Health Policy Commons^™

Pornography: Social, Emotional And Mental Implications Among Adolescents, William K. Canady

National Youth Advocacy and Resilience Conference

This presentation will explain the historical development of pornography. It will highlight three segments: 1- Porn’s impact on brain development of reward pathways, ultimately increasing the appetite for more porn. 2- Porn can be a false substitute for real intimacy, resulting in decreased sexual satisfaction with a real person and increased verbal and physical aggression. 3- Porn promotes sex trafficking, promotes multiple sex partners and reduced STD prevention.

An Integrated Evidence-Based Approach To Provide A Practicum-Based Learning Experience To Students, Dziyana Nazaruk, Joseph Telfair, Jamie S. Cromley, Joanne Chopak-Foss, Ana M. Palacios

Department of Health Policy and Community Health Faculty Publications

Background

Due to the challenges created by the COVID-19 pandemic, the public health field has an exceptional opportunity not only to address current challenges but also to rebuild and expand the workforce. Objectives

The main objective of this presentation is to highlight the 2018-2022 academic year's progress of the practice-based learning experience of the JPH College of Public Health at Georgia Southern University in Georgia, USA. The College serves more than 59, mostly rural counties, and involves diverse practicum preceptors, students, and existing professionals from the USA and other countries. The College provides a unique opportunity for students to develop …

Strengths, Weaknesses, Opportunities And Threats Of A Community-Based Egg Program In Rural Honduras, Lilly Karsa, Dziyana Nazaruk, G. Ramos, L. Manship, Ana M. Palacios

Department of Health Policy and Community Health Faculty Publications

Background

Young children living in poor rural areas in Honduras are susceptible to suffering from undernutrition. About 1 in every 4 children under age 5 have stunting. Stunting during early childhood has negative consequences on an individual's life that can have short-term and lasting effects. This study's purpose was to explore the perceptions of the mothers of children that participate in a community-based nutrition-agriculture program that offers 1 egg daily to all children ages 6 to 24 months in 13 communities. Methods

Using community-engaged methods, we implemented a SWOT analysis to identify strengths, weaknesses, opportunities, and threats using a semi-structured …

Clinical And Demographic Attributes Of Patients With Diabetes Associated With The Utilization Of Telemedicine In An Urban Medically Underserved Population Area, Lisa Ariellah Ward, Gulzar H. Shah, Kristie C. Waterfield

Department of Health Policy and Community Health Faculty Publications

Marginalized populations often experience health disparities due to the significant obstacles to care associated with social, economic, and environmental inequities. When compared with advantaged social groups, these populations frequently experience increased risks, poorer health outcomes, and reduced quality of life (QoL). This research examines the clinical and demographic characteristics—age, gender, and race—related to patients with varying stages of type 2 diabetes mellitus (T2DM), comparing the utilization of telemedicine (TM) with traditional healthcare face-to-face (F2F) appointments in an urban medically underserved population area (UMUPA). A logistic regression model, was used to analyze retrospective electronic patient health records (EHRs) from 1 January …

Use Of Advance Directives In Us Veterans And Non-Veterans: Findings From The Decedents Of The Health And Retirement Study 1992–2014, Ho-Jui Tung, Ming-Chin Yeh

Department of Health Policy and Community Health Faculty Publications

Evidence shows that older patients with advance directives such as a living will, or durable power of attorney for healthcare, are more likely to receive care consistent with their preferences at the end of life. Less is known about the use of advance directives between veteran and non-veteran older Americans. Using data from the decedents of a longitudinal survey, we explore whether there is a difference in having an established advance directive between the veteran and non-veteran decedents. Data were taken from the Harmonized End of Life data sets, a linked collection of variables derived from the Health and Retirement …

Evaluation Of Feasibility And Acceptability Of A Web-Based Diabetes Prevention Program (Dpp) For Diabetes Risk Reduction In Chinese Americans In New York City, Ming-Chin Yeh, Wincy Lau, Claire Anselmo Keady, Margrethe Horlyck-Romanovsky, Ho-Jui Tung, Lu Hu, Grace X. Ma, Judith Wylie-Rosett

Department of Health Policy and Community Health Faculty Publications

Introduction: Intensive lifestyle intervention remains an effective modality to reduce diabetes incidence and delay the progression to type 2 diabetes. The primary aim of this study was to pilot-test the feasibility and acceptability of a culturally and linguistically tailored web-based DPP intervention among Chinese Americans with prediabetes living in New York City.

Methods: Thirteen Chinese American participants with prediabetes were recruited to complete a 1-year web-based Diabetes Prevention Program (DPP) lifestyle intervention. Quantitative and qualitative measures such as retention rate and data collected from web-based questionnaires and focus groups were collected and analyzed to assess study feasibility and …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Department of Health Policy and Community Health Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Department of Health Policy and Community Health Faculty Publications

No abstract provided.

