Community Health and Preventive Medicine Commons^™

The Ryan White Hiv/Aids Program, Jessamyn Taylor

National Health Policy Forum

This publication describes the basics of the Ryan White HIV/AIDS Program, the largest federal program solely focused on treating people living with HIV/AIDS in the United States. The program funds cities, states, and community-based organizations to provide primary care, prescription drugs, and support services to low-income, uninsured, and underinsured people living with HIV/AIDS.

Unmasking The Moving Threat: Reckless Driving, Borderline Personality Disorder, And The Impact On Motor Vehicle Accidents, Charlene Lam

Master of Public Health Program Student Publications

Background: Motor vehicle accidents (MVAs), a leading cause of mortality in the United States have an enormous impact on public health. Researchers contend that approximately 90% of all MVAs are, to some extent, a result of driver characteristics and behavior (Lewin, 1982). One of the least researched driver characteristics is psychiatric comorbidity, especially borderline personality disorder (BPD), a disorder that is characterized by impulsivity and emotional volatility.

Objective: The purpose of this study is to examine the relationship between BPD and driving citations.

Method: Using two measures for BPD, we surveyed a consecutive sample of patients who were being seen …

Changing Po2licy: The Elements For Improving Childhood Asthma Outcomes, Anne Rossier Markus, Meagan Lyon, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Childhood asthma is a serious and chronic health issue that affects one in seven U.S. children and their families, compromising their health and quality of life and placing a heavy financial burden on families as well as an enormous strain on the health care system. Treating, managing, and ultimately preventing and reducing the burden of asthma represents a critical test of the ability of the U.S. health system – health insurers, clinical care providers, and public health agencies – to work together. Our investigation found that, as a country, we already know enough to act and improve life for the …

The Medical Education Of Physicians, Jonathan Saxton

National Health Policy Forum

This background paper provides a descriptive overview of the process of education, licensing, certification, and continuing education involved in becoming and continuing to practice as a physician.

The Economic Stimulus: Gauging The Early Effects Of Arra Funding On Health Centers And Medically Underserved Populations And Communities, Peter Shin, Brian K. Bruen, Emily Jones, Leighton C. Ku, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

During times of economic crisis, community health centers and other health care safety net providers become even more vital to the communities they serve. The current downturn, with its high levels of unemployment and enormous impact on family incomes, carries major implications for health insurance coverage. The American Recovery and Reinvestment Act (ARRA), signed into law on February 17, 2009, provided slightly more than two billion dollars to community health centers for capital improvements, expansion (or retention) of personnel and services, and adoption of health information technology. All of these uses not only support health centers' mission to serve populations …

Culturally-Adapted And Audio-Technology Assisted Hiv/Aids Awareness And Education Program In Rural Nigeria: A Cohort Study, Ighovwerha Ofotokun, Jose Nilo G. Binongo, Eli S. Rosenberg, Michael Kane, Rick Ifland, Jeffrey L. Lennox, Kirk A. Easley

Faculty Articles

Background: HIV-awareness programs tailored toward the needs of rural communities are needed. We sought to quantify change in HIV knowledge in three rural Nigerian villages following an integrated culturally adapted and technology assisted educational intervention.

Methods: A prospective 14-week cohort study was designed to compare short-term changes in HIV knowledge between seminar-based education program and a novel program, which capitalized on the rural culture of small-group oral learning and was delivered by portable digital-audio technology.

Results: Participants were mostly Moslem (99%), male (53.5%), with no formal education (55%). Baseline HIV knowledge was low (< 80% correct answers for 9 of the 10 questions). Knowledge gain was higher (p < 0.0001 for 8 of 10 questions) in the integrated culturally adapted and technology-facilitated (n = 511) compared with the seminar-based (n = 474) program.

