Social and Behavioral Sciences Commons^™

Potentially Traumatic Experiences And Sexual Health Among Orphaned And Separated Adolescents In Five Low- And Middle-Income Countries, Christine L. Gray, Kathryn Whetten, Lynne C. Messer, Rachel A. Whetten, Jan Ostermann, Karen O'Donnell, Nathan M. Thielman, Brian W. Pence

Community Health Faculty Publications and Presentations

Orphans and separated children (OSC) are a vulnerable population whose numbers are increasing, particularly in sub-Saharan Africa and Asia. Over 153 million children worldwide have lost one or both parents, including 17 million orphaned by AIDS, and millions more have been separated from their parents. As younger orphans enter adolescence, their sexual health and HIV-related risk behaviors become key considerations for their overall health. Importantly, their high prevalence of exposure to potentially traumatic events (PTEs) may put OSC at additional risk for adverse sexual health outcomes. The Positive Outcomes for Orphans study followed OSC randomly sampled from institution-based care and …

An Introduction To The Loop Analysis Of Qualitatively Specified Complex Causal Systems, Alexis Dinno

Community Health Faculty Publications and Presentations

This presentation introduces the loop analysis method.

The Oregon Health System Transformation: Preliminary Report Of Coordinated Care Organizations In The First Year Implementation, Carlos J. Crespo, Ellen Smit

Community Health Faculty Publications and Presentations

Because of the US Affordable Care Act, 16% of Oregonians without health insurance will be able to obtain coverage through Coordinated Care Organizations (CCO).

Absence Of Evidence And Evidence Of Absence In The Effects Of Same Sex Marriage Laws On Rates Of Opposite Sex Marriage, Alexis Dinno

Community Health Faculty Publications and Presentations

This presentation will explore the question of whether legal recognition of same sex marriages affects state- rates of opposite sex marriages in the U.S., with attention given to statistical methods for equivalence testing.

Putting Regulatory Data To Work At The Service Of Public Health: Utilizing Data Collected Under The Clean Water Act, Jyotsna S. Jagai, Barbara J. Rosenbaum, Suzanne M. Pierson, Lynne C. Messer, Kristen M. Rappazzo, Elena N. Naumova, Danelle T. Lobdell

Community Health Faculty Publications and Presentations

Under the Clean Water Act, the US Environmental Protection Agency (EPA) collects information from states on intended use and impairment of each water body. We explore the feasibility of using these data, collected for regulatory purposes, for public health analyses. Combining EPA impairment data and stream hydrology information we estimated the percent of stream length impaired for any use, recreational use, or drinking water use per county in the US as exposure variables. For health outcomes we abstracted county-level hospitalization rates of gastrointestinal infections, GI (ICD-9CM 001-009 excluding 008.45) and gastrointestinal symptoms, GS (ICD-9CM 558.9, 787) among US adults aged …

Transport And Health: A Look At Three Latin American Cities, Janeth Mosquera Becerra, Rodrigo S. Reis, Lawrence D. Frank, Farah A. Ramirez-Marrero, Benjamin Welle, Eugenio Arriaga Cordero, Fabian Mendez Paz, Carlos J. Crespo, Veronica Dujon, Enrique Jacoby, Jennifer Dill, Lynn Weigand, Carlos M. Padin

Community Health Faculty Publications and Presentations

Transport is associated with environmental problems, economic losses, health and social inequalities. A number of European and US cities have implemented initiatives to promote multimodal modes of transport. In Latin America changes are occurring in public transport systems and a number of projects aimed at stimulating non-motorized modes of transport (walking and cycling) have already been implemented. Based on articles from peer-reviewed academic journals, this paper examines experiences in Bogota (Colombia), Curitiba (Brazil), and Santiago (Chile), and identifies how changes to the transport system contribute to encourage active transportation. Bus rapid transit, ciclovias, bike paths/lanes, and car use restriction are …

Differences In Demographic, Behavioral, And Biological Variables Between Those With Valid And Invalid Accelerometry Data: Implications For Generalizability, Paul D. Loprinzi, Bradley J. Cardinal, Carlos J. Crespo, Gary R. Brodowicz, Ross E. Andersen, Ellen Smit

Community Health Faculty Publications and Presentations

Background: The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population. Methods: Ambulatory participants from NHANES (2003-2004) who were 20-85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A "valid person" was defined as those with 4 or more days of at …

Absence Of Evidence And Evidence Of Absence In The Effects Of Same Sex Marriage Laws On Rates Of Opposite Sex Marriage: Mutual Reinforcement Of Research, Scholarly Growth And The Classroom, Alexis Dinno

Community Health Faculty Publications and Presentations

This presentation will explore the question of whether legal recognition of same sex marriages affects state- rates of opposite sex marriages in the U.S., with attention given to statistical methods for equivalence testing.

Increasing The Relevance Of Research To Underserved Communities: Lessons Learned From A Retreat To Engage Community Health Workers With Researchers, Heather Angier, Noelle Wiggins, Jessica Gregg, Rachel Gold, Jennifer E. Devoe

Community Health Faculty Publications and Presentations

This article presents information on a community retreat developed to seek input from community health workers (CHWs) to increase the relevance of our research to underserved communities in Oregon. Retreats facilitating dialogue between researchers and CHWs could yield important insight to enhance the significance of research for communities.

Health Behaviour Changes After Diagnosis Of Chronic Illness Among Canadians Aged 50 Or Older, Jason T. Newsom, Nathalie Huguet, Pamela L. Ramage-Morin, Michael Joseph Mccarthy, Julie Bernier, Mark S. Kaplan, Bentson H. Mcfarland

Community Health Faculty Publications and Presentations

Changes in health behaviors (smoking, physical activity, alcohol consumption, and fruit and vegetable consumption) after diagnosis of chronic health conditions (heart disease, cancer, stroke, respiratory disease, and diabetes) were examined among Canadians aged 50 or older. Results from 12 years of longitudinal data from the Canadian National Population Health Survey indicated relatively modest changes in behavior. Although significant decreases in smoking were observed among all groups except those with respiratory disease, at least 75% of smokers did not quit. No significant changes emerged in the percentage meeting physical activity recommendations, except those with diabetes, or in excessive alcohol consumption, except …

Lower Nutritional Status And Higher Food Insufficiency In Frail Older Us Adults, Ellen Smit, Kerri M. Winters-Stone, Paul D. Loprinzi, Alice M. Tang, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Frailty is a state of decreased physical functioning and a significant complication of ageing. We examined frailty, energy and macronutrient intake, biomarkers of nutritional status and food insufficiency in US older adult (age ≥ 60 years) participants of the Third National Health and Nutrition Examination Survey (4731). Frailty was defined as meeting ≥ 2 and pre-frailty as meeting one of the following four-item criteria: (1) slow walking; (2) muscular weakness; (3) exhaustion and (4) low physical activity. Intake was assessed by 24 h dietary recall. Food insufficiency was self-reported as ‘sometimes’ or ‘often’ not having enough food to eat. Analyses …

Body Mass Index And The Risk Of Prostate Cancer, Daniel Lee Mcgee, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: This article presents cohort studies that use data from the National Health Information Survey from 1986 to 1994 and compares the effectiveness of Cox proportional hazards models that assume a linear relationship between body mass index (BMI) and the risk of prostate cancer with models that assume a J-shaped relationship. Methods and results: Our study found that for black males over 40 years of age, neither a linear nor a J-shaped relationship yielded a statistically significant model. With white males over 40 years, assuming a linear relationship did not yield a statistically significant model (P = 0.582). When we …

A Novel Tool For Assessing And Summarizing The Built Environment, Gretchen L. Kroeger, Lynne C. Messer, Sharon E. Edwards, Marie Lynn Miranda

Community Health Faculty Publications and Presentations

Background: A growing corpus of research focuses on assessing the quality of the local built environment and also examining the relationship between the built environment and health outcomes and indicators in communities. However, there is a lack of research presenting a highly resolved, systematic, and comprehensive spatial approach to assessing the built environment over a large geographic extent. In this paper, we contribute to the built environment literature by describing a tool used to assess the residential built environment at the tax parcel-level, as well as a methodology for summarizing the data into meaningful indices for linkages with health data. …

A Study Of Riders' Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno, Cynthia Powell, Margaret Mary King

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics. We made 268 dosimetry measurements on a convenience sample of 51 line segments. Dosimetry measures were modeled using linear and non-linear multiple regression as functions of average velocity, tunnel enclosure, flooring, and wet weather conditions, and presented visually on a map of the BART system. This …

Approximating Confidence Intervals About Discrete Time Survival/Cumulative Incidence Estimates Using The Delta Method, Alexis Dinno, Jong-Sung Kim

Community Health Faculty Publications and Presentations

Poster focuses on answering the questions whether and when and event will happen in a population at risk.

Community-Based Approaches To Reduce Toxins In Housing: Lessons Learned From Working With Diverse Communities, Erin Mcnally, Ian Blazina, Stephanie Farquhar

Community Health Faculty Publications and Presentations

This article will review lessons learned from a community-based participatory research project with Latino and Somali residents in Portland, Oregon. The aim of the Healthy Futures Collaborative (HFC) project was to reduce in-home environmental health hazards associated with childhood respiratory illness and asthma through a process that strengthened social support and civic engagement. Using a community-based approach, the HFC trained community residents as community scientists to ensure local leadership and participation. Results suggest an increase in Somali and Latino residents' knowledge of environmental stressors and changes in behavior that may improve indoor environmental quality. Especially when working with historically marginalized …

Interpretations Of Interpretations: Combining Community-Based Participatory Research And Interpretive Inquiry To Improve Health, Jessica Gregg, Lourdes Centurion, Julio Maldonado, Raquel Aguillon, Rosemary Carmela Celaya-Alston, Stephanie Farquhar

Community Health Faculty Publications and Presentations

Background: Latina immigrants from Mexico suffer significantly increased morbidity and mortality from cervical cancer when compared with non-Hispanic White women, largely owing to lack of screening and appropriate treatment. Objectives: To demonstrate that by combining the tools of community-based participatory research (CBPR) with the tools of interpretive inquiry, it is possible to address explicit community concerns surrounding a particular problem such as cervical cancer while also examining what other, perhaps less immediately visible, matters consume the time and attention of community members. Methods: We first briefly discuss and compare CBPR as an approach to research and interpretive inquiry as a …

A Pilot Study Of Riders’ Noise Exposure On Bay Area Rapid Transit Trains, Alexis Dinno

Community Health Faculty Publications and Presentations

Excessive noise exposure may present a hazard to hearing, cardiovascular and psychosomatic health. Mass transit systems, such as the Bay Area Rapid Transit (BART) system, are potential sources of excessive noise. The purpose of this study was to characterize transit noise and riders' exposure to noise on the BART system using three dosimetry metrics.

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 …

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 …

"Sitting In Different Chairs:" Roles Of The Community Health Workers In The Poder Es Salud/Power For Health Project, Stephanie Farquhar, Noelle Wiggins, Yvonne L. Michael, G. Luhr, Jennifer Jordon, A. Lopez

Community Health Faculty Publications and Presentations

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs' perspective. This article presents the CHWs' points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. Methods: Authors draw from an analysis of transcript data from in-depth interviews conducted with CHWs to present a description of the strategies employed by the CHWs to build leadership skills and knowledge among community members. CHWs …

Loop Analysis Of Causal Feedback In Epidemiology: An Illustration Relating To Urban Neighborhoods And Resident Depressive Experiences, Alexis Dinno

Community Health Faculty Publications and Presentations

The causal feedback implied by urban neighborhood conditions that shape human health experiences, that in turn shape neighborhood conditions through a complex causal web, raises a challenge for traditional epidemiological causal analyses. This article introduces the loop analysis method, and builds off of a core loop model linking neighborhood property vacancy rate, resident depressive symptoms, rate of neighborhood death, and rate of neighborhood exit in a feedback network. I justify and apply loop analysis to the specific example of depressive symptoms and abandoned urban residential property to show how inquiries into the behavior of causal systems can answer different kinds …

Building Community Research Capacity: Process Evaluation Of Community Training And Education In A Community-Based Participatory Research Program Serving A Predominately Puerto Rican Community, Laurene M. Tumiel-Berhalter, Victoria Mclaughlin-Diaz, John Vena, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Background: Education and training build community research capacity and have impact on improvements of health outcomes.

Objectives: This manuscript describes the training and educational approaches to building research capacity that were utilized in a community-based participatory research program serving a Puerto Rican population and identifies barriers and strategies for overcoming them.

Methods: A process evaluation identified a multitiered approach to training and education that was critical to reaching the broad community.

Results: This approach included four major categories providing a continuum of education and training opportunities: networking, methods training, on-the-job experience, and community education. Participation in these opportunities supported the …

Advancing Transdisciplinary And Translational Research Practice: Issues And Models Of Doctoral Education In Public Health, Linda Neuhauser, Dawn M. Richardson, Sonja Mackenzie, Meredith Minkler

Community Health Faculty Publications and Presentations

Finding solutions to complex health problems, such as obesity, violence, and climate change, will require radical changes in cross-disciplinary education, research, and practice. The fundamental determinants of health include many interrelated factors such as poverty, culture, education, environment, and government policies. However, traditional public health training has tended to focus more narrowly on diseases and risk factors, and has not adequately leveraged the rich contributions of sociology, anthropology, economics, geography, communication, political science, and other disciplines. Further, students are often not sufficiently trained to work across sectors to translate research findings into effective, large-scale sustainable actions. During the past 2 …

Measuring The Influence Of Built Neighborhood Environments On Walking In Older Adults, Yvonne L. Michael, Tracey Beard, Dongseok Choi, Stephanie Farquhar, Nichole Carlson

Community Health Faculty Publications and Presentations

Examined the degree of association between perceived and objective characteristics of the neighborhood environment and the relation of each type of measurement to neighborhood walking in older adults. Participants included 105 adults aged 65-92 (mean age 75.1) from 10 neighborhoods in Portland, Oregon, participating in Senior Health and Physical Exercise (SHAPE), a randomized walking intervention. Neighborhoods were stratified by a "walking friendliness" ranking variable. This variable was derived for each neighborhood based on available social and environmental data that were hypothesized to correlate with walking and physical activity: high income, high older adult population density, high proportion of white residents, …

Community-Based Participatory Research: Defining Community Stakeholders, Laurene M. Tumiel-Berhalter, Robert Watkins, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Community-based participatory research requires the participation of community stakeholders to inform the process. The West Side Community Asthma Project, a community-based participatory research program to study the effects of the environment on asthma conducted in Buffalo, N. Y, identified a stakeholders group of community leaders and activists. Creative strategies have been implemented to reach out to other community residents to invite them to participate in the participatory process.

Precautionary Approaches For Health And The Environment: Making The Case For A Toxics Reduction Strategy At Multnomah County And City Of Portland, Stephanie Farquhar, Molly Chidsey, Neha Patel

Community Health Faculty Publications and Presentations

This report summarizes an overview of the problem, local concerns, model policies, and best practices for toxic pollution prevention and provides recommendations for next steps to protect human health and the local environment in Portland and Multnomah County. This report accompanies the Multnomah County and City of Portland resolutions to "Recognize National Pollution Prevention Week and develop a Toxics Reduction Strategy jointly with City of Portland / Multnomah County using the Precautionary Principle."