Public Health Education and Promotion Commons^™

Reproductive, Maternal, Neonatal And Child Health In Conflict: A Case Study On Syria Using Countdown Indicators, Jocelyn Dejong, Hala Ghattas Ph.D., Hyam Bashour, Rima Mourtada, Chaza Akik, Amelia Reese-Masterson

Faculty Publications

Introduction Women and children account for a disproportionate morbidity burden among conflictaffected populations, and yet they are not included in global accountability frameworks for women's and children's health. We use Countdown to 2015 (Millennium Development Goals) health indicators to provide an up-to-date review and analysis of the best available data on Syrian refugees in Jordan, Lebanon and Turkey and internally displaced within Syria and explore data challenges in this conflict setting.

Methods We searched Medline, PubMed, Scopus, Popline and Index Medicus for WHO Eastern Mediterranean Region Office and relevant development/humanitarian databases in all languages from January 2011 until December 2015. …

Gulf States Health Policy Center Community Research Fellows Birmingham, Al Evaluation Report, Candace Bright, Braden Bagley

Faculty Publications

The Gulf States Community Research Program (GSCRP) program took place in Birmingham between January 10th, 2017 and May 16th, 2017. This report reflects the implementation and evaluation of a community based participatory training (CBPR) program for this cohort of community members. The report provides data on the assessment of the program’s effectiveness in promoting the role of underserved populations in research by enhancing the capacity for CBPR. In assessing the social network development of the cohort, we seek to understand effectiveness in bridging many community roles to serve the purpose of addressing health disparities. Specifically, the report assesses if the …

Gulf States Health Policy Center Community Research Fellows Mobile, Al Evaluation Report, Candace Bright, Braden Bagley

Faculty Publications

The Gulf States Community Research Program (GSCRP) program took place in Mobile between January 10th, 2017 and May 9, 2017. This report reflects the implementation and evaluation of a community based participatory training (CBPR) program for this cohort of community members. The report provides data on the assessment of the program’s effectiveness in promoting the role of underserved populations in research by enhancing the capacity for CBPR. In assessing the social network development of the cohort, we seek to understand effectiveness in bridging many community roles to serve the purpose of addressing health disparities. Specifically, the report assesses if the …

Future Orientation, Social Support, And Psychological Adjustment Among Left-Behind Children In Rural China: A Longitudinal Study, Shaobing Su, Xiaoming Li, Danhua Lin, Maoling Zhu

Faculty Publications

Existing research has found that parental migration may negatively impact the psychological adjustment of left-behind children. However, limited longitudinal research has examined if and how future orientation (individual protective factor) and social support (contextual protective factor) are associated with the indicators of psychological adjustment (i.e., life satisfaction, school satisfaction, happiness, and loneliness) of left-behind children. In the current longitudinal study, we examined the differences in psychological adjustment between left-behind children and non-left behind children (comparison children) in rural areas, and explored the protective roles of future orientation and social support on the immediate (cross-sectional effects) and subsequent (lagged effects) status …

Breastfeeding Practices, Beliefs, And Social Norms In Low-Resource Communities In Mexico: Insights For How To Improve Future Promotion Strategies, Tessa M. Swigart, Anabelle Bonvecchio, Florence L. The´Odore, Sophia Zamudio-Hass, Maria Angeles Villanueva-Borbolla, Jim Thrasher

Faculty Publications

INTRODUCTION:

Breastfeeding is recommended exclusively for the first 6 months after birth, with continued breastfeeding for at least 2 years. Yet prevalence of these recommendations is low globally, although it is an effective and cost-effective way to prevent serious infections and chronic illness. Previous studies have reported that social support greatly influences breastfeeding, but there is little evidence on perceived social norms in Mexico and how they affect actual behavior.

OBJECTIVE:

Our objective was to investigate breastfeeding intention, practices, attitudes, and beliefs, particularly normative, among low-resource communities in central and southern Mexico.

METHODS:

We performed a secondary analysis using the …

Individual And Structural Environmental Influences On Utilization Of Iron And Folic Acid Supplementation Among Pregnant Women In Harare, Zimbabwe, Chiwoneso B. Tinago, Lucy Annang Ingram, Christine E. Blake, Edward A. Frongillo Jr.

Faculty Publications

Micronutrient deficiencies are prevalent among Zimbabweans with serious health and social implications. Due to alack of a national micronutrient food fortification policy, the Zimbabwe Ministry of Health and Child Careestablished a policy for the prevention of maternal micronutrient deficiencies, which centres on pregnant womenreceiving daily iron and folic acid (IFA) at theirfirst antenatal care visit and throughout pregnancy. Despite theseefforts, utilization of IFA supplementation in pregnancy in Zimbabwe is low. This study aimed to understand theexperiences and knowledge of IFA supplementation among pregnant women and healthcare workers in Harare,Zimbabwe, and the influence of health-service and social environments on utilization. Semi-structured …

Implications Of Synchronous Ivr Radio On Syrian Refugee Health And Community Dynamics, R. Talhouk, T. Bartindale, K. Montague, S. Mesmar, C. Akik, A. Ghassani, M. Najem, Hala Ghattas Ph.D., P. Olivier, M. Balaam

Faculty Publications

With 1,033,513 Syrian refugees adding a strain on the Lebanese healthcare system, innovation is key to improving access to healthcare. Our previous work identified the potential for technology to improve access to antenatal care services and increase refugee agency. Using (1) paper mock ups and a mobile based prototype, (2) process mapping, (3) focus groups and interviews and (4) key informant meetings, we explored the concept of refugee led community radio shows to deliver peerled healthcare.1We observed the influence of community radio shows on Syrian refugee health education, community dynamics and community agency in relationships between healthcare providers and refugees. …

Association Of Alzhemier's Disease With Hepatitis C Among Patients With Bipolar Disorder, Herng-Ching Lin, Sudha Xirasagar, Hsin-Chien Lee, Chung-Chien Huang, Chao-Hung Chen

Faculty Publications

Associations of hepatitis C virus infection with Alzheimer’s disease have not been studied among higher risk, bipolar disorder patients. This population-based case-control study investigated the risks of hepatitis C virus infection among Alzheimer’s disease patients with bipolar disorder in the years preceding their Alzheimer’s disease diagnosis. We used 2000–2013 data from the Longitudinal Health Insurance Database in Taiwan. Among patients with bipolar disorder, 73 were diagnosed with Alzheimer’s disease (cases), who were compared with 365 individuals with bipolar disorder but without Alzheimer’s disease (randomly selected controls matched on sex, age, and index year with cases). Prior claims (before the diagnosis …

Dietary Inflammatory Index In Relation To Sub-Clinical Atherosclerosis And Atherosclerotic Vascular Disease Mortality In Older Women, Nicola P. Bondonno, Joshua R. Lewis, Lauren C. Blekkenhorst, Nitin Shivappa, Richard J. Woodman, Catherine P. Bondonno, Natalie C. Ward, James R. Hébert, Peter L. Thompson, Richard L. Prince, Jonathan M. Hodgson

Faculty Publications

Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual’s diet. The primary objective of this study was to assess the association of the DII with common carotid artery–intima-media thickness (CCA–IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted …

Changes In The Policy Environment For Infant And Young Child Feeding In Vietnam, Bangladesh, And Ethiopia, And The Role Of Targeted Advocacy, Jody Harris, Edward A. Frongillo Jr., Phuong H. Nguyen, Sunny S. Kim, Purnima Menon

Faculty Publications

Background

There is limited literature examining shifts in policy environments for nutrition and infant and young child feeding (IYCF) over time, and on the potential contribution of targeted advocacy to improved policy environments in low- and middle-income countries. This study tracked changes in the policy environment over a four-year period in three countries, and examined the role of targeted nutrition and IYCF advocacy strategies by a global initiative.

Methods

Qualitative methods, including key informant interviews, social network mapping, document and literature review, and event tracking, were used to gather data on nutrition and IYCF policies and programs, actor networks, and …

A Higher Dietary Inflammatory Index Score Is Associated With A Higher Risk Of Breast Cancer Among Chinese Women: A Case–Control Study, Wu-Qing Huang, Xiong-Fei Mo, Yan-Bing Ye, Nitin Shivappa, Fang-Yu Lin, Jing Huang, James R. Hébert, Bo Yan, Cai-Xia Zhang

Faculty Publications

Previous studies have investigated the association between dietary inflammatory potential and the development of cancer. For breast cancer the results have been equivocal. The present study aimed to investigate whether higher Dietary Inflammatory IndexTM (DII) scores were associated with increased risk of breast cancer among Chinese women. A total of 867 cases and 824 controls were recruited into the present case–control study from September 2011 to February 2016. DII scores were computed based on baseline dietary intake assessed by a validated 81-item FFQ. The OR and 95 % CI were assessed by multivariable logistic regression after adjusting for various potential …

Gender Disparities In Midlife Hypertension: A Review Of The Evidence On The Arab Region, Christelle Akl, Chaza Akik, Hala Ghattas Ph.D., Carla Makhlouf Obermeyer

Faculty Publications

Objective

While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region.

Methods

We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region. We abstracted information on the prevalence of hypertension among women and men, in general populations during midlife.

Results

Nineteen studies provided data on the …

Trading Pounds For Points: Engagement And Weight Loss In A Mobile Health Intervention, Sarah Hales, Gabrielle Turner-Mcgrievy, Sarah Wilcox, Rachel Davis, Arjang Fahim, Michael N. Huhns, Homayoun Valafar

Faculty Publications

Abstract Objective The objective of this study was to describe participant engagement and examine predictors of weight loss and points earned through the point-based incentive system of the Social Pounds Off Digitally (POD) app.

Materials and methods Overweight and obese adults with Android smartphones/tablets (body mass index 25–49.9 kg/m2; N = 24) were recruited for a 3-month weight loss intervention. Participants completed a survey assessing demographics and personality and had their weight measured. Participants received the content of the intervention via podcasts and used the Social POD app to self-monitor diet, physical activity, and weight. The Social POD app contained: …

Social Franchising And A Nationwide Mass Media Campaign Increased The Prevalence Of Adequate Complementary Feeding In Vietnam: A Cluster-Randomized Program Evaluation, Rahul Rawat, Phuong Hong Nguyen, Lan Mai Tran, Nemat Hajeebhoy, Huan Van Nguyen, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( = ∼500 children aged 6-23.9 …

First Year Physical Activity Findings From Turn Up The Heat (Healthy Eating And Activity Time) In Summer Day Camps, Robert Weaver, Keith Brazendale, Jessica L. Chandler, Gabrielle Turner-Mcgrievy, Justin B. Moore, Jennifer L. Huberty, Dianne S. Ward, Michael W. Beets

Faculty Publications

Background Summer day camps (SDCs) serve 14 million children yearly in the U.S. and aim to provide participating children with 60 minutes of moderate-to-vigorous physical activity (MVPA). This study evaluated an intervention designed to increase the percent of children meeting this MVPA guideline.

Design Two-group, pre-post quasi-experimental.

Setting/Participants Twenty SDCs serving 1,830 children aged 5–12 years were assigned to MVPA intervention (n = 10) or healthy eating attention control (n = 10).

Intervention

The STEPs (Strategies to Enhance Practice) intervention is a capacity-building approach grounded in the Theory of Expanded, Extended and Enhanced Opportunities. Camp leaders and staff receive training …

Inflammatory Potential Of Diet, Weight Gain, And Incidence Of Overweight/Obesity: The Sun Cohort, Alyson Haslam, Sara Wagner Robb, James R. Hébert, Hanwen Huang, Michael David Wirth, Nitin Shivappa, Mark H. Ebell

Faculty Publications

Objective

The Dietary Inflammatory Index (DII)TM, which was developed to characterize the inflammatory potential of a person’s diet, has been shown to be associated with inflammatory conditions such as cancer. The present study aimed to investigate the association between DII scores and colorectal adenoma (CRA), a pre-cancerous condition.

Design

Responses to baseline dietary questionnaires were used calculate DII scores. In a cross-sectional study design, the association between DII scores and CRA prevalence was determined in men and women separately using logistic regression models.

Setting

Ten cancer screening centres across the USA.

Subjects

Participants were those included in the screening arm …

Changes In Underlying Determinants Explain Rapid Increases In Child Linear Growth In Alive & Thrive Study Areas Between 2010 And 2014 In Bangladesh And Vietnam, Phuong Hong Nguyen, Derek Headey, Edward A. Frongillo Jr., Lan Mai Tran, Rahul Rawat, Marie T. Ruel, Purnima Menon

Faculty Publications

Background: Child linear growth sometimes improves in both intervention and comparison groups in evaluations of nutrition interventions, possibly because of spillover intervention effects to nonintervention areas or improvements in underlying determinants of nutritional change in both areas.

Objective: We aimed to understand what changes in underlying socioeconomic characteristics and behavioral factors are important in explaining improvements in child linear growth.

Methods: Baseline (2010) and endline (2014) surveys from the Alive & Thrive impact evaluation were used to identify the underlying determinants of height-for-age z scores (HAZs) among children aged 24–48 mo in Bangladesh (n = 4311) and 24–59 mo …

Fewer Acute Respiratory Infection Episodes Among Patients Receiving Treatment For Gastroesophageal Reflux Disease, Herng-Ching Lin, Sudha Xirasagar, Shiu-Dong Chung, Chung-Chien Huang, Ming- Chieh Tsai, Chao-Hung Chen

Faculty Publications

Patients with gastroesophageal reflux disease (GERD) present with comorbid complications with implications for healthcare utilization. To date, little is known about the effects of GERD treatment with a proton-pump inhibitor (PPI) on patients’ subsequent healthcare utilization for acute respiratory infections (ARIs). This population-based study compared ARI episodes captured through outpatient visits, one year before and one year after GERD patients received PPI treatment. We used retrospective data from the Longitudinal Health Insurance Database 2005 in Taiwan, comparing 21,486 patients diagnosed with GERD from 2010 to 2012 with 21,486 age-sex matched comparison patients without GERD. Annual ARI episodes represented by ambulatory …

Large-Scale Behavior-Change Initiative For Infant And Young Child Feeding Advanced Language And Motor Development In A Cluster-Randomized Program Evaluation In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Kuntal K. Saha, Tina Sanghvi, Kaosar Afsana, Raisul Haque, Jean Baker, Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Background: Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development.

Objective: We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding.

Methods: A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts …

Hair Measurements Of Cortisol, Dhea, And Dhea To Cortisol Ratio As Biomarkers Of Chronic Stress Among People Living With Hiv In China: Known-Group Validation, Shan Qiao Ph.D., Xiaoming Li, Samuele Zilioli, Zheng Chen, Huihua Deng, Juxian Pan, Weigui Guo

Faculty Publications

Background

Existing literature suggests that endocrine measures, including the steroid hormones of cortisol and Dehydroepiandrosterone (DHEA), as well as the DHEA to cortisol ratio in the human hair can be used as promising biomarkers of chronic stress among humans. However, data are limited regarding the validity of these measures as biomarkers of chronic stress among people living with HIV (PLWH), whose endocrine system or hypothalamic pituitary adrenal (HPA) axis may be affected by HIV infection and/or antiretroviral therapy (ART) medications.

Method

Using hair sample data and self-reported survey from 60 PLWH in China, we examined the validity of three endocrine …

Ethnicity, Stigma And Adherence To Antiretroviral Therapy (Art) Among People Living With Hiv/Aids In Guangxi, China, Yuchen Mao, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou, Qun Zhao

Faculty Publications

This study examines the impact of ethnicity and multiple types of HIV-related stigma on adherence to antiretroviral therapy (ART) among 2,146 people living with HIV/AIDS (PLWHA) in Guangxi, China who had initiated ART. The results of multiple binary logistic regressions indicate that those who had experienced enacted stigma tended to report lower adherence, while better adherence was associated with older age, being women and having a job. Ethnicity had a moderator effect on the association between internalized stigma and adherence since better adherence was associated with lower internalized stigma among participants in ethnic minority groups other than Zhuang. Our findings …

Changing Hearts And Minds: Results From A Multi-Country Gender And Sexual Diversity Training, Tonia Poteat, Chulwoo Park, Diego Solares, John K. Williams, R. Cameron Wolf, Noah Metheny, Andrea Vazzano, Juan Dent, Ashley Gibbs, Bareng Aletta Sanny Nonyane, Nora Toiv

Faculty Publications

Engaging key populations, including gender and sexual minorities, is essential to meeting global targets for reducing new HIV infections and improving the HIV continuum of care. Negative attitudes toward gender and sexual minorities serve as a barrier to political will and effective programming for HIV health services. The President’s Emergency Plan for AIDS Relief (PEPFAR), established in 2003, provided Gender and Sexual Diversity Trainings for 2,825 participants including PEPFAR staff and program implementers, U.S. government staff, and local stakeholders in 38 countries. The outcomes of these one-day trainings were evaluated among a subset of participants using a mixed methods pre- …

Knowledge And Use Of E-Cigarettes And Risk Perception In Brazil: Results From A Country With Strict Regulatory Requirements, Tânia Maria Vavalcante, André Salem Szklo, Cristina De Abreu Perez, James Thrasher Phd, Moyses Szklo, Janine Ouimet, Shannon Gravely, Geoffrey T. Fong, Liz Maria De Almeida

Faculty Publications

Due to uncertainties about the impact of electronic cigarettes on health, Brazil adopted, in 2009, a regulation that prohibited the sale, importation and advertising of these products until manufacturers can demonstrate that they are safe and/or effective in smoking cessation. The objective of the study was to analyze among Brazilian smokers: (1) knowledge about the existence of electronic cigarettes, lifetime use, and recent use; (2) risk perception of e-cigarettes compared to conventional cigarettes; and (3) factors correlated with knowledge and perception of risk. This is a cross-sectional study among Brazilian smokers (≥ 18 years old) using a replacement sample from …

Prevalence And Predictors Of E-Cigarette Trial Among Adolescents In Argentina, Paola Morello, Adriana Perez, Lorena Peña, Paula Lozano, Jim Thrasher, James Sargent, Raul Mejia

Faculty Publications

Introduction: Over the last few years, the increasing use of electronic cigarettes has become a new public health problem. Since 2011, Argentina has had a complete ban on marketing and sale of e-cigarettes. However, e-cigarettes are marketed online and can be easily bought in stores. We conducted a longitudinal study to evaluate the determinants of e-cigarette trial among Argentinean early adolescents.

Methods: A school-based longitudinal study was conducted in 2014-15, in 3 large cities in Argentina. Among students who reported never smoking an e-cigarette at baseline, we assessed demographics, media use, sensation seeking, smoking behavior, network member smoking, use of …

The Impact Of Digital Technology On Health Of Populations Affected By Humanitarian Crises: Recent Innovations And Current Gaps, Sandra Mesmar, Reem Talhouk, Chaza Akik, Patrick Olivier, Imad H. Elhajj, Shady Elbassuoni, Sarah Armoush, Joumana Kalot, Madeline Balaam, Aline Germani, Hala Ghattas Ph.D.

Faculty Publications

Digital technology is increasingly used in humanitarian action and promises to improve the health and social well-being of populations affected by both acute and protracted crises. We set out to (1) review the current landscape of digital technologies used by humanitarian actors and affected populations, (2) examine their impact on health and well-being of affected populations, and (3) consider the opportunities for and challenges faced by users of these technologies. Through a systematic search of academic databases and reports,weidentified 50digital technologies used by humanitarian actors, and/or populations affected by crises. We organized them according to the stage of the humanitarian …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li, Yu Liu, Shan Qiao, Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Impacts On Breastfeeding Practices Of At Scale Strategies That Combine Intensive Interpersonal Counseling, Mass Media, And Community Mobilization: Results Of Cluster Randomized Program Evaluations In Bangladesh And Viet Nam, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Andrew Kennedy, Lan Mai Tran, Tina Sanghvi, Nemat Hajeebhoy, Jean Baker, Silvia Alayon, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background

Despite recommendations supporting optimal breastfeeding, the number of women practicing exclusive breastfeeding (EBF) remains low, and few interventions have demonstrated implementation and impact at scale. Alive & Thrive was implemented over a period of 6 y (2009–2014) and aimed to improve breastfeeding practices through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM) intervention components delivered at scale in the context of policy advocacy (PA) in Bangladesh and Viet Nam. In Bangladesh, IPC was delivered through a large non-governmental health program; in Viet Nam, it was integrated into government health facilities. This study evaluated the population-level impact …

Exposure To Large-Scale Social And Behavior Change Communication Interventions Is Associated With Improvements In Infant And Young Child Feeding Practices In Ethiopia, Sunny S. Kim, Rahul Rawat, Edina M. Mwangi, Roman Tesfaye, Yewelsew Abebe, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and …

Civic Engagement Among Orphans And Non-Orphans In Five Low- And Middle-Income Countries, Christine L. Gray, Brian W. Pence, Lynne C. Messer, Jan Ostermann, Rachel A. Whetten, Nathan M. Thielman, Karen O’Donnell, Kathryn Whetten

Faculty Publications

Background: Communities and nations seeking to foster social responsibility in their youth are interested in understanding factors that predict and promote youth involvement in public activities. Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in resource-poor settings. Understanding whether and how OSC are engaged in civic activities is important for community and world leaders who need to provide care for OSC and ensure their involvement in sustainable development.

Methods: The Positive Outcomes for Orphans study (POFO) is a multi-country, longitudinal cohort study of OSC randomly sampled from institution-based care and from family-based care, and …