Community-Based Research Commons^™

The Administrative Prevalence Of Autism Spectrum Disorders In Nevada School Districts: A Pooled Time Series Analysis, 1996-2004, John P. Tuman, Sheniz Moonie, Danielle Roth-Johnson

Nevada Journal of Public Health

Objective: To examine the administrative prevalence of Autism Spectrum Disorders (ASD) in all seventeen school districts in Nevada during the period of 1996 to 2004.

Methods: Normalized administrative prevalence rates (per 1,000 children ages 6-17) for ASD, Mental Retardation (MR), Learning Disability (LD), and Speech and Language Impairment (SLI) were calculated. Covariates for board certified pediatricians per 1,000 students, Federal special education funding per student, and other measures of school resources were employed. Models were estimated with pooled Ordinary Least Squares (OLS) regression with panel corrected standard errors. A separate analysis compared pooled OLS results to results from Latent Growth …

The Effects Of Television Food Advertising On Childhood Obesity, Aleathia Cezar

Nevada Journal of Public Health

Children’s food choices are influenced by the media, television advertising, focusing directly at infants and toddlers. This literature review presents multiple studies that explain how TV advertising of fast food, sugary cereals and other foods high in calories, fat, sugar, sodium and low in nutrients are contributing to the increase rates of childhood obesity. It is concluded that children are exposed to high amounts of food advertisements which affect young children’s food choices and poor food consumption. Due to the growing numbers of hours that children sit in front of the television, less physical activity and the epidemic of childhood …

Prevalence And Antimicrobial Agent Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Healthy Pediatric Outpatients In Las Vegas, Echezona E. Ezeanolue, Mark P. Buttner, Patricia Cruz, Joanne L. Henry, Chad L. Cross, Linda D. Stetzenbach

Nevada Journal of Public Health

Colonization and infection by community-associated resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The purpose of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children and to characterize the MRSA isolates in the laboratory with regard to antimicrobial agent susceptibility patterns, and the presence of the mecA and the Panton-Valentine leukocidin (PVL) genes. Nasal swabs were collected at two pediatric clinics from a total of 505 children during health maintenance visits. A brief questionnaire was administered to collect demographic data and pertinent medical, family, and social history. Samples were cultured …

First-Year Compliance With The Nevada Clean Indoor Air Act, Leslie Elliott, Dana Loomis, Andrew B. Bridgforth, Stephanie O’Mara, Louise T. Brock, Brian Hansen, Melanie Marie Minarik, Kathryn Louderback

Nevada Journal of Public Health

Objectives: We quantitatively evaluated compliance with the Nevada Clean Indoor Air Act (NCIAA) by different types of businesses in Nevada and determined whether compliance affected indoor concentrations of benzene and 3-ethenyl pyridine (3-EP), markers of tobacco smoke.

Methods: Managers of 181 businesses in Washoe County, Nevada, were interviewed about business characteristics and practices and policies related to smoking. During unannounced visits, compliance data and air samples (n=66) were collected from interviewed businesses and from an additional sample (n = 56) of businesses without knowledge of the study.

Results: Overall compliance, as defined by the NCIAA, was low (28.2%). Benzene concentrations …

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 …

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 …

Health Care Insurance And Advance Directive Completion: A Population Based Study, Wei Yang, Sally P. Hardwick, Noel Tiano, Clare T. Pettis

Nevada Journal of Public Health

Background: The relationship between advance directive (AD) completion and health insurance status is rarely studied.

Method: AD completion information was collected through the 2008 Nevada Behavior Risk Factor Surveillance System (BRFSS), a statewide cross-sectional telephone survey. Nevada non-institutionalized population over 18 were randomly selected as a population sample. Respondents were divided to “health care plan group” (HCPG) and “no health care plan group” (NHCPG). Demographic and behavior risk factors were also collected. Weighted multiple logistic regressions were utilized to assess the relationships between ADs, healthcare coverage and other factors.

Results: Of 4,461 respondents completing the survey, HCPG were six times …

Blood Lead Levels In Nevada Children, Arthur F. Di Salvo, Terry R. Hall

Nevada Journal of Public Health

The purpose of this study was to assess the prevalence of plumbism in children one to six years of age in Nevada. During a four-year period from 1992 – 1996, 10,700 children were screened for evidence of blood lead intoxication. The capillary specimens were analyzed by atomic absorption spectrometry. All children with a lead level => 10 ug/L were retested using venous blood. Ninety three percent of the children had blood lead levels < 10 µg/dL

Carbohydrate Consumption And Fatigue: A Review, Jennifer R. Pharr

Nevada Journal of Public Health

Fatigue is a condition that negatively impacts quality of life and occurs in about twenty four percent of adults worldwide. Many factors may contribute to fatigue. One factor is the macronutrient composition of a person’s diet, particularly, the amount of simple carbohydrates. This paper is a review of the current literature and examines the relationship of carbohydrate consumption and fatigue to determine if a diet low in simple carbohydrates results in an improvement in fatigue ratings. Results of studies regarding carbohydrate consumption and fatigue vary, the preponderance demonstrate a positive relationship between simple carbohydrate consumption and fatigue. Additionally, diets low …

Adverse Maternal Outcomes In Nevada: Does Asthma Matter?, Jay J. Shen, Hong Wei, Robin Mukalian

Nevada Journal of Public Health

Objective. Asthma is a common clinical complication of pregnancy and women with asthma are at greater risk of having complications. This study compared adverse maternal outcomes between women with asthma and women without asthma in Nevada.

Methods. A total of 64,664 hospital discharges of delivery were abstracted from the Nevada 2003-2004 hospital discharges and thirteen adverse maternal outcomes were examined. Logistic regression was applied to compare the maternal outcomes between women with and without asthma.

Results. Women with asthma were more likely to have pre-eclampsia (OR [CI] 1.73 [1.13, 2.65]), transient hypertension of pregnancy (OR [CI] 1.76 [1.11, 2.78]), pregnancy-induced …

The Economic Impact Of The Nevada Clean Indoor Air Act In Clark County, Nevada – Preliminary Findings, Robin Mukalian, Fang Lin, Christopher R. Cochran, Jay J. Shen, Nancy L. York

Nevada Journal of Public Health

Objective. The primary purpose of this exploratory study was to quantitatively evaluate the economic impact of the Nevada Clean Indoor Air Act (NCIAA) on businesses in Clark County.

Methods. The goal of this research was to assess economic indicators over a ten year period utilizing measurable data points, including restaurant and drinking establishment employment rates, taxable sales, openings and closings, as well as slot gaming revenues. This ten year time period consisted of a seven year span prior to the enactment of the NCIAA, and three years post enactment. Researchers conceived this study as a means to independently evaluate and …

Prevalence And Antimicrobial Susceptibility Of Methicillin-Resistant Staphylococcus Aureus In Pregnant Women And Their Newborns In Las Vegas, Nevada, Mark P. Buttner, Echezona E. Ezeanolue, Patricia Cruz, Joanne L. Henry, Ineada Jack, Chad L. Cross

Nevada Journal of Public Health

Colonization and infection by resistant strains of Staphylococcus aureus are being reported in epidemic proportions. The goal of this study was to determine the local prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in pregnant women in southern Nevada and how it correlates with colonization and infection of their neonates. Signed consent was obtained, and a brief questionnaire was administered by the medical staff to each pregnant woman to collect demographic data and pertinent medical, family and social history. Nasal and vaginal specimens were obtained from pregnant women at ≥35 weeks gestation, and nasal and umbilicus specimens were obtained from their …

Effects Of The Master Settlement Agreement On Smoking Among Nevada Teens: A Decade After Implementation And Implications Of Reduced Funding, Christina A. Demopoulos, Christopher R. Cochran

Nevada Journal of Public Health

Background: Tobacco control programs that have adapted the Centers for Disease Control and Prevention (CDC) Best Practices for a Comprehensive Tobacco Control Program (CTCP) have been effective in reducing the rates of tobacco use. This paper investigates the effectiveness that Nevada’s tobacco control programs have had on teen tobacco use and rates to date and examines changes to programs given reduced Master Settlement Agreement (MSA) funding.