Conclusions: Baseline HIV-awareness was low. Culturally …

Birthweight And Natural Deaths In A Remote Australian Aboriginal Community, Wendy E. Hoy, Jennifer L. Nicol

Aboriginal Policy Research Consortium International (APRCi)

Objectives: To describe associations between birthweight and infant, child and early adult mortality from natural causes in a remote Australian Aboriginal community against a background of rapidly changing mortality due to better health services. Design, participants and setting: Cohort study of 995 people with recorded birthweights who were born between 1956 and 1985 to an Aboriginal mother in a remote Australian Aboriginal community. Participants were followed through to the end of 2006. Main outcome measures: Rates of natural deaths of infants (aged 0 to < 1 year), children (aged 1 to < 15 years) and adults (aged 15 to < 37 years), compared by birth intervals (1956–1965, 1966–1975 and 1976–1985 for infants and children, and 1956–1962 and 1963–1969 for adults) and by birthweight. Results: Birthweights were low, but increased over time. Deaths among infants and children decreased dramatically over time, but deaths among adults did not. Lower birthweights were associated with higher mortality. Adjusted for birth interval, hazard ratios for deaths among infants, children and adults born at weights below their group birthweight medians were 2.30 (95% CI, 1.13–4.70) ), 1.78 (95% CI, 1.03–3.07) and 3.49 (95% CI, 1.50–8.09), respectively. The associations were significant individually for deaths associated with diarrhoea in infants, with cardiovascular and renal disease in adults, and marginally significant for deaths from pulmonary causes in children and adults. Conclusion: The striking improvements in infant and child survival over time must be applauded. We confirmed a predisposing effect of lower birthweights on deaths in infants and children, and showed, for the first time, an association between lower birthweights and deaths in adults. Together, these factors are probably contributing to the current epidemic of chronic disease in Aboriginal people, an effect that will persist for decades. Similar phenomena are probably operating in developing countries.

Correlates Of Weight Concern And Control In A Hispanic College Student Sample., J. Blow, T. Taylor, Theodore Cooper, C. Redfearn

Selected Works Temporary Series

No abstract provided.

Consumer-Directed Health Insurance Vs. Managed Care: Analysis Of Health Care Utilization And Expenditure Incurred By Employees In A Rural Area, Cecilia M. Watkins, J. White, D. Duncan, D. Wyant, T. Nicholson, J. Khubchandani, C. Lakshminarayana

Public Health Faculty Publications

Consumer-Directed Health Plans (CDHPs) are proposed as an option to control healthcare costs. No research has addressed their applicability in rural settings. This study analyzes three years (2003–2005) of healthcare expenditure and utilization incurred by two employers and a national carrier providing data from a rural state, Kentucky. The study included two measures of expenditures (health care and prescription drugs) and three measures of utilization (physician visits, hospital admissions, and hospital inpatient days). In general, the CDHP successfully controlled the growth of medical costs. These findings suggest that CDHPs may be a viable alternative benefit structure for rural employers.

Assessment Of Support Service Needs Of Primary Caregivers Of Hiv And Aids Infected Children: A Review Of Literature And Suggestions For Practice, Barry Eneh

Master of Public Health Program Student Publications

Summary: With the advent of highly active antiretroviral treatment, routine screening and treatment options for pregnant women for perinatally acquired HIV and AIDS, infection is on dramatic decline in the U.S. In spite of the declines and the medical advances, primary and informal caregivers of infected children continue to face innumerable challenges with regard to the availability, access and utilization of non-medical supportive service care needs. HIV/AIDS continues to create unique challenges for infected children and the non-infected family caregivers at multiple levels; impacting their relationships, resources and resilience.

Objective: This literature review identifies and assesses the unique and critical …

Ua12/4 Stall Street Journal, Vol. 2, Wku Health Services

WKU Administration Documents

Broadsides developed by WKU Health Services to convey public health information in students in bathroom stalls. Incomplete run.

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

Environmental Influences On Pediatric Obesity: An Examination Of The 2007 National Survey Of Children's Health (Nsch), Donny Dunfee

Master of Public Health Program Student Publications

Obese children are more likely to become obese as adults; hence, they are at increased risk for a number of adult diseases. As with adult obesity, several variables contribute to the increasing prevalence of childhood obesity. The intent of this report is to illustrate the connection between childhood obesity and the social environmental interactions of populations. With the increasing prevalence of obesity in adults and children, healthcare and public health professionals view childhood overweight and obesity as one of the most serious public health concerns of our time. This research conducts a secondary analysis of the National Survey of Children’s …

Demographic Factors That Predict Cervical Cancer Screenings In Ohio Women With Disabilities, Shari Mae Martin

Master of Public Health Program Student Publications

Background: Cervical cancer screening (CCS) rates are lower for women with disabilities than for the general population. The purpose of this project was to describe cervical cancer screening rates in women with disabilities, living in Ohio, and explore the relationship of select demographic factors to cervical cancer screening participation.

