Community Health and Preventive Medicine Commons^™

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

Journal of Health Disparities Research and Practice

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

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

Journal of Health Disparities Research and Practice

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

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

Journal of Health Disparities Research and Practice

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

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

Bedbugs Biting Back? A Multifactorial Consideration Of Bedbug Resurgence, Vanessa L. Abejuela-Matt

Journal of Patient-Centered Research and Reviews

Bedbugs, previously thought to be eradicated during the mid-20th century, have reemerged in the new millennium with unforeseen furor. Affected patients and families frequently present in primary care settings, not only with complaints of pruritus or rash, but with anxiety and shame regarding the condition. Changes in eradication techniques and resistance, as well as lack of reporting – from both patients and lodging institutions – have hindered control. The increased mobility of goods and the human population has provided further avenues for bedbug spread. While current literature thoroughly describes the clinical presentation of bedbugs and the increasingly problematic effects on …

How Will Public Health And Primary Care Come Together In Massachusetts?, Javier Crespo

Public Affairs Capstones Collection

The Patient Protection and Affordable Care Act aims to place public health and prevention practice closer to the clinical care delivery system by mandating basic preventive services and creating a national prevention plan. The Massachusetts health care system has a number of elements that can help foster closer linking of public health practices in the primary care setting. This research set out to examine whether the current healthcare system in Massachusetts will enable public health and primary care integration as intimated upon by the Affordable Care Act. This study will assess the current connection between public health and primary care …

Using Chipra Immunization Measures For Primary Care Quality Improvement: Leveraging Registry Data From The State Of Maine’S Immunization Information System To Calculate Practice-Level Quality Measures, Kyra Chamberlain

Muskie School Capstones and Dissertations

This report describes key challenges and successes of a federally-funded, cross-organizational effort to use registry data from the State of Maine’s Immunization Information System to calculate childhood and adolescent immunization measures in support of a nine-month, multi-practice learning collaborative which resulted in significant increases in immunization rates and adoption of recommended immunization-related office system procedures. Also highlighted are lessons learned about promoting the use of standardized immunization measures for quality improvement (QI), supporting primary care practices in using and understanding data for QI activities, and emphasizing the value of public-private collaboration in achieving shared goals.

A New Brief Scale To Assess Suicidality: Scale For Impact Of Suicidality-Management, Assessment And Planning Of Care (Sis-Map- Brief Scanner), Amresh Srivastava, Megan Johnston, Miky Kaushal, Robbie Campbell, Charles Nelson

Data and Test Instruments

Purpose: In this study we examine merit of a short version (Brief Interview Screener (SIS-MAP-scn )of a previously developed and validated 108 item scale, known as ‘ Scale for Impact of Suicidality-Management, Assessment and Planning of Care ( SIS MAP), for rapid assessment in challenging clinical settings e.g. primary care and emergency room. Background: Generally suicide risk is assessed clinically and structured assessments optimize the direction for decision-making across various settings e.g. inpatient care, emergency rooms and crisis centers. We believe that measures with accurate and valid information should be based upon multifactorial risk-constituent domains, e.g. biological, social, psychological, environmental …

Exploring Obstacles To Perinatal Care-Seeking Behavior In Women Of Rural Odisha, India Using A Community Based Participatory Research Approach, Sarah Law, Runjhun Bhatia

Senior Theses

This project resulted from collaboration between USC student organization GlobeMed and the Alternative for Rural Movement (ARM), a non-governmental organization in Odisha, India. Rajendra Rana, the head of ARM, expressed the need to delineate the factors underlying the tendency of rural Odishan women to deliver with unskilled birth attendants as opposed to institutionally. A literature review was conducted to explore possible economic, cultural, and social factors. During five weeks in Odisha, discussions with women's groups, community health workers, and ARM staff members built on the literature review. A preliminary survey and plan for its dissemination were developed. The community based …

Assessing The Potential Impact Of The Affordable Care Act On Uninsured Community Health Center Patients: An Update, Peter Shin, Jessica Sharac, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

No abstract provided.

Phytochemicals Added To The Feed Of Ovariectomized Adult Rats Increase Brown Adipose Activity, Colette N. Miller, Suresh Ambati, Erica Bass, Natalie Hohos, Diane Hartzel, Emily England, Mary Anne Della-Fera, Srujana Rayalam, Clifton A. Baile

Research Day

Background: Brown adipose tissue (BAT) uncouples respiration, using lipids as an energy source while dissipating heat. Increases in BAT activity are protective against obesity, thus compounds that increase BAT activation may help prevent weight gain. Resveratrol (R) increases BAT activity by upregulating thermogenic genes. As phytochemicals have synergistic properties, our research strategy has included investigation of the efficacy of relatively low concentrations of phytochemical blends on BAT activation. Methods: Previously, we showed that R combined with genistein (G) and quercetin (Q) reduced weight gain in aged ovariectomized (OVX) female rats. In the current study, OVX rats were fed diets containing …

A Program Evaluation Of A Housing With Services Project For Low-Income Adults In Portland, Oregon, Jack A. Phillips, Paula C. Carder, Diana White

Student Research Symposium

Reducing hospital use and connecting individuals to local available services and supports are key features of the Affordable Care Act. Adult residents of public housing tend to experience worse health outcomes than other adults. Poor self-rated health and high rates of emergency department use and hospitalization among these residents have prompted efforts to improve health outcomes. Even among residents living independently, prior research indicates that health and social disparities can be effectively addressed through coordinated care and improved access to health and social services.

Cedar Sinai Park—a nonprofit residential care organization located in Portland, Oregon—will implement a demonstration project attempting …

Teens 4 Good: Positive Youth Development Through Urban Community Gardening, Katelyn Hurley, Mph, Nancy L. Chernett, Ma, Mph, Colleen Payton, Mph, Ches, Diane Cornman-Levy, Ms Pt

College of Population Health Lectures, Presentations, Workshops

Background and Rationale

• Teens that grow up in poor, blighted neighborhoods are at risk for a variety of negative outcomes, including poor health.¹

• In Philadelphia and many other urban communities, disparities in race, income, and education impact access to and consumption of fresh, healthy foods.²

• Youth development programs (YDP) have grown as a viable solution to ameliorate negative outcomes among at-risk youth.³

• Community gardens have been introduced in many urban environments to address issues of food insecurity.⁴

Teens 4 Good (T4G) is a youth-led entrepreneurial program that converts vacant city lots into community gardens.

• T4G was …

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The Effect Of Patient Reminders On Osteoporosis Screenings, Billie-Ann Black

Evidence-Based Practice Project Reports

Osteoporosis is characterized by reduction of bone mass and compromised bone strength, resulting in an increased fracture risk. Since a reduction of bone mass has been shown to be predictive of future fracture risk, prevention strategies target screening those patients at risk for decreased bone mass by using bone mineral density (BMD) dual energy x-ray absorptiometry (DXA) scans. Current national guidelines recommend that all women 65 years and older undergo BMD testing using central DXA every two years. Despite these recommendations, women age 65 years and older still do not participate in this screening. Greater rates of osteoporosis screening could …

The Effects Of Education On Cardiovascular Disease Knowledge, Lauren A. Ostrowski-Winkler

Evidence-Based Practice Project Reports

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. The three main risk factors for the development of CVD include hypertension, high cholesterol, and tobacco use; these factors are largely prevented or reduced through lifestyle modifications. Researchers indicate that knowledge of CVD mortality has been linked with individual action to reduce one’s CVD risk. Researchers have also indicated that segments of our underserved society, particularly those with the highest CVD mortality rates, are also the least knowledgeable about CVD and their own personal risk. These risk factors were a concern within the …

One-On-One Delivery Of Living Well With A Disability, Tracy Boehm, Craig Ravesloot Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

The RTC: Rural conducted a research project on health management support for rural Americans. The approach used individually-focused programs, one of which included selected content from the Living Well with a Disability (LWD) health promotion program. The project noted that transportation and limited access to group-based programs in rural areas may act as barriers for participation in health promotion programs. Findings suggest the traditional 10- week LWD group-based program is the recommended practice, but a shorter LWD program delivered one-on-one with a consumer may be an option in rural areas.

