Community Health and Preventive Medicine Commons^™

Health Insurance Enrollment Of Children And Young Adults In Wayne County, Michigan: A Qualitative Evaluation, Kristin Kan, Richard Lichtenstein, Michelle Famulare, Alison Jensen, Theresa Kowalski-Dobson, Joslyn Pettway, Erminia Ramirez, Madiha Tariq, Minal Patel

Journal of Health Disparities Research and Practice

Since the Affordable Care Act went into effect, community outreach to increase health insurance enrollment of young adults and children in low-income families of color has been a priority in Wayne County, Michigan. Our objective was to inform community efforts for improved outreach, we explored perceptions around the importance of health insurance and barriers to enrollment for children and young adults through a qualitative research study. We conducted a focus group with enrollment assisters and nine focus groups with Arab American, Latino/Hispanic, and African American community members. Several themes emerged about community members’ perceptions and experiences: they believe that children …

Perceptions Of Chronic Disease Among Older African Americans: A Qualitative Analysis, Karon Phillips, Charles Rogers, Adrienne Morgan

Journal of Health Disparities Research and Practice

Research has documented that African Americans suffer disproportionately from chronic diseases when compared to the general population. Yet, limited research examines older African Americans’ perceptions about having chronic diseases. Accordingly, the first aim of the study provided insight into this disparity with the intent of revealing how older African Americans feel about their overall health, and how much they understand about their individual chronic disease(s). The second aim was to gather information about strategies and coping mechanisms older African Americans use to manage their chronic diseases. The purpose of this aim was to determine if any of the strategies they …

Wdph 2017 Summer Internship Report, Lauren Meininger

Mosakowski Institute for Public Enterprise

In the spring of 2014, the Worcester Division of Public Health, UMass Memorial Health Care, and Clark University’s Mosakowski Institute for Public Enterprise joined forces to begin developing a partnership that would combine academic resources, student input, and public health needs in the City of Worcester. Founders of this program were motivated to seek and implement innovative interventions for public health issues while simultaneously inspiring a new generation of public health professionals.

Each year, the Academic Health Collaborative of Worcester (AHCW) brings in student interns to work on the pressing public health issues of the moment. Interns work alongside epidemiologists, …

Process Evaluation Of The Healthesteps™ Lifestyle Prescription Program, Wendy Blunt, Dawn P. Gill, Brendan Riggin, Judith Belle Brown, Robert Petrella

Lifestyle Research Team

Background: Physical inactivity, sedentary behaviour, and poor diet are contributing to the rise in chronic disease rates throughout the world. HealtheSteps™ is a lifestyle prescription program focused on reducing risk factors for chronic disease through in-person coaching sessions, goal setting and tracking, and technology supports.

Purpose:A process evaluation was conducted alongside a pragmatic randomized controlled trial to: a) explore the acceptability of HealtheSteps™ program from coach and participant perspectives; and b) identify where the program can be improved.

Methods:Participants at risk or diagnosed with a chronic disease were recruited from five primary care/health services …

Qualitative Evaluation Of The Saleema Campaign To Eliminate Female Genital Mutilation And Cutting In Sudan., Andrea C Johnson, W Douglas Evans, Nicole Barrett, Howida Badri, Tamador Abdalla, Cody Donahue

Prevention and Community Health Faculty Publications

BACKGROUND: Female genital mutilation and cutting (FGM/C, herein FGM) is a widespread and harmful practice. The Government developed a national campaign in Sudan, called Saleema, to change social norms discouraging FGM. Saleema translates to being "whole", healthy in body and mind, unharmed, intact, pristine, and untouched, in a God-given condition. An interim evaluation was conducted using focus groups among Sudanese adults. The primary aim was to explore perceptions of the Saleema poster exemplars and to assess if the desired themes were being communicated. Secondary aims were to understand more about participants' information sources, values, and suggestions for the campaign broadly. …

Community Health News, Georgia Southern University

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

• Georgia Southern Professor Selected a Governor’s Teaching Fellow

Community Health News, Georgia Southern University

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

• East Carolina, Georgia Southern Examine Tobacco Policies, Alcohol Sponsorship at LGBT Pride Festivals

Assessment Of Temperature And Ultraviolet Radiation Effects On Sunburn At An Inland U.S. Beach: A Cohort Study, Jason W. Marion, Jiyoung Lee, James Rosenblum, Timothy J. Buckley

EKU Faculty and Staff Scholarship

Background

Increases in outdoor temperature may lead to increases in sunburn, outdoor exposure, and skin cancer in human populations.

Objective

This study aimed to quantify sunburn incidence and risk for Ohio beachgoers exposed to varying outdoor conditions.

