Community Health and Preventive Medicine Commons^™

Money Follows The Person (Mfp) Rebalancing Demonstration: A Work In Progress, Carol O'Shaughnessy

National Health Policy Forum

In recent years, federal and state policy efforts have expanded opportunities for people to live in home- and community-based settings rather than in nursing homes and other institutions. As part of the Deficit Reduction Act of 2005, Congress enacted the Money Follows the Person Rebalancing (MFP) program, a Medicaid demonstration to help people who need long-term services and supports (LTSS) transition from nursing homes and other institutions to their own homes or other community settings. The Patient Protection and Affordable Care Act of 2010 extended the program through September 30, 2016. Now in its eighth year of operation, MFP grants …

Beyond Basic Exercise Guidelines: Is Sitting Really The New Smoking?, Mary Stenson

Forum Lectures

The "Just Stand" movement has recently gained a foothold at CSB|SJU with the addition of sit-stand workstations in Clemens Library, Murray Hall, and several faculty and staff offices. Researchers have been studying "sitting disease," more formally termed sedentary physiology, for over a decade and have begun to conclude that simply meeting exercise guidelines is not enough to reduce risk for chronic diseases. An individual can be physically active and lead a sedentary lifestyle. The two are not mutually exclusive. The average American adult, even those who meet the general exercise guidelines, spends 55% of their waking hours sedentary. Sedentary behaviors …

Pain Interference Patterns, Catherine Ipsen, Tannis Hargrove, University Of Montana Rural Institute

Health and Wellness

Advocates for community participation and quality of life issues may benefit from a better understanding of how pain intensity and environmental barriers influence participation outcomes. Unfortunately, little evidence exists on how the interaction between personal factors (e.g., pain) and environmental factors (e.g., physical accessibility) influence participation. To address this gap, we studied Pain Interference Patterns (PIP) by collecting both longitudinal and ecological momentary assessment (EMA or real-time) data to explore these factors and outcomes. Through better understanding of these interactions, we hope to inform interventions, policy, and services that can promote full participation in community life. This fact sheet reports …

Chhs February 2014 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Effect Of A Liver Cancer Education Program On Hepatitis B Screening Among Asian Americans In The Baltimore-Washington Metropolitan Area, 2009-2010, Hee-Soon Juon, Sunmin Lee, Carol Strong, Rajiv N. Rimal, Gregory D. Kirk, Janice Bowie

Prevention and Community Health Faculty Publications

Introduction
Asian Americans have the highest incidence of hepatocellular carcinoma (HCC), the major form of primary liver cancer, of all ethnic groups in the United States. Chronic hepatitis B virus (HBV) infection is the most common cause of HCC, and as many as 1 in 10 foreign-born Asian Americans are chronically infected with HBV. We tested the effectiveness of a culturally tailored liver cancer education program for increasing screening for HBV among Chinese, Korean, and Vietnamese Americans residing in the Baltimore–Washington metropolitan area, from November 2009 through June 2010.

Methods
We used a cluster randomized controlled trial to recruit volunteer …

Emerging Challenges And Health System Capacity: The Case Of Non- Communicable Diseases In Pakistan; A Review, Mubashir Zafar, Muhammad Ashar Malik

Community Health Sciences

Background: Pakistan is facing double burden of disease and the contribution of mortality by non-communicable diseases has over numbered the communicable diseases. The focus of health system of Pakistan is inclined more towards communicable disease and maternal & child health. Therefore, there is a need to review health policy, health sector budgeting and health setup in order to meet the needs of healthcare in context of non-communicable disease.

Objective: To review the health system capacity to manage the emerging challenge of non-communicable diseases in Pakistan.

