Demography, Population, and Ecology Commons^™

Process Evaluation In Action: Lessons Learned From Alabama Reach 2010, M. C. Nagy, Rhoda E. Johnson, Robin C. Vanderpool, Mona N. Fouad, Mark Dignan, Theresa A. Wynn, Edward E. Patridge, Isabel Scarinci, Cheryl Holt, Sharina D. Person

Journal of Health Disparities Research and Practice

The CDC-funded Alabama Racial and Ethnic Approaches to Community Health (REACH 2010) project is designed to reduce and eliminate disparities in breast and cervical cancer between African American and white women in six rural and three urban counties in Alabama. In this manuscript, we report on the development, implementation, results, and lessons learned from a process evaluation plan initiated during the Phase I planning period of the Alabama REACH 2010 program. The process evaluation plan for Alabama REACH 2010 focused on four main areas of activity that coincided with program objectives: assessing coalition development, building community capacity, conducting a needs …

Increasing Rate Of Pneumonia Hospitalizations Among Older American Indian And Alaska Native Adults, Robert C. Holman, Krista L. Yorita, Rosalyn J. Singleton, James E. Cheek, Edna L. Paisano, Jay C. Butler, Larry J. Anderson, Alicia M. Fry

Journal of Health Disparities Research and Practice

Objective: To examine rates and trends of pneumonia hospitalization among older American Indian and Alaska Native (AI/AN) adults.

Methods: Pneumonia hospitalizations for older AI/AN adults ≥65 years of age living in the Alaska and Southwest Indian Health Service (IHS) regions during 1988 through 2002 from the IHS hospital discharge data were analyzed.

Results: The average annual hospitalization rate for first-listed pneumonia for older AI/AN adults in both the Alaska and the Southwest regions has increased (15.3 and 23.0 in 1988-1990 to 25.9 and 28.8 in 2000-2002 per 1,000 population, respectively), with the greatest increase seen among older AI/AN adults in …

Elevated Depressive Symptoms In A Community Sample Of African-Americans And Whites, Robert J. Jagers, Fernando A. Wagner, Pamela E. Scott-Johnson, Yan Wang, Dorothy C. Browne

Journal of Health Disparities Research and Practice

This study examined demographic and psychosocial correlates of elevated depressive symptoms among African-Americans and Whites from comparable socioeconomic and neighborhood backgrounds. 851 African-Americans and 597 Whites from adjacent census tracts were interviewed using previously validated indicators of depressive symptoms, social support, religious practices and various demographic characteristics. More Whites than African-Americans reported elevated depressive symptoms and the groups also differed on several demographic variables and psychosocial variables. Employment, marital status and age were salient demographic covariates for African Americans, while income was for Whites. For both groups, social support and church attendance were inversely associated with depressive symptoms. Prayer was …

Racial And Ethnic Differences In Cardiovascular Disease Risk Factors In U.S. Older Women: Findings From Behavioral Risk Factor Surveillance Survey, 2003 & 2004, Anita K. Kurian, Kristine Lykens, Sejong Bae, Karan P. Singh

Journal of Health Disparities Research and Practice

The purpose of this study was to examine racial and ethnic variations in the modifiable CVD risk factors in older women (65 years and older). The study data was drawn from the merged 2003 and 2004 national Behavioral Risk Factor Surveillance Survey (BRFSS). Multinomial regression analyses for indicator outcome and multiple logistic regression analyses for binary outcomes were performed to determine the relationship between each of the six dependent variable and the independent variables. Compared to older white women, older black women had significantly higher odds of hypertension, diabetes and obesity. No significant association was found between Hispanics and hypertension. …

African American Adults’ Experiences With The Health Care System: In Their Own Words, Keri A. Jupka, Nancy L. Weaver, Vetta L. Sanders-Thompson, Nicole M. Caito, Matthew W. Kreuter

Journal of Health Disparities Research and Practice

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and …

Examination Of Racial Disparities In Childhood Asthma Management Practices, Crystal N. Piper, Saundra Glover, Kieth Elder, Jong-Deuk Baek

Journal of Health Disparities Research and Practice

Objective: To analyze asthma management plan practices for children with asthma in the United States considering race and other demographic and person-level characteristics.

Methods: Univariate/Bivariate/Multivariate analysis was performed to examine asthma management plan physician recommendations among children in the United States utilizing secondary data analysis of the 2002 and 2003 National Health Interview Survey.

Results: The majority of the study participants reported not having an asthma management plan at (59.00%). In multivariate analysis using SAS callable SUDAAN, Whites were significantly more likely to have an asthma management plan (OR=1.66, p=.0031).

Conclusion: Findings from this study indicate that Black and Hispanic …

Utilizing Community Resources To Reduce The Presence Of Type 2 Diabetes In Rural Youth, Antonia S. Mead, M. C. Nagy, Stephen Nagy

Journal of Health Disparities Research and Practice

The purpose of this study was to implement a program designed to promote diabetes prevention activities among preadolescents in a rural southern setting using a day camp intervention. Participants in the study were eleven youth from a rural Alabama county who participated in a week-long half-day camp administered by local and community volunteers. Change scores were used to compare pre- to post- to follow-up measures for camp participant responses. Program results consistently demonstrated that the day camp was theoretically sound and that program activities positively impacted behavioral antecedents. This study demonstrated the feasibility of conducting a diabetes prevention day camp …

Hepatitis C Diagnoses In An American Indian Primary Care Population, Hillary E. Norton, John T. Redd, Ralph T. Bryan

Journal of Health Disparities Research and Practice

BACKGROUND: Despite large disparities in the burden of chronic liver disease, data on hepatitis C virus (HCV) infection among American Indians (AIs) are lacking. We reviewed hepatitis C diagnoses in 35,712 AI/AN primary care patients.

MAIN FINDINGS: At least one HCV-associated ICD-9 code was recorded in 251 (1%) patients between October 1, 2001 and September 30, 2003. An HCV enzyme-linked immunoassay (HCVEIA) was sent in 209 (83.0%); 206/209 (99%) were positive. Confirmatory testing was performed in 144/206 (70%) HCV-EIA positive patients; HCV infection was confirmed in 144 (100%). In the 90/144 (63%) charts with risk factor documentation, injection drug use …

Tribally-Driven Participatory Research: State Of The Practice And Potential Strategies For The Future, Patricia Mariella, Eddie Brown, Michael Carter, Vanessa Verri

Journal of Health Disparities Research and Practice

This paper discusses current practice of research with and by American Indian tribal governments in the United States. It begins with a brief overview of Community-Based