Community Health and Preventive Medicine Commons^™

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 …

Comunicación Entre Personal Médico Y Pacientes Indígenas Un Estudio De La Medicina Intercultural En Huancarani, Cusco, Peru, Jordan Cahn

Independent Study Project (ISP) Collection

Esta investigación describe la relación entre personal médico y el paciente en un contexto intercultural. La ubicación del estudio es un centro de salud en la comunidad rural de Huancarani, Cusco, Perú. El personal médico viene de un perspectivo occidental y mayormente hablan castellano mientras que los pacientes son de orígenes indígenas y hablan quechua. El objetivo de la investigación es para observar la interacción intercultural entre el personal médico y los pacientes para determinar si las barreras culturales y preferencias para biomedicina o medicina tradicional infringen la calidad de servicios médicos. El personal médico prefiere la biomedicina y ve …

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 …

Homelessness: Causes, Culture And Community Development As A Solution, Kaitlin Philipps

Pell Scholars and Senior Theses

This thesis seeks to explain the reasons that homelessness occurs, and how it is currently being dealt with in public policy. Triggers and predictors of homelessness are explored and it is shown that triggers are almost always compounded, indicating a multitude of factors that lead to homelessness. The culture and community surrounding the homeless lifestyle is seen as playing a significant role in how the individual copes with their homelessness. The norms and values of their culture are investigated and its role in rehabilitation is explored. Current institutions for helping the homeless are analyzed for different success rates. Additionally, initiatives …

Design Of A Prostate Cancer Patient Navigation Intervention For A Veterans Affairs Hospital, Narissa J. Nonzee, June M. Mckoy, Alfred W. Rademaker, Peter Byer, Thanh H. Luu, Dachao Liu, Elizabeth A. Richey

Dartmouth Scholarship

Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP) aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA) hospital in Chicago.

Community Health Workers: A Front Line For Primary Care?, Lisa Sprague

National Health Policy Forum

Among the potential changes invoked in discussions on health system transformation, a need to revitalize primary care remains paramount. One way of doing this, most agree, is to move more in the direction of team-based care. Professionals such as physician assistants and nurse practitioners may be able to ease some of the physician’s clinical care load, but some populations also need help accessing services and basic health education in a familiar setting. Enter the community health worker (CHW), known by many titles and playing a variety of roles, who comes from the community he or she is serving and therefore …

Who Tended To Continue Smoking After Cancer Diagnosis: The National Health And Nutrition Examination Survey 1999-2008, Tung-Sung Tseng, Hui-Yi Lin, Sarah Moody-Thomas, Michelle Martin, Ted Chen

School of Public Health Faculty Publications

BACKGROUND: It has been estimated that there are approximately 12 million cancer survivors in the United States. Continued smoking after a cancer diagnosis is linked to adverse effects among cancer survivors on overall survival, treatment effectiveness, and quality of life. Little is known about who is more likely to quit smoking after his/her cancer diagnosis. The objective of this study is to evaluate factors associated with smoking cessation in cancer survivors, which to date has not been well studied. METHOD: The National Health and Nutrition Examination Survey (NHANES) 1999-2008 surveys were used in this study. A total of 2,374 cancer …

Are Dutch Patients Willing To Be Seen By A Physician Assistant Instead Of A Medical Doctor?, Luppo Kuilman, Roos M.B. Nieweg, Cees P. Van Der Schans, Jaap H. Strijbos, Roderick S. Hooker

Prevention and Community Health Faculty Publications

Background

The employment of physician assistants (PAs) is a strategy to improve access to care. Since the new millennium, a handful of countries have turned to PAs as a means to bridge the growing gap between the supply and demand of medical services. However, little is known about this new workforce entity from the patient’s perspective. The objective of this study was to assess the willingness of Dutch patients to be treated by a PA or a medical doctor (MD) under various time constraints and semi-urgent medical scenarios.

Methods

A total of 450 Dutch adults were recruited to act as …

Stubborn, Persistent, Dangerous C.Difficile Infections. Is Improvement Possible?, Sara Townsend

Master of Science in Healthcare Quality and Safety Capstone Presentations

C.difficile also known as C.diff or CDI has developed into a dangerous infection for the United States’ health care system. While much work has been done to improve C.diff rates, health care teams have not been successful in reducing C.difficile infections. Many studies have focused on the mode of transmission of C.difficle, yet there still is not consensus on understanding how this infection is spread. Bryn Mawr Hospital, a community hospital in the suburbs of Philadelphia, Pa, has struggled to improve their C.diff rates like their peers throughout the country. While their infection rates for C.diff are …

Effect Of Food Security And Federal Food Assistance Participation On Household Availability And Recorded Preschool Child Consumption Of Sugar Sweetened Beverages And 100% Fruit Juice, Katherine A. Yarbrough

Master's Theses

Sugar sweetened beverage consumption is on the rise in the United States, particularly among children. However, the impact of household food security and federal food assistance participation on beverage habits has not been extensively analyzed. This paper sought to fill the current gap in literature on household beverage availability and recorded preschool child consumption of sugar sweetened beverages (SSB) and 100% fruit juice based on food security levels and status of federal food assistance participation. For this thesis, SSB are beverages that have added sugar and include fruit drinks, sodas, sports drinks, syrups, flavored milks, and teas. Baseline data from …

Are Maternal Child Health Outcomes Affected By Adequacy Of Prenatal Care In Montgomery County, Oh?, Amy Rouse

Master of Public Health Program Student Publications

Background: Prenatal Care has been recommended by the World Health Organization for all pregnant women in order to improve health outcomes of the mother and the child. However, recommendations for the number of visits required to provide adequate health care and improve outcomes continue to be debated. Understanding if adequate prenatal care is improving maternal child outcomes is essential before making these recommendations. This research aims to determine if in Montgomery County, OH the adequacy of prenatal care influenced gestational age at birth, birth weight, breastfeeding rate, rate of cesarean sections, and smoking cessation rates.

Methods: De-indentified birth data was …

College Drinking: A Call To Physicians, Shawn Sorrel, Hatim A. Omar

Pediatrics Faculty Publications

The aim of this paper was to review literature related to prevalence of drinking on college campuses and current prevention practices targeting this population. This paper focuses on current data surrounding alcohol use and misuse. It further discusses strategies which have been successful to prevent alcohol abuse. Finally, it discusses the need for further research to determine the role of the physician in alcohol prevention at university student health services.

Utilization Of A Metabolic Syndrome Index In Evaluating The Life In Balance Lifestyle Intervention For Prevention Of Type 2 Diabetes Among Urban American Indians And Alaska Natives, Hongbin Jin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: A myriad of diabetes prevention programs modeled on the Diabetes Prevention Program (DPP) are carried out worldwide to fight against the current diabetes pandemic. The percentage of weight reduction is a widely used indicator to evaluate diabetes prevention programs. However, weight change alone may not fully reflect the efficacy of lifestyle intervention. A metabolic syndrome index is a promising novel scale for evaluation of diabetes prevention programs because it is a systematic, comprehensive, and stable indicator that reflects the metabolic risk reduction for diabetes and its complications at multiple levels and dimensions.

Methods: A total of 22 overweight and …

Identifying And Correcting Health Hazards In The Home: A Pilot Test Among Homes In Clark County, Nevada, Sabrina La Monica

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Nevada Healthy Homes Partnership (NVHHP) is collaboration between University of Nevada - Las Vegas (UNLV), the Southern Nevada Health District (SNHD), and other public and private housing authorities and health agencies throughout Clark County, Nevada. The primary mission of the NVHHP is to improve the health of Nevada residents, particularly those in disadvantaged communities, by identifying and addressing conditions in the home environment. For this study, a program created by the NVHHP, entitled "Nevada Healthy Homes" (hereafter, Healthy Homes) was piloted. Home health and risk assessments were conducted in 52 homes, with one or more interventions being provided to …

Missed Opportunities For Diagnosis And Treatment Of Diabetes, Hypertension, And Hypercholesterolemia In A Mexican American Population, Cameron County Hispanic Cohort, 2003-2008, Susan P. Fisher-Hoch, Kristina Vatcheva, Susan T. Laing, Monir Hossain, M Hossein Rahbar, Craig Hanis, H Shelton Brown, Anne R. Rentfro, Belinda M. Reininger, Joseph B. Mccormick

School of Mathematical & Statistical Sciences Faculty Publications

Introduction

Diabetes, hypertension, and hypercholesterolemia are common chronic diseases among Hispanics, a group projected to comprise 30% of the US population by 2050. Mexican Americans are the largest ethnically distinct subgroup among Hispanics. We assessed the prevalence of and risk factors for undiagnosed and untreated diabetes, hypertension, and hypercholesterolemia among Mexican Americans in Cameron County, Texas.

Methods

We analyzed cross-sectional baseline data collected from 2003 to 2008 in the Cameron County Hispanic Cohort, a randomly selected, community-recruited cohort of 2,000 Mexican American adults aged 18 or older, to assess prevalence of diabetes, hypertension, and hypercholesterolemia; to assess the extent to …

Carrs Surveillance Study: Design And Methods To Assess Burdens From Multiple Perspectives, Manisha Nair, Mohammed K. Ali, Vamadevan S. Ajay, Roopa Shivashankar, Viswanathan Mohan, Rajendra Pradeepa, Mohan Deepa, Hassan Mehmood Khan, Muhammad Masood Kadir, Zafar Fatmi, Srinath Srinath Reddy, Nikhil Tandon, Km Venkat Narayan, Dorairaj Prabhakaran

Community Health Sciences

Background: Cardio-metabolic diseases (CMDs) are a growing public health problem, but data on incidence, trends, and costs in developing countries is scarce. Comprehensive and standardised surveillance for non-communicable diseases was recommended at the United Nations High-level meeting in 2011.
Aims: To develop a model surveillance system for CMDs and risk factors that could be adopted for continued assessment of burdens from multiple perspectives in South-Asian countries.
Design: Hybrid model with two cross-sectional serial surveys three years apart to monitor trend, with a three-year prospective follow-up of the first cohort.Sites: Three urban settings (Chennai and New Delhi in India; Karachi in …

A Comparison Of Individual Versus Community Influences On Youth Smoking Behaviours: A Cross-Sectional Observational Study, Anna M. Adachi-Mejia, Heather A. Carlos, Ethan M. Berke, Susanne E. Tanski, James Sargent

Dartmouth Scholarship

Objectives: To compare individual with community risk factors for adolescent smoking. Design: A cross-sectional observational study with multivariate analysis.Setting: National telephone survey.Participants: 3646 US adolescents aged 13–18 years in 2007 recruited through a random digit-dial survey.

How The Supreme Court's Medicaid Decision May Affect Health Centers: An Early Estimate, Katherine J. Hayes, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The nation's federally funded health centers are the principal source of primary health care for medically underserved populations. In CY 2011, more than 1,200 health centers, operating in more than 8,500 urban and rural locations, served 20.2 million patients, 36 percent of whom were uninsured and 93 percent of whom had family incomes below twice the federal poverty level. Federal grants provide core support to health centers, but Medicaid represents the largest single health center financing mechanism, accounting for 39 percent of revenues. Medicaid revenue growth allows health centers to preserve their core grant funding to reach uninsured patients while …

Influence Of Obesity, Race And Gender On Cardiac Catheterization After Stress Testing, Robert Finkelhor

Journal of Health Disparities Research and Practice

Female gender and black race have been associated with lower use of cardiac resources however; these patients also have a higher prevalence of obesity. Therefore we determined their relation to cardiac catheterization after stress testing. Clinical characteristics were determined for all patients stress tested over one year at a safety-net, urban, teaching hospital. Subsequent cardiac catheterizations were identified. Univariate and multivariate analyses were performed to determine the factors associated with catheterization. 3644 patients underwent stress testing and 484 (13%) underwent cardiac catheterization. The population was 58% female, 33% black, 53% were obese and 32% lacked insurance. Obese patients were mostly …

A Mixed Methods Approach To Food Safety Knowledge, Beliefs And Practices In Hispanic Families With Young Children In Nebraska, Kristen M. Stenger

College of Education and Human Sciences: Dissertations, Theses, and Student Research

This mixed methods study addresses food safety for Hispanic families with young children in Nebraska. A convergent mixed methods design was used, where qualitative and quantitative data were collected in parallel, analyzed separately and then merged in analysis and interpretation. A quantitative food safety knowledge survey (n=90, 52 from focus groups, 38 from piloting the survey), was used to assess the FightBac!™ concepts: Clean, Separate, Cook, Chill, and two additional concepts: foods that increase risk, and groups at increased risk. Qualitative focus groups explored food safety handling beliefs and practices through the lens of the Health Belief Model. Focus groups …

Food Deserts And Their Association With Obesity And Diabetes In Ohio, Alexis Holmes, Detra Thompson

Master of Public Health Program Student Publications

Objective- The purpose of this study was to explore the association of food access, and availability, on prevalence of diabetes and obesity in Ohio census tracts designated as food deserts.

Methods- County and census tract-level data were combined from the USDA Food Environment Atlas and USDA Food Desert Locator respectively. Statistical analysis was conducted using IBM Statistical Package for Social Sciences (SPSS). Non-normally distributed variables were assessed using the Mann-Whitney nonparametric U-test and Spearman’s correlation coefficient. Significance was considered at the p

Results- The mean rate of obesity and diabetes in Ohio in food deserts are 29.5% and 10.7%, when …

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Racial Inequality In The Valuation Of Health Outcomes Expressed By The 1992 Acs Guidelines For Prostate Cancer Screening, C. A. Beam

Journal of Health Disparities Research and Practice

In 1992, the American Cancer Society (ACS) recommended annual screening for prostate cancer for men 50 and older using PSA. In this article, I introduce a method to use race and age-specific PSA accuracy data to evaluate differences in the valuation of outcomes by race and age that were expressed by the ACS guidelines. Using this new method, it can be concluded that the guidelines implied a 4-fold greater valuation was assigned to screening young white males with prostate cancer than the value that was assigned to young black males with cancer. Future implementation of guidelines for screening and testing …

Assessing Behavioral Health Risks, Health Conditions, And Preventive Health Practices Among American Indians/Alaska Natives In Nevada, Gwen Hosey, Shirley A. Llorens-Chen, Fares Qeadan, Daryl Crawford, Charlton Wilson, Wei Yang

Journal of Health Disparities Research and Practice

The 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was administered to American Indian/Alaska Native (AI/AN) adults in Nevada to determine whether health disparities exist between AI/ANs and the state’s general population. Results showed AI/ANs were 1.5 times more likely to smoke cigarettes, 3.5 times more likely to be exposed to secondhand smoke, 3.2 times more likely to lack leisure-time physical activity, 9.7 times more likely to report fair/poor health status, and 7.7 times more likely to have a disability. In addition, AI/ANs were more likely to have current asthma (OR=5.0) and diabetes (OR=1.8). AI/AN women were 4.8 times as …

Developing A Preference Assessment Tool For Use Among Minority And Low Literacy Primary Care Patients, Sarah T. Hawley, Maria Jibaja-Weiss, Partha Krishnamurthy, Sally W. Vernon, Natoshia Hebert, Robert Volk

Journal of Health Disparities Research and Practice

Incorporating patients’ preferences into healthcare decisions has been identified as one mechanism for reducing health disparities. Some research suggests that providers need to tailor medical recommendations to the preferences of their patients. Yet there are few tools to facilitate clarification of preferences for health services. This paper reports the process of testing an innovative preference elicitation technique—conjoint analysis—among minorities and low literacy patients using the example of colorectal cancer (CRC) screening. CRC screening exemplifies preference-sensitive healthcare as there exist several screening options. However, screening rates among minorities are low. Better methods for preference assessment could improve patient-provider communication and increase …

Concepts Of Health In Older Urban African American Women With Chronic Health Conditions: A Focus Group Study, Priscilla T. Ryder, Linda Ellis, Doshia Harris, Anita Ohmit, Kathleen M. Russell, Amber Scott

Scholarship and Professional Work – COPHS

The purpose of this report is to relate the findings of the study ‘Concepts of Health in Older Urban African American Women with Chronic Health Conditions.’ This investigation, undertaken at the request of the Indiana Minority Health Coalition, Inc. (IMHC) is collaboration between IMHC, Butler University College of Pharmacy and Health Sciences, and the community partner, the Black Nurses Association of Indianapolis, Inc. (BNA). The purpose of the study is to gain an understanding of the ways older African American women from medically underserved areas of Indianapolis characterize the various parts of the concept of health; how they understand and …

Perceptions Of The Food Shopping Environment Are Associated With Greater Consumption Of Fruits And Vegetables, Jonathan L. Blitstein, Jeremy Snider, W. Douglas Evans

Prevention and Community Health Faculty Publications

Objective

The present study examined whether characteristics such as quality, selection and convenience are associated with dietary intake of fruits and vegetables independent of perceived costs in an inner-city, low-income population.

Design

Secondary analysis of baseline data from a social marketing intervention designed to change household dietary practices among parents of 3- to 7-year-old children.

Setting

A community sample drawn from six low-income, primarily minority neighbourhoods in Chicago, IL, USA.

Subjects From the parent study, 526 respondents completed the baseline survey and were eligible for inclusion. Of this number, 495 provided complete data on sociodemographic characteristics, fruit and vegetable consumption, …