Methodology: A thorough literature search on PubMed and Google Scholar was done. Reports from W.H.O, …

Gently Clarifying The Application Of Horn’S Parallel Analysis To Principal Component Analysis Versus Factor Analysis, Alexis Dinno

Community Health Faculty Publications and Presentations

Horn’s parallel analysis (PA) is an empirical method used to decide how many components in a principal component analysis (PCA) or factors in a common factor analysis (CFA) drive the variance observed in a data set of n observations on p variables (Horn, 1965). This decision of how many components or factors to retain is critical in applications of PCA or CFA to reducing the dimensionality of data in analysis (as when compositing multiple scale items into a single score), and also in exploratory factor analysis where the different contributions of each factor to each observed variable help generate theory …

Assessing The Potential Impact Of State Policies On Community Health Centers’ Outreach And Enrollment Activities, Peter Shin, Jessica Sharac, Julia Zur, Carmen Alvarez, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

A Systematic Review Of Internet-Based Worksite Wellness Approaches For Cardiovascular Disease Risk Management: Outcomes, Challenges & Opportunities, Ehimen Aneni, Lara Roberson, Arthur Agatston, Theodore Feldman, Maribeth Rouseff, Thinh Tran, Khurram Nasir

All Publications

No abstract provided.

Perceptions Of Neighborhood Safety And Asthma Among Children And Adolescents In Los Angeles: A Multilevel Analysis, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

Background: Research examining the impact of neighborhoods on asthma has shown an increased interest in the role of the psychosocial environment. We examined the associations between various measures of neighborhood safety, individual and family characteristics, and asthma outcomes among children in Los Angeles. Methods: Multilevel logistic regression models were used to analyze data on 3,114 children across 65 neighborhoods from Wave 1 of the Los Angeles Family and Neighborhood Survey (2000 to 2002). Primary caregivers reported asthma outcome and all individual covariates; home environmental characteristics were observed by the interviewer. Results: In fully adjusted models, parents who reported their neighborhood …

Associations Between Human Papillomavirus And History Of Cancer Among Us Adults In The National Health And Nutrition Examination Survey (2003-2010), B. Liu, E. Taioli

Journal Articles

Background: Human papillomavirus (HPV) is an infectious agent that has been associated with human cancer. We have updated the U.S. population sero-prevalence using a large National Health and Nutrition Examination Survey (NHANES) sample of adults from 2003 to 2010, and have analysed the associations between HPV seropositivity and self-reported history of cancer. Methods: Four cross-sectional cycles (2003-2004, 2005-2006, 2007-2008, and 2009-2010) were used, for a total of 12 759 participants who had both cancer history and HPV serum information. Results: The sero-prevalences of HPV types 6, 11, 16, and 18 were 15.0%, 4.8%, 11.5%, and 4.1%, respectively. Females had significantly …

World Trade Center Disaster Exposure-Related Probable Posttraumatic Stress Disorder Among Responders And Civilians: A Meta-Analysis, B. Liu, L. H. Tarigan, E. J. Bromet, H. Kim

Journal Articles

The World Trade Center (WTC) disaster on September 11, 2001 was an unprecedented traumatic event with long-lasting health consequences among the affected populations in the New York metropolitan area. This meta-analysis aimed to estimate the risk of probable posttraumatic stress disorder (PTSD) associated with specific types of WTC exposures. Meta-analytical findings from 10 studies of 3,271 to 20,294 participants yielded 37 relevant associations. The pooled summary odds ratio (OR) was 2.05 (95% confidence interval (CI): 1.82, 2.32), with substantial heterogeneity linked to exposure classification, cohort type, data source, PTSD assessment instrument/criteria, and lapse time since 9/11. In general, responders (e. …

Hpv-Associated Lung Cancers: An International Pooled Analysis, C. Ragin, D. Gibbs, C. Koriyama, J. Koshiol, J. Sykes, S. W. Hee, J. Yokota, A. Zaravinos, E. Taioli

Journal Articles

Human papillomavirus (HPV) is the etiologic risk factor for cervical cancer. Some studies have suggested an association with a subset of lung tumors, but the etiologic link has not been firmly established. We performed an international pooled analysis of cross-sectional studies (27 datasets, n = 3249 patients) to evaluate HPV DNA prevalence in lung cancer and to investigate viral presence according to clinical and demographic characteristics. HPV16/18 were the most commonly detected, but with substantial variation in viral prevalence between geographic regions. The highest prevalence of HPV16/18 was observed in South and Central America, followed by Asia, North America and …

Smokefree Moms: A Qualitative Study For The Development Of A Text-Based Intervention For Smoking Cessation In Pregnant Women, Monika Lin, Lorien C. Abroms

GW Research Days 2014

No abstract provided.