Rural Self-Management Support, Craig Ravesloot Ph.D., Tracy Boehm, Tannis Hargrove, University Of Montana Rural Institute

Health and Wellness

The Rural Self-Management Support research project used an individually-focused health self-management support intervention to help people with disabilities locate resources for health support in rural America. This intervention led to better long term maintenance of health self-management behaviors compared to the control condition which did not include a focus on locating health resources. Future research will continue to look at how local communities impact long term health.

Personal Community Resource Mapping Road Maps To Better Health, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Personal Community Resource Mapping (PCRM) was used in a research project that led to positive health outcomes for people with disabilities living in rural America. Lack of health resources and long distances between them creates a barrier for consumers to manage complex health needs. Personal Community Resource Mapping (PCRM) is a way to identify resources in a community that can support health needs and a variety of independent living goals.

Self-Advocacy For Rural American Health (Sarah) Program Overview And Implementation, Tannis Hargrove, Bob Liston, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Self-Advocacy for Rural American Health was a program developed for a research project that helped consumers locate community resources to support their health. Those who used community resources to manage health and pursue goals experienced long term positive outcomes.

A Guide For Creating A Community Resource Map, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Using individualized community resource maps is an engaging way to introduce a consumer to the importance of place and the role the environment plays in health. Below you will find some suggestions for working with a consumer to create a personal community resource map.

The Johnson City Community Health Center: A Qualitative Analysis Of The Center's Strengths, Weaknesses, Opportunities, And Threats In Johnson City, Tennessee, Enrique A. Cruz Enriquez

Undergraduate Honors Theses

The Johnson City Community Health Center is one of over 1200 community health centers serving over 22 million patients across the United States. Community health centers primarily serve patients with low income or without health insurance, but most serve all the members of their communities. These centers provide many services and treat health problems in a holistic manner in order to improve the health of their communities and also allow the members of those communities to progress. The Johnson City Community Health Center is compared to successful CHCs from across the nation to determine if it has characteristics to be …

"Nursing Contamination: Wearing Scrubs In Public", Kemble Green

Undergraduate Honors Theses

Nurses are frequently seen in public in their “scrubs,” which could mean that contaminated clothing is being brought into the community, thereby posing an infection risk. The purpose of this study is to investigate if and which contaminants are present on the fabrics and the actions nurses are taking to eliminate contamination risks.

Eleven scrub tops were worn on hospital units over one twelve-hour shift. The contaminated scrubs and three control tops were then swabbed and used to inoculate agar plates. After incubation, colonies were counted, streaked onto nutrient and Mannitol-salt agar for isolation, and incubated. Using API Staph strips …

The Prevalence Of Smoking In Nursing Students, Jennifer Trotter

Undergraduate Honors Theses

Tobacco use is one of the most preventable sources of death and disease, and yet remains a worldwide problem. With the rising costs of healthcare, the focus of efforts to control them has honed in on lifestyle behaviors that contribute to the escalating costs. Within the scope of this scrutiny, the prevention or cessation of smoking and tobacco usage has become a global priority and a major focal point of worldwide anti-tobacco initiatives. The World Health Organization (WHO) has identified cessation interventions by health care professionals as a crucial factor in successful patient smoking cessation, and studies have shown that …

Using The Theory Of Planned Behavior To Explain Physical Activity Among College Students, Ese B. Aghenta

Masters Theses & Specialist Projects

The health benefits of physical activity include improved cardiovascular health, reduced rates of diabetes and other metabolic diseases, weight maintenance and improved bone and mental health (United States Department Health & Human Services (2008). According to the American College Health Association National College Health Assessment (ACHA-NCHA, 2013), only 20.0% of college students in the United States meet this recommendation. The Theory of Planned Behavior (TPB) attempts to explain the intention to perform behaviors that are not under an individual’s complete volitional control and has been highly utilized in predicting intention and performance of physical activity (Courneya, Nigg & Estabrooks, 1998). …

Global Malnutrition: Challenges Associated With Current Intervention Strategies And Prevention Initiatives, Duncan Stiller

Senior Honors Projects

Few, if any, tribulations in the field of public health have managed to transcend the epidemiological transition from acute to chronic disease as malnutrition has. Officially, malnutrition is a category of diseases that includes micronutrient deficiency, under-nutrition (calories/protein), as well as excessive nutrition. The World Food Program estimates that 842 million people worldwide do not have access to enough food, approximately 146 million of which are children. The most serious types of hunger are known as Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM), with 20 million and 35 million respective cases each year occurring in children less than …

An Exploratory Study Of Generational Differences In Health Information Seeking And Smoking Behaviors In Bulgaria, Iva Stoyneva

Communication & Theatre Arts Theses

Smoking is a serious global public health threat that causes more than 6 million deaths annually (WHO, 2013). Smoking is also the single, most preventable cause of death (CDC, 2014). According to a recent study, Bulgaria was ranked as one of onlyl 1 countries in the world, in which half of the adult male population smokes, as well as one of 11 countries in which more than one-quarter of the adult female population smokes. Research suggests that the most significant predictors of smoking behavior in Bulgaria were age and geographic location (Balabanova, Bobak & McKee, 1998). Contributing to these finings, …

The Proliferation Of Diabetes: A Cultural Epidemiological Review Of Type 2 Diabetes In The Global Community, Kelly Heuer

Renée Crown University Honors Thesis Projects - All

Global diabetes is a serious and growing problem, which has quickly turned into a public health crisis. The rapid spread of type 2 diabetes can be contributed to several different factors, including genetics, environmental influences, poor nutrition habits, and sedentary lifestyle. A large part of the proliferation of this diease is the spread of western culture, specifically diet.

A problem faced when addressing this disease from a global standpoint of prevention, control, and treatment is that type 2 diabetes affects different cultures in different manners around the globe due to differences in risk factors (including genetics, age, race, sex, education, …

Substance Abuse Trends In Maine: State Epidemiological Profile 2014, Tim Diomede

Muskie School Capstones and Dissertations

This report takes into account the primary objectives of the Office of Substance Abuse and Mental Health Services (SAMHS): to identify substance abuse patterns in defined geographical areas, establish substance abuse trends, detect emerging substances, and provide information for policy development and program planning. It also highlights all the prevention priorities identified in the SAMHS strategic prevention plan: underage drinking, high-risk drinking among 18-25 year olds, misuse of prescription drugs among 18-25 year olds, and marijuana use in 12-25 year olds; as well as monitors the progress being made to address these priorities. This report includes data available through December …

Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …

Integrated Care Management In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd

Mental Health / Substance Use Disorders

No abstract provided.

Vitamin D Status Of College Students: Implications For Health Leaders, Eileen M. Cress

Electronic Theses and Dissertations

Vitamin D deficiency is considered to be a pandemic with implications for compromised bone health and other chronic diseases. Few studies have examined vitamin D status in college-aged individuals where prevention of future health consequences is still possible. Serum vitamin D 25(OH)D status and vitamin D intake were examined in 98 college students ages 18-29 years during winter. BMI was classified as < 25and 25 or greater. Race was categorized as Caucasian or other. Overall, 69.5% had suboptimal serum vitamin D levels, <30ng/mL. Only 8 students (8.2%) met the EAR (400 IU) per day for vitamin D intake. t tests were used to determine if there were significant differences in serum vitamin D level and dietary intake based on gender, race and BMI. Significant differences were found in serum vitamin D level when compared by gender and race. Females tended to have a higher serum vitamin D level than males. Those representing minorities had lower serum vitamin D levels than Caucasians; One hundred percent of the minority students had suboptimal serum vitamin D levels. Based on these findings, dietitians should increase efforts to target college-aged individuals in educational programming related to factors affecting vitamin D synthesis, vitamin D intake, and health consequences of suboptimal vitamin D status, particularly in winter. Consideration should be given to vitamin D fortification of foods that meet the preferences of today’s consumer.