Community Health and Preventive Medicine Commons^™

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 …

Use Of The County Health Rankings By Local Health Departments In Florida, 2010 - 2011, Nancy L. Winterbauer, Bonita Sorensen, James B. Tidwell

Frontiers in Public Health Services and Systems Research

This paper describes how local health departments (LHDs) in Florida used the County Health Rankings over the first two years of their release (2010 – 2011). We surveyed LHD leadership to describe if, how and to what extent the Rankings were used by Florida’s 67 LHDs to improve the health of their communities and describe changes in use from the 2010 to the 2011 release. Our results indicate substantial use of the Rankings by Florida’s LHDs, particularly as applied to community health assessments, staff education, as a starting point for examining other indicators and databases, and in grant applications. From …

Changes In Latitudes, Changes In Attitudes: Fqhcs And Community Clinics In A Reformed Health Care Market, Jessamyn Taylor

National Health Policy Forum

The Patient Protection and Affordable Care Act of 2010 and the Supreme Court’s related decision have significantly shifted the health care landscape for safety net providers. Federally qualified health centers (FQHCs) are a mainstay of primary care for the uninsured and those with limited access to care. This paper focuses on the impact of health reform on FQHCs given the significant federal investment in them through grants, Medicaid, and Medicare reimbursement. Where noteworthy, the effect on non-FQHC community clinics is also discussed. The implications of Medicaid coverage expansions (or lack thereof in states that choose not to expand), Medicaid disproportionate …

Role And Effectiveness Of Community Health Workers Among Underserved Us Populations, Hibo H. Noor

Master of Public Health Program Student Publications

The role of the Community Health Workers (CHWs) in the health care system has great value both domestically and internationally. CHWs have training in healthcare; they are members of the community in which they serve. They have in depth understanding of the barriers to health care the community faces; they can speak the same language, and can promote and improve health status, quality of care and assist managing chronic disease. This paper focuses on the role and documented effectiveness of CHWs in terms of quality, health care services, cost health services, as well as health behaviors and knowledge about the …

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" …

Pilot Evaluation Of The Text4baby Mobile Health Program, William D. Evans, Jasmine L. Wallace, Jeremy Snider

Prevention and Community Health Faculty Publications

Background

Mobile phone technologies for health promotion and disease prevention have evolved rapidly, but few studies have tested the efficacy of mobile health in full-fledged programs. Text4baby is an example of mobile health based on behavioral theory, and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health, health care beliefs, practices, and behaviors in order to improve clinical outcomes. The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign.

Methods

We conducted a randomized pilot evaluation study. All participants were pregnant women first presenting for care …

Multisite Qualitative Study Of Primary Care Physicians’ And Midlevel Providers’ Self-Reported Practices And Perceptions About Maintaining Cognitive Health, Angela K. Hochhalter, Lucinda L. Bryant, Rebecca Hunter, Rui Liu, Daniela B. Friedman, Anna E. Greer, Joseph Sharkey, Swarna Reddy, Anthony J. Caprio, Sindy Mccrystle

All PTHMS Faculty Publications

To facilitate national efforts to maintain cognitive health through public health practice, the Healthy Brain Initiative recommended examining diverse groups to identify stakeholder perspectives on cognitive health. In response, the Healthy Aging Research Network (HAN), funded by the Centers for Disease Control and Prevention (CDC), coordinated projects to document the perspectives of older adults, caregivers of people with dementia, and primary care providers (PCPs) on maintaining cognitive health. Our objective was to describe PCPs’ perceptions and practices regarding cognitive health.

Jshp Hosts Region Iii Hiv/Aids Meeting August 2, 2012, Kate Cecil Ms

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Ambiguity, Ambivalence, And Apprehensions Of Taking Hiv-1 Pre-Exposure Prophylaxis Among Male Couples In San Francisco: A Mixed Methods Study, Parya Saberi, Kristine Elizabeth Gamarel, Torsten B. Neilands, Megan Comfort, Nicolas Sheon, Lynae A. Darbes, Mallory O. Johnson

Publications and Research

Objective: We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIVpositive) male couples’ PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple.

Design: Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants’ awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level …

Developing A Business Plan For Sustaining School Mental Health Services: Three Success Stories, Donna Behrens, Julia Graham Lear, Olga Acosta Price

Prevention and Community Health Faculty Publications

No abstract provided.

Lower Nutritional Status And Higher Food Insufficiency In Frail Older Us Adults, Ellen Smit, Kerri M. Winters-Stone, Paul D. Loprinzi, Alice M. Tang, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses …

Information On Small Populations With Significant Health Disparities: A Report On Data Collected On The Health Of Asian Americans In Massachusetts, Carolyn Wong, Hannah Hosotani, John Her

Institute for Asian American Studies Publications

An analysis of publicly available sources of data on Asian Americans in Massachusetts with recommendations on ways to improve this collection of data.

