christina M. Pacheco, Charlotte Mccloskey, Rebecca Jeanne Crosthwait, Justin Begaye, Jb Kinlacheeny, Won S. Choi, K Allen Greiner, Christine M. Daley

Journal of Health Disparities Research and Practice

Our research team explored Internet use among a heterogeneous American Indian (AI) population to determine Internet use in relation to health information seeking behaviors. Participants examined an AI culturally-tailored tobacco website as an example to explain what they wanted in an AI Internet health site. Using community-based participatory research, we conducted 10 focus groups with non-college AI men and women (N=96), stratified by age (18-29, 30-49, and 50 and over) to better understand their perceptions of Internet use and health information needs. We found that Internet use varied greatly among all strata. Participants referenced WebMD^© more than any other …

Association Analysis Of Reported Attitudes And Culturally Competent Behavior Engagement Among Public Health Department Employees, Marla B. Hall Phd, Jeffrey J. Guidry Phd, E. Lisako Mckyer Phd, Corliss Outley Phd, Danny Ballard Phd

Journal of Health Disparities Research and Practice

Objective: The purpose of this research is to analyze the association of attitudes and beliefs on engaging in culturally competent behavior.

Design: Explorational case study of individuals employed within an urban public health department.

Participants: Employees (n=90) from four metropolitan clinical sites of an urban public health department located in the southwest region of the United States were solicited and recruited during a monthly staff meeting. This sample is representative of 84% of the total employees which is comprised of 107 individuals.

Main Outcome Measures: The Cultural Competence Assessment is designed to explore individual knowledge, feelings …

The Association Between Health Literacy And Diet Adherence Among Primary Care Patients With Hypertension, Jenny A. Hutchison Ms., Jan Warren-Findlow Dr., Michael Dulin Dr., Hazel Tapp Dr., Lindsay Kuhn

Journal of Health Disparities Research and Practice

This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between …

Developing An Action Learning Community Advocacy/Leadership Training Program For Community Health Workers And Their Agencies To Reduce Health Disparities In Arizona Border Communities, Kenneth A. Schachter Md, Mba, Maia Ingram Mph, Laurel Jacobs Drph, Mph, Hannah Hafter Mph, Jill Guernsey De Zapien Ba, Scott Carvajal Phd, Mph

Journal of Health Disparities Research and Practice

Community health workers (CHWs) make unique and important contributions to society. They serve as patient advocates, educators, and navigators in our health care system and a growing body of research indicates that they play an important role in the effective delivery of prevention and treatment services in underserved communities. CHWs also serve as informal community leaders and advocates for organizational and community change, providing valuable insiders' insights about health promotion and the interrelatedness of individuals, their community, its institutions, and the surrounding environment. Accion Para La Salud or Action for Health (Accion) is a CDC-funded community based participatory research (CBPR) …

Prevalence And Correlates Of Hiv-Risk Behaviors Among Homeless Adults In A Southern City, Kristen R. Morrell, Latrice C. Pichon, Theresa Chapple-Mcgruder, Jennifer M. Kmet, Amanda Chandler, Marvell L. Terry Ii

Journal of Health Disparities Research and Practice

This paper aims to describe the prevalence and correlates of HIV-risk behaviors among adults receiving transitional and emergency housing services in Memphis, Tennessee. A cross-sectional, interviewer-administered survey was conducted with a convenience-based sample (N=116) of homeless adults. Sex without a condom, sex while on drugs or drunk, and sex with an unknown person emerged as the three most prevalent HIV-risk behaviors. Sex while drunk or high on drugs was also assessed as a significant predictor for sex without a condom and sex with an unknown person. Multivariate logistic regressions revealed that mental health status, duration of homelessness, incarceration history, and …

Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice To Describe The Assets And Barriers To Sexual And Reproductive Health Among Latinos In North Carolina, Barbara Baquero, Shira Goldman, Florence Siman, Sadiya Muqueeth, Laura Villa-Torres, Eugenia Eng, Scott D. Rhodes

Journal of Health Disparities Research and Practice

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a …

Social Determinants Of Late Presentation To Hiv Care, Connie Leeper, Michael Mugavero, James Willig, Eric Chamot, Shatomi Kerbawy, Anne Zinski

Journal of Health Disparities Research and Practice

Background: In recent years, increased attention has shifted toward evaluating social determinants of health, and understanding how community, environment, and system factors affect health outcomes. HIV policies and guidelines emphasize the importance of earlier HIV diagnosis and presentation for care. This study evaluated the role of individual and community-level factors in late presentation to HIV care.

