Social and Behavioral Sciences Commons^™

Advocacy In Action: A Framework For Implementation Of The American Counselors Association Advocacy Competencies On A Local Level, Jeffrey M. Lown

Educational Specialist, 2009-2019

Despite calls from within the professional field and external forces, counselors have faced ongoing challenges in their efforts to be effective advocates for their clients and themselves. A review of the literature reveals that throughout the history of the profession, prominent figures have called on counselors to assume advocacy roles, and that some initiatives have been successful in fostering lasting change. However, as counselors and their clients’ needs continue to evolve, so too must strategies to address these needs be reevaluated and new initiatives put into place.

In this paper, I have outlined a committee structure and agenda that seeks …

Puerto Rico’S Community Health Centers In A Time Of Crisis, Peter Shin, Jessica Sharac, Marie Nina Luis, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In 2014, Puerto Rico’s twenty federally funded community health centers, operating in 71 sites located throughout the Commonwealth, served 330,736 patients, approximately one in ten Commonwealth residents. Compared to other Puerto Rico residents, health center patients are less likely to be insured. Despite considerable growth in Medicaid as a result of the supplemental funding provided under the Affordable Care Act, in 2014, 12.2% of health center patients remained uninsured.

Compared to health centers outside Puerto Rico, Puerto Rico’s health centers show a greater proportion of Medicaid patients served (69% compared to 46% outside Puerto Rico), a greater dependence on physician …

Health Center Trends: Recent Experience In Medicaid Expansion And Non-Expansion States., Peter Shin, Jessica Sharac, Julia Zur, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

In thousands of medically underserved communities across the U.S., community health centers enroll lowincome people in health coverage and provide care to millions of patients. Against the backdrop of significant health center expansion over several years and a full year of expanded health coverage under the Affordable Care Act (ACA), this brief examines change between 2013 and 2014 in the volume and health coverage profile of health center patients, and health center enrollment activities and service capacity, comparing states that implemented the ACA Medicaid expansion in 2014 and states that did not expand Medicaid in 2014. The study is based …

Hospital Practices Related To Breastfeeding In Mississippi: A Socio-Ecological Approach, Amir Alakaam

Dissertations

Mississippi continues to have one of the lowest rates and the weakest support in respect to breastfeeding in the nation (Centers for Disease Control and Prevention, 2014a). Hospital practices supporting breastfeeding such as the Ten Steps to Successful Breastfeeding (TSSB) can dramatically increase breastfeeding rates and duration (Rosenberg, Stull, Adler, Kasehagen, & Crivelli-Kovach, 2008). The aim of this study was to explore breastfeeding practices in Mississippi hospitals based on two levels of the Socio-Ecological Model: the organizational level (phase I) examined the hospital practices based on the level of implementation of the TSSB; the individual level (phase II) examined knowledge …

Using A New Evidence-Based Health Workforce Innovation Research Framework To Compare Innovations In Community Health Center And Other Ambulatory Care Settings, Leah E. Masselink, Patricia Pittman, Claire Houterman

Health Workforce Research Center Publications

In the United States, changing demographics, rising costs, and the impact of new regulations and payment models arising from the Affordable Care Act have placed unprecedented pressures on healthcare providers to increase access to care, improve quality and to control costs. To meet these challenges, some providers are forming accountable care organizations (ACOs) while others are pursuing medical homes or other novel payment and care delivery models designed to help meet these challenges. Within established organizations such as federally funded community health centers (CHCs), healthcare leaders are exercising significant latitude in developing innovative solutions for meeting their patients’ needs more …

Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd

Access / Insurance

The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …

In Search Of Safety, Negotiating Everyday Forms Of Risk: Sex Work, Criminalization, And Hiv/Aids In The Slums Of Kampala, Serena Cruz

FIU Electronic Theses and Dissertations

This dissertation offers an in-depth descriptive account of how women manage daily risks associated with sex work, criminalization, and HIV/AIDS. Primary data collection took place within two slums in Kampala, Uganda over the course of fourteen months. The emphasis was on ethnographic methodologies involving participant observation and informal and unstructured interviewing. Insights then informed document analysis of international and national policies concerning HIV prevention and treatment strategies in the context of Uganda. The dissertation finds social networks and social capital provide the basis for community formation in the sex trade. It holds that these interpersonal processes are necessary components for …

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Analytic Approaches For Causal Inference With Complex Multi-Component Interventions, Glen P. Mays, Arnold J. Stromberg, Jing Li, Mark V. Williams

Health Management and Policy Presentations

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Analytic Approaches For Causal Inferences With Complex Multi-Component Interventions: Project Achieve's Study Of Managing Care Transitions, Glen P. Mays

Glen Mays

Estimating the causal effects of complex, multi-component health interventions is a task with many challenges in measurement and methodology. This presentation profiles the methods being used as part of the PCORI-funded Project Achieve, a national study to estimate the comparative effectiveness of heterogeneous care transition programs designed to help hospitalized patients and their caregivers navigate care delivery systems effectively and return back to the community with optimal health and wellbeing.

Goddesses Versus Gynecologists: An Analysis Of The History Of Women’S Healthcare, Marion A. Mckenzie

Student Publications

Starting from the downfall of Goddess cultures in Europe, women's health care has been negatively impacted for generations. The rise of the white, male Indo-European "dominator model" along with the witch craze, caused the end of widespread wise women traditions and pharmacopeia methods. After women's traditional voice was silenced, medical colleges were established to pronounce new, "professional" knowledge. Only those who attended these universities were allowed to legally practice medicine; however, during this time, medical research and treatments for women primarily included mutilation and painful, nonsensical regimens. The horrifying state of women's healthcare has since improved, but was originally a …

Exploring Community Health Through The Lens Of The Community Unit In Kariobangi North And The Surrounding Areas, Maya Paris-Saper

Independent Study Project (ISP) Collection

Healthcare is a challenge in countries of the Global South. Not only do climates and trends of rapid urbanization affect the health status of many negatively, but also many health facilities are inaccessible and not of good quality, they lack enough medical personnel and lack the resources to adequately provide for patients who do not have the resources them selves. As the wealth gap increases all over the world and resources continue to be distributed unequally communicable and non-communicable health issues plague those in urban and rural settings at an alarmingly high rate and as health innovation has worked to …

Nutrition And Education In An Urbanizing Nation, Molly Pritz

Independent Study Project (ISP) Collection

Child malnutrition is a growing public health issue in Nepal, particularly in urban areas. Not eating enough, or not eating enough of healthy foods, can have life-long implications on development and cognitive ability. Because of its relevance to development within the country, many donor organizations and non-governmental organizations are working to promote child nutrition education programs. The purpose of this research is to investigate the implementation and structure of urban child nutrition educational programs involving treatment and prevention in Kathmandu, Nepal. Through qualitative interviews and field observations with three primary organizations, this research analyzes the patterns and disconnects between various …

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

Think Inside The Blocks: Health Literacy Outreach To Disadvantaged People In Their Own Environment, Nancy Patterson

Georgia International Conference on Information Literacy

This bilingual (Spanish/English) poster highlights six creative health literacy outreach projects that have proven to be successful in increasing participation in health-related events in their communities and in boosting health literacy in the process.

For example, in Georgetown, South Carolina, a beauty salon owner, concerned about her clients’ frequent frustration with trying to decipher medical information, partners with her local public library and is grant funded to provide a Wellness Workstation in her salon. Years later, her clients research health information between services using the workstation, evening health literacy classes are regularly conducted for community members and continued funding has …

Health Literacy 101: Increasing Literacy Reduces Health Disparities, Nancy Patterson

Georgia International Conference on Information Literacy

According to the Center for Disease Control and Prevention (CDC), health disparities are “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations”. The American Medical Association (AMA) has identified literacy as the number one social determinant of an individual’s health, above education, income and race.

Learn about health literacy as a tool in the fight against health disparities from this poster as well as methods of effective health communication between health information providers and information seekers. Self-advocacy, plain language cultural competence, and the teach-back technique are …

The Developmental Effect Of State Alcohol Prohibitions At The Turn Of The 20th Century, Mary F. Evans, Eric Helland, Jonathan Klick, Ashwin Patel

All Faculty Scholarship

We examine the quasi-randomization of alcohol consumption created by state-level alcohol prohibition laws passed in the U.S. in the early part of the 20th century. Using a large dataset of World War II enlistees, we exploit the differential timing of these laws to examine their effects on adult educational attainment, obesity, and height. We find statistically significant effects for education and obesity that do not appear to be the result of pre-existing trends. Our findings add to the growing body of economic studies that examines the long-run impacts of in utero and childhood environmental conditions.