Our report begins with a discussion of the important issues of data collection and reporting and then discusses the particular challenges of collecting and reporting on data in Massachusetts. Profiles of major datasets based on records for administrative entities are presented such as the Massachusetts Cancer Registry, hospital discharges, MassHealth, and Medicare, and mortality and natality records. This is followed by a description of major datasets based on population surveys such as the Behavioral Risk Factor Surveillance …

Health Behaviour Changes After Diagnosis Of Chronic Illness Among Canadians Aged 50 Or Older, Jason T. Newsom, Nathalie Huguet, Pamela L. Ramage-Morin, Michael Joseph Mccarthy, Julie Bernier, Mark S. Kaplan, Bentson H. Mcfarland

Community Health Faculty Publications and Presentations

Changes in health behaviors (smoking, physical activity, alcohol consumption, and fruit and vegetable consumption) after diagnosis of chronic health conditions (heart disease, cancer, stroke, respiratory disease, and diabetes) were examined among Canadians aged 50 or older. Results from 12 years of longitudinal data from the Canadian National Population Health Survey indicated relatively modest changes in behavior. Although significant decreases in smoking were observed among all groups except those with respiratory disease, at least 75% of smokers did not quit. No significant changes emerged in the percentage meeting physical activity recommendations, except those with diabetes, or in excessive alcohol consumption, except …

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 …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Primary Care Survival Skills In An Age Of Reform, Therese M. Zink, Peter Harper, Nancy Arnston, Jean Jansen

Family Medicine Faculty Publications

The Triple Aim - improved outcomes/quality of care, improved patient experience, and reduced cost - is driving health care reform in Minnesota and nationally. Minnesota is among those states moving quickly to new payment models that reward practices for meeting these three goals and is gradually reducing payments based only on increased volume of services. Primary care is growing into a new leadership role to meet these new demands while managing the reality that full funding for population based care is developing more slowly than the rhetoric. There are many encouraging signs, including an expanding interest in primary care medical …

Deteriorating Access To Women's Health Services In Texas: Potential Effects Of The Women's Health Program Affiliate Rule, Leighton C. Ku, Lara Cartwright-Smith, Jessica Sharac, Erika Steinmetz, Julie Lewis, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Based on an earlier study and an in-depth analysis of five market areas, the authors find that Texas' plan to bar Planned Parenthood clinics from participating in the state Women's Health Program (WHP) would leave tens of thousands of women without a source of care, because Planned Parenthood clinics are the dominant WHP providers in those areas and other local family planning clinics lack the capacity to absorb a large number of additional patients.

Librarians Collaborate To Touch The Lives Of Patients Through Community Pediatricians, Keri Swaggart, Nancy Allen

Posters

MCMLA 2012 Annual Meeting Presentation

Trends In Condom Use Among Female Sex Workers In Andhra Pradesh, India: The Impact Of A Community Mobilisation Intervention, Jennifer T. Erausquin, Monica Biradavolu, Elizabeth Reed, Rebekah Burroway, Kim M. Blankenship

Prevention and Community Health Faculty Publications

Background

Community mobilisation interventions for HIV prevention among female sex workers (FSWs) aim to organise FSWs for collective action and challenge the structures of power that underlie HIV risk. Assessing intervention impact is challenging because the importance of direct individual exposure to intervention components may decrease over time as change occurs at social-normative, policy and other structural levels. In this paper, the authors examine changes over time in consistent condom use among FSWs in Rajahmundry, Andhra Pradesh, the location of a long-standing community mobilisation intervention.

Methods

The authors analyse cross-sectional data collected among FSWs at three time points (n=2276) using …

Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan

School of Nursing & Midwifery

Objectives: To assess and describe the experiences of those caring for hepatitis C patients in Karachi, Pakistan.

Methods: Using a qualitative approach, the study adopted a descriptive exploratory design for which 8 caregirers were selected through snowball sampling technique from different parts of Karachi. Data was collected between May and July 2010 through semi-structured interviews from the caregivers. The interviews were recorded on tape and were transcribed verbatim. The data was manually analysed for extracting themes and categories.