Neighborhood Factors That Contribute To Alcohol Use And Loneliness In Hiv Positive Patients, Erica Kiernan, Eugene Dunne, Barbara Curbow, William Latimer

Public Health Collection

Background: Neighborhood factors contribute to substance abuse and increased health risk behavior. Alcohol use has adverse consequences as it may interfere with antiretroviral medication adherence. In addition, studies have shown that those who are HIV positive have decreased social network size, limited social support, and social isolation as well as decreased treatment adherence. It is hypothesized that participants with high neighborhood density of alcohol outlets combined with increased feelings of loneliness will be more likely to drink.

Methods: Participants included 85 patients from an HIV treatment clinic in Jacksonville. Interviewer-administered measures included the Alcohol Use Disorders Identification Test …

Healthy Kids Out Of School: Using Mixed Methods To Develop Principles For Promoting Healthy Eating And Physical Activity In Out-Of-School Settings In The United States., Sarah A. Sliwa, Shanti Sharma, William H. Dietz, Peter R. Dolan, Miriam E. Nelson, Molly B. Newman, Maya Rockeymoore, Christina D. Economos

Prevention and Community Health Faculty Publications

INTRODUCTION:

Widespread practices supporting availability of healthful foods, beverages, and physical activity in out-of-school-time (OST) settings would further obesity prevention efforts. The objective of this article was to describe principles to guide policy development in support of healthy eating and physical activity practices in out-of-school settings to promote obesity prevention.

METHODS:

The Institute of Medicine's L.E.A.D. framework (Locate Evidence, Evaluate it, Assemble it, and Inform Decisions) was used to identify practices relevant to children's healthful eating in most OST settings: 1) locate and evaluate information from a national survey of children's perceptions of healthful-food access; published research, reports, policies and …

Community Engagement As A Process And An Outcome Of Developing Culturally Grounded Health Communication Interventions: An Example From The Decide Project, Angela L. Palmer-Wackerly, Jessica Krok, Phokeng M. Dailey, Linda Kight, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Community engagement is a process often used in developing effective health communication interventions, especially in traditionally underserved cultural contexts. While the potentially positive outcomes of community engagement are well established, the communication processes that result in engagement with cultural groups are less apparent. The focus on the outcomes of engagement at the expense of describing how engagement occurs makes it difficult for methods to be improved upon and replicated by future studies. The purpose of the current manuscript is to illustrate the process of achieving community engagement through the development of a culturally grounded health communication intervention. We offer practical …

Revisiting The Hispanic Health Paradox: The Relative Contributions Of Nativity, Country Of Origin, And Race/Ethnicity To Childhood Asthma, M. Camacho-Rivera, I. Kawachi, G. G. Bennett, S. V. Subramanian

Journal Articles

This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9 % of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also …

Average Values And Racial Differences Of Neutrophil Lymphocyte Ratio Among A Nationally Representative Sample Of United States Subjects, B. Azab, M. Camacho-Rivera, E. Taioli

Journal Articles

Introduction: Several studies reported the negative impact of elevated neutrophil/lymphocyte ratio (NLR) on outcomes in many surgical and medical conditions. Previous studies used arbitrary NLR cut-off points according to the average of the populations under study. There is no data on the average NLR in the general population. The aim of this study is to explore the average values of NLR and according to race in adult non-institutional United States individuals by using national data. Methods: The National Health and Nutrition Examination Survey (NHANES) of aggregated cross-sectional data collected from 2007 to 2010 was analyzed; data extracted included markers of …

Distribution Of Human Papillomavirus Genotypes Among Hiv-Positive And Hiv-Negative Women In Cape Town, South Africa, A. C. Mcdonald, A. I. Tergas, L. Kuhn, L. Denny, T. C. Wright Jr.