Social Norms About A Health Issue In Work Group Networks, Lauren B. Frank

Communication Faculty Publications and Presentations

The purpose of this study is to advance theorizing about how small groups understand health issues through the use of social network analysis. To achieve this goal, an adapted cognitive social structure examines group social norms around a specific health issue, H1N1 flu prevention. As predicted, individual’s attitudes, self-efficacy, and perceived social norms were each positively associated with behavioral intentions for at least one of the H1N1 health behaviors studied. Moreover, collective norms of the whole group were also associated with behavioral intentions, even after controlling for how individual group members perceive those norms. For members of work groups in …

The Sixties Scoop Among Aboriginal Veterans: A Critical Narrative Study, Munira Abdulwasi

Electronic Thesis and Dissertation Repository

This study explored the experience of Aboriginal Veterans adopted and/or fostered during the Sixties Scoop using critical narrative inquiry. The objectives were to: 1) understand the lived experience of Aboriginal veterans adopted and/or fostered during the Sixties Scoop, 2) explore any health needs expressed by Aboriginal veterans adopted and/or fostered during the Sixties Scoop, and 3) provide recommendations for the implementation of health services and programs to assist this group of Aboriginal veterans with their health needs. Eight individual interviews were conducted with participants in Kitchener-Waterloo, London, Ottawa, Winnipeg, and Vancouver. All interviews were audio-taped, transcribed verbatim, and analyzed using …

The Stephen Klein Wellness Center As A Community-Centered Health Home - A Partnership Between Jefferson And Project Home, James D. Plumb Md, Mph, Lara Weinstein Md, Mph, Monica Mccurdy Pa-C, Mhs

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Health Hub Program Evaluation, Natalie Macias

Master's Projects and Capstones

This paper examines and evaluates the work of LIFT-Levántate a non-profit organization in San Rafael, California on their school-based nutritional education “health hub,” through health promotion interventions with adolescents. The James B. Davidson Middle School health hub educates students on topics related to nutrition and physical activity with the goal of providing access and increasing consumption of fruits and vegetables while lowering students’ intake of high-fat and sugary processed foods. Through research and observations of the students and families in this community, the data seems to indicate apparent disparities which vary by ethnicity, socioeconomic status and access. Underserved populations, including …

How Has The Affordable Care Act Benefitted Medically Underserved Communities? : National Findings From The 2014 Community Health Centers Uniform Data System, Jessica Sharac, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Community health centers represent the single largest comprehensive primary health care system serving medically underserved communities, operating in more than 9,000 urban and rural locations. Newly-released data for 2014 from the Uniform Data System (UDS; the federal health center reporting system) shed important light on the impact of the Affordable Care Act in its first full year of implementation in medically underserved urban and rural communities across the U.S. These communities experience elevated poverty, heightened health risks, lack of access to primary health care, and a significantly greater likelihood that residents will be uninsured.

The UDS data show the ACA’s …

Should Educators Be ‘Wrapping School Playgrounds In Cotton Wool’ To Encourage Physical Activity? Exploring Primary And Secondary Students’ Voices From The School Playground, Brendon P. Hyndman, Amanda Telford

Dr Brendon P Hyndman

Physical activity in school playgrounds has changed considerably over recent decades to reflect a climate of ‘surplus safety’. A growing culture of surplus safety can be attributed to a desire of parents and teachers responsible for children to protect school students from danger. The aim of this research was to examine students’ perceptions of playground safety influences on physical activity during school breaks from the perspectives of the ‘users’ of school playgrounds. Data collection consisted of seven focus groups (4 primary school & 3 secondary school) conducted across four schools (2 primary & 2 secondary). During this study, the focus …

Should Educators Be ‘Wrapping School Playgrounds In Cotton Wool’ To Encourage Physical Activity? Exploring Primary And Secondary Students’ Voices From The School Playground, Brendon P. Hyndman, Amanda Telford

Dr Brendon P Hyndman

Physical activity in school playgrounds has changed considerably over recent decades to reflect a climate of ‘surplus safety’. A growing culture of surplus safety can be attributed to a desire of parents and teachers responsible for children to protect school students from danger. The aim of this research was to examine students’ perceptions of playground safety influences on physical activity during school breaks from the perspectives of the ‘users’ of school playgrounds. Data collection consisted of seven focus groups (4 primary school & 3 secondary school) conducted across four schools (2 primary & 2 secondary). During this study, the focus …

Convalescent Serum Therapy As Rapid Advance Treatment For Ebola In West Africa, J Bankole Thompson Md, Phd, Patricia F. Mejabi Msc., Olugbenga O. Mejabi Phd, S Ahmed Tejan-Sie Md

International Journal of African Development

The 2014 public health crisis in Guinea, Liberia, and Sierra Leone has brought Ebola Viral Disease (EVD) to everyone’s attention. Discovered in 1976, this deadly disease infrequently struck in remote areas of Africa. This article will critically review the literature and describe the pathobiology, transmission, signs and symptoms, diagnosis, treatment, and prevention of EVDwhich, was predicted by the Centers for Disease Control to potentially infect 1.4 million persons in Liberia and Sierra Leone by January 2015 (“Questions and Answers”, 2014). Thankfully this worst case scenario did not occur and we may be experiencing natural burn out of the outbreak along …

Know Your Value: Negotiation Skill Development For Junior Investigators In The Academic Environment—A Report From The American Society Of Preventive Oncology's Junior Members Interest Group, Allison B. Burton-Chase, Maria C. Swartz, Stephanie A. Navarro Silvera, Karen Basen-Engquist, Faith E. Fletcher, Peter G. Shields

Department of Public Health Scholarship and Creative Works

The American Society of Preventive Oncology (ASPO) is a professional society for multidisciplinary investigators in cancer prevention and control. One of the aims of ASPO is to enable investigators at all levels to create new opportunities and maximize their success. One strategy adopted by ASPO was to develop the Junior Members Interest Group in 1999. The Interest Group membership includes predoctoral fellows, postdoctoral fellows, and junior faculty members who are provided career development and training opportunities (1). Responsibilities of the members of the Junior Members Interest Group include serving on the ASPO Executive Committee and the Program Planning …

Patient Experiences With Family Planning In Community Health Centers, Susan F. Wood, Tishra Beeson, Debora Goetz Goldberg, Holly Mead, Peter Shin, Aliyah Abdul-Wakil, Anna Rui, Bhakti Sahgal, Maya Shimony, Hallie Stevens, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Women of childbearing age represent one of the single largest groups of community health center patients, and family planning plays a critical role in the health, economic, and social circumstances of women, their children, and families. Family planning is a required service at all health centers, and the major expansion of health centers under the Affordable Care Act means that for low-income women of reproductive age this service should be increasingly available. The Quality Family Planning (QFP) Guidelines, jointly developed by the Centers for Disease Control and Prevention (CDC) and the Office of Population Affairs (OPA) and released in 2014, …

Socially Constructing Drug Addicts From The Poor: A Critical Discourse Analysis, Kalynn Susan Amundson

Graduate Theses and Dissertations

Welfare drug testing was authorized by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, and has subsequently garnered extensive legislative interest in numerous states. This policy raises several questions, which are the subjects of the two journal articles and one manuscript included in this dissertation.

The first article addresses the question of a possible confluence of War on Drugs and Welfare Reform policies as evidenced through welfare drug testing policy, and indicated by continuity in policymakers’ rhetoric. This study examines federal-level policymakers’ debate discourse in these two policy streams. The analysis finds themes of the Social pathology, …

How Will Texas’ Affordable Care Act Implementation Decisions Affect The Population? A Closer Look, Sara J. Rosenbaum, Sara Rothenberg, Sara Ely

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The Affordable Care Act (ACA) gives states two key choices: Whether to expand Medicaid to cover poor uninsured adults; and whether to establish a state Exchange. No population stands to gain more from these choices than residents of Texas, who experience the nation’s highest uninsured rate. National estimates show that by not expanding Medicaid, the state has foregone coverage for 1.5 million people. County‐level estimates show that in 249 out of 254 counties, the proportion of uninsured adults exceeds 20 percent of the total adult county population. In 31 counties, the proportion of low income uninsured adults exceeds 60 percent …

Jefferson's New Smoking Policies: Steps Toward A Healthier Work Environment, Russell K. Mcintire Phd,Mph, Amber Bowie Mph Student

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.