Results: The analyses of data led to one theme - \'deadly, dangerous, and devastating. Two associated categories could also be noted: \'perceptions …

El Dengue En Puerto López La Incidencia Y El Nivel De Conocimiento De La Gente Sobre Las Enfermedades Transmitidas Por Los Mosquitos, Mckenzie Momany

Independent Study Project (ISP) Collection

This study took place in Puerto López, Manabí, Ecuador and focuses primarily on the level of knowledge the townspeople have about dengue and how it is transmitted. It also looks at the incidence of dengue in the town and across neighborhoods. In order to carry out this study, I spent a month living in the coastal town of Puerto López and interviewed 50 townspeople – 10 in each of the five neighborhoods of Jonas Gonzalez, Miraflores, Luís Gencón, San Alejo, and the central neighborhood. Interviewees were questioned about their past history of dengue, as well as their knowledge of the …

Body Mass Index And The Risk Of Prostate Cancer, Daniel Lee Mcgee, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: This article presents cohort studies that use data from the National Health Information Survey from 1986 to 1994 and compares the effectiveness of Cox proportional hazards models that assume a linear relationship between body mass index (BMI) and the risk of prostate cancer with models that assume a J-shaped relationship. Methods and results: Our study found that for black males over 40 years of age, neither a linear nor a J-shaped relationship yielded a statistically significant model. With white males over 40 years, assuming a linear relationship did not yield a statistically significant model (P = 0.582). When we …

Accuracy Of Self-Reported Sun Exposure And Sun Protection Behavior, Joel J. Hillhouse, Robert Turrisi, James Jaccard, June K. Robinson

ETSU Faculty Works

The objective of this study was to compare the accuracy of self-reported skin cancer risk outcome measures proposed as standards by prevention experts to aggregated estimates of behavior from weekly diaries. Weekly electronic diaries of ultraviolet radiation (UVR) behaviors, initially validated by comparison with daily electronic diaries, were used to assess the accuracy of commonly used end-of-summer self-reported measures among 250 adults. Results revealed low biases, and good correspondence between simple open-ended self-reported estimates of days outside, hours outside, sunbathing days and hours, and days outside when not protected by either sunscreen, long-sleeved shirts, hats, or shade. Rating scale measures …

Is It Really Just All About Sex And Money? A Case Study Of Teenage Motherhood In The Village Of Kwaximba In The Valley Of A 1,000 Hills, Margaret Nelson

Independent Study Project (ISP) Collection

The aim of this learnership at the Valley Trust was to gain insight into why teenage girls in the Valley of the 1,000 Hills fall pregnant and what is the cost of early motherhood on the future of young women. Previous research of the province KwaZulu-Natal has revealed that teenage pregnancies are a large problem in school districts and restricting the future academic pursuits of teenage mothers. The learner worked alongside the Valley Trust in coordination with their outreach programs in the local villages of the Valley of a 1,000 Hills to learn fundamental and underlying reasons behind teenage pregnancy …

The Valley Trust: A Historical Review Of Food Security And Nutrition-Related Programs At A Health Promotion Non-Governmental Organization In The Valley Of A Thousand Hills, Kwazulu-Natal, Jeannine Garcia

Independent Study Project (ISP) Collection

The aim of this study is to provide an in-depth review and analysis of past and present programs focused on food security and nutrition at The Valley Trust, in the Valley of a Thousand Hills, KwaZulu-Natal. The Valley Trust is a socio-medical health promotion NGO that works to improve the health of the communities it serves through development, empowerment, and educational initiatives. The study will seek to provide an overview of the various activities The Valley Trust has engaged in over its long history related to improving the nutritional status of communities it influences.

Data was collected on the history …

Nutrition And Diabetic Management In Urban Kenya, Madeline Jackson

Independent Study Project (ISP) Collection

This Independent Study project sought to identify the changes in nutrition from the traditional Luo culture to the new urban setting and explore the management, perceptions and prevalence of Type II diabetes in an increasingly urban area. The focus was on Type II diabetes since the majority of disease burden stems from this acquired form of the diabetes. Through speaking with elderly community members and shadowing the first line diabetic treatment centers in Kisumu, an assessment of the relationship between changing nutrition and diabetic management showed numerous gaps in the system that will continue to increase unless something is done. …

The Development Of Hiv-Prevention Programs In Public Health Centers And Their Impact On Women: Opportunities For Changes In The City Of Buenos Aires - El Desarrollo De Programas De Prevención Contra El Vih Y Sus Impactos En Las Mujeres En El Primer Nivel De Atención. Oportunidades Por Cambios En La Ciudad De Buenos Aires., Anna Longo

Independent Study Project (ISP) Collection

The focus of my research is the implementation and continued efforts of HIV-prevention plans that are provided in primary care public health centers in the city of Buenos Aires. Much of the outline for these programs has been created and maintained by la Coordinación SIDA, a government-based AIDS group that works to organize and moderate public sector prevention efforts in the city. Public health centers are an effective channel through which HIV-prevention can be provided, due to the fact that they are often very integrated in their communities and tend to have a good sense of the social context that …