International Public Health Commons^™

Clean Water For Developing Countries, Hilary Wighton

Social Sciences

No abstract provided.

Environmental Health Service Learning And Water Quality In Gales Point, Belize, Ritchie D. Taylor, Shabbar Ranapurwala, Matthew Hill

Impact Belize

Belize is a country in Central America, formerly British Honduras, located south of Mexico and east of Guatemala on the Yucatan Peninsula. As part of the WKU International Health and Human Service Learning Program, an assessment of the local water supply in Gales Point, Belize was conducted. Gales Point is a small rural village located on the Caribbean Sea coast of Belize. Belize is a developing country thus access to safe drinking water can be problematic, as was observed on the local scale. The lack of technical, managerial and financial capacity coupled with the rural location of the village, create …

Tailoring Messages To Individual Differences In Monitoring- Blunting Styles To Increase Fruit And Vegetable Intake, Pamela Williams-Piehota, Amy E. Latimer, Nicole A. Katulak, Ashley Cox, Stephanie A. Navarro Silvera, Linda Mowad, Peter Salovey

Department of Public Health Scholarship and Creative Works

Objective

To examine whether messages matched to individuals' monitoring-blunting coping styles (MBCS) are more effective in increasing fruit and vegetable intake than mismatched messages. MBCS refers to the tendency to either attend to and amplify, or distract oneself from and minimize threatening information.

Design/Setting

Randomly assigned messages were tailored to resonate with either monitors or blunters and delivered at baseline, 1 week, 2 months, and 3 months later. Surveys were conducted at baseline and 2 and 4 months later.

Participants

531 callers to a cancer information hotline who did not meet the 5 A Day guideline.

Intervention

A brief telephone-delivered …

Lavichè: Haiti's Vulnerability To The Global Food Crisis, John Mazzeo

John Mazzeo, Ph.D.

No abstract provided.

Developing A School Functioning Index For Middle Schools, Amanda Birnbaum, Leslie A. Lytle, Cheryl L. Perry, David Murray, Mary Story

Department of Public Health Scholarship and Creative Works

Despite widespread recognition of schools' role in the healthy development of youth, surprisingly little research has examined the relationships between schools' overall functioning and the health‐related behavior of students. School functioning could become an important predictor of students' health‐related behavior and may be amenable to intervention. This paper describes the development and testing of the School Functioning Index (SFI) as a first step in investigating this question. The index was developed for use with middle schools and conceived as a predictor of students' violent behavior, with the potential for extending research applications to additional health and social behaviors. Using social …

Peer-Led, School-Based Nutrition Education For Young Adolescents: Feasibility And Process Evaluation Of The Teens Study, Mary Story, Leslie A. Lytle, Amanda Birnbaum, Cheryl L. Perry

Department of Public Health Scholarship and Creative Works

Peer education has become a popular strategy for health promotion interventions with adolescents, but it has not been used widely in school‐based nutrition education. This paper describes and reports on the feasibility of the peer leader component of school‐based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower-fat foods. About 1,000 seventh‐grade students in eight schools received the nutrition intervention. Of these, 272 were trained as peer leaders to assist the teacher in implementing the activities. Results from a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher …

Breastfeeding: A Landmark In Global Public Health, Melissa Tinling

Independent Study Project (ISP) Collection

In the study of public health and the discipline of global health, what is the meaning of the term “global public health”? The author, Melissa Tinling, defines the concept and gives an illustration through the model of the global effort to increase breastfeeding prevalence. Using the WHO and UNICEF joint Global Strategy for Infant and Young Child Feeding as the central framework, the responsibilities of the global, international, national, and local levels are depicted within the context of Geneva, Switzerland. The author identifies the ethical considerations implicated in the application of the global public health strategy to breastfeeding.

“I Didn’T Feel Like Living”: The Prevalence, Perceptions, And Prevention Of Hiv/Aids Among Tibetan Refugees In Kathmandu, Caitlin Macleod-Bluver

Independent Study Project (ISP) Collection

The fight against HIV/AIDS is a global one, a concern that is addressed by both the Nepali government and the Tibetan government in exile. Both governments have taken measures to prevent the further spread of the epidemic among their populations, increase knowledge and awareness about the disease, and provide better treatment and care to those living with HIV/AIDS. However, there is a gap between these efforts, particularly within the Tibetan refugee community. As a result of Tibetan’s refugee status in Nepal, fewer resources have been allocated for dealing with and understanding the risk factors for Tibetans in exile in Nepal. …

Community Empowerment Through An Academic Product: Implications For The Social-Justice, Tamara Leech, Edrose Potts Jr.

Department of Public Health Scholarship and Creative Works

Often, African American community organizations are distanced from government institutional practices. In response, they may approach local academics to help bridge the divide. This think piece explores lessons that one academic scholar learned during the process of writing and distributing an applied report that ultimately helped a community organization to gain access to the governmental decision-making process. In exploring the project, we first focus on the process and value of shifting from a charity orientation to a social justice orientation. Second, we use the report itself to provide examples of essential, concrete aspects of social justice-oriented products. In the end, …

Issues For Dsm-V: The Role Of Culture In Psychiatric Diagnosis, Renato D. Alarcón, Anne E. Becker, Roberto Lewis-Fernández, Robert C. Like, Prakash Desai, Edward Foulks, Junius Gonzales, Helena Hansen, Alex Kopelowicz, Francis G. Lu, María A. Oquendo, Annelle Primm

Publications from Provost Junius J. Gonzales

No abstract provided.

Residential Modifications And Decline In Physical Function Among Community-Dwelling Older Ad, Sze Yan Liu, Kate L. Lapane

Department of Public Health Scholarship and Creative Works

Purpose: The purpose of this study is to quantify the effect of residential modification on decreasing the risk of physical function decline in 2 years.

Design: Cohort study using propensity scores method to control for baseline differences between individuals with residential modifications and those without residential modifications.

Participants: Participants (N = 9,447) were from the Second Longitudinal Study on Aging, a nationally representative sample of the civilian noninstitutionalized population, aged 70 years and older in the United States at the time of baseline interview in 1994-1995.

Methods: Participants self-reported residential modifications at baseline (e.g., railings, bathroom modifications). The decline in …

Program “Miracle Grow”: Program Staff And Evaluators Joining Forces To Power-Up Program Potential, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Like all living things, health education programs grow, change, and mature. If left unattended, however, they can fade, fail, or fall apart. Evaluation can strengthen a program, particularly when it is rooted in a strong relationship among experienced, knowledgeable, and motivated teams of planners, implementers, clients, and evaluators. Evaluation can be the key to helping your program realize its full potential and, even, if threatened, flourish. When program and evaluation staff work together on pilot/demonstration projects, new program roll-outs, or established interventions, the results are like “Miracle Grow” to your programs!

Public Health Ethics: Establishing “Durable Solutions” Within The Global Polio Eradication Initiative In Nigeria, Tiffany T. Mason

Independent Study Project (ISP) Collection

Discussions on public health ethics often appeal to the same codes of conduct established in the field of bioethics. Principles of bioethics contribute to the morality of the study of public health—proposing an optimal code of conduct in the medical care and human research aspects of the field. For example, public health researchers are aware of their obligations to consider informed consent, confidentiality, and the equal distribution of risks and benefits in the implementation of their studies and interventions. However, public health practice extends far beyond medical care and human research. Thus, it is inappropriate to assume that codes established …

Area Specific Self-Esteem, Values, And Adolescent Substance Use, Joseph Donnelly, Michael Young, Rebecca Pearson, Tina M. Penhollow, Aida Hernandez

Department of Public Health Scholarship and Creative Works

The use of illicit and licit drugs continues to be a major public health concern. Many prevention and drug education programs address this issue by attempting to enhance self-esteem. The idea is that increased levels of self-esteem will serve as a protective factor in decreasing the motivation and increasing the resistance to use drugs. This study explored the relationship between area specific self-esteem and adolescent substance use. Participants (n = 700) completed a self-report questionnaire which included items measuring the use and expected use of selected substances. Results indicated significant differences in home and school self-esteem scores between users/expected …

Vitamin D Status Among Bangladeshi Women Of Reproductive Age, Ann Micka

Masters Theses 1911 - February 2014

Vitamin D deficiency is of particular concern among women in many south Asian countries due to low availability of vitamin D-rich foods, dark skin pigmentation, and cultural and religious practices that promote the wearing of concealing clothing. However, information regarding the vitamin D status of many subpopulations in south Asian countries is limited. The current study was conducted to assess the vitamin D status of 147 Bangladeshi women of reproductive age and determine whether vitamin D status influences susceptibility to arsenic-associated skin lesions (75 cases, 72 controls). Serum 25(OH)D3 levels were measured using a radioimmunoassay. The mean serum vitamin D …

Final Evaluation Of The Project For Expanding The Role Of Networks Of People Living With Hiv/Aids, Young-Mi Kim, John Lukwago, Stella Neema

HIV and AIDS

In July 2006, the International HIV/AIDS Alliance launched a three-year project on Expanding the Role of Networks of People Living with HIV/AIDS in Uganda. The project, which is funded by the United States Agency for International Development (USAID)/Uganda, sought to increase the involvement of people living with HIV/AIDS (PHA) in the HIV/AIDS response and to improve access to and utilization of prevention, treatment, care, and support services for PHA households. USAID/Uganda commissioned an evaluation of the project’s design, strategies, and performance in order to improve its implementation and learn from its successes and challenges. The study was a cross-sectional descriptive …

Breast Cancer Survival In Ontario And California, 1998-2006: Socioeconomic Inequity Remains Much Greater In The United States, Kevin M. Gorey

Social Work Publications

This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998-2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care.

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Wait Times For Surgical And Adjuvant Radiation Treatment Of Breast Cancer In Canada And The United States: Greater Socioeconomic Inequity In America, Kevin M. Gorey

Social Work Publications

PURPOSE: The demand for cancer care has increased among aging North American populations as cancer treatment innovations have proliferated. Gaps between supply and demand may be growing. This study examined whether socioeconomic status has a differential effect on waits for surgical and adjuvant radiation treatment (RT) of breast cancer in Canada and the US.

METHODS: Ontario and California cancer registries provided 929 and 984 breast cancer cases diagnosed between 1998 and 2000 in diverse urban and rural places. Residence-based socioeconomic data were taken from censuses. Cancer care variables were reliably abstracted from health records: stage, receipt of surgery and RT, …

Levels, Trends, And Reasons For Contraceptive Discontinuation, Sarah E.K. Bradley, Hilary Schwandt, Shane Khan

Fairhaven Faculty Publications

Contraceptive discontinuations contribute substantially to the total fertility rate, unwanted pregnancies, and induced abortions. This study examines levels and trends in contraceptive switching, contraceptive failure, and abandonment of contraception while still in need of pregnancy prevention. Data come from the two most recent Demographic and Health Surveys in Armenia, Bangladesh, Colombia, the Dominican Republic, Egypt, Indonesia, Kenya, and Zimbabwe. Results show that contraceptive discontinuation in the first year of use is common (18 to 63 percent across countries), and that the majority of these discontinuations are among women who are still in need of contraception: between 12 and 47 percent …

The Adolescent Experience In-Depth: Using Data To Identify And Reach The Most Vulnerable Young People—Honduras 2005, Population Council

Poverty, Gender, and Youth

“The Adolescent Experience In-Depth: Using Data to Identify and Reach the Most Vulnerable Young People: Honduras 2005” is part of a series of Population Council guides that draw principally on data from the Demographic and Health Surveys to provide decisionmakers at all levels—from governments, nongovernmental organizations, and advocacy groups—with evidence on the situation of adolescent girls and boys and young women aged 10–24 years. The data are presented in graphs, tables, and maps (wherever possible), providing multiple formats to make the information accessible to a range of audiences. Section I is the Foreword. Section II offers brief technical notes specific …

The Copperbelt Model Of Integrated Care For Survivors Of Rape And Defilement: Testing The Feasibility Of Police Provision Of Emergency Contraceptive Pills, Jill Keesbury, Mary Zama, Sudha Shreeniwas

Reproductive Health

The Zambian Ministry of Home Affairs (Police Service), Ministry of Health (MOH) and the Population Council collaborated on an operations research study designed to improve services for survivors of gender-based violence (GBV). Specifically, the study tested the feasibility of police provision of emergency contraception (EC). It also hypothesized that the intervention could strengthen GBV services at both police and health facilities through an increased emphasis on multisectoral collaboration. Based on the study’s findings, national scale-up of this program has been widely endorsed. The following recommendations are offered to guide such scale-up: ensure that a dedicated EC pill is available through …

Translating Medical Evidence Into Practice: Working With Communities And Providers To Promote Active Management Of The Third Stage Of Labour, B. Subha Sri

Reproductive Health

Although postpartum hemorrhage is a leading cause of death in India, and despite the fact that active management of the third stage of labor (AMTSL) has been established as a best practice, efforts to promote it have been limited. This paper documents the experiences of a project that aimed to enable the translation of available evidence regarding AMTSL into practice through two strategies, at community and provider levels respectively. Community-level activities included efforts to build awareness regarding safe delivery practices, sensitize individuals regarding the rights perspective and their entitlement to safe services, and facilitate the translation of this awareness into …

Revitalizing Family Planning: Lessons Learned On Strengthening Contraceptive Provision, Frontiers In Reproductive Health

Reproductive Health

Attention and resources have gradually shifted from family planning (FP) in the past decade, but globally need remains high, with an estimated 350 million couples lacking access to FP. FRONTIERS in Reproductive Health Program findings can help address this need by providing useful lessons on process and impact of improving quality of care in clinics, feasibility and effectiveness of community‐based distribution, and proven ways to increase access to underutilized contraceptive methods. This evidence can help strengthen programs and can be used for advocacy in revitalizing FP efforts, particularly in sub‐Saharan Africa where modern method contraceptive prevalence is only 16 percent. …

Maximizing Utilization Of Research, Frontiers In Reproductive Health

Reproductive Health

Operations research (OR) can only be judged successful if results are utilized for making decisions to strengthen RH/FP policies and service delivery. How can this best be achieved? How can both process and impact of OR be measured? Drawing from ten years of FRONTIERS in Reproductive Health OR experience, a number of key principles for promoting research utilization, illustrated with documented examples, are presented here. One important first step is clarifying terms used, almost interchangeably, in research utilization, as it incorporates a range of ways in which research can be used for making decisions to strengthen RH/FP policies and programs. …

Capacity Building: Creating A Culture Of Evidence-Based Decisionmaking, Frontiers In Reproductive Health

Reproductive Health

For research to have significant impact, it is important to have not only trained individuals and institutions capable of conducting research, but also program managers and donors who believe in making decisions based on evidence. The focus on fostering research utilization through capacity building has been a major contribution of the FRONTIERS legacy. The FRONTIERS capacity-building initiative began in 1999 in response to the need for developing-country partners and institutions to conduct research, understand study findings, and develop policies and programs based on evidence. This is one of eight Legacy Papers synthesizing major lessons learned in research conducted under the …

Youth Reproductive Health: Investing In The Future, Frontiers In Reproductive Health

Reproductive Health

Youth—young people aged 10–24—constitute about a quarter of the world's population. Nearly three-quarters of these young people live in the developing world, and they suffer a disproportionate share of unplanned pregnancies, STIs including HIV, and other reproductive health (RH) problems. Research undertaken by FRONTIERS has shed light on numerous aspects of youth RH, including the information needs of young people, married adolescents, and parents and guardians. Findings from over 20 studies on youth RH provide important lessons about which interventions are effective, what kind of impact is possible, and what approaches have limited impact. This paper focuses on engaging all …

Financial Sustainability Of Reproductive Health Services—Understanding Costs: An Essential Skill In Reproductive Health Programs, Frontiers In Reproductive Health

Reproductive Health

Reproductive health (RH) services remain a low priority for most developing country health programs and face continuing reductions in donor funding and competition from other priorities, such as HIV and malaria. Thus, it is important to understand the costs of interventions and to compare them with existing or alternative service-delivery strategies. FRONTIERS studies provide important lessons about measuring costs and effectiveness of public and nongovernmental programs, planning for costing during scale-up, and improving understanding of issues influencing financial sustainability. This is one of eight Legacy Papers synthesizing major lessons learned in research conducted under the FRONTIERS in Reproductive Health Program. …

Pilot Community-Based Intervention To Address The Needs Of Elderly Caregivers In The Eastern Cape Province, South Africa, Priscilla Reddy, Shegs James, H. Mutumba Bilay-Boon, Eka Esu-Williams, Hena Khan

HIV and AIDS

The HIV epidemic in South Africa has placed a substantial burden on elderly caregivers, mainly women, who are often tasked with caring for their grandchildren who are orphaned and rendered vulnerable by the death or illness of their parents. The Medical Research Council (MRC), Age-in-Action, and the Horizons Program conducted formative research, as described in this research summary, to assess the needs of elderly caregivers in the Eastern Cape Province of South Africa in 2005. The investigations revealed that elderly caregivers faced a number of challenges including difficulty communicating with youth, fears and a sense of hopelessness around matters regarding …

Formative Evaluation: Presidential Initiative On Aids Strategy For Communication To Youth, Netsayi N. Mudege, Chi-Chi Undie

HIV and AIDS

HIV prevention programming is increasingly taking place in school settings, which provide an expansive population of young people and offer immense potential for impact on the lives of this target group. The Presidential Initiative on AIDS Strategy for Communication to Youth (PIASCY) is a school-based program that has sought to address the HIV/AIDS epidemic in Uganda in a holistic manner since 2002, targeting young people, school personnel, parents, and the wider community. A formative evaluation was conducted by the African Population and Health Research Center in February 2009 to provide an understanding of: the extent to which PIASCY is achieving …