Social and Behavioral Sciences Commons^™

A Descriptive Review Of Health Care Providers Perspective On Stigmatization Of Hiv/Aids Patients: United States And South Africa, Ana I. Fonseca

Honors Projects

Compares the issue of social stigma affecting people with HIV/AIDS in the United State and in South Africa. Posits that stigma is more of an interpersonal problem in the United States, while it is a huge barrier to access to care in South Africa. Data was compiled through personal conversations and experiences in South Africa during June 2009, interviews with health professional and community members in Rhode Island during the fall of 2009, and reading of the professional literature.

Validation Of A Commercial Geographical Information Systems Database Of Walking And Bicycling Destinations, Heather A. Whitcomb, Ellen K. Cromley, Kosuke Tamura, Steven J. Melly, Sayali Kale, Francine Laden, Peter James, Robin Puett, Eran Ben-Joseph, Philip J. Troped

GIS Day

Background: Recent interdisciplinary studies in public health, transportation, and urban planning have shown that stores and other destinations such as banks, post offices, and physical activity facilities within close proximity to residences are positively related to recreational and transportation physical activity. The built environment has been measured several different ways, including conducting field audits and by surveying individuals’ perceptions of their neighborhood. Increasingly researchers are also using geographic information systems (GIS) software and commercially available data sources to create objective measures of the built environment. The advantages of commercial data are that they are relatively easy to access and are …

Using Primary Care To Bend The Cost Curve: The Potential Impact Of Health Center Expansion In Senate Reforms, Leighton C. Ku, Sara J. Rosenbaum, Peter Shin

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This analysis of reforms being considered in the United States Senate reaches conclusions similar to those of our prior analyses of reforms being considered in the House of Representatives. The combination of expanded health insurance coverage and investments in the expansion of community health centers can produce substantial long-term savings both for the overall health care system and for the federal government. Our analysis of the Senate provisions from the HELP and Finance Committees estimates $369 billion in total medical savings, including $105 billion in federal Medicaid savings. The Senate provisions produce larger savings because they authorize larger funding increases …

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 …

Estimating The Economic Gains For States As A Result Of Medicaid Coverage Expansions For Adults, Peter Shin, Leighton C. Ku, D. Richard Mauery, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This policy research brief examines the Medicaid eligibility expansions under the pending legislative proposals, including the House Tri-Committee bill, the Senate Health, Education, Labor and Pensions Committee bill and the Senate Finance Committee bill. Using new Census Bureau data, the researchers find that under both the House and Senate Finance Committee proposals, about 9.6 million nonelderly adults would gain Medicaid eligibility by 2014. Furthermore, the federal and state expenditures are less than Medicaid's positive impact on the economy amounting in a return of three dollars in new business activities for every dollar of state Medicaid investment. Because Medicaid is designed …

Using Primary Care To Bend The Curve: Estimating The Impact Of A Health Center Expansion On Health Care Costs, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief, the third in a series examining the link between national health reform proposals and community health centers, estimates the cost savings that would be realized by making important investments in non-profit health centers as an element of national health reform. Key findings include:

Increasing health center capacity by another 20 million patients by 2019 (to 39 million patients) under health reform can be expected to generate an additional $35.6 billion savings in 2019 and $212 billion in additional savings over the 2010-2019 ten-year time period.

Were the Medicaid prospective payment rate system to be applied to exchange …

Health Center Data Warehouses: Opportunities And Challenges For Quality Improvement, A. Seiji Hayashi, Emily Jones, David M. Stevens, Peter Shin, Brad Finnegan, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This Policy Research Brief reports on a pilot effort to leverage the growing presence of health center data warehouses to advance health care quality improvement through data sharing and exchange. This project builds on a partnership between the Michigan Primary Care Association and The George Washington University's Geiger Gibson/RCHN Community Health Foundation Research Collaborative that centers on developing approaches to using existing health center data for quality improvement.

