Community Health and Preventive Medicine Commons^™

Strong Structuration Analysis Of Patterns Of Adherence To Hypertension Medication, Maureen L. Seguin, Jhaki A. Mendoza, Gideon Lasco, Lia M. Palileo-Villanueva, Benjamin Palafox, Alicia Renedo, Martin Mckee, Dina Balabanova

Development Studies Faculty Publications

Achieving blood pressure control is among the highest priorities for reducing the burden of cardiovascular diseases globally. Control is poor in the Philippines; especially in socioeconomically marginalised communities. This paper explores long-term adherence to anti-hypertensive medication in these communities; identifying 4 distinct medication adherence patterns. We draw on Strong Structuration Theory to explore motivations of action for those who are consistently adherent; consistently non-adherent; and those who became more or less adherent over time. We employ longitudinal qualitative methods comprising repeat interviews and digital diaries collected over 12 months by 34 participants. Twelve participants were consistently adherent; 9 consistently non-adherent; …

The Impact Of Global Health Disparities On Atopic Dermatitis In Displaced Populations: Narrowing The Health Equity Gap For Patients With Skin Of Color., Sami Jelousi, Divya Sharma, Andrew Alexis, Jenny E Murase

Ambulatory and Primary Care Articles

Atopic dermatitis (AD) is a relatively common inflammatory skin disease marked by eczematous lesions and pruritus often leading to significant morbidity and quality of life impairment for those affected. Recent studies have shown that patients with skin of color (SOC) carry a larger disease burden than patients of European descent. In the USA, these disparities are partly due to structural, environmental, and interpersonal racism. From a global perspective, there is a paucity of research on the burden of atopic dermatitis and other inflammatory skin diseases experienced by the record numbers of refugees, migrants, and asylum seekers around the world. Although …

Knowledge, Attitudes, And Practices (Kap) Towards Covid-19 Pandemic Among Pregnant Women In A Tertiary Hospital In Karachi, Pakistan, Sumaira Naz, Syeda Dur E Shawar, Shamila Saleem, Ayesha Malik, Amir Raza

Department of Obstetrics & Gynaecology

Background: The aim of this study was to evaluate the knowledge, attitude, and practices (KAP) of the pregnant population during the COVID-19 pandemic in a tertiary care hospital.
Methods: This cross-sectional study was conducted at Aga Khan University Hospital, Karachi, Pakistan. KAP towards COVID-19 was assessed using 21-item questionnaires. A score for each category was calculated and points were summed. The outcome variables of KAP were compared with demographic characteristics. Data were analyzed by using SPSS 19.
Results: A total of 377 patients participated in the study. The majority of the patients were multiparous (36.8%) in the age group of …

Lessons Learned: Covid-19 In Post-Corrections Secured Behavioral Rehabilitation, Jennifer G. Jones, Maria Devalpine, Erica J. Lewis

Virginia Journal of Public Health

Background: The COVID-19 case rate on June 5, 2020, for prisoners in the United States (US) was 5.5 times higher than the US population case rate (Saloner et al., 2020). Secure facilities were challenged to mitigate the spread of COVID-19. One secure behavioral rehabilitation facility made many changes to facility and program protocols to meet this challenge.

Methods: The purpose of this program evaluation was to assess newly implemented infection control measures at a secure behavioral rehabilitation facility and to inform policy and procedure recommendations for the mitigation of COVID-19 transmission in congregate living facilities in the future. Case rates, …

A Mixed Methods Investigation Of How Young Adults In Virginia Received, Evaluated, And Responded To Covid-19 Public Health Messaging, Natalie Cook, Sophie G. Wenzel, Rachel Silverman, Danielle Short, Kristina Jiles, Teace Markwalter, Mary Ann Friesen

Virginia Journal of Public Health

The purpose of this study was to investigate how young adults in Virginia received, evaluated, and responded to messages related to the coronavirus/COVID-19, a major disruptor of our time, and to understand how and when these messages influenced behavior. This was a sequential explanatory mixed methods study, including an online survey (quantitative) and virtual focus groups (qualitative). We surveyed a convenience sample of 3,694 Virginia residents by distributing a link to complete the survey online. Only data from18-24 year old adults (n=207) were included in the analysis for this study. Focus group participants were recruited from the survey participants as …

Evaluation Of Recruitment Strategies On Inclusiveness Of Populations At Risk For Health Disparities In The Statewide Remote Online Covidsmart Registry, Marilyn M. Bartholmae, Amira A. Roess, Keith D. Renshaw, Brian L. Levy, Matvey V. Karpov, Joshua M. Sill, Sunita Dodani

Virginia Journal of Public Health

Background

The COVID-19 pandemic affected health research practices. The large-scale impacts of COVID-19 and restrictions on face-to-face interaction led to increased use of remote online data collection methods. However, it is unclear if such efforts led to the representation of populations at risk for health disparities. We evaluated whether multiple recruitment strategies would capture a representative sample of individuals at risk for health disparities.

Methods

The COVIDsmart registry collected clinical, social, economic, and behavioral data in the state of Virginia from March to November, 2021. Seven hundred eighty-two adult participants were enrolled. We compared the representation of COVIDsmart participants at …

The Pharmacy Community Apgar Questionnaire: A Modified Delphi Technique To Develop A Rural Pharmacist Recruitment And Retention Tool, Daniel R. Terry, Blake Peck, Danny Hills, Jaclyn Bishop, Mark Kirschbaum, Kehinde O. Obamiro, Hoang Phan, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Introduction: An adequate healthcare workforce remains essential for the health of rural communities. Strategies to address rural health workforce challenges have often centred on the medical and nursing workforce; however, addressing the rural pharmacist workforce also remains critical as they are often the first point of contact for health advice. Initiatives have increased pharmacist supply; however, key issues such as poor attraction, recruitment, and retention to rural areas remain. The aim of this study was to support the recruitment and retention of pharmacists in rural areas of Australia through the development of the Pharmacy Community Apgar Questionnaire (PharmCAQ).

Methods …

Tip-Over Injuries Among Children: Data From An Urban Emergency Department Of Karachi, Pakistan, Rubaba Naeem, Asrar Ali, Ahmed Raheem Buksh, Ayesha Quddusi, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: Most unintentional injuries among children occur in the home environment. Tip-overs, defined as incidents where heavy objects fall on children due to some type of interaction, are one of the reasons for injuries inside the home. This study aims to determine injury patterns and outcomes for child injuries resulting from tip-overs in the home environment as reported in the emergency department.
Methods: We performed a retrospective chart review of pediatric (under 18 years) tip-overs injuries occurred in years 2010 to 2015 at the Aga Khan University Hospital. Furthermore, parents of injured children participated in phone interviews to provide information …

Criterion Validity Of A Short Food Frequency Questionnaire For Mexican American Adults, Natalia I Heredia, Deanna M Hoelscher, Vanessa Vega, Belinda M Reininger

Faculty, Staff and Student Publications

Background: The purpose of this study was to validate the School Physical Activity and Nutrition (SPAN) Food Frequency Questionnaire (FFQ) for Mexican American adults (SPAN MAA). Methods: A sample of 100 Mexican American adult participants was drawn from the Cameron County Hispanic Cohort (on the Texas–Mexico border). We used Spearman rank order correlation coefficients, kappa statistics, and percent agreement to compare the SPAN MAA questionnaire to a 24 h recall collected on the same day. Results: Of 100 participants, 93 were included in the analyses. One item showed substantial (>0.6), five items moderate (>0.4), five items fair ( …

Factors Associated With Meeting Physical Activity Guidelines During The Covid-19 Pandemic, Natalia I Heredia, Michael Machiorlatti, Belinda M Reininger, Candace Robledo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic impacted individual physical activity levels. Less is known regarding how factors such as sociodemographic and built environment were associated with physical activity engagement during the pandemic. Understanding these factors is critical to informing future infectious disease mitigation policies that promote, rather than hinder physical activity. The purpose of this study was to assess predictors of physical activity levels during the beginning of the pandemic (April-June 2020), including Stay-at-Home length and orders, neighborhood safety, and sociodemographic characteristics.

METHODS: Data included 517 participants who responded to an anonymous online survey. Physical activity was assessed with a modified Godin …

Assessing Impact Of Covid-19 Pandemic On Receipt And Timeliness Of Newborn Hearing Screening And Diagnostic Services Among Infants Born In Four States, Suhana Ema, Sana Charania, Xidong Deng, Charles Rose, Craig A. Mason, Marcus Gaffney, Brandt Culpepper, Michael Lo, Tri Tran, Marcia Fort

Journal of Early Hearing Detection and Intervention

The study compares receipt and timeliness of newborn hearing screening and follow-up diagnostic services between the pre-pandemic birth cohort and the pandemic birth cohort in four participating states. Findings from this study will help inform state Early Hearing Detection and Intervention (EHDI) programs in the future should major public health event occur again.

A Quantification And Impact Of Incomplete Revascularization Using Residual Syntax Score In Nstemi Patients After Percutaneous Coronary Intervention, Syed Waqar Ahmed, Nasir Rahman

Section of Cardiology

Objectives: The aim of this study was to assess the prognostic significance of rSS after PCI for NSTEMI in terms of all-cause mortality and MACE (Major adverse cardiac event) at 3 years of follow-up.
Methodology: A retrospective analysis of 115 consecutive NSTEMI patients who underwent PCI at the Aga Khan University Hospital Karachi between January 2016 and December 2016 was performed. 7 patients were excluded from the final analysis due to missing data (n=108). The SYNTAX scores before (baseline syntax=bSS) and after PCI (rSS) were calculated. Patients were stratified as CR if rSS =0, RICR if rSS >0 and ≤8 …

Vaccinate: Posters From The Covid-19 Pandemic, Aaron Sutherlen, Judy Diamond, Meghan Leadabrand, Julia Mcquillan, St Patrick Reid

Zea E-Books Collection

In 2022 we are living through a global pandemic, and vaccines are one of the most effective strategies for slowing the spread of infectious disease, minimizing symptoms, and lowering healthcare demands. In short, vaccines save lives and can reduce the risk of contagion from social interaction.

In the United States in late 2021, after the vaccines had been broadly available for almost a year, one in five adults still chose not to get vaccinated against COVID-19.

Art can disrupt what is embedded in our minds and open us up to new perspectives and insights. We hope to offer access to …

A Review Of Risk Concepts And Models For Predicting The Risk Of Primary Stroke, Elizabeth Hunter, John D. Kelleher

Articles

Predicting an individual's risk of primary stroke is an important tool that can help to lower the burden of stroke for both the individual and society. There are a number of risk models and risk scores in existence but no review or classification designed to help the reader better understand how models differ and the reasoning behind these differences. In this paper we review the existing literature on primary stroke risk prediction models. From our literature review we identify key similarities and differences in the existing models. We find that models can differ in a number of ways, including the …

Screening For Social Determinants Of Health To Improve Care In Pediatric Patients With Recurrent Urinary Tract Infections: A Scoping Review, Emily Gray Msn, Fnp-C, Michelle Rickard Dnp, Cpnp-Ac

Doctor of Nursing Practice Projects

Purpose: To describe what is known about how SDoH screening impacts adherence to treatment in pediatric patients with recurrent UTIs.

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

An Interprofessional Public Library-Academic Partnership For Community Outreach On Women's Health, Lyndonna Marrast, Eun Ji Kim, Danielle Ezzo, Joseph Conigliaro

Urban Library Journal

This article describes a collaboration between a branch of the Queens Public Library in NY and an academic medical center that delivered a women’s health educational program with an interprofessional team of faculty, trainees, and students. The team delivered interactive 1-hour long monthly sessions in a Question and Answer format guided by a Powerpoint presentation. The overall goal was to deliver health education workshops on common medical conditions (i.e. diabetes, heart disease) and concerns of interest to women across the lifespan (i.e. infertility, dementia) to improve the health literacy of local community members. We outlined the steps in establishing this …

Prevalence Of Sleep-Related Problems And Risks In A Community-Dwelling Older Adult Population: A Cross-Sectional Survey-Based Study, Nancy P Gordon, Jimmy H Yao, Leslea A Brickner, Joan C Lo

Faculty, Staff and Student Publications

BACKGROUND: Despite evidence of adverse health consequences of inadequate restorative sleep for older adults, assessment of sleep quantity, quality, and use of sleep aids is not routinely done. We aimed to characterize sleep problems, sleep risks, and advice received about sleep in a community-dwelling older adult population, overall and in subgroups with health conditions and functional difficulties.

METHODS: This cross-sectional study used weighted self-report data for 5074 Kaiser Permanente Northern California members aged 65-79y who responded to a 2017 or 2020 Member Health Survey. We estimated usual amount of sleep (< 6, 6 to < 7, ≥7 hours) and prevalence of sleep problems (frequent insomnia, frequent daytime fatigue, poor quality sleep, and potential sleep apnea (OSA) symptoms (frequent very loud snoring, apnea episodes)) for older adults overall, by self-rated health, and in subgroups reporting hypertension, diabetes, heart disease, frequent problems with balance/walking, and frequent memory problems. We also estimated percentages who regularly used sleep aids and had discussed sleep adequacy with a healthcare professional in the past year.

RESULTS: Approximately 30% of older adults usually got less …

Determinants Of Ambulatory Patients’ Satisfaction With Encounter At Core Service Stations In A Tertiary Hospital Of A Developing Country, Ndubuisi Emuka Opurum, Ogaji Samuel Daprim, Felix Emeka Anyiam

Patient Experience Journal

Patients may have different and complex convictions of what their idea of satisfaction is, which may not be addressed regarding what they perceive as satisfaction. Therefore, using the patients’ demographic and clinical characteristics could tailor the individual needs of these patients, hence, providing feedback and recommendations on improvement in services provided. This study examined the determinants of patients’ satisfaction with general outpatient department (GOPD) services of a tertiary hospital in Rivers State, Nigeria. A descriptive cross-sectional study was carried out among new and repeat patients attending the GOPD of the University of Port-Harcourt Teaching Hospital, Rivers State, Nigeria. A structured …

Working Out The Kinks: Creating Solutions To Assist Health Care Workers To Take Vital Signs Through Effective Cable Management, Carl R. Russell Iii, Emily J. Linder, Maya A. Godbole

Purdue Journal of Service-Learning and International Engagement

EPICS (Engineering Projects in Community Service) is a service-learning design program run through Purdue University. It strives to teach students design skills through providing solutions for individuals, communities, and organizations in the surrounding area while mirroring engineering industry standards. BME (Bio-medical Engineering) is a team within EPICS that strives to serve community partners through biomedical applications. Members of a health care team often spend valuable time organizing cables associated with machines used to take patients’ vital signs. Due to time constraints and the fast-paced work environment, these cables may be mismanaged and damaged. The BME team is working on a …

Policy Forum: Examining The Relationship Between Vacant Health Director Positions & Public Health, Ben Barber

Virginia Journal of Public Health

No abstract provided.

If Smoking Were Eliminated, Which Us Counties Would Still Have High Rates Of Smoking-Related Cancers?, Douglas J. Myers, David Kriebel

Public and Population Health Faculty Publications and Presentations

Objective: to characterize the county variability of the impact of smoking elimination on rates of smoking-related cancers and explore whether common environmental indices predicted which metropolitan counties would experience high rates of smoking-related cancers even after smoking was eliminated. Methods: Surveillance, Epidemiology, and End Results Program (SEER) and Environmental Protection Agency (EPA) data were obtained. County level cancer rates for 257 metropolitan SEER counties, including the observed rates and those predicted after eliminating smoking, were derived via multilevel regression modeling and age standardized to the 2016 SEER population. Associations between the EPA’s Environmental Quality Index (EQI) scores and “Low Benefit” …

Breast Surgery Super-Specialization: Impact On Advanced Surgical Training And Research, Danish Ali, Sana Zeeshan, Nifasat Farooqi, Lubna Vohra

Medical College Documents

The earliest records of breast cancer (BC) date back to 3,000 - 2,500 B.C., ever since multiple curative options have been explored. First known wide margin excision was performed around 1st Century AD and a prototype of the modern-day BC surgery, Halsted radical mastectomy, was performed in the 20th Century. BC is the most common cancer in Pakistan accounting for up to 14.5% of the total cancer incidences. Accredited breast surgery fellowships were established in the UK and USA in 2002 and 2003, respectively. In Pakistan, the movement was delayed and the two-year College of Physicians and Surgeons Pakistan (CPSP) …

Use Of A Microsimulation Method For Assessing Dynamics Of Smoking Status And Gains In Life Expectancy After Quitting In A Longitudinal Cohort Of Us Older Adults, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Objectives: Previous studies were unable to estimate the dynamics of smoking status in the US elderly general population, and no study has assessed the benefit of quitting in terms of resultant gains in life expectancy. We proposed a novel method to estimate the per cent of quitting in remaining lifetime, successful quitting and relapse, as well as life expectancy by participants' baseline smoking status.

Design: Longitudinal cohort.

Setting: US community-dwelling population.

Participants: Respondents from the Medicare Health Outcome Survey Cohort 15 (baseline 2012, follow-up 2014). We included respondents who were aged ≥65 years and alive at the baseline and participated …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Faculty, Staff and Student Publications

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …

The Causes Of Preterm Neonatal Deaths In India And Pakistan (Purpose): A Prospective Cohort Study, Sangappa M. Dhaded, Sarah Saleem, Shivaprasad S. Goudar, Shiyam Sunder Tikmani, Kay Hwang, Gowdar Guruprasad, Gayathri H. Aradhya, Varun B. Kusagur, Sana Roujani, Sayyeda Reza

Community Health Sciences

Background: Preterm birth remains the major cause of neonatal death worldwide. South Asia contributes disproportionately to deaths among preterm births worldwide, yet few population-based studies have assessed the underlying causes of deaths. Novel evaluations, including histological and bacteriological assessments of placental and fetal tissues, facilitate more precise determination of the underlying causes of preterm deaths. We sought to assess underlying and contributing causes of preterm neonatal deaths in India and Pakistan.
Methods: The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe) was a prospective cohort study done in three hospitals in Davangere, India, and …

Risk Factors For Community-Acquired Bacterial Infection Among Young Infants In South Asia: A Longitudinal Cohort Study With Nested Case–Control Analysis, Nicholas E. Connor, Mohammad Shahidul Islam, Luke C. Mullany, Nong Shang, Zulfiqar Ahmed Bhutta, Anita K. M. Zaidi, Sajid Bashir Soofi, Muhammad Imran Nisar, Pinaki Panigrahi, Kalpana Panigrahi

Department of Paediatrics and Child Health

Objective: Risk factors predisposing infants to community-acquired bacterial infections during the first 2 months of life are poorly understood in South Asia. Identifying risk factors for infection could lead to improved preventive measures and antibiotic stewardship.
Methods: Five sites in Bangladesh, India and Pakistan enrolled mother-child pairs via population-based pregnancy surveillance by community health workers. Medical, sociodemographic and epidemiological risk factor data were collected. Young infants aged 0-59 days with signs of possible serious bacterial infection (pSBI) and age-matched controls provided blood and respiratory specimens that were analysed by blood culture and real-time PCR. These tests were used to build …

The Experiences And Challenges Of Community Health Volunteers As Agents For Behaviour Change Programming In Africa: A Scoping Review, Mary Ndu, Ellena Andoniou, Sorcha Mcnally, Francisco Olea Popelka, Marisa Tippet, Elysee Nouvet

Health Studies Publications

ommunity health volunteers are considered a vital part of the community health structure in Africa. Despite this vital role in African health systems, very little is known about the community health volunteers’ day-to-day lived experiences providing services in communities and supporting other health workers. This scoping review aims to advance understanding of the day-to-day experiences of community health volunteers in Africa. In doing so, this review draws attention to these under-considered actors in African health systems and identifies critical factors and conditions that represent challenges to community health volunteers’ work in this context. Ultimately, our goal is to provide a …

Vaccination For Newly Emerged Infectious Diseases As A Blessing Or Curse From The Perspective Of The Lebanese Population: A Two-Phase Study, May Saab, Souraya Domiati

BAU Journal - Health and Wellbeing

Although vaccination campaigns have been vital in mitigating the spread of many pandemics, false information about COVID-19 vaccine through social media might have a negative impact on its acceptance. In Lebanon, prior to the vaccination campaign, the acceptance rate of COVID-19 vaccination did not exceed 20 %. In the current study, the acceptance of vaccination by Lebanese participants was studied following the launching of the vaccine. The aim of the work is to reveal the actual intention of the studied sample once the vaccine is available and investigate the change in the perception and acceptance rate of Lebanese citizens about …

Neurodevelopment Assessment Of Small For Gestational Age Children In A Community-Based Cohort From Pakistan, Sabahat Naz, Zahra Hoodbhoy, Ali Jaffar, Sidra Kaleem Jafri, Babar Hasan, Devyani Chowdhury, Melissa Gladstone

Department of Paediatrics and Child Health

Background: Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.
Methods: This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth …