Community-Based Research Commons^™

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

The Relationship Between Breastfeeding And Child Care For Working Mothers In The United States, Patricia Wonch Hill

Department of Sociology: Dissertations, Theses, and Student Research

Whether or not child care provider characteristics and factors related to the care giving environment impact breastfeeding duration for working mothers has not been systematically studied. In this dissertation, I use Ecological Health Promotion Theory to explore the relationship between child care and breastfeeding through three different analyses. First, I interviewed nine child care providers to assess their knowledge, attitudes and beliefs about infant feeding and whether they vary on these factors across individuals and child care licensing types. Second, I conducted a small mail survey of 93 licensed child care providers in order to create a scale measuring attitudes …

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 …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

School of Public Health Faculty Research

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …

Brief Report: Activities And Achievements Of The P4p Project—Introducing Pay-For-Performance (P4p) Approach To Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Population Council

Reproductive Health

A pilot study was initiated in Bangladesh for testing Pay-for-Performance for providers and clients in improving maternal, newborn, and child health (MNCH) services by addressing supply and demand-side barriers. With funding from UNICEF, the Population Council provided technical assistance for the operations research study implemented by the Directorate General of Health Services, Ministry of Health and Family Welfare of the Government of Bangladesh. Necessary and key human resource placement and training on integrated management of childhood illness, emergency operations centers, newborn care, infection prevention, and waste management are important for better performance in all facilities. In spite of existing barriers, …

Training Institutions For Community Midwives In Pakistan: An Initial Assessment, Zakir Hussain Shah, Momina Salim, Mumraiz Khan

Reproductive Health

This study focuses on the training of community midwives (CMWs) in Pakistan, to specifically look at the institutions providing CMW training to see what resources (both physical and human resources) they had available and how these resources were being utilized. This study served as an early evaluation of the trainings and upgrades by the PAIMAN project, to assess how their interventions fared, and provides documentation for future decisions regarding the management, training, and practice of CMWs in Pakistan. As Pakistan transitions from a country with a high level of home births to a country where most births take place in …

Assessing The Feasibility Of Home Administration Of Misoprostol In The Prevention Of Postpartum Hemorrhage In Rural Pakistan, Ali M. Mir, Abdul Wajid, Sadaf Gull

Reproductive Health

This report details an operations research project carried out by the Population Council as part of the Pakistan Initiative for Mothers and Newborns. The overall goal of the project was to test the feasibility of administering misoprostol for the prevention of postpartum hemorrhage (PPH) in a home setting through community‐based healthcare providers, including traditional birth attendants (TBAs), or family members, in two districts of Pakistan. Furthermore, it aimed to identify common side effects of misoprostol and determine the reduction in demand for referral due to PPH after oral ingestion of misoprostol. The results provide a useful addition to the literature …

Assessing The Potential Acceptability Of A New Cadre Of Community Midwives For Pregnancy And Delivery Related Care In Rural Pakistan: Findings From A Qualitative Study, Abdul Wajid, Ali M. Mir, Zubaida Rashid, Abida Aziz

Reproductive Health

The Population Council designed an operations research study to assess the potential acceptability of a new cadre of community midwives (CMWs) for pregnancy and delivery-related care in rural Pakistan. Specific objectives of the study were to determine the need for skilled birth attendants, identify any misconceptions in the community about CMWs, determine levels of acceptance in the community, and explore barriers to the placement of CMWs in the community. The report recommends sensitizing family members so they are more willing to grant permission for pregnant women to consult CMWs, developing flexible fee structures, giving clients greater accessibility, building a network …

Process Evaluation Of Community Mobilization Activities, Zakir Hussain Shah

Reproductive Health

This report presents the findings of a process evaluation by the Population Council of community mobilization (CM) activities implemented under the PAIMAN project in Pakistan. PAIMAN developed a comprehensive communication, advocacy, and mobilization (CAM) strategy to increase knowledge and awareness of harmful practices among women and their family and to improve their health-seeking behaviors. The CAM roadmap acknowledges the importance of engaging communities in order to achieve behavior change and links clients with providers and services. The main objective of this evaluation was to assess the process of CM implementation and to identify its gaps in order to develop corrective …

The Role Of Traditional Leaders In Preventing And Addressing Sexual And Gender-Based Violence: Findings From Kwazulu-Natal, Northwest And Limpopo Provinces In South Africa, Mantshi Teffo-Menziwa, Saiqa Mullick, Prince Cedza Dlamini

Reproductive Health

The Population Council, in partnership with the Ubuntu Institute, embarked on a program to engage traditional Leaders in three South African provinces (North West, KwaZulu-Natal and Limpopo) to address sexual and gender-based violence (SGBV) in rural communities. The overarching goals of the program were to strengthen linkages between the Population Council and traditional communities, generate and share strategic information on SGBV, strengthen prevention and response to child sexual assault, engage new partners to address prevention of and access to SGBV services, and expand access to comprehensive post-rape services by working with traditional leadership structures. Some of the key findings reflect …

Introducing And Pilot-Testing The National Guidelines On Integrating The Management Of Stis/Rtis Into Reproductive Health Settings In Kenya, Wilson Liambila, Saiqa Mullick, Ian Askew, Nathalie Broutet, Bartilol Kigen, Cosmas Mutunga, Daniel Sande, Nimrod Garama, Benjamin Tsofa, Christine Awuor, Ibrahim Mohammed

Reproductive Health

This report evaluated a project in ten Kenyan health facilities. It examined the feasibility, acceptability and effect of introducing reproductive tract infection and sexually transmitted infection (RTI/STI) guidelines on the quality of care provided, and the incremental costs of integrating these services into existing reproductive health (RH) services; it also disseminated the results and lessons learnt within Kenya. Overall, the results showed that integration of activities to screen for and manage STIs/RTIs into RH services is feasible, acceptable to clients and providers, and effective in improving the range and quality of services offered to clients.

Emergency Contraception: Idea To Program, Saumya Ramarao, John Townsend, Sarah Raifman

Reproductive Health

This report summarizes the role of the Population Council in generating evidence, providing technical leadership, and demonstrating at scale that emergency contraception (EC) can be easily integrated into national family planning programs and other reproductive health services. Since the 1990s, the Population Council, along with other partners, has contributed to the changes seen in the provision and availability of EC, now available in over 140 countries around the world. While much progress has been made in the campaign for access to EC, the Council is committed to improving existing methods of service delivery and to leading advocacy efforts and research …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Quality Of Life Estimation With Structural Equation Modeling In School Aged Children With Asthma, Sheniz Moonie, Xuan Huang, David A. Sterling

Environmental & Global Health Faculty Research

Significant increases in childhood asthma prevalence and mortality has prompted federal and regulatory agencies to work towards a national framework to address childhood asthma. Quality of life is an important component of chronic disease, and the evaluation of healthcare outcomes. There is little discussion in the literature regarding the implications of QoL as a theoretical construct. This study determined the effect of asthma on the QoL of our study population and caregiver’s missed workdays on the child’s QoL scores. A negative relationship was found between the child’s QoL and the caregiver’s missed workdays due to their child’s asthma. The use …

Implications For Child Welfare Teaching And Human Services Personnel Perspectives Experiences Of Children With Special Needs, Sarah Huesmann

Honors Capstones

Capstone submitted as a graduation requirement for the BSU Honors Program.

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 …

Youth Participation In Civil Society And Political Life In Bihar, International Institute For Population Sciences (Iips), Population Council

Poverty, Gender, and Youth

Youth participation in civil society and political life is increasingly recognized as an important development objective. The opportunities for participation that young people experience in their communities may influence their development and the kind of transitions they make to adulthood. Moreover, behaviors and attitudes relating to community participation that individuals adopt as young people predict their lifelong civic affiliations and perspectives. In India, the National Youth Policy 2003 underscored the role of India’s youth in political decision-making and argued for greater representation of youth in appropriate bodies as well as more extensive youth participation in the design and implementation of …

"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 …

Sexual Behavior And Sti/Hiv Status Among Adolescents In Rural Malawi: An Evaluation Of The Effect Of Interview Mode On Reporting, Barbara Mensch, Paul C. Hewett, Richard Gregory, Stephane Helleringer

Poverty, Gender, and Youth

This paper presents the results from an interview-mode experiment conducted by the Population Council with unmarried young women in rural southern Malawi. To collect data on sexual behavior and the dynamics of HIV transmission, respondents were randomly assigned to either an audio computer-assisted self-interview (ACASI) or a conventional face-to-face (FTF) interview. Clear evidence indicates that the mode of interviewing and probing concerning various sexual partnerships affects respondents’ reporting of their sexual activity, yet the results are not always in accordance with expectations. Reporting for “ever had sex” and “sex with a boyfriend” is higher in the FTF mode, whereas, when …

Technical Assistance For Implementing Best Practices In The Asia And Near East Region, M.E. Khan, Sohini Roychowdhury, Mary Philip Sebastian, Sitanshu Sekhar Kar, Anurag Mishra, Vivek Sharma, G. Narayana, Bhawana Sharma, Nahla G. Abdel-Tawab, Ahmed Afifi

Reproductive Health

The Population Council's Frontiers in Reproductive Health (FRONTIERS) program offered technical assistance to any Asia Near East (ANE) country mission interested in funding adaptation of USAID‟s “best practices” in family planning or reproductive health. The ANE Bureau provided funding for the costs of FRONTIERS technical assistance. The overall objective of this study was to replicate and scale up "best practices" based on findings from FRONTIERS. The specific objectives were to institutionalize the Systematic Screening Instrument in the entire state of Uttarakhand, India; to strenghten emergency contraceptive pills service provision in Uttarakhand, India; and to enhance the use of Lactational Amenorrhea …

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 …

Lead-Contaminated Candies In Southern Nevada, Shawn Gerstenberger, Glenn Savage, Clayton Sellers, Keith Zupnik, Emmanuel C. Gorospe

Environmental & Global Health Faculty Research

Lead-contaminated candies from Latin America are beginning to gain attention in the public media1,2 and in the medical literature.3–5 These candies come from a number of sources and are manufactured outside Food and Drug Administration regulatory control. In 2005, we sampled 50 imported Latin American candies sold in Southern Nevada. A total of 20 (40%) tested positive with an average lead content of 1.46  0.27 mg/kg in the candies’ wrappers and straws, based on standard Graphite Furnace Atomic Absorption Spectrophotometry methodology. Given these results, the Southern Nevada Health District issued a cease-and-desist order on February 13, 2006, to local …

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 …

Care Patterns And Outcomes For Hospitalized Patients With Diabetes In Nevada, Jay J. Shen

Nevada Journal of Public Health

This study demonstrates substantial differences between Nevada and the national average in patterns of hospital based care in patients with type 2 diabetes. Diabetic patients in Nevada are more likely to be hospitalized through the emergency department, and more likely to be admitted for a condition related to diabetes. Moreover, in Nevada, Medicaid and uninsured patients with diabetes are more likely to experience adverse outcomes then their privately insured counterparts. These differences may be primarily reflective of variances in access to ambulatory care, care seeking behavior, and availability of health services and facilities. Policies promoting expansion of health care benefits …

Learning From The Grandmothers: Incorporating Indigenous Principles Into Qualitative Research, Charlotte Loppie

Aboriginal Policy Research Consortium International (APRCi)

In this article, the author describes the process she undertook to incorporate Indigenous principles into her doctoral research about the midlife health experiences of elder Aboriginal women in Nova Scotia, Canada. By employing qual- itative methods within the context of an Indigenous worldview, she gained knowledge of and developed competence in Aboriginal health research. The emergent partnership among Aboriginal community research facilitators, participating Mi’kmaq women, and the researcher provided many opportunities for the researcher to incorporate the paradigmatic and methodological traditions of Western science and Indigenous cultures. The application of these principles to this study might provide a useful example …

The Status Of Childhood Lead Poisoning And Prevention In Nevada, Usa, Anne Rothweiler, Elena E. Cabb, Shawn Gerstenberger

Environmental & Global Health Faculty Research

One of the first steps in addressing the problem of childhood lead poisoning is to identify the possible sources of exposure in specific communities and target high-risk populations with appropriate interventions. Due to several factors, such as lack of funding and lack of blood lead reporting, little information exists regarding the occurrence of childhood lead poisoning and the prevalence of potential exposure sources in the state of Nevada. Following the recent establishment of a Nevada-based Lead Poisoning Program, we compiled the most current information available on Nevadans, and use this knowledge to suggest future research objectives and outreach activities for …

Episiotomy And Obstetric Trauma In Nevada: Evidence From Linked Hospital Discharge And Birth Data, Gulzar H. Shah, Joseph A. Greenway, Wei Yang

Nevada Journal of Public Health

Based on the perception that episiotomy prevents obstetric trauma, the procedure is liberally performed in U.S. Hospitals. Using linked Nevada Birth Registry and Nevada Impatient Hospital Discharges (2000 to 2005), we applied descriptive analyses and logistic regression to examine the status of Nevada episiotomy practice and its impact on birth trauma for mothers. Of 106,461 vaginal live births, 26,383 (24.8%) episiotomies were conducted. Obstetric trauma rate declined from 5.2% of vaginal deliveries in 2000 to 4.4% in 2005. After statistically controlling for the effect of other risk factors, zero parity, episiotomy, other instrument assisted deliveries, non-MDs as birth attendants, rural …

Las Vegas: A Sustainable Urban Environment For Health?, Nancy Menzel

Nevada Journal of Public Health

The rapid growth of Las Vegas has resulted in negative consequences for the health of its residents to a level that threatens the area’s sustainability. This article reviews key indicators of population health in Las Vegas through the framework of the US Centers for Disease Control and Prevention’s Healthy People in Healthy Places and concludes that public health professionals, citizens, businesses, and political leaders must act now to protect and improve population health.

Hiv-Positive Inmates Released From Nevada’S Prisons In 2001: Results From Matching Health Division And Corrections’ Databases, Paul G. Devereux, Kristen Clements-Nolle, Sharon Clodfelter, Jessey Bargmann-Losche, Miguel Feroro, Wei Yang

Nevada Journal of Public Health

It is estimated that about one quarter of all HIV-infected individuals in the United States are released from a correctional facility each year. To better understand the needs of inmates with HIV exiting the prison system, a partnership with the Nevada State Health Division (NSHD), the Nevada Department of Corrections (DOC), and the University of Nevada, Reno School of Public Health was formed to examine this population using information contained in existing databases. An analysis of DOC data matched with the data from the HIV/AIDS Reporting System (HARS) maintained by the NSHD identified 2,802 HIV-negative inmates (2,451 males and 350 …