Community Health Centers In Indiana: State Investments And Returns, Avi Dor, Patrick Richard, Ellen Tan, Sara J. Rosenbaum, Peter Shin, Lee Repasch

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Indiana Community Health Centers (I-CHC), including Federally Qualified Health Centers (FQHCs) and State Funded Health Centers (SFHCs), play a vital role in caring for the state's most vulnerable populations. Although their patient base tends to be poorer and experience greater health challenges than the general population, these health centers have generated substantial health care savings while providing high quality, low cost care. In this brief, key findings are presented from a recent study, conducted for the Indiana State Department of Health by GWU faculty and staff that was designed to estimate the cost savings and benefits generated by the state's …

Estimating The Effects Of Health Reform On Health Centers' Capacity To Expand To New Medically Underserved Communities And Populations, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Nearly 100 million persons reside in urban and rural communities that can be considered medically underserved as a result of inadequate supply of primary care physicians and elevated health risks. A report by the National Association of Community Health Centers and the Robert Graham Center estimated that 60 million people are "medically disenfranchised" and lack access to adequate primary health care because of where they live, even though many have health insurance. This brief assesses the potential effects of national health reform on health centers and on the number of patients they can serve. Because improving primary care access is …

National Health Reform: How Will Medically Underserved Communities Fare?, Sara J. Rosenbaum, Emily Jones, Peter Shin, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This brief examines the factors underlying medical underservice. It finds that the number of Americans living in communities at risk for medical underservice is more than double the number of persons who are uninsured. The report notes that even with health insurance reform, these communities and providers that serve them will continue to be affected by elevated numbers of low income uninsured persons, as well as persons who may be seriously under-insured because of poorer health status and lower family income.

Describing health insurance expansion as the single most important strategy to alleviate medical underservice, the Brief also identifies a …

Boosting Health Information Technology In Medicaid: The Potential Effect Of The American Recovery And Reinvestment Act, Brad Finnegan, Leighton C. Ku, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The American Recovery and Reinvestment Act of 2009 (ARRA) will invest approximately $49 billion to expedite health information technology (HIT) adoption through Medicare and Medicaid. Our analysis of 2006 NAMCS data found that approximately 15 percent of the practicing office-based physicians in the country would qualify for up to $63,750 over six years in Medicaid financial incentives for HIT adoption. Included within the 45,000 eligible physicians are about 99 percent of all community health center physicians. If all qualifying physicians apply for the Medicaid incentives and receive the maximum level of payments, the federal government would invest more than $2.8 …

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 …

To Vaccinate, Or Not? Health Care Providers And The Hpv Controversy, Nicole Elizabeth Hanbury

Honors Scholar Theses

Gardasil® – the vaccine was first thought to be a medical breakthrough in the fight against cancer, but it quickly became plagued with controversy. Despite wide media coverage, little attention has been paid to today’s health care professionals who are ultimately responsible for prescribing the vaccine, and who may be the most knowledgeable about it. The present study seeks to expand on previous literature by investigating health care providers’ current beliefs and practices with the human papillomavirus (HPV) immunization. It is essential that more recent research be performed in order to encompass current views of the vaccine, post FDA-approval.

Data …

Examining The Experiences Of Puerto Rico's Community Health Centers Under The Government Health Insurance Plan, A. Seiji Hayashi, Brad Finnegan, Peter Shin, Emily Jones, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This research brief examines the experiences of Puerto Rico's community health centers under the Commonwealth’s 1994 Government Health Insurance Plan (GHIP) – the Commonwealth's Medicaid program – also known as the Reforma. Of particular interest are the effects of Medicaid under-financing coupled with health centers' continuing obligations to furnish subsidized care for uninsured patients. To finance GHIP, the Commonwealth substantially curtailed its involvement with the direct provision of health care in both community and inpatient settings, transforming the former system of direct care provision into health insurance premium subsidies.

In 2007, the 47 operating sites of Puerto Rico's 19 federally …

Revisiting The Regulation Debate: The Effect Of Food Marketing On Childhood Obesity, Nicole E. Hunter

The University of New Hampshire Law Review

[Excerpt] “Despite the widespread concern regarding childhood obesity, there is broad divergence of opinion regarding responsibility for the crisis. Whether the government, food industry, or parents are accountable has become the focus of much debate. Public health groups have attempted various strategies to confront childhood obesity, such as litigation, legislation, and government regulation. While many researchers and advocates agree that government should play an affirmative role with respect to childhood obesity, they are very much divided over what that role should be. For example, although none of these acts has become law, eighty-six bills have been proposed regarding obesity since …

Eligibility, Recruitment, And Retention Of African Americans With Severe Mental Illness In Community Research, Michelle Hampton, Mary White, Linda Chafetz

Faculty Publications

Data that addresses severely mentally ill (SMI) African Americans (AAs) likelihood to participate in clinical research is limited. This study’s purpose was to determine if differences exist between races regarding eligibility, recruitment, and retention in a community-based clinical trial. The sample included 293 participants. Data sources included clinical records and interviews. Logistic regression was used for analysis. AAs were as likely to participate and to complete followup interviews as Whites. In contrast to studies about non-mentally ill AAs, AAs with SMI appeared to be as willing to consent to and to remain in clinical research studies as Whites.

College Of Health And Human Services International Service Learning Program: Gales Point, Belize, Jordan Norris, Carrierobin Menapace

Impact Belize

No abstract provided.

Tuberculosis Por Los Ojos De La Vida Aymara: La Correlación Entre Estilo De Vida Y Tuberculosis En Los Aymara Del Norte De Chile, Sam Percy

Independent Study Project (ISP) Collection

Background: Explanations for disparities in health between groups of people are complex, and based in differences in genetics, environment, access to medical care, socioeconomic, educational, and cultural factors. In short a person’s lifestyle is inextricably related to a person’s health and their propensity to contract disease. Members of the indigenous group Aymara who live in Arica, Chile have 6 times the rate of morbidity from Tuberculosis (TB) as non-Aymara and 9 times the rate of mortality from the disease. This study examined if there was a link between the rate of TB amongst the Aymaran people and the way Aymarans …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith M. Williams, Carlos J. Crespo, Joan Dorn

Community Health Faculty Publications and Presentations

Women with lupus are at increased risk for developing cardiovascular disease (CVD). Previous studies of atherosclerosis in SLE have not been representative of the minority groups most affected by lupus and its complications. Therefore, a study of 41 lupus cases and 83 controls was conducted to investigate the relationship between carotid atherosclerosis and inflammation in African-American women. Participation consisted of a questionnaire, physical examination, fasting blood draw, and ultrasound of the carotid arteries. There were observed differences between cases and controls with regard to carotid intima media thickness (IMT) and traditional cardiovascular risk factors, although few reached statistical significance. Tumor …

Constructions Of Disease In Mayo Village, Rachel Eades

Independent Study Project (ISP) Collection

Understanding how individuals and institutions negotiate illness and construct ideas about disease is important to public health efforts across the globe. Countries in sub-Saharan Africa suffer from a variety of health problems that many regions of the world have long since eradicated. Economic hardship, combined with high rates of communicable diseases, food poverty, lack of sanitation, and poor water quality make countries in sub-Saharan Africa some of the poorest and sickest in the world. Tanzania is a prime example. The purpose of this study was to explore how people in one rural, Tanzanian village construct ideas about disease – its …

Restoring Medicaid And Schip Coverage To Legal Immigrant Children And Pregnant Women: Implications For Community Health And Health Care For Tomorrow's Citizens, Leighton C. Ku

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In the coming weeks, Congress will consider the reauthorization of the State Children's Health Insurance Program (SCHIP), whose legislative authorization will expire on March 31, 2009. SCHIP's overarching goal, in tandem with Medicaid, is to assure coverage of low-income children, regardless of race or national origin. As the proportion of uninsured immigrant children grows, a crucial question is whether the SCHIP reauthorization will address the need to restore eligibility for legal immigrant children and pregnant women. Although SCHIP and Medicaid have been successful in improving health insurance coverage for most low-income American children since the mid-1990s, the health coverage gaps …

A Photovoice Participatory Evaluation Of A School Gardening Program Through The Eyes Of Fifth Graders, Catherine Sands, Krista Harper, Lee Ellen Reed, Maggie Shar

Anthropology Department Faculty Publication Series

In the springtime, fifth grade students at the Williamsburg Elementary School in rural Western Massachusetts ask to snack on sorrel and chives from the school garden, between planting potatoes and building a shade structure for their outdoor classroom. They are members of the first cohort of the curriculum-integrated program initiated by Fertile Ground, a grassroots organization in western Massachusetts. The children’s delight in the fresh greens they have grown marks a national phenomenon: the farm-to-school movement. With limited resources, parents, teachers, students, administrators, and community activists are developing inroads to better school food and food education, by constructing school teaching …

Across The Bridge: Using Photovoice To Study Environment And Health In A Romani Community., Krista Harper, The Sajó River Association For Environment And Community Development, Hungary

Selected Publications of EFS Faculty, Students, and Alumni

This photo essay is the product of a partnership between Prof. Krista Harper, the Sajó River Association for Environment and Community Development, and community organizer Judit Bari. The project took place in a small city in northeastern Hungary hit hard by factory closings since the collapse of state socialism in 1989. The Roma community, about 20% of the town’s population, has been especially vulnerable. A team of six young people participated as photographers and discussion participants, working closely with Harper and Bari. Other community members joined discussions of the images. The team held a photo exhibition in the neighborhood where …

School-Based Screening To Identify At-Risk Students Not Already Known To School Professionals: The Columbia Suicide Screen, Michelle A. Scott, Holly C. Wilcox, Irvin Sam Schonfeld, Mark Davies, Roger C. Hicks, J. Blake Turner, David Shaffer

Publications and Research

Objectives.Wesought todeterminethedegreeofoverlapbetweenstudents identified through school-based suicide screening and those thought to be at risk by school administrative and clinical professionals. Methods. Students from7 high schools in theNewYorkmetropolitan area completed the Columbia Suicide Screen; 489 of the 1729 students screened had positive results. The clinical status of 641 students (73% of those who had screened positive and 23%of thosewho had screened negative) was assessedwithmodules from the Diagnostic Interview Schedule for Children. School professionals nominated by their principal and unaware of students’ screening and diagnostic status were asked to indicate whether they were concerned about the emotional well-being of each participating student. …

Differences Between Intermittent And Light Daily Smokers In A Population Of U.S Military Recruits, Theodore Cooper, Thom Taylor, Ashley Murray, Margaret Debon, Mark Vander Weg, Robert Klesges, G. Wayne Talcott

Theodore V. Cooper

No abstract provided.

A Photovoice Participatory Evaluation Of A School Gardening Program Through The Eyes Of Fifth Graders, Catherine Sands, Krista Harper, Lee Ellen Reed, Maggie Shar

Krista M. Harper

In the springtime, fifth grade students at the Williamsburg Elementary School in rural Western Massachusetts ask to snack on sorrel and chives from the school garden, between planting potatoes and building a shade structure for their outdoor classroom. They are members of the first cohort of the curriculum-integrated program initiated by Fertile Ground, a grassroots organization in western Massachusetts. The children’s delight in the fresh greens they have grown marks a national phenomenon: the farm-to-school movement. With limited resources, parents, teachers, students, administrators, and community activists are developing inroads to better school food and food education, by constructing school teaching …

Occupational Health And Safety Status Of Indigenous And Latino Farmworkers In Oregon, Stephanie Farquhar, Nancy M. Goff, Nargess Shadbeh, Julie Samples, Santiago Ventura, Valentin Sanchez, Pamela Rao, Shelley Davis

Community Health Faculty Publications and Presentations

Exposure to pesticides poses great risk to agricultural workers and their families. Of the approximately 174,000 agricultural workers in Oregon, studies estimate that up to 40% of the workers in Oregon are indigenous and may be particularly vulnerable to the health risks of working in pesticide treated areas. Surveys conducted with Oregon farmworkers suggest that Latino and indigenous farmworkers differ demographically and may have diverse occupational and health needs. All Latino workers reported Spanish as their native language, while indigenous workers spoke several different native languages. Latino workers were employed mostly in orchards (28%) and nurseries (24%), while indigenous workers …

Health Coverage In Kentucky's Community Newspapers: Toward A More Informed Populace, Anna G. Hoover, Al Cross

Anna G. Hoover

This study explores the role that Kentucky community newspapers play in providing information about health behaviors and their related outcomes. Through content analysis of sixteen newspapers, the researcher examines the amount of health behavior coverage, the most prevalent topics of the articles, and the article sources. The resulting data point to challenges related to 1) a lack of health coverage, 2) a need for better source attribution, and 3) a blurring of the lines between editorial and advertising content. Implications and future research directions are discussed.

Hegemony Of The West And The Librarian’S Role In The Struggle Against Hiv/Aids In Africa, Emy Nelson Decker

Collaborative Librarianship

No abstract provided.

Potential Demographic And Cultural Predictors Of Heavy Episodic Drinking In Hispanic College Students., Theodore V. Cooper, Jennifer Venegas, Natahsa Naylor, Brenda S. Hanson

Theodore V. Cooper

No abstract provided.