Community Health and Preventive Medicine Commons^™

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Utilizing Three Years Of Epidemiological Data From Medical Missions In Cambodia To Shape The Mobile Medical Clinic Formulary, Jeany Kim Jun, Junia S. Koo, Amy Y. Kang, Deborah B. Chien, Albert Shim, Dale Knutson, Eda M. Kim

Pharmacy Faculty Articles and Research

Objective: The purpose of this project was to gather epidemiological data on common diseases and medications dispensed during medical mission teams to Cambodia to shape the mobile medical clinic formulary.

Methods: Data for patients seen during week-long, mobile, medical clinics was collected in Cambodia during Septembers 2012 to 2014. Patient’s gender, age, weight, blood pressure, glucose, pertinent laboratory values, diagnoses, and medications dispensed were collected. Blood pressure and glucose were measured in patients 18 years and above. Data collected onto paper intake forms were transferred onto spreadsheets without patient identifying information and analyzed for aggregate means, common diseases, and most …

Engagement Of Latino/Hispanic Msm In Hiv Prevention, Natividad Hernandez

UNO Student Research and Creative Activity Fair

Nationally, men who have sex with men (MSM) continue to be significantly affected by HIV compared to other populations. Surveillance data indicates that in Nebraska, between 2011 and 2015, over 55% of new HIV cases were MSM.¹ More specifically, the majority of new HIV cases in the state of Nebraska are reported in Douglas County.² The rate of Hispanic Latino males living with an HIV diagnosis is 2.3 times of white males.³ Similarly, the rate of Hispanic/Latina women living with HIV diagnosis is 3.4 times that white females.³ It is important to identify culturally appropriate messages …

Individual And Store Characteristics Associated With Brand Choices In Select Food Category Redemptions Among Wic Participants In Virginia, Qi Zhang, Chuanyi Tang, Patrick W. Mclaughlin, Leigh Diggs

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) often allows participants to redeem food benefits for various brands at different costs. To aid the program’s food cost containment efforts, it is important to understand the individual and store characteristics associated with brand choices. This study used the WIC Electronic Benefit Transfer (EBT) data for 239,062 Virginia WIC participants’ brand choices in infant fruits and vegetables (F&Vs) and whole grain bread in May 2014–February 2015, one of the first such data sets available in the U.S. for research purposes. Mixed effects logistic regression models were used to analyze …

Validation Of Bioelectrical Impedance Analysis For Assessing Dry Weight Of Dialysis Patients In Pakistan, Huma Asmat, Romaina Iqbal, Fatima Sharif, Aamer Mahmood, Aamir Abbas, Waqar Kashif

Department of Medicine

Accurate dry weight estimation (DW) to achieve euvolemia is one of the key objectives of hemodialysis (HD). While conventionally DW is estimated by clinical examination, bioelectrical impedance analysis (BIA) has been proposed as an objective method to determine DW and has been tested extensively in the Western population. We aim to validate BIA for determining DW in a Pakistani population against the conventional clinician's method. This is a single-center validation study conducted at two outpatient HD units of Aga Khan Hospital, Karachi. One hundred and forty-eight DW readings of patients who were on maintenance HD were taken both by BIA …

Community To Clinic Navigation To Improve Diabetes Outcomes, Nancy E. Schoenberg, Gabriele Ciciurkaite, Mary Kate Greenwood

Behavioral Science Faculty Publications

Rural residents experience rates of Type 2 Diabetes Mellitus (T2DM) that are considerably higher than their urban or suburban counterparts. Two primary modifiable factors, self-management and formal clinical management, have potential to greatly improve diabetes outcomes. “Community to Clinic Navigation to Improve Diabetes Outcomes,” is the first known randomized clinical trial pilot study to test a hybrid model of diabetes self-management education plus clinical navigation among rural residents with T2DM. Forty-one adults with T2DM were recruited from two federally qualified health centers in rural Appalachia from November 2014–January 2015. Community health workers provided navigation, including helping participants understand and implement …

Evaluating The Accountable Health Communities Demonstration Project., Laura Gottlieb, Jeffrey D. Colvin, Eric Fleegler, Danielle Hessler, Arvin Garg, Nancy Adler

Manuscripts, Articles, Book Chapters and Other Papers

Despite substantial evidence documenting the social patterning of disease, relatively little information is available on how the health care system can best intervene on social determinants to impact individual and population health. Announced in January 2016, the Centers for Medicare and Medicaid Innovation's (CMMI) Accountable Health Communities (AHC) initiative provides an important opportunity to improve the evidence base around integrated social and medical care delivery. To maximize learning from this large-scale demonstration, comprehensive evaluation efforts should focus on effectiveness and implementation research by supporting local, regional, and national studies across a range of outcomes. Findings from this demonstration could transform …

The Scoping Review Method: Mapping The Literature In “Structural Change” Public Health Interventions, Rosie Hanneke, Yuka Asada, Lisa D. Lieberman, Leah Christina Neubauer, Michael C. Fagan

Department of Public Health Scholarship and Creative Works

This case discusses how we used scoping review methodology to map the literature in an emergent area of research, “structural change” public health interventions. Scoping reviews are similar to systematic reviews in both scale and rigor; both of these literature review methodologies are comprehensive approaches to reviewing the literature on a topic. However, while a systematic review attempts to answer a specific, targeted research question, a scoping review is designed to map and categorize all of the literature on a broad topic. For this reason, it is an excellent method to employ in emergent research areas, in which researchers have …

Community Health News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Examines Maternal Caregiver Support for Prevention of Childhood Obesity

Readyvax: A New Mobile Vaccine Information App, Robert A. Bednarczyk, Paula M. Frew, Daniel A. Salmon, Ellen Whitney, Saad B. Omer

Environmental & Global Health Faculty Research

Vaccine information of varying quality is available through many different sources. We describe the creation, release and utilization of ReadyVax, a new mobile smartphone app providing access to trustworthy, evidence-based vaccine information for a target audience of healthcare providers, pharmacists, and patients (including parents of children). We describe the information content and technical development of ReadyVax. Between the hard launch of the app on February 12, 2015 and October 8, 2016, the app has been downloaded by 5,142 unique users, with 6,841 total app sessions initiated, comprising a total of 15,491 screen views (2.3 screens/session on average). ReadyVax has been …

The Use Of Vital Statistics Data For Research Of Consequence: Birth Outcomes And Population Health In A Rural Region, Claudia Kozinetz, Shimin Zheng, Eunice Mogusu

ETSU Faculty Works

Objective: The Affordable Care Act (ACA) has influenced increasing interests in population health and population health outcomes. The purpose of this study was to exemplify the importance of using existing vital statistics data for understanding and monitoring health outcomes and consequentially health disparities at the population level. Data from birth records for two geographic regions from 2009-2014 were compared; low birth weight (LBW) and preterm delivery (PD) were used as surrogates for population health outcomes.

Methods: A population-based, multi-year, cross-sectional study design using a pooled dataset of birth records from Tennessee (TN) was the framework for the analyses. …

Factors Associated With Sexual Dysfunction In Taiwanese Females With Rheumatoid Arthritis, Miao-Chiu Lin, Ming-Chi Lu, Hanoch Livneh, Ning-Sheng Lai, How-Ran Guo, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Patients with rheumatoid arthritis (RA) may experience sexual dysfunction because of symptoms or adverse effects from treatments. Data on female sexual dysfunction (FSD) in Asian females with RA issue are limited. This study investigated the prevalence and factors associated with FSD in Taiwanese patients with RA.

Methods: This cross-sectional study used a purposive sampling method to recruit 195 females with RA from a single hospital in southern Taiwan. Demographic and clinical characteristics were obtained by review of medical records and a structured questionnaire. The Chinese version of the Female Sexual Function Index and the Taiwanese Depression Questionnaire were …

Hepatitis C Serosorting Among People Who Inject Drugs In Rural Puerto Rico, Ian Duncan, Ric Curtis, Juan Carlos Reyes, Roberto Abadie, Bilal Khan, Kirk Dombrowski

Publications and Research

Due to the high cost of treatment, preventative measures to limit Hepatitis C (HCV) transmission among people who inject drugs (PWID) are encouraged by many public health officials. A key one of these is serosorting, where PWID select risk partners based on concordant HCV status. Research on the general U.S. population bySmith et al. (2013) found that knowledge of one's own HCV status facilitated serosorting behaviors among PWID, such that respondents with knowledge of their own status were more likely to ask potential partners about their status prior to sharing risk. Our objective was to see if this held true …

Neighborhood Environment And Falls Among Community-Dwelling Older Adults, Emily Nicklett, Matthew Lohman, Matthew Smith

Dartmouth Scholarship

Falls present a major challenge to active aging, but the relationship between neighborhood factors and falls is poorly understood. This study examined the relationship between fall events and neighborhood factors, including neighborhood social cohesion (sense of belonging, trust, friendliness, and helpfulness) and physical environment (vandalism/graffiti, rubbish, vacant/deserted houses, and perceived safety walking home at night).

Using Quality Improvement Methods To Increase Use Of Pain Prevention Strategies For Childhood Vaccination., Jennifer Verrill Schurman, Amanda D. Deacy, Rebecca J. Johnson, Jolynn Parker, Kristi Williams, Dustin Wallace, Mark Connelly, Lynn Anson, Kevin Mroczka

Manuscripts, Articles, Book Chapters and Other Papers

AIM: To increase evidence-based pain prevention strategy use during routine vaccinations in a pediatric primary care clinic using quality improvement methodology.

METHODS: Specific intervention strategies (i.e., comfort positioning, nonnutritive sucking and sucrose analgesia, distraction) were identified, selected and introduced in three waves, using a Plan-Do-Study-Act framework. System-wide change was measured from baseline to post-intervention by: (1) percent of vaccination visits during which an evidence-based pain prevention strategy was reported as being used; and (2) caregiver satisfaction ratings following the visit. Additionally, self-reported staff and caregiver attitudes and beliefs about pain prevention were measured at baseline and 1-year post-intervention …

Understanding Contributing Factors To Child Drownings In Public Pools In Australia: A Review Of National Coronial Records, Lauren A. Petrass Dr, Jennifer Blitvich

International Journal of Aquatic Research and Education

This study examined the incidence and circumstances associated with child drowning in public pools in Australia; and identified the frequency and nature of coroners’ recommendations. Retrospective case-series analysis of child (aged 0-10 years) unintentional drowning deaths in public pools were conducted based on Coronial data. A total of 12 child drownings were identified. A lack of supervision was recognized as the key contributing factor in 92% of cases, with the caregiver responsible for multiple children (83%); older children supervising younger children (17%); and a busy pool environment (25%) consistently linked with in-adequate supervision. To address drownings in public pools it …

North Douglas County Community Needs Health Assessment (Phase 2), Callie H. Lambarth, Diane Reid, Beth L. Green

Early Childhood

Beginning in August 2016, Phase 2 of the North Douglas County (NDC) Community Health Needs Assessment (CHNA) built on work completed in the Phase 1 planning process, and engaged the communities of Drain, Elkton, and Yoncalla, Oregon in the development and administration of a regional health services survey. The purpose of the survey was to learn from families with children ages 0-8 in the NDC region in order to:

• Identify service needs across a range of health service types, e.g., dental care, immunizations, prenatal care, well-child care, primary care, and mental health;
• Identify barriers to access;
• Prioritize the programs and …

Smoking Behavior Among Saudi Arabian Male College Students In The U.S.: A Case Study, Zi Yan, Hend Altobaiti Altobaiti, Kathleen Fitzpatrick

Health Sciences Faculty Publications

Background: Saudi Arabia is ranked 23rd for tobacco consumption globally, and approximately, 25-43% of male college students in Saudi Arabia were smokers. This study uses a qualitative approach to explore the facilitators and barriers that influence the smoking behavior among Saudi international college students in the U.S. Methods: About 15 Saudi male international students who studied at a small liberal arts college were recruited and interviewed for about 30-50 min, following a semi-structured interview guideline. Results: The hookah was preferred by participants to the cigarettes because of its smell and the entertaining way of doing it. The major facilitators of …

Validation Of Respiratory Questionnaire For Lung Function Assessment Among An Occupational Group Of Textile Workers In Pakistan, Tanzil Jamali, Asaad Ahmed Nafees

Community Health Sciences

Objective: To determine the association of spirometric lung pattern with respiratory symptoms and to validate the American Thoracic Society respiratory questionnaire for lung function assessment among textile workers.
Methods: This cross-sectional survey was conducted from August to December 2009 among adult textile workers of Karachi. Data was collected through the American Thoracic Society Division of Lung Disease respiratory questionnaire and the lung function was assessed by using a spirometer. Results of three acceptable readings of spirogram were recorded and the best of the three readings was used for analysis. SPSS 19 was used for data analysis.
Results: There were 372 …

Aids Awareness Interventions For Women: The Role Of Voluntary Organizations In The Secunderabad And Hyderabad Region Of Southwestern India, G.S. Chayadevi, Bindu A. Bambah

Journal of International Women's Studies

In this paper, we examine the role of Voluntary organizations (VO’s) in combating the incidence of HIV/AIDS and Sexually Transmitted Diseases among Female Sex Workers in Hyderabad and Secundrabad. These are twin cities in the newly formed state of Telangana state in the southwestern region of India, called the Deccan Plateau. We trace the evolution of VO’s towards becoming agents of information and prevention of AIDS in the region. Our focus is on how VOs’ interventions impact the prevention of HIV among female sex workers. The activities that contribute towards this aim are sexual health, counseling, medication and continuous health …

Clinical Outcomes Of Community-Acquired Pneumonia In Patients With Diabetes Mellitus, Siddartha Bandhary, Bolivar Y. Contreras-Mora, Ruby Gupta, Patricia Fernandez, Patricio Jimenez, Paula Peyrani, Timothy L. Wiemken, Steven Burdette, Julio A. Ramirez, Hadi Harati, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Background: Studies have found admission hyperglycemia as a predictor of poor outcomes in Community acquired Pneumonia (CAP), whereas others have not. The objective of this study was to evaluate the impact of diabetes mellitus (DM) on mortality as well as Length of stay (LOS) and Time to clinical stability (TCS) of hospitalized patients with CAP.

Materials and Methods: Adult patients hospitalized with CAP enrolled at Community-Acquired Pneumonia Organization (CAPO) database with DM were categorized as admission blood glucose ≥ 250 mg/dL (diabetes mellitus blood sugar (BG) > 250) and admission blood glucose ≤ 250 mg/dL (DM BG ≤ 250). CAP outcomes …

Why A New Journal?, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

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Time To Clinical Stability In Patients With Ventilator-Associated Pneumonia Due To Methicillin-Resistant Staphylococcus Aureus Treated With Linezolid Versus Vancomycin: Results From The Impact-Hap Study, Paula Peyrani, Timothy L. Wiemken, Marcus J. Zervos, Daniel H. Kett, Thomas M. File Jr., Gary E. Stein, Kimbal D. Ford, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Time to clinical stability is a well-defined early clinical outcome in hospitalized patients with community-acquired pneumonia, but it has not been evaluated in patients with ventilator-associated pneumonia (VAP). The objective of this study was to compare time to clinical stability in patients with MRSA VAP treated with linezolid versus vancomycin.

Methods: This was a secondary analysis of the IMPACT-HAP study database. VAP was defined according to CDC criteria. MRSA VAP was considered when MRSA was isolated from a tracheal aspirate or bronchoalveolar lavage. A patient was considered to reach clinical stability the day that the following four criteria were …

A Review Of Macrolide Based Regimens For Community-Acquired Pneumonia, Forest W. Arnold, Leslie A. Beavin

The University of Louisville Journal of Respiratory Infections

Community-acquired pneumonia (CAP) has significant morbidity and mortality. The Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) guidelines recommend two antimicrobial regimens for hospitalized patients with CAP, one of which includes a macrolide, and one of which does not. Both regimens have antimicrobial properties, but macrolides also possess immunomodulatory properties. Macrolides, however, may also have potential arrhythmia adverse effects. The purpose of this review is to provide an update of studies evaluating outcomes for patients with CAP treated with or without a macrolide-based regimen. Two recent randomized controlled trials conflict with each other regarding the benefit versus noninferiority of including …

Self-Reported Tobacco Use And Correlation With Umbilical Cord Blood Cotinine Levels At Delivery Among Appalachian Gravidas, Jesse Cottrell, Brenda L. Mitchell, Pooja N. Sangani, D'Andrea S. Thomas, Monica A. Valentovic

Marshall Journal of Medicine

The detrimental effects of cigarette use during pregnancy are well documented. Studies have shown that cigarette smoking while pregnant is associated with multiple adverse outcomes including: pre-term birth, placental abruption, placenta previa, fetal growth restriction, stillbirth, increased rate of birth defects, and increased risk of sudden infant death syndrome. Cotinine is the primary metabolite of nicotine and allows for measurement of active as well as passive exposure. Cotinine freely cross the placental barrier and maternal concentrations are closely correlated with newborn plasma levels. The aim of this study was to compare maternally reported rates of tobacco use to fetal umbilical …

Community Health News, Georgia Southern University

Health Policy & Community Health: News & Publications (2011-2018)

• Georgia Southern Applies Mixed-Methods Design in CommunityEngaged Research

Use Of Grounded Theory In Cardiovascular Research, Patrick J. Dunn, Vasileios Margaritis, Cheryl Anderson

The Qualitative Report

While grounded theory is often cited in the qualitative literature as the methodology, there are few good examples of publications that follow the principles of grounded theory and result in an actual theory. The purpose of this paper is to demonstrate how the Corbin and Strauss (2015) method of grounded theory was used in a study looking at how patients with cardiovascular disease and diabetes develop health literacy skills that are used to manage their condition. The key principles of grounded theory include theoretical sampling, constant comparison, open, axial, and selective coding, the use of memoing, and theoretical saturation. Data …

Characteristics Of Hiv-Infected Children At Enrollment Into Care And At Antiretroviral Therapy Initiation In Central Africa, Adebola Adedimeji, Andrew Edmonds, Donald Hoover, Qiuhu Shi, Jean D'Amour Sinayobye, Martin Nduwinmana, Patricia Lelo, Denis Nash, Kathryn Anastos, Marcel Yotebieng

Publications and Research

Background Despite the World Health Organization (WHO) regularly updating guidelines to recommend earlier initiation of antiretroviral therapy (ART) in children, timely enrollment into care and initiation of ART in sub-Saharan Africa in children lags behind that of adults. The impact of implementing increasingly less restrictive ART guidelines on ART initiation in Central Africa has not been described.

Materials and Methods Data are from the Central Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) pediatric cohort of 3,426 children (0±15 years) entering HIV care at 15 sites in Burundi, DRC, and Rwanda. Measures include CD4 count, WHO clinical stage, age, and …

Sociocultural Risk Factors For Elevated Perceived Stress Among African American Smokers, Monica Webb Hooper, Noella A. Dietz, Joseph C. Wilson

Journal of Health Disparities Research and Practice

Introduction: African Americans experience unique stressors that may inhibit smoking cessation and enhance relapse rates. Few studies, however, have focused on risk factors for perceived stress among treatment seekers. Because African Americans are less likely to quit compared to the larger community, understanding factors associated with perceived stress among smokers has the potential to improve intervention outcomes. This study examined psychosocial and cultural correlates of stress in a sample of African American participants in a randomized controlled trial.

Methods: At baseline, participants reported demographic factors and completed assessments of smoking history, alcohol use, friend and household smoking, weight concerns, acculturation, …

Emergency Department Utilization: A Qualitative Analysis Of Illinois Medical Home Network Patients., Crystal M. Glover, Yanina A. Purim-Shem-Tov

Journal of Health Disparities Research and Practice

Background

Inappropriate emergency department (ED) use continues to plague healthcare in terms of disease management and costs. In 2012, the State of Illinois implemented Medical Home Network (MHN) where Medicaid recipients were assigned to primary care providers to, in part, reduce overreliance on EDs. However, MHN patients have continued to use EDs.

Objective

The purpose of this study is to provide a qualitative analysis of Medicaid patient-identified barriers to primary care, facilitators of emergency use, and related mental health and psychosocial factors.

Methods

Patients who presented themselves at the ED located at an urban, academic medical center participated in one-time, …