Methods: A chart audit of 350 randomly selected women with disabilities, ages 20-80, enrolled in a statewide home care waiver program was completed.

Results: Less than half of the women (45.4%) had obtained a CCS within the last 3 years, compared to a rate of 82% for the general population of …

Diabetes Obesity-Wellness Opportunity Program (Dowop) Evaluation, Francis Banahene

Master of Public Health Program Student Publications

The aim of the study was to evaluate Diabetes Obesity - Wellness Opportunities Program (DOWOP) for overweight and obese adolescents aged eight to 14 years.

The study was conducted over 14 weeks at Victor J. Cassano, Sr. Health Center in Dayton, Ohio. Thirteen weekly nutrition, exercise and cognitive presentations were held. Cooking class was held on week thirteen. Participants completed food and activity diaries. The program sessions focused on healthy eating, increasing physical activity, decreasing sedentary behavior and supporting participants maintain healthy lifestyle.

Nurses recorded BMI and waist circumference at baseline, week 7 and week 14. Program administrators were interviewed …

2010 Community Benefit Annual Report: Redefining Pediatric Medicine One Child At A Time, Children's Mercy Hospital

Community Benefits

Fiscal year report on the community benefits provided by Children's Mercy Kansas City to the communities in the Kansas City region.

Gender Differences In Risk Behaviors Of Adolescents Enrolled In An Inner City Charter High School, Kimbra Dent

Master of Public Health Program Student Publications

Adolescents engage in health risk behaviors (Grunbaum, 2001). Persons engaging in high‐risk behaviors during adolescence have disproportionally poor health as adults (Grunbaum et al., 2003; Resnick et al., 1997). Adolescents comprise a target group for health promotion and education programs to establish healthy lifestyle choices that transcend into adulthood. The purpose of this descriptive research study was to identify, analyze, and compare the health interests and health risk behaviors between male and female inner city, adolescent, charter high school students. The study served as a needs assessment before a health promotion and education program was implemented into the high school. …

Barriers To Accessing Primary Dental Care For The Uninsured/ Underinsured Population In The City Of Cincinnati, Kiana R. Trabue

Master of Public Health Program Student Publications

Despite federal, state and local efforts to provide access to dental services to vulnerable populations such as the uninsured and underinsured, many people still do not receive adequate dental care. This study seeks to identify barriers to primary dental care in the City of Cincinnati. The Cincinnati Health Department (CHD) operates five safety net health centers which provide dental care for the citizens of the Cincinnati service area. Surveys conducted in these centers found that cost was the main reason individuals do not see the dentist regularly. Even in those with dental insurance cost was a major barrier, although most …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Correlates Of Weight Concern And Control In A Hispanic College Student Sample., J. Blow, T. Taylor, Theodore Cooper, C. Redfearn

Departmental Papers (Psych)

No abstract provided.

Prevention With Positives: How Do We Reach Them In The Community?, Avina Sarna, Jerry Okal, Stanley Luchters, Nzioki King'ola, Scott Geibel

HIV and AIDS

In the past, HIV prevention efforts have focused primarily on developing risk-reduction interventions for those presumed to be HIV-negative and therefore at risk of becoming infected with HIV. In recognition of the need for prevention among people living with HIV (PLHIV), programs have been initiated in Africa, but primarily in clinical settings for those who are on antiretroviral therapy (ART). There is little knowledge about how to reach those PLHIV not on ART, and therefore not in regular contact with the health system or with effective prevention messages. This diagnostic study aimed to address the gap in information on how …

Rapids Evaluation Final Report 2005-2009 Key Findings, Louis Apicella, Katie D. Schenk, Hena Khan

HIV and AIDS

RAPIDS (Reaching HIV/AIDS Affected People with Integrated Development and Support) is an intervention funded by the United States Agency for International Development (USAID), and is designed to mitigate the impact of HIV/AIDS in Zambia. The overall goal of RAPIDS is to improve the quality of life of Zambians affected by HIV and AIDS by expanding successful community-based models of home-based care and support to orphans and vulnerable children and people who are chronically ill, as well as through interventions targeting youth with livelihood opportunities and life-skills training, focusing on initiatives supporting abstinence and being faithful.