Methods

Sunburn incidence data were obtained through a prospective cohort study at East Fork Lake (Cincinnati, Ohio, USA). Recruitment occurred over 26 weekend days. Beach interviews and follow-up telephone interviews obtained exposure and health information. New sunburns were self-reported 8–9 days post-enrollment. Survey data were paired with ultraviolet radiation (UVR) index and temperature data for statistical analysis.

Results

Among 947 beachgoers, new sunburns …

Comparing Men Who Have Sex With Men And Transgender Women Who Use Grindr, Other Similar Social And Sexual Networking Apps, Or No Social And Sexual Networking Apps: Implications For Recruitment And Health Promotion, Christina J. Sun, Erin L. Sutfin, Laura H. Bachmann, Jason Stowers, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: Researchers and public health professionals have increased their attention to GPS-based social and sexual networking applications (apps) tailored to gay, bisexual, and other men who have sex with men (MSM) and transgender women. These populations continue to be disproportionately affected by HIV in the United States; therefore, these apps, in particular Grindr, have become an important sampling venue for the recruitment of HIV-related research participants. As such, it is essential to identify differences among app users to avoid potential sampling bias. This paper seeks to identify differences in MSM and transgender women who use Grindr and those who …

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Facilitating Factors And Barriers To Weight Management In Women: Physician Perspectives, Renee E. Walker, Jennifer Kusch, Jennifer T. Fink, David A. Nelson, George Morris Iii, Jessica Skalla, Ron A. Cisler

Journal of Patient-Centered Research and Reviews

Purpose: The complexity of addressing overweight and obesity in women has been an ongoing public health and health care challenge. While the mechanism for addressing overweight and obesity in women remains unclear, it has been speculated that disparities in overweight and obesity by race and gender contribute to the complexity. The purpose of the present study was to examine perceptions of primary care physicians when discussing weight management with their patients.

Methods: We conducted focus group discussions exploring facilitators and barriers to discussing weight management and weight loss among women patients. Participants included 18 family medicine and internal medicine physicians …

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Journal of Patient-Centered Research and Reviews

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

An Undergraduate Curriculum In Public Health Benchmarked To The Needs Of The Workforce, J. Michael Stoots, Randy Wykoff, Amal Khoury, Robert P. Pack

ETSU Faculty Works

East Tennessee State University (ETSU) has offered an undergraduate degree in public health for 60 years. Alumni survey data have documented that the majority of the graduates from this program enter the workforce [see accompanying commentary by Wykoff, et al. (1)]. To keep pace with ongoing changes in the workforce, the decision was made to completely review, and, as appropriate, revise and restructure the Bachelor of Science in Public Health (BSPH) curriculum.

Exploring Health Care Seeking Knowledge, Perceptions And Practices For Childhood Diarrhea And Pneumonia And Their Context In A Rural Pakistani Community, Wafa Aftab, Leah Shipton, Fauziah Rabbani, Kashif Sangrasi, Shagufta Perveen, Aysha Zahidie, Imran Naeem, Shamim Qazi

Community Health Sciences

BACKGROUND:

Where access to facilities for childhood diarrhea and pneumonia is inadequate, community case management (CCM) is an effective way of improving access to care. In Pakistan, utilization of CCM for these diseases through the Lady Health Worker Program remains low. Challenges of access to facilities persist leading to delayed care and poor outcomes. Estimating caregiver knowledge, understanding their perceptions and practices, and recognizing how these are related to care seeking decisions about childhood diarrhea and pneumonia is crucial to bring about coherence between supply and demand-side practices.

METHODS:

Data was collected from family caregivers to explore their knowledge, perceptions …

Community Health News, Georgia Southern University

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

• Georgia Southern Examines Physician Attitudes

Pharmacists' Role In Harm Reduction: A Survey Assessment Of Kentucky Community Pharmacists' Willingness To Participate In Syringe/Needle Exchange, Amie Goodin, Amanda Fallin-Bennett, Traci Green, Patricia R. Freeman

Nursing Faculty Publications

Background: Pharmacists' role in harm reduction is expanding in many states, yet there are limited data on pharmacists' willingness to participate in harm reduction activities. This study assessed community pharmacists' willingness to participate in one harm reduction initiative: syringe/needle exchange.

Methods: In 2015, all Kentucky pharmacists with active licenses were emailed a survey that examined attitudes towards participation in syringe/needle exchange. Response frequencies were calculated for community pharmacist respondents. Ordinal logistic regression estimated the impact of community pharmacist characteristics and attitudes on willingness to provide clean needles/syringes to people who inject drugs and to dispose of used syringes/needles, where both …

Implementation Of A Low-Cost Unna Boot Alternative As Adjunctive Treatment For Kaposi Sarcoma, Alexander Robert Mills, Edith Tonui, Sonak Pastakia, Rakhi Karwa, Phelix Were

Engagement & Service-Learning Summit

There are 6 million people living with HIV; 70% reside in Sub-Saharan Africa (SSA). Furthermore, 1.1 million deaths occur due to opportunistic infections (OIs) that can be minimized with antiretroviral therapy. In Kenya, Kaposi Sarcoma (KS) is an especially debilitating OI that presents with dermatologic lesions; magnifying the stigma that patients with HIV face physically and psychosocially. Dermatology research is underway to determine the effectiveness of an unna boot (medicated, layered compression dressing) to speed the healing of these lesions with anecdotal success. Commercially available unna boot products are too expensive and not readily available in SSA. Clinicians from Purdue …

Frequency And Factors Associated With Adult Immunization In Patients Visiting Family Medicine Clinics At A Tertiary Care Hospital, Karachi, Samar Zaki, Asma Usman, Swaleha Tariq, Sameena Shah, Iqbal Azam Syed, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: The goal of this study was to determine the frequency and factors associated with adult immunization in patients visiting family medicine clinics at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted from March 2014 to March 2015 in a tertiary care hospital in Karachi, Pakistan. Participants more than 18 years were invited to participate in the study. A pretested questionnaire was used to collect information. Data were entered and analyzed using IBM SPSS Statistics for Windows, version 19.0 (Armonk, NY: IBM Corp).
Results: A total of 340 patients were surveyed. The majority of patients …

The Role Of Rural Hospitals In Addressing Opioid And Other Substance Use Problems, John A. Gale Ms

Mental Health / Substance Use Disorders

Webinar presentation to the Small Rural Hospital Transition project addressing issues of rural opioid and other substance use issues, focusing on the role of rural hospitals, and the importance of community engagement. Component parts of an effective opioid/substance use system of care include prevention, treatment, and recovery. Models must be adapted to the geographic, resource, and cultural realities of rural areas. Examples of strategies are provided.

An Ambivalent Embrace: Service Needs And Gaps For Asian Immigrants In New Destinations, John J. Chin

Journal of Health Disparities Research and Practice

Asian immigrants to the U.S. are settling in "new destinations," but there has been little research on their health care and social service needs. Our analysis of Census data to identify cities with the fastest Asian immigrant population growth (1990-2000) yielded 33 smaller cities in 13 states. The cities ranged in population from 7,677 to 86,660; were spread across 13 states in the Northeast, South, and Midwest regions of the US; and varied widely demographically. Pilot surveys conducted in 2009 indicated that, although many residents had positive attitudes towards immigrants, many were also concerned about job competition and dilution of …

Using Photovoice As A Tool For Community Engagement To Assess The Environment And Explore Environmental Health Disparities, Heather M. Brandt, Venice E. Haynes, Lashanta J. Rice, Dayna Campbell, Edith Williams, *Sacoby Wilson, Saundra H. Glover

Journal of Health Disparities Research and Practice

Photovoice was used as a participatory research method to document perceived local environmental hazards, pollution sources, and potential impact on health among community members to address environmental health disparities. A convenience sample of 16 adults in Orangeburg, South Carolina participated in Photovoice. Photos depicted positive and negative implications of the environment across seven themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive and negative photos demonstrated a high level of interest among community members in considering how the environment influences health and health disparities.

Race And “Hotspots” Of Preventable Hospitalizations, Caryn N. Bell, Janice V. Bowie, Roland J. Thorpe Jr.

Journal of Health Disparities Research and Practice

Abstract

Preventable hospitalizations (PHs) are those for ambulatory care-sensitive conditions that indicate insufficiencies in local primary healthcare. PH rates tend to be higher among African Americans, in urban centers, rural areas and areas with more African American residents. The objective of this study is to determine geographic clusters of high PH rates (“spatial clusters”) by race. Data from Maryland hospitals were utilized to determine the rates of PHs in zip code tabulation areas (ZCTAs) by race in 2010. Geographic clusters of ZCTAs with higher than expected PH rates were identified using Scan Statistic and Anselin’s Local Moran’s I. 10 PH …

Persistence With Mammography Screening And Stage At Breast Cancer Diagnosis Among Elderly Appalachia-West Virginia Women, Ami Vyas, Suresh Madhavan, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

The objective of this study is to evaluate the association between persistence with mammography screening and stage at breast cancer diagnosis in elderly Appalachia-West Virginia women diagnosed with first incident breast cancer. The study utilized West Virginia Cancer Registry-Medicare linked database to identify women age 70 and above diagnosed with first incident breast cancer in 2007. Persistence to mammography screening was defined as having had at least three mammography screenings before breast cancer diagnosis. A multiple logistic regression was conducted to assess the association between persistence with mammography screening and stage at breast cancer diagnosis in these women. Of the …

The Influence Of Insurance Type On Stage At Presentation, Treatment, And Survival Between Asian American And Non-Hispanic White Lung Cancer Patients, A. Tantraworasin, E. Taioli, B. Liu, R. M. Flores, A. J. Kaufman

Journal Articles

© 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. The effect of insurance type on lung cancer diagnosis, treatment, and survival in Asian patients living in the United States is still under debate. We have analyzed this issue using the Surveillance, Epidemiology, and End Results database. There were 102,733 lung cancer patients age 18–64 years diagnosed between 2007 and 2013. Multilevel regression analysis was performed to identify the association between insurance types, stage at diagnosis, treatment modalities, and overall mortality in Asian and non-Hispanic White (NHW) patients. Clinical characteristics were significantly different between Asian and NHW …

Liver Cancer Disparities In New York City: A Neighborhood View Of Risk And Harm Reduction Factors, G. R. Kamath, E. Taioli, N. N. Egorova, J. M. Llovet, P. V. Perumalswami, J. J. Weiss, M. Schwartz, S. Ewala, N. A. Bickell

Journal Articles

© 2018 Kamath, Taioli, Egorova, Llovet, Perumalswami, Weiss, Schwartz, Ewala and Bickell. Introduction: Liver cancer is the fastest increasing cancer in the United States and is one of the leading causes of cancer-related death in New York City (NYC), with wide disparities among neighborhoods. The purpose of this cross-sectional study was to describe liver cancer incidence by neighborhood and examine its association with risk factors. This information can inform preventive and treatment interventions. Materials and methods: Publicly available data were collected on adult NYC residents (n = 6,407,022). Age-adjusted data on liver and intrahepatic bile duct cancer came from the …

Prevalence, Comorbidity, And Correlates Of Psychiatric And Substance Use Disorders And Associations With Hiv Risk Behaviors In A Multisite Cohort Of Women Living With Hiv, J. A. Cook, J. K. Burke-Miller, P. J. Steigman, R. M. Schwartz, N. A. Hessol, J. Milam, D. J. Merenstein, K. Anastos, E. T. Golub, M. H. Cohen

Journal Articles

© 2018, The Author(s). We used the World Health Organization’s Composite International Diagnostic Interview to determine the prevalence, comorbidity, and correlates of lifetime and 12-month behavioral health disorders in a multisite cohort of 1027 women living with HIV in the United States. Most (82.6%) had one or more lifetime disorders including 34.2% with mood disorders, 61.6% with anxiety disorders, and 58.3% with substance use disorders. Over half (53.9%) had at least one 12-month disorder, including 22.1% with mood disorders, 45.4% with anxiety disorders, and 11.1% with substance use disorders. Behavioral health disorder onset preceded HIV diagnosis by an average of …

Controversies On Lung Cancers Manifesting As Part-Solid Nodules., R. Yip, K. Li, L. Liu, D. Xu, K. Tam, D. F. Yankelevitz, E. Taioli, B. Becker, C. I. Henschke

Journal Articles

PURPOSE: Summarise survival of patients with resected lung cancers manifesting as part-solid nodules (PSNs).

METHODS: PubMed/MEDLINE and EMBASE databases were searched for all studies/clinical trials on CT-detected lung cancer in English before 21 December 2015 to identify surgically resected lung cancers manifesting as PSNs. Outcome measures were lung cancer-specific survival (LCS), overall survival (OS), or disease-free survival (DFS). All PSNs were classified by the percentage of solid component to the entire nodule diameter into category PSNs

RESULTS: Twenty studies reported on PSNs

CONCLUSION: A clear definition of the upper limit of solid component of a PSN is needed to avoid …

Community Health Worker Interventions To Promote Psychosocial Outcomes Among People Living With Hiv—A Systematic Review, H Han, K Kim, Jeanne Murphy, J Cudjoe, P Wilson, P Sharps, J Farley

Nursing Faculty Publications

Background

Community health worker (CHW) interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH). Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.

Methods

We performed database searches—PubMed, EMBASE, CINAHL, and Cochrane—to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.

Results

Half of the …

Hungary: Cardiovascular Disease, Taylor Steger

Global Public Health

Hungary faces many public health issues. In particular, cardiovascular disease has impacted the majority of the Hungarian people with a mortality rate of 50-60%. The high consumption of fattening food, excessive alcohol drinking, smoking habits and tobacco use impact the entire population’s health status. This disease impacts blood vessels and causes them to narrow or be blocked. This blockage causes blood flow from the heart to be suppressed which can cause heart attacks, strokes etc. Hungary has the highest amount of people with cardiovascular disease out of all European countries. The most impacted people are in the urban areas. This …