Methods: Aggregate data from the Nevada Department of Health and Human Services/Fund for a Healthy Nevada program was analyzed to determine if the tobacco control programs adapted the CDC’s Best Practices for a CTCP. …

Analysis Of Lead Levels In Deciduous Teeth From Children In Clark County, Nevada., Kristin Murphy, Jennifer Berger-Ritchie, Shawn L. Gerstenberger, Amol B. Amin, Jason K. Nitta, Frederick G. More, Jeanne A. Hibler, Karl Kingsley

Nevada Journal of Public Health

Background: Elevated blood lead levels (EBLL) are declining in the United States, although some population subgroups continue to exhibit significant health disparities. A childhood lead poisoning prevention program was recently started in Nevada, and many efforts have been made to support this program and increase the screening rates.

Methods: To expand the potential pool of children screened for EBLLs, a pilot study was performed to evaluate lead concentrations in extracted deciduous teeth using Graphic Furnace Atomic Absorption Spectrometry (GFAAS), Inductively Coupled Plasma Mass Spectrometry (ICP-MS), and X-Ray Fluorescence (XRF) analysis.

Results: Lead concentrations as determined by GFAAS and ICP-MS were …

Chronic Disease And Risk Factors Among Nevadans With Disabilities: A 2009 Brfss Study, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Previous research has found that people with disabilities are more likely to have chronic diseases (coronary artery disease, stroke, cancer, asthma, diabetes), secondary conditions (high blood pressure, high cholesterol) and risk factors for chronic disease (physical inactivity and obesity) (Havercamp, Scandlin, & Roth, 2004; Kinne, Patrick, & Doyle, 2004; Nosek, Hughes, Petersen et al., 2006; Reichard, Stolzle, & Fox, 2011). The purpose of this study was to conduct a secondary analysis using data from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) to identify differences in chronic disease risk factors and chronic disease/ secondary conditions between adults with and without …

Nutrition Education In Clark County, Nevada, Matt Bittle, Mildred Mcclain, Jeanne A. Hibler, Marcia M. Ditmyer

Nevada Journal of Public Health

Over 51 million school hours are missed annually by school-aged children due to a dental problem or visit, with 117 hours missed per 100 children (NIDCR, 2002). Approximately half a million of California's 7.2 million school-age children missed at least one day of school in 2007 because of dental issues such as toothaches (Pourat, & Nicholson, 2009). Independent research regarding various educational and intervention programs have been conducted in elementary schools across the country that focus on nutrition and/or physical activity, some of which have found that the programs positively impacted students’ dietary behaviors (Edwards, Mauch, & Winkelman, 2011; Muth, …

Utilization Of Preventative Health Services By Nevadans With Disabilities, Jennifer R. Pharr, Sheniz Moonie

Nevada Journal of Public Health

Health disparities are differences in access to health care, quality of health care and health outcomes observed between population-specific groups of people (Health Resources and Services Administration, 2000). Previous research has found that people with disabilities experience unequal access to preventative health care services. The purpose of this study was to conduct a secondary data analysis using data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to determine differences in utilization of preventative health services between adults with and without disabilities in Nevada. Nevadans with disabilities were significantly more likely to have access to health insurance and to have …

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 …

Homelessness: Causes, Culture And Community Development As A Solution, Kaitlin Philipps

Pell Scholars and Senior Theses

This thesis seeks to explain the reasons that homelessness occurs, and how it is currently being dealt with in public policy. Triggers and predictors of homelessness are explored and it is shown that triggers are almost always compounded, indicating a multitude of factors that lead to homelessness. The culture and community surrounding the homeless lifestyle is seen as playing a significant role in how the individual copes with their homelessness. The norms and values of their culture are investigated and its role in rehabilitation is explored. Current institutions for helping the homeless are analyzed for different success rates. Additionally, initiatives …

Filling The Gap: An Examination Of Hiv/Aids Treatment And Prevention At Uganda Cares Masaka, Andrew Robert Mcasey

Independent Study Project (ISP) Collection

A six week internship was conducted at Uganda Cares Masaka, a HIV/AIDS treatment organization, to learn about the development issues surrounding the HIV/AIDS pandemic. The internship was aimed at gaining practical experience at an HIV/AIDS clinic to learn about the challenges faced and the strategies used by Uganda Cares as wells as the effectiveness of their strategies. Uganda Cares represents a collaborative relationship between the private, international HIV treatment and advocacy group, the AIDS Healthcare Foundation (AHF), and the public Ministry of Health (MOH) in Uganda. A final objective of the internship was to gain an inside perspective on this …

Building Trust And Collaboration With Rural Minorities: Experiences With Minority Farmers In The Mississippi Delta, Ari Mwachofi

Journal of Health Disparities Research and Practice

The paper focuses on the question “What research approach is effective in building trust with minority farmers?” The question is answered through a documentation of researchers’ experiences building trust and collaboration with minority farmers in the lower Mississippi Delta. The researchers applied two research paradigms -logical positivism and paradigm of praxis. The logical positivism research approach was met with mistrust and open animosity and had to be abandoned for one based on the paradigm of praxis. Through this approach, and cognizant of the historical-social-political context, the researchers included insiders from the focus population as collaborators and researchers and succeeded in …

An Innovative Approach For Community Engagement: Using An Audience Response System, Jenna L. Davis, Kara E. Mcginnis, Margaret L. Walsh, Coni Williams, Kevin B. Sneed, Julie A. Baldwin, B. Lee Green

Journal of Health Disparities Research and Practice

Community-based participatory research methods allow for community engagement in the effort to reduce cancer health disparities. Community engagement involves health professionals becoming a part of the community in order to build trust, learn from the community and empower them to reduce disparities through their own initiatives and ideas. Audience Response Systems (ARS) are an innovative and engaging way to involve the community and obtain data for research purposes using keypads to report results via power point. The use of ARS within communities is very limited and serves to widen the disparity gap by not delivering new advances in medical knowledge …

Emerging Disparities Among Self-Pay Trauma Patients, Michelle Chino Dr, Deborah A. Kuhls, Mark K. Markarian, Sam Holland, John J. Fildes

Journal of Health Disparities Research and Practice

Preliminary results from a study of trauma patients in Southern Nevada are yielding some unexpected findings with implications for both trauma centers and the growing Hispanic population. Hispanic patients are more likely to be self pay irrespective of income level and employment status when compared to non-Hispanic patient groups. Further, self pay Hispanics, unlike their non-Hispanic, self pay counterparts, tend to be employed, have families, and report stable living conditions. The implication is that the financial and social cost of traumatic injury may place a significant burden on trauma centers, patients, their families and the community.

The Convergence Of Science And Culture: Developing A Framework For Diabetes Education In Tribal Communities, Michelle Chino Dr, Carolee Dodge Francis, Lemyra Debruyn, Lynn Short, Dawn Satterfield

Journal of Health Disparities Research and Practice

In an unprecedented effort to address the epidemic of diabetes in tribal communities, the Diabetes Education in Tribal Schools project brought together a group of individuals from eight tribal colleges and three federal agencies to develop a diabetes prevention curriculum for American Indian and Alaska Native school children. The curriculum incorporates Western and Native science with culturally responsive teaching techniques. Both the project and its evaluation process have reached beyond conventional bounds to acknowledge fundamental issues of tribal culture, history and health and the integration of science, culture, and community. This article will discuss the challenges and rewards of the …

Racial Inequality In The Valuation Of Health Outcomes Expressed By The 1992 Acs Guidelines For Prostate Cancer Screening, C. A. Beam

Journal of Health Disparities Research and Practice

In 1992, the American Cancer Society (ACS) recommended annual screening for prostate cancer for men 50 and older using PSA. In this article, I introduce a method to use race and age-specific PSA accuracy data to evaluate differences in the valuation of outcomes by race and age that were expressed by the ACS guidelines. Using this new method, it can be concluded that the guidelines implied a 4-fold greater valuation was assigned to screening young white males with prostate cancer than the value that was assigned to young black males with cancer. Future implementation of guidelines for screening and testing …

Disparities In Mental Health Utilization Among Persons With Chronic Diseases, Saundra Glover, Keith Elder, Sudha Xirasagar, Jong-Deuk Baek, Crystal Piper, Dayna Campbell

Journal of Health Disparities Research and Practice

This study used Aday and Andersen’s Behavioral Model of Health Services Use to examine the role of chronic disease and the joint impact of race and chronic disease type on mental health utilization. Using data from Community Tracking Survey Household Survey, we tested the assumption that chronic disease, chronic disease type, and race are related to lower rates of mental health visits when adjusted for predisposing, enabling, and need factors. After adjusting for population characteristics, we found that race significantly moderated the impact of chronic disease type on mental health utilization, showing that African Americans with cardiovascular disease were half …

Assessing Behavioral Health Risks, Health Conditions, And Preventive Health Practices Among American Indians/Alaska Natives In Nevada, Gwen Hosey, Shirley A. Llorens-Chen, Fares Qeadan, Daryl Crawford, Charlton Wilson, Wei Yang

Journal of Health Disparities Research and Practice

The 2004 Behavioral Risk Factor Surveillance System (BRFSS) survey was administered to American Indian/Alaska Native (AI/AN) adults in Nevada to determine whether health disparities exist between AI/ANs and the state’s general population. Results showed AI/ANs were 1.5 times more likely to smoke cigarettes, 3.5 times more likely to be exposed to secondhand smoke, 3.2 times more likely to lack leisure-time physical activity, 9.7 times more likely to report fair/poor health status, and 7.7 times more likely to have a disability. In addition, AI/ANs were more likely to have current asthma (OR=5.0) and diabetes (OR=1.8). AI/AN women were 4.8 times as …

Hispanic Ethnicity, Male Gender And Age Predict Restraint Use And Hospital Resource Utilization In Pediatric Trauma, Deborah A. Kuhls, Lynne Fullerton-Gleason, Virginia A. Landry, Julie A. Rabeau, Elizabeth Snavely, John J. Fildes

Journal of Health Disparities Research and Practice

Child restraint reduces the severity of injuries in motor vehicle crashes. Racial/ethnic groups appear to have differing restraint use rates. The objective of this study was to identify restraint use differences between ethnic and other demographic subgroups of pediatric trauma patients. Prospective data were analyzed for 1072 consecutive pediatric patients aged 19 or less who were involved in motor vehicle crashes and brought to our Trauma Center over a 42 month period. The demographic breakdown of this study cohort was 55.3% male, 21.4% Hispanic, 9.7% African American, 64.5% Caucasian, 2.2% Asian and 2.2% other. The highest rates of restraint use …

The Hiv/Aids Pandemic In African American Msm: Targets For Intervention, Kelly Neff

Journal of Health Disparities Research and Practice

The Centers for Disease Control and Prevention estimated in 2005 that 46% of African American men who have sex with men (MSM) are HIV positive. This review explores the unique factors that contribute to risky sexual behavior and the spread of HIV within this population, suggesting that the disparate prevalence of HIV among African American MSM is rooted in experiences of stigmatization from multiple sources and lack of social support from society at large as well as from within the African American community. Beliefs in HIV conspiracy myths are also thought to hinder HIV education, awareness and prevention for African …

Racial Differences In Preventive And Complementary Health Behaviors And Attitudes, Steven E. Shive, Grace X. Ma, Yin Tan, Jamil I. Toubbeh, Lalitha Parameswaran, Lalitha Parameswaran, Joe Halowich

Journal of Health Disparities Research and Practice

Screening tests have been developed for many diseases—the presence of cancer, especially—but are differentially utilized among racial/ethnic groups. In addition to standard medical screening techniques, some patients opt to use Complementary and Alternative Medicine (CAM) for prevention and treatment. The purpose of the current study is to examine racial/ethnic disparities in primary and secondary preventive health behaviors, determine differences in use of complementary and alternative health regimens, and determine which health attitudes and health self-management factors are associated with use of complementary alternative medicine. If differences among ethnic/racial groups in perceived health status, preventive health care behaviors, and use of …