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. …

Mental Health And Substance Abuse Issues Among Native Americans Living On A Remote Reservation: Results From A Community Survey, Theodore W. Mcdonald, Mary E. Pritchard

Public and Population Health Faculty Publications and Presentations

The purpose of the study was to document the perceived and actual mental health and substance abuse issues of residents living on a remote reservation in the Northwestern United States. Surveys were completed by 138 Native Americans, who reported on mental health status and problems, perceptions of personal and community health issues on the reservation, and patterns of substance use and abuse (e.g., how often respondents use alcohol, what drugs present the most serious problems on the reservation). The respondents perceived their own mental health to be quite good. However, they reported that several mental health problems were prevalent in …

Rural Idaho Family Physicians’ Scope Of Practice, Ed Baker, David Schmitz, Ted Epperly, Ayaka Nukui, Carissa Moffat Miller

Public and Population Health Faculty Publications and Presentations

Context: Scope of practice is an important factor in both training and recruiting rural family physicians.

Purpose: To assess rural Idaho family physicians’ scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status.

Methods: A survey instrument was developed based on a literature review and was validated by physician educators, practicing family physicians and executives at the state hospital association. This survey was mailed to rural family physicians practicing in Idaho counties with populations of less than 50,000. Descriptive, bivariate and multivariate analyses were employed to describe and compare scope …

Hospital Evacuations: Historical Precedence And Modern Preparedness, Nicholas Squillace

Master of Public Health Program Student Publications

Objectives: The purpose of this research was to identify common problems encountered during hospital evacuations and how those problems are or should be addressed when creating a hospital evacuation plan.

Methods: Articles relating to hospital evacuations were retrieved from PubMed and CINAHL in addition to government websites and the Joint Commission on Accreditation of Healthcare Organizations. The articles collected were limited to within the last 20 years, from 1990 to 2010. Hospital plans were collected from search engines including Google and Yahoo. Moreover, a plan was obtained from a Dayton area hospital.

Results: Numerous instances of hospital evacuations that were …

The Relationship Between Body Image And Body Mass Index In Attendees At A Health Fair, Millie S. Olds

Master of Public Health Program Student Publications

The purpose of this study was to examine the relationship between body image and body mass index (BMI) in attendees at a health fair. BMI and body image was also compared between races, ages and genders. It was hypothesized that there would be discrepancies between perceived body image and weight status, as measured by BMI. Sixty-two participants at a health fair in Cincinnati completed a survey about perceived body image and had their height and weight measured and BMI calculated later. Results suggested a positive relationship between BMI and body image. Participants with a higher BMI identified themselves with a …

Unmet Medical Need Of Underserved Population In A Safety-Net Organization, Leslie Clem

Master of Public Health Program Student Publications

Background: Safety net providers serve a large proportion of America’s uninsured and low income population. The purpose of this study is to determine if differences in unmet medical needs exist between the provisional and clinic populations, age groups, and sex and race categories. This research study provides information about the population that receives services from Good Neighbor House, a non-profit social service organization in Dayton, Ohio.

Methods: GNH created a survey to assess the unmet medical need of their clients. The instrument contains questions about routine medical care, unmet medical care in the last 12 months, medical bills, and demographic …

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 …

The Healthy Food Slide Rule (Hfsr): A Nutrition Education Tool For Children, Elaine M. Long, Uwe Reischl, Barbara B. Abo

Public and Population Health Faculty Publications and Presentations

The Healthy Food Slide Rule (HFSR) is a new educational tool designed specifically for use by school children in grades 4-6. The HFSR teaches the importance of including the 5 food groups and the importance of complying with appropriate portion sizes as presented in MyPyramid.^{1, 2} The portion size information included in the HFSR combines the healthy eating and physical activity messages offered by MyPyramid for Kids.^{3, 4} The new tool can be easily incorporated into existing math lessons (weights, measures, and fractions), into language arts lessons, or into science lessons.⁵