Journal Articles

OBJECTIVE: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). METHODS: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17-65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid …

Association Between Systemic Inflammatory Markers And Serum Prostate-Specific Antigen In Men Without Prostatic Disease-The 2001-2008 National Health And Nutrition Examination Survey, A. C. Mcdonald, M. A. Vira, A. C. Vidal, W. Q. Gan, S. J. Freedland, E. Taioli

Journal Articles

No abstract provided.

Incidence Of Extended-Spectrum-Beta-Lactamase-Producing Escherichia Coli And Klebsiella Pneumoniae Isolates That Test Susceptible To Cephalosporins And Aztreonam By The Revised Clsi Breakpoints, C. S. Mcwilliams, S. Condon, R. M. Schwartz, C. C. Ginocchio

Journal Articles

The incidence of aztreonam and cephalosporin susceptibility, determined using the revised CLSI breakpoints, for extendedspectrum-beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae isolates was evaluated. Our analysis showed that results for aztreonam and/or> 1 cephalosporin were reported as susceptible or intermediate for 89.2% of ESBLproducing E coli isolates (569/638 isolates) and 67.7% of ESBL-producing K. pneumoniae isolates (155/229 isolates).

Do Hiv-Positive Women Receive Depression Treatment That Meets Best Practice Guidelines?, J. A. Cook, J. K. Burke-Miller, D. D. Grey, J. Cocohoba, C. L. Liu, R. M. Schwartz, E. T. Golub, K. Anastos, P. J. Steigman, M. H. Cohen

Journal Articles

This study addressed whether psychopharmacologic and psychotherapeutic treatment of depressed HIV+ women met standards defined in the best practice literature, and tested hypothesized predictors of standard-concordant care. 1,352 HIV-positive women in the multi-center Women's Interagency HIV Study were queried about depressive symptoms and mental health service utilization using standards published by the American Psychiatric Association and the Agency for Healthcare Research and Quality to define adequate depression treatment. We identified those who: (1) reported clinically significant depressive symptoms (CSDS) using Centers for Epidemiological Studies-Depression Scale scores of a parts per thousand yen16; or (2) had lifetime diagnoses of major depressive …

Comparative Definitions For Moderate-Severe Ischemia In Stress Nuclear, Echocardiography, And Magnetic Resonance Imaging, L. J. Shaw, D. S. Berman, M. H. Picard, G. W. Stone, R. Senior, J. K. Min, R. Hachamovitch, M. Scherrer-Crosbie, J. H. Mieres, P. S. Douglas, +19 Additional Authors

Journal Articles

The lack of standardized reporting of the magnitude of ischemia on noninvasive imaging contributes to variability in translating the severity of ischemia across stress imaging modalities. We identified the risk of coronary artery disease (CAD) death or myocardial infarction (MI) associated with >= 10% ischemic myocardium on stress nuclear imaging as the risk threshold for stress echocardiography and cardiac magnetic resonance. A narrative review revealed that >= 10% ischemic myocardium on stress nuclear imaging was associated with a median rate of CAD death or MI of 4.9%/year (interquartile range: 3.75% to 5.3%). For stress echocardiography, >= 3 newly dysfunctional segments …

Knowledge And Prevention Practices Before Breast Cancer Diagnosis In A Cross-Sectional Study Among Survivors: Impact On Patients' Involvement In The Decision Making Process, E. Taioli, G. R. Joseph, L. Robertson, S. Eckstein, C. Ragin

Journal Articles

Disparities exist in breast cancer knowledge and education, which tend to influence symptom interpretation and decision to seek screening/care. The present project describes a cohort of women's experiences, knowledge, and health behavior prior to and after a diagnosis of breast cancer. It also studies how knowledge and demographic factors are associated with level of involvement participants had in the treatment of their breast cancer. Women > 18 years who have been diagnosed and treated for breast cancer within 10 years were recruited in Pittsburgh, PA, through the Healthy People Cohort Registry, a database of volunteers from the community, and Brooklyn, NY, …

Leveraging Practice-Based Research Networks To Accelerate Implementation And Diffusion Of Chronic Kidney Disease Guidelines In Primary Care Practices: A Prospective Cohort Study, James W. Mold, Cheryl B. Aspy, Paul D. Smith, Therese M. Zink, Lyndee Knox, Paula Darby Lipman, Margot Krauss, D. Robert Harris, Chester Fox, Leif I. Solberg, Rachel Cohen

Family Medicine Faculty Publications

Background

Four practice-based research networks (PBRNs) participated in a study to determine whether networks could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices.

Methods

Motivated practices from four PBRNs received baseline and periodic performance feedback, academic detailing, and weekly practice facilitation for 6 months during wave I of the study. Each wave I practice then recruited two additional practices (wave II), which received performance feedback and academic detailing and participated in monthly local learning collaboratives led by the wave I clinicians. They received only monthly practice facilitation. The primary outcomes …

Long-Term Exposure To Traffic-Related Air Pollution And Progression Of Carotid Artery Atherosclerosis: A Prospective Cohort Study, W. Q. Gan, R. W. Allen, M. Brauer, H. W. Davies, G. B. J. Mancini, S. A. Lear

Journal Articles

Objectives Epidemiological studies have demonstrated associations between long-term exposure to traffic-related air pollution and coronary heart disease (CHD). Atherosclerosis is the principal pathological process responsible for CHD events, but effects of traffic-related air pollution on progression of atherosclerosis are not clear. This study aimed to investigate associations between long-term exposure to traffic-related air pollution and progression of carotid artery atherosclerosis. Setting Healthy volunteers in metropolitan Vancouver, Canada. Participants and outcome measures 509 participants aged 30-65years were recruited and followed for approximately 5years. At baseline and end of follow-up, participants underwent carotid artery ultrasound examinations to assess atherosclerosis severity, including carotid …

Psychosocial Correlates Of Gender-Based Violence Among Hiv-Infected And Hiv-Uninfected Women In Three Us Cities, R. M. Schwartz, K. M. Weber, G. E. Schechter, N. C. Connors, Y. Gousse, M. A. Young, M. H. Cohen

Journal Articles

Gender-based violence (GBV) is common among women with and at risk for HIV, yet little is known about the GBV associated psychological factors that could be modifiable through behavioral interventions. The current study examined the associations between some of these psychological factors (i.e., hopelessness, consideration of future consequences, self esteem), mental health symptoms, substance abuse, and GBV among a sample of 736 HIV-infected and sociodemographically similar uninfected participants in the Women's Interagency HIV Study (WIHS). Results indicated high rates of lifetime GBV among the sample (58%), as well as high rates of childhood sexual abuse (CSA) (22.2%). HIV-infected women were …

High-Risk Cervical Human Papillomavirus Infections Among Human Immunodeficiency Virus-Positive Women In The Bahamas, D. N. Dames, E. Blackman, R. Butler, E. Taioli, S. Eckstein, K. Devarajan, A. Griffith-Bowe, P. Gomez, C. Ragin

Journal Articles

BACKGROUND: High-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women. METHODS: One hundred sixty-seven consecutive, non-pregnant, HIV-positive females >/=18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients. RESULTS: Mean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value = 0.040). 78% (130/167) …

A Qualitative Study Of Rural Primary Care Clinician Views On Remote Monitoring Technologies, Melinda M. Davis, Jillian M. Currey, Sonya Howk, Molly R. Desordi, Linda Boise, Lyle J. Fagnan, Nancy Vuckovic

Community Health Faculty Publications and Presentations

Purpose: Remote monitoring technologies (RMTs) may improve the quality of care, reduce access barriers, and help control medical costs. Despite the role of primary care clinicians as potential key users of RMTs, few studies explore their views. This study explores rural primary care clinician interest and the resources necessary to incorporate RMTs into routine practice.

Methods: We conducted 15 in-depth interviews with rural primary care clinician members of the Oregon Rural Practice-based Research Network (ORPRN) from November 2011 to April 2012. Our multidisciplinary team used thematic analysis to identify emergent themes and a cross-case comparative analysis to explore variation by …