Methods: HIV-infected patients newly initiating outpatient HIV medical care at an academic medical center between 2005-2010 were included. Patients' self-reported addresses at their first clinic visit were geocoded using geographic information systems software to the appropriate United States census block group. Using …

Factors Which Predict The Use Of Active Transportation To School Among Children In Clark County, Nv, Sheila G. J. Clark

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Active transportation to school (ATS) shows promise for increasing activity levels in children, but prevalence and correlates vary widely in cities and regions with different barriers and supports for active travel. Classification of ATS users is a current issue in the field. The purpose of this study was to determine the prevalence of ATS use and develop a predictive model of ATS for the novel population of children enrolled in grades K-8 in Clark County School District, a large metropolitan school district in Southern Nevada. Methods: This study used a secondary data from the National Center for Safe Routes …

The Reduction Of Central Line-Associated Bloodstream Infections In Intensive Care Units Through The Implementation Of The Comprehensive Unit-Based Safety Program, Michael Andrew Basinger

UNLV Theses, Dissertations, Professional Papers, and Capstones

Central line-associated bloodstream infections (CLABSIs) are one of the most significant healthcare-associated infections (HAIs) in the Intensive Care Unit (ICU) setting resulting in increased lengths of stay, increased healthcare costs, and higher mortality rates (Institute of Healthcare Improvement [IHI], 2012). Evidence that CLABSIs are largely preventable has created opportunities for healthcare organizations to implement evidence-based bloodstream infection prevention practices to reduce or eliminate these infections (Lissauer, Leekisa, Prease, Thom, & Johnson, 2012). Other efforts to reduce CLABSIs include implementation of safety programs to improve the safety culture in ICUs (Lissauer et al., 2012). One program, the comprehensive unit-based safety program …

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

School of Public Health Faculty Research

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …

Factors Associated With Parental Decision Making And Childhood Vaccination, Zuwen Qiu-Shultz

UNLV Theses, Dissertations, Professional Papers, and Capstones

In order to better understand factors affecting immunization status, logistic regression was used to assess the association of various socio-demographic factors and whether parents would have their child immunized if not a state mandate. Factors included in the study were race, household income, number of children in the household, number of adults in the household, if the child had a primary provider, if the child had a health check-up in the last twelve months, and medical insurance status of the child. The combined Nevada Kindergarten Health Survey Result of 2009-2010 (Year Two) and 2010-2011 (Year Three) conducted by the Nevada …

Prevention Of Type 2 Diabetes In Urban American Indian/Alaskan Native Communities: The Life In Balance Pilot Study, Daniel C. Benyshek, Michelle Chino, Carolee Dodge-Francis, Toricellas O. Begay, Hongbin Jin, Celeste Giordano

Environmental & Global Health Faculty Research

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years; BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) < 6.4 percent (46 mmol/mol) participated in the program between April and December, 2011. Study participants completed a 16 week intensive lifestyle coaching intervention. In addition to obtaining qualitative data regarding opportunities and challenges of applying the lifestyle intervention for AI/AN participants in an urban setting, clinical data, including BMI, waist circumference, blood pres- sure, fasting blood glucose, and blood lipids (HDL, LDL and Triglycerides), were collected. Results: Only 12 of the 22 participants remained in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was ob- served in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.

The Effect Of Race/Ethnicity On The Age Of Colon Cancer Diagnosis, Matthew Katz, Maryann E. Parrish, Ellen Li, Yuanhao Zhang, Wei Zhu, Kenneth Shroyer, Roberto Bergamaschi, Jennie L. Williams

Journal of Health Disparities Research and Practice

ABSTRACT

BACKGROUND: Colorectal cancer is the third most commonly diagnosed cancer in the United States. Notably, racial/ethnic disparities exist in both incidence and mortality.

PURPOSE: The aim of this case study was to investigate the impact of race/ethnicity on age at diagnosis of colorectal cancer in a defined population in Suffolk County, NY.

METHODS: Data were retrospectively collected on race/ethnicity, health insurance status, age at diagnosis, stage at diagnosis, gender, smoking status, alcohol intake, tumor location, and body mass index for colorectal cancer patients with medical records in the Stony Brook University Medical Center database (2005-2011). Population-based data on Hispanic …

Evaluation Of The Childhood Blood Lead Screening Component Of The Southern Nevada Childhood Lead Poisoning Prevention Program, Melissa Breunig, Shawn Gerstenberger

Interdisciplinary Research Scholarship Day

The objective of this paper is to highlight the progress of the lead poisoning prevention program in Southern Nevada. Specifically, we present blood lead screening results for Clark County, Nevada from 2006 through 2011, and review the progress towards recommendations made by Rothweiler et al. for Nevada in 2007.7

Pre- And Post-Interrvention Perceptions Of Illness, Health, And The Home Environment Among Nevada Healthy Homes Participants, Michelle Ching, Shawn Gerstenberger

Interdisciplinary Research Scholarship Day

The Nevada Healthy Homes Partnership (NVHHP) is a collaborative program between the University of Nevada, Las Vegas (UNLV), Southern Nevada Health District (SNHD), Rebuilding Together (RBT), HELP of Southern Nevada, and other public/private housing authorities and health agencies in Southern Nevada.

Publications On Chronic Disease In Coal Dependent Communities In Central Appalachia, Susan Meacham, Phd, Suporn Sukpraput, Phd, Thomas Taber Oms I, Diana Metzger

Journal of Health Disparities Research and Practice

CONTEXT:

Agency and nonprofit reports have traditionally been the source of health information in Appalachia. Recently, publications have appeared in the literature associating coal mining, specifically mountain top mining, with numerous chronic health conditions spurring debate among environmental and industry interest groups. Publication quantity and quality were objectively assessed. This article reports on a literature review and analysis of publications on chronic disease in coal dependent communities in Appalachia.

OBJECTIVE:

To conduct a review and analysis of original, peer reviewed research publications on chronic health conditions in communities dependent on coal mining with a focus on central Appalachia and report …

2012 Southern Nevada Existing Conditions Report, Southern Nevada Regional Planning Coaltion, Lincy Institute, Unlv Urban Sustainability Initiative, Unlv School Of Community Health Sciences, Jennifer Pharr Phd, Courtney Coughenour

Lincy Institute Reports and Briefs

No abstract provided.

Formative Development Of A Culturally Appropriate Mammography Screening Campaign For Low-Income African-American Women., Kimberly D. Leeks, Ingrid J. Hall, C. Ashani Johnson-Turbes, Ngozi Kamalu, Yasmine Zavahir

Journal of Health Disparities Research and Practice

The purpose of this qualitative study was to conduct a formative evaluation of messages and materials to inform the development of a promotional, health campaign designed to increase breast cancer screening awareness and utilization among low-income, uninsured African American women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in Savannah and Macon, Georgia (GA). A priority of CDC is to understand why women eligible for screening through the NBCCEDP do not participate in NBCCEDP screening services as well as to identify effective strategies for increasing enrollment among NBCCEDP-eligible women who have never received breast cancer screening. As …

The Effectiveness Of Health Education Materials In Influencing Hiv Testing Behavior: The Unlv-Siphi Study, Rebecca Tsegay

UNLV Theses, Dissertations, Professional Papers, and Capstones

The UNLV-SIPHI (Sexual Health Internet-Based Public Health Intervention) Study focused on HIV prevention by improving HIV testing behavior through the development and dissemination of health education materials. The goal of the UNLV-SIPHI Study was to develop effective, custom-made HIV health education materials that promote the knowledge, intention and practice of HIV testing among UNLV students. The UNLV-SIPHI Study was conducted during Spring 2012 semester in selected UNLV undergraduate classes. An online quasi-randomized-control trial (RCT) was used to measure the difference in HIV testing behavior contributing factors among students exposed to the health education materials. Several nonparametric tests were used to …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …