Public Health Education and Promotion Commons^™

Parenting Around Child Snacking: Development Of A Theoretically-Guided, Empirically Informed Conceptual Model, Kirsten K. Davison, Christine E. Blake Ph.D., Rd, Rachel E. Blaine, Nicholas A. Younginer, Alexandria Orloski, Heather A. Hamtil, Claudia Ganter, Yasmeen P. Bruton, Amber E. Vaughn, Jennifer O. Fisher

Faculty Publications

Background: Snacking contributes to excessive energy intakes in children. Yet factors shaping child snacking are virtually unstudied. This study examines food parenting practices specific to child snacking among low-income caregivers. Methods: Semi-structured interviews were conducted in English or Spanish with 60 low-income caregivers of preschool-aged children (18 non-Hispanic white, 22 African American/Black, 20 Hispanic; 92% mothers). A structured interview guide was used to solicit caregivers' definitions of snacking and strategies they use to decide what, when and how much snack their child eats. Interviews were audio-recorded, transcribed verbatim and analyzed using an iterative theory-based and grounded approach. A conceptual model …

Provider Behavior Under Global Budgeting And Policy Responses: An Observational Study On Eye Care Services In Taiwan, Chao-Kai Chang, Sudha Xirasagar, Brian Chen, James R. Hussey, I-Jong Wang, Jen-Chieh Chen, Ie-Bin Lian

Faculty Publications

Third-party payer systems are consistently associated with health care cost escalation. Taiwan’s single-payer, universal coverage National Health Insurance (NHI) adopted global budgeting (GB) to achieve cost control. This study captures ophthalmologists’ response to GB, specifically service volume changes and service substitution between low-revenue and high-revenue services following GB implementation, the subsequent Bureau of NHI policy response, and the policy impact. De-identified eye clinic claims data for the years 2000, 2005, and 2007 were analyzed to study the changes in Simple Claim Form (SCF) claims versus Special Case Claims (SCCs). The 3 study years represent the pre-GB period, post-GB but prior …

Eliciting Preferences For Waterpipe Tobacco Smoking Using A Discrete Choice Experiment: Implications For Product Regulation, Ramzi G. Salloum, Wasim Maziak, David Hammond, Rima Nakkash, Farahnaz Islam, Xi Cheng, Jim Thrasher

Faculty Publications

Objectives Waterpipe smoking is highly prevalent among university students, and has been increasing in popularity despite mounting evidence showing it is harmful to health. The aim of this study was to measure preferences for waterpipe smoking and determine which product characteristics are most important to smokers.

Setting A large university in the Southeastern USA.

Participants Adult waterpipe smokers attending the university (N=367).

Design Participants completed an Internet-based discrete choice experiment to reveal their preferences for, and trade-offs between, the attributes of hypothetical waterpipe smoking sessions. Participants were presented with waterpipe lounge menus, each with three fruit-flavoured options and one tobacco …

Individual Attitudes Toward Innovation, Occupational Stress And Social Support For Work Among Hiv Health Care Providers In Southwest China, Shan Qiao Ph.D., Xiaoming Li Ph.D., Bonita Stanton, Yuejiao Zhou, Zhiyong Shen, Zhenzhu Tang

Faculty Publications

No abstract provided.

Food Insecurity Reported By Children, But Not By Mothers, Is Associated With Lower Quality Of Diet And Shifts In Foods Consumed, Jennifer Bernal, Edward A. Frongillo Jr., Juan A. Rivera

Faculty Publications

Household food security shows little indication of nutrient inadequacy among children, according to reports made by parents. We examined the associations of food insecurity as reported by children and mothers with children’s consumption of energy, macronutrients such as vitamin A, calcium, iron and zinc, and selected foods, and whether these associations differed by child’s gender. This cross-sectional study had non-probabilistic 128 Venezuelan mother–child pairs. We assessed food insecurity and management strategies in children using 10- and nine-item instruments, respectively. Mothers’ report of food insecurity came from a previously validated 12-item instrument. Nutrient intake of children was assessed with a 67-item …

Federally Qualified Health Centers’ Capacity And Readiness For Research Collaborations: Implications For Clinical-Academic-Community Partnerships, Heather M. Brandt, Vicki M. Young, Dayna A. Campbell, Seul Ki Choi, Jessica S. Seel, Daniela B. Friedman

Faculty Publications

BACKGROUND: Federally qualified health centers (FQHCs) provide a health care safety net for underserved populations and contribute unique expertise to research that could further enhance quality of patient care. The purpose of this research was to assess interest in, readiness to, and capacity for conducting research in FQHCs in South Carolina (SC). METHODS: A Web-based survey was administered to 20 FQHCs across SC. Fourteen representatives of FQHCs completed the 39-item survey that assessed research experience and interest, partnerships and funding, barriers and benefits to research participation, training and technical assistance needs, and research capacity. RESULTS: FQHCs are interested in conducting …

Stages Of Change Of The Readiness To Quit Smoking Among A Random Sample Of Minority Arab-Male Smokers In Israel, Nihaya Daoud, Samah Hayek, Ahmad Sheikh Muhammad, Kathleen Abusaad, Jim Thrasher, Ofra Kalter-Leibovici

Faculty Publications

Background

Despite advanced smoking prevention and cessation policies in many countries, the prevalence of cigarette smoking among indigenous and some ethnic minorities continues to be high. This study examined the stages of change (SOC) of the readiness to quit smoking among Arab men in Israel shortly after new regulations of free-of-charge smoking cessation workshops and subsidized medications were introduced through primary health care clinics.

Methods

We conducted a countrywide study in Israel between 2012–2013. Participants, 735 current smokers; 18–64 years old; were recruited from a stratified random sample and interviewed face-to-face using a structured questionnaire in Arabic. We used ordered …

Evaluating The Validity Of Self-Reported Smoking In Mexican Adolescents, María Del Carmen Valladolid-López, Tonatiuh Barrientos-Gutiérrez, Luz Myriam Reynales-Shigematsu, Jim Thrasher, Ingris Peláez-Ballestas, Eduardo Lazcano-Ponce, Mauricio Hernández-Ávila

Faculty Publications

Objectives We aimed to evaluate the validity of the self-reported smoking indicator used in the Global Youth Tobacco Survey (GYTS).

Setting 43 middle and high-school classrooms from 26 schools were selected from Mexico City and Cuernavaca, Morelos.

Participants A total of 1257 students provided both a questionnaire and a urine sample.

Primary and secondary outcome Sensitivity and specificity of self-reported smoking compared to urinary cotinine. Validity indices were evaluated by subgroups of gender, social acceptability of smoking (ie, smoking parents or friends) and smoking frequency.

Results Sensitivity and specificity for current smoking were 93.2% and 81.7%, respectively. Validity indices remained …

Prevalence And Correlates Of Food Insecurity Among Palestinian Refugees In Lebanon: Data From A Household Survey, Hala Ghattas Ph.D., Annie Belle J. Sassine, Karin Seyfert, Mark Nord, Nadine R. Sahyoun

Faculty Publications

Lebanon hosts the highest per capita refugee concentration worldwide. The Palestinian presence in Lebanon dates from 1948 and they remain a marginalized population. No information on their food security status has been reported previously. A survey of a representative sample of Palestinian refugee households in Lebanon (n = 2501) was conducted using a stratified two stage cluster sampling approach. We measured food insecurity using a modified USDA household food security module, locally validated. We collected data on household demographic, socioeconomic, health, housing, coping strategies and household intake of food groups and analysed these by food security status. About 41% (CI: …

The Impact Of Free Trial Acceptance On Demand For Alternative Nicotine Products: Evidence From Experimental Auctions, Matthew C. Rousu, Richard J. O'Connor, Maans Bansal-Travers, James M. Pitcavage, Jim Thrasher

Faculty Publications

Objectives: This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP).

Methods: An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opportunity to try, but did not have to accept, one of three relatively novel ST products (i.e., snus, dissolvable tobacco, or medicinal nicotine), or they were placed into a control group (i.e., no trial). All the participants then bid on all three of these products, as well as on cigarettes. We assessed interest in using ANP based on …

Colonoscopy Screening Among Us Adults Aged 40 Or Older With A Family History Of Colorectal Cancer, Meng-Han Tsai, Sudha Xirasagar, Yi-Jhen Li, Piet C. De Groen

Faculty Publications

Introduction
Colonoscopy screening reduces colorectal cancer (CRC) incidence and mortality. CRC screening is recommended at age 50 for average-risk people. Screening of first-degree relatives of CRC patients is recommended to begin at age 40 or 10 years before the age at diagnosis of the youngest relative diagnosed with CRC. CRC incidence has increased recently among younger Americans while it has declined among older Americans. The objective of this study was to determine whether first-degree relatives of CRC patients are being screened according to recommended guidelines.

Methods
We studied colonoscopy screening rates among the US population reporting a CRC family history …

The Role Of Social Relationship In Hiv Healing And Its Implications In Hiv Cure In China, Shan Qiao Ph.D., Jing-Bao Nie, Joseph Tucker, Stuart Rennie, Xiao-Ming Li

Faculty Publications

HIV is both a biomedical disease and a social phenomenon that is constructed in particular cultural contexts. A successful and humane HIV cure requires not only the science of eradicating pathogens, but also the art of healing to restore harmony between mind and body. Healing in the context of HIV cure will be both personal and interpersonal, biological and social, and will involve rebuilding connections between HIV patients and their social environment. Social conceptions of healing have been highlighted in many regions with rich non-biomedical healing traditions, including China. Based on an adapted theoretical model on social relationships and health, …

Experiential Learning: Using Virtual Simulation In An Online Rn-Bsn Program, Henny Breen, Melissa Jones

Faculty Publications

This article highlights the innovative experiential learning used by an online RN-BSN program through the use of simulation that takes place in an online classroom. Three experiential learning activities using a virtual community are described. These learning activities engage the students in thinking about social justice and health policy as well as teaching concepts that include community, leadership, influence, advocacy, networking, collaboration, and vulnerable populations. These concepts are critical to the learning needs of diploma and associate degree-prepared nurses who wish to continue their education to be better prepared to meet the complex needs of today’s health care environment.

Neural Biomarkers For Assessing Different Types Of Imagery In Pictorial Health Warning Labels For Cigarette Packaging: A Cross-Sectional Study, Roger D. Newman-Norlund, Jim Thrasher, Johann Fridriksson, William Brixius, Brett Froeliger, David Hammond, Michael K. Cummings

Faculty Publications

Objective Countries around the world have increasingly adopted pictorial health warning labels (HWLs) for tobacco packages to warn consumers about smoking-related risks. Research on how pictorial HWLs work has primarily analysed self-reported responses to HWLs; studies at the neural level comparing the brain's response to different types of HWLs may provide an important complement to prior studies, especially if self-reported responses are systematically biased. In this study we characterise the brain's response to three types of pictorial HWLs for which prior self-report studies indicated different levels of efficacy.

Methods Current smokers rated pictorial HWLs and then observed the same HWLs …

Awareness, Trial, And Use Of Electronic Cigarettes Among 10 Countries: Findings From The Itc Project, Shannon Gravely, Geoffrey T. Fong, K. Michael Cummings, Mi Yan, Anne C. K. Quah, Ron Borland, Hua-Hie Yong, Sara C. Hitchman, Ann Mcneill, David Hammond, James F. Thrasher, Marc C. Willemsen, Hong Gwan Seo, Yuan Jiang, Tania Cavalcante, Cristina Perez, Maizurah Omar, Karin Hummel

Faculty Publications

Background: In recent years, electronic cigarettes (e-cigarettes) have generated considerable interest and debate on the implications for tobacco control and public health. Although the rapid growth of e-cigarettes is global, at present, little is known about awareness and use. This paper presents self-reported awareness, trial and current use of e-cigarettes in 10 countries surveyed between 2009 and 2013; for six of these countries, we present the first data on e-cigarettes from probability samples of adult smokers. Methods: A cross-sectional analysis of probability samples of adult (≥ 18 years) current and former smokers participating in the International Tobacco Control (ITC) surveys …

Psychological Fears Among Low-Paid Female Sex Workers In Southwest China And Their Implications For Hiv Prevention, Shan Qiao Ph.D., Xiaoming Li Ph.D., Chen Zhang, Yuejiao Zhou, Zhiyong Shen, Zhenzhu Tang, Bonita Stanton

Faculty Publications

Commercial sex plays a critical role in rapidly increasing heterosexual transmission of HIV in China. Low-paid female sex workers (FSWs) are especially vulnerable to HIV/AIDS. Because of the illegality and stigma associated with sex work, FSWs may constantly live with fears in their daily life. Based on cross-sectional study of 794 low-paid FSWs in China we described their psychological fears related to commercial sex and examined the associations between fears and HIV-related behaviors. Fear of HIV infection was significantly associated with consistent use of condoms with clients. However, fear of breaching sex worker identity significantly prevented the FSWs from consistently …

Predictors Of Healthcare Professionals’ Attitudes Towards Family Involvement In Safety-Relevant Behaviours: A Cross-Sectional Factorial Survey Study, Rachel Davis, M Savvopoulou, R Shergill, S Shergill, D Schwappach

Faculty Publications

OBJECTIVES: To investigate predictors of healthcare professionals' (HCPs) attitudes towards family involvement in safety-relevant behaviours. DESIGN: A cross-sectional fractional factorial survey that assessed HCPs' attitudes towards family involvement in two error scenarios relating to hand hygiene and medication safety. Each survey comprised two randomised vignettes that described the potential error, how the family member communicated with the HCP about the error and how the HCP responded to the family member's question. SETTING: 5 teaching hospitals in London, the Midlands and York. HCPs were approached on a range of medical and surgical wards. PARTICIPANTS: 160 HCPs (73 doctors; 87 nurses) aged …

A Qualitative Examination About Providers’ Perceptions And Recommendations Regarding The Role Of Public Librarians In Addressing Communities’ Health Literacy., Van Ta Park, Lili Luo, Denise Rosidi

Faculty Publications

We assessed health care providers’ perspectives on libraries as a source of health information and elicited input on how to adequately prepare public librarians to provide health information services. Sample text-based reference transactions were shown to determine whether they think the health inquiries were adequately answered. Results showed that participants had favorable perspectives about public libraries, and thought that the public librarians’ role includes addressing the health literacy community needs. Participants provided recommendations for public librarians to improve health literacy. To enhance the ability of public librarians to meet the health literacy needs of their communities, diverse perspectives such as …

Three-Year Change In The Wellbeing Of Orphaned And Separated Children In Institutional And Family-Based Care Settings In Five Low- And Middle-Income Countries, Kathryn Whetten, Jan Ostermann, Brian W. Pence, Rachel A. Whetten, Lynne C. Messer, Sumedha Ariely, Karen O'Donnell, Augustine I. Wasonga, Vanroth Vann, Dafrosa Itemba, Misganaw Eticha, Ira Madan, Nathan M. Thielman, The Positive Outcomes For Orphans (Pofo) Research Team

Faculty Publications

Background With more than 2 million children living in group homes, or “institutions”, worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.

Methods A two-stage random sampling methodology identified community representative samples of 1,357 institution-dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, and …

Weekly And Holiday-Related Patterns Of Panic Attacks In Panic Disorder: A Population-Based Study, Li-Ting Kao, Sudha Xirasagar, Kuo-Hsuan Chung, Herng-Ching Lin, Shih-Ping Liu, Shiu-Dong Chung

Faculty Publications

Background: While chronobiological studies have reported seasonal variation in panic attacks (PA) episodes, information on the timing of PA by week-days may enable better understanding of the triggers of PA episodes and thereby provide pointers for suitable interventional approaches to minimize PA attacks. This study investigated weekly variation in potential PA admissions including associations with holidays using a population-based longitudinal, administrative claims-based dataset in an Asian population.

Methods: This study used ambulatory care data from the ‘‘Longitudinal Health Insurance Database 2000. We identified 993 patients with panic disorder (PD), and they had 4228 emergency room (ER) admissions for potential PA …

Phosphorus Supplement Alters Postprandial Lipemia Of Healthy Male Subjects: A Pilot Cross-Over Trial, Jana Hazim, Sani Hlais, Hala Ghattas Ph.D., Dareen Shatila, Maya Bassil, Omar Obeid

Faculty Publications

Background:

Epidemiological studies have found a U-shaped relationship between serum phosphorus and cardiovascular disease (CVD). The mechanism(s) behind such a relationship are poorly understood. Phosphorus (P) is reported to improve insulin sensitivity, which is involved in lipid metabolism, and thus we were interested in determining the impact of phosphorus ingestion on postprandial lipemia, a recognized CVD risk factor.

Findings.

A within-subject study design was conducted, whereby 8 healthy male subjects received a high fat meal (330Kcal; 69% energy from fat; 35 mg of phosphorus) with placebo or phosphorus (500 mg) in a random order. Postprandial blood samples (∼10 ml) were …

Reducing Colorectal Cancer Incidence And Disparities: Performance And Outcomes Of A Screening Colonoscopy Program In South Carolina, Sudha Xirasagar, Yi-Jhen Li, James B. Burch, Virginie G. Daguisé, Thomas G. Hurley, James R. Hébert

Faculty Publications

This study evaluated the efficiency, effectiveness, and racial disparities reduction potential of Screening Colonoscopies for People Everywhere in South Carolina (SCOPE SC), a state-funded program for indigent persons aged 50–64 years (45–64 years for African American (AA)) with a medical home in community health centers. Patients were referred to existing referral network providers, and the centers were compensated for patient navigation. Data on procedures and patient demographics were analyzed. Of 782 individuals recruited (71.2% AA), 85% (665) completed the procedure (71.1% AA). The adenoma detection rate was 27.8% (males 34.6% and females 25.1%), advanced neoplasm rate 7.7% (including 3 cancers), …

Meal Pattern Of Male Rats Maintained On Amino Acid Supplemented Diets: The Effect Of Tryptophan, Lysine, Arginine, Proline And Threonine, Raghad Ayaso, Hala Ghattas Ph.D., Mohamad Abiad, Omar Obeid

Faculty Publications

The macronutrient composition of the diet has been shown to affect food intake, with proteins having distinct effects. The present study investigated the effect of diet supplementation with individual amino acids (tryptophan, lysine, arginine, proline and threonine) on meal pattern among male rats. Meal pattern and body weight were monitored for two weeks. Proline and threonine had minimal effects on meal pattern, while the most pronounced changes were observed in the tryptophan group. Both tryptophan and lysine decreased overall food intake, which was translated into a reduction in body weight. The reduced food intake of the tryptophan group was associated …

Conflict Translates Environmental And Social Risk Into Business Costs, Daniel M. Franks, Rachel Davis, Anthony J. Bebbington, Saleem H. Ali, Deanna Kemp, Martin Scurrah

Faculty Publications

Sustainability science has grown as a field of inquiry, but has said little about the role of large-scale private sector actors in socio-ecological systems change. However, the shaping of global trends and transitions depends greatly on the private sector and its development impact. Market-based and command-and-control policy instruments have, along with corporate citizenship, been the predominant means for bringing sustainable development priorities into private sector decision-making. This research identifies conflict as a further means through which environmental and social risks are translated into business costs and decision making. Through in-depth interviews with finance, legal, and sustainability professionals in the extractive …

Primary Care And Youth Mental Health In Ireland: Qualitative Study In Deprived Urban Areas, Dorothy Leahy, Elisabeth Schaffalitzky, Claire Armstrong, Gerard Bury, Paula Cussen-Murphy, Rachel Davis, Barbara Dooley, Blanaid Gavin, Rory Keane, Eamon Keenan, Linda Latham, David Meagher, Pat Mcgorry, Fiona Mcnicholas, Ray O'Connor, Ellen O'Dea, Veronica O'Keane, Tom P. O'Toole, Edel Reilly, Patrick Ryan, Lena Sanci, Bobby P. Smyth, Walter Cullen

Faculty Publications

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people's unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

The Influence Of Family Dynamics On Contraceptive Use In Madagascar And The Ensuing Impact On Family Well-Being, Joel Zafitandra Hajason, Kayla Piña, Joel L. Raveloharimisy

Faculty Publications

While studies have shown a relationship between family dynamics and contraceptive use and between contraceptive use and family well-being, no empirical study has been conducted to test whether a relationship exists between family influence on contraceptive use and family wellbeing. The objective of this study is to explore whether there is such a relationship between family influence on contraceptive use and family well-being.

Trauma History And Depression Predict Incomplete Adherence To Antiretroviral Therapies In A Low Income Country, Kathryn Whetten, Kristen Shirey, Brian Wells Pence, Jia Yao, Nathan Thielman, Rachel Whetten, Julie Adams, Bernard Agala, Jan Ostermann, Karen O'Donnell, Amy Hobbie, Venance Maro, Dafrosa Itemba, Elizabeth Reddy, Chat Research Team

Faculty Publications

Background: As antiretroviral therapy (ART) for HIV becomes increasingly available in low and middle income countries (LMICs), understanding reasons for lack of adherence is critical to stemming the tide of infections and improving health. Understanding the effect of psychosocial experiences and mental health symptomatology on ART adherence can help maximize the benefit of expanded ART programs by indicating types of services, which could be offered in combination with HIV care. Methodology: The Coping with HIV/AIDS in Tanzania (CHAT) study is a longitudinal cohort study in the Kilimanjaro Region that included randomly selected HIV-infected (HIV+) participants from two local hospital-based HIV …

Parental Height And Child Growth From Birth To 2 Years In The Who Multicentre Growth Reference Study, Cutberto Garza, Elaine Borghi, Adelheid W. Onyango, Mercedes De Onis, Edward A. Frongillo Jr.

Faculty Publications

inear growth from birth to 2 years of children enrolled in the World Health Organization Multicentre Growth Reference Study was similar despite substantial parental height differences among the six study sites. Within-site variability in child length attributable to parental height was estimated by repeated measures analysis of variance using generalized linear models. This approach was also used to examine relationships among selected traits (e.g. breastfeeding duration and child morbidity) and linear growth between 6 and 24 months of age. Differences in intergenerational adult heights were evaluated within sites by comparing mid-parental heights (average of the mother's and father's heights) to …

What Attributes Of Patients Affect Their Involvement In Safety? A Key Opinion Leaders’ Perspective, Stephen Buetow, Rachel E. Davis, Kathleen Callaghan, Susan Dovey

Faculty Publications

OBJECTIVE: Little is known about which attributes the patients need when they wish to maximise their capability to partner safely in healthcare. We aimed to identify these attributes from the perspective of key opinion leaders. DESIGN: Delphi study involving indirect group interaction through a structured two-round survey. SETTING: International electronic survey. PARTICIPANTS: 11 (65%) of the 17 invited internationally recognised experts on patient safety completed the study. OUTCOME MEASURES: 50 patient attributes were rated by the Delphi panel for their ability to contribute maximally to safe health care. RESULTS: The panellists agreed that 13 attributes are important for patients who …