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Department of Health Policy and Community Health Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Department of Health Policy and Community Health Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Department of Health Policy and Community Health Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Fighting For The Public’S Health: Challenges And Opportunities To Reinvigorate Public Health Advocacy, Madeleine S. Frey

Georgia Public Health Association Annual Meeting and Conference

Background

Covid-19 shed a painful light on racial health disparities. As health officials asserted their public health authority to stop the pandemic and promote health equity, elected officials moved to limit their ability to do so. Without strong advocacy infrastructure, public health has struggled to defend its legal public health authority, support the workforce, and ensure equitable health outcomes for everyone.

Methods

Fighting for Public Health, a 2022 Feasibility Study from the Network for Public Health Law, assessed what’s happening in public health advocacy, and what’s needed to strengthen it on state and national levels. With funding from Healthcare …

Covid-19, Health Inequities, And Behavioral Health Issues Facing Children, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

No abstract provided.

Assessing The Influence Of Gender Equity In The Us State Legislatures On Prenatal Healthcare Utilization, Prachi Joshi

Electronic Theses and Dissertations

Prenatal care is crucial for achieving public health and primary healthcare objectives. It is one of the goals of Healthy People 2030, which is the US federal initiative to improve the health and well-being of people nationwide. Unfortunately, despite the lofty goals, the United States has the highest maternal mortality rate among developed countries. In 2020, the maternal mortality rate in the US was 24 deaths per 100,000 live births, more than three times the rate in most high-income countries. What is concerning is that it is getting worse. Seven hundred women die of pregnancy-related complications. Among them, black and …

Development Of A Web-Based Diabetes Prevention Program (Dpp) For Chinese Americans: A Formative Evaluation Approach, Ming-Chin Yeh, Wincy Lau, Zoey Gong, Margrethe Horlyck-Romanovsky, Ho-Jui Tung, Lin Zhu, Grace X. Ma, Judith Wylie-Rosett

Department of Health Policy and Community Health Faculty Publications

Increasing evidence demonstrates that an online Diabetes Prevention Program (DPP) can delay the onset of type 2 diabetes. However, little has been done for Chinese Americans. This study, using Community-Based Participatory Research and Intervention Mapping approaches, describes a formative research process in the development of a culturally and linguistically tailored online DPP program among Chinese Americans with prediabetes living in New York City. Using a triangulation approach, data were collected to inform the development of an online DPP curriculum through (1) a literature review, (2) three focus groups (n = 24), and (3) a community advisory board meeting among 10 …

Healthfulness Of Fast-Food And Full-Service Restaurants In 16 Georgia Counties After Mandatory Menu Labeling, Janani Rajbhandari-Thapa, Donglan Zhang, Nicole Katapodis, Dana Alvin, Melanie Andrews

Journal of the Georgia Public Health Association

Background: Despite that the effect of menu labeling on consumer choices has been studied, there are gaps in the research on the healthfulness of the restaurant food environment post-mandatory menu labeling, specifically in the Southern United States. This study aims to assess the healthfulness of fast-food and full-service chain restaurant environments after compliance with mandatory menu labeling.

Methods: The healthfulness of 46 representative fast-food and full-service chain restaurants in 16 Georgia counties was examined using the Nutritional Environment Measures in Restaurants (NEMS-R) survey. The scores were compared between full-service and fast-food restaurants using t-tests across several healthfulness measures such as …

Hiv Viral Load Suppression Before And After Covid-19 In Kinshasa And Haut Katanga, Democratic Republic Of The Congo, Gulzar H. Shah, Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates …

Socioeconomic Status And Other Factors Associated With Hiv Status Among Ovc In Democratic Republic Of Congo (Drc), Gulzar H. Shah, Gina D. Etheredge, Lievain Maluantesa, Kristie Cason Waterfield, Osaremhen Ikhile, Elodie Engetele, Astrid Mulenga, Alice Tabala, Bernard Bossiky

Department of Health Policy and Community Health Faculty Publications

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa.

Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC.

Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We …

Air Quality And Cancer Prevalence Trends Across The Sub-Saharan African Regions During 2005–2020, Omolola Okunromade, Jingjing Yin, Clara Ray, Atin Adhikari

Department of Health Policy and Community Health Faculty Publications

Poor air quality and environmental pollution remain some of the main etiological factors leading to cancers and cancer-related deaths worldwide. As a result of human activities, deleterious airborne chemicals can be dispersed not only in the environment but also released in occupational environments and industrial areas. Air pollutants and cancer links are now established through various oxidative stress-related mechanisms and related DNA damages. Generally, ambient and indoor air pollutants have been understudied in sub-Saharan Africa (SSA) compared to other regions in the world. Our study not only highlights the deleterious effects of air pollutants in these developing countries, but it …

The Protective Effects Of Influenza Vaccination In Elderly Patients With Breast Cancer In Taiwan: A Real-World Evidence-Based Study, Szu-Yuan Wu, Ho-Jui Tung, Kuang-Hua Huang, Chiachi Bonnie Lee Lee, Tung-Han Tsai, Yu-Chia Chang

Department of Health Policy and Community Health Faculty Publications

In elderly patients with newly diagnosed breast cancer, clarity is lacking regarding the effects of influenza vaccines, particularly on clinical outcomes. This study conducted two nationwide, population-based, and propensity score-matched cohorts to estimate and compare the protective effects of influenza vaccine in elderly women and elderly patients with breast cancer. Data were derived from the National Health Insurance Research Database and Cancer Registry Database. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. Adjusted odds ratios (aORs) were used to estimate the relative risks, and stratified analyses in the breast cancer cohort were performed …

Adaptation Of Diabetes Prevention Program For Chinese Americans – A Qualitative Study, Ming-Chin Yeh, Wincy Lau, Siqian Chen, Ada Wong, Grace X. Ma, Judith Wylie-Rosett

Department of Health Policy and Community Health Faculty Publications

Background: Studies have demonstrated that a culturally and linguistically tailored Diabetes Prevention Program (DPP) can be effective in reducing diabetes risk in Chinese Americans. The purpose of this study was to explore the cultural and linguistic acceptability of the Centers for Disease Control and Prevention’s Prevent T2 curriculum in an online format in the Chinese American community in New York City (NYC). Methods: Three focus groups among a total of 24 Chinese Americans with prediabetes and one community advisory board (CAB) meeting with 10 key stakeholders with expertise in diabetes care and lifestyle interventions were conducted. Each focus group lasted …

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Department of Health Policy and Community Health Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

Characterization Of Folic Acid, 5-Methyltetrahydrofolate And Synthetic Folinic Acid In The High-Affinity Folate Transporters: Impact On Pregnancy And Development, Ana M. Palacios, Rachel A. Feiner, Robert M. Cabrera

Department of Health Policy and Community Health Faculty Publications

Objectives:

Folates are B vitamins that are essential for several molecular, cellular, and biological processes, including nucleotide synthesis, methylation, and methionine cycling. The physiological impacts of these processes on health also extend to cell proliferation, folate deficiency anemia, and reduction of the risk of birth defects during pregnancy. The primary objective of this study was to characterize the binding affinities of different folate forms, folic acid (FA), 5-methyltetrahydrofolate (5MTHF), and folinic acid, to the folate receptors α and β, and to the bovine milk folate binding protein. These three dietary forms of folate are found in enriched grains (FA), various …

Public Health Interventions For Children Of Incarcerated Parents, Daniel Bullman

GS4 Georgia Southern Student Scholars Symposium

The impact of social and structural determinants of health have lifelong consequences on an individual’s quality of life. Literature focusing on child health and wellbeing of incarcerated parents indicate significant negative health outcomes and adopted detrimental health behaviors. Using a systematic realist review, recent publications were reviewed for their potential discussion or recommendation for interventions in changing health outcomes. This review found that additional research is needed in identifying and testing potential interventions or determining if parallel public health initiatives have had positive impacts in promoting the health behavior change process for children and adolescents of incarcerated parents.

Children Receiving A Nutrition And High-Quality Early Childhood Education Intervention Are Associated With Greater Math And Fluid Intelligence Scores: The Guatemala City Municipal Nurseries, Ana M. Palacios, Lisa A. Villanueva, Matthew B. Flynn, Erik Parker, Stephanie Dickinson, Helen W. Bland, Greg A. Reinhart

Department of Health Policy and Community Health Faculty Publications

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35–10.61)) and (ß = 1.20; 95% CI (0.12–2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09–0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Association Between Serum Lycopene And Lung Cancer Mortality: An 18-Year Follow-Up Study Of A National Cohort, Evans Afriyie-Gyawu, Padmini Shankar, Gulzar H. Shah, Alicia A. Brown, Shannon Cearley, Akwasi Ampofo-Yeboah, Nathaniel Abrams, Jian Zhang

Department of Health Policy and Community Health Faculty Publications

Background: Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited.

Objective: The primary objective of this study was to see if there was a link between lycopene levels in the blood and lung cancer mortality. A secondary goal was to see if dietary factors influence lycopene levels in the blood.

Materials and Methods: A retrospective …

Covid-19 And Social Determinants Of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs, Samuel T. Opoku, Bettye Apenteng, Linda Kimsey, Angela H. Peden, Charles F. Owens

Department of Health Policy and Community Health Faculty Publications

Background

The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined.

Aim

The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic.

Methods

The study was a qualitative study using data from 28 semi-structured …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

States' Public Health Funding And Population Health Outcomes: An Examination Through A Socio-Ecological Lens, Maureen K. Akubu-Odero

Electronic Theses and Dissertations

The US public health system has been underfunded for decades, despite its significant mandate of improving overall population health outcomes. This ecological study evaluates the association between state public health funding and population health outcomes and the role of state public health funding in reducing state-level health disparities. The findings show that the relationships between public health investments and improvements in health outcomes and health disparity in states are moderated by socioeconomic contextual factors. The findings suggest a need for continued and increased public health investments, tailored to community needs and context

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Department of Health Policy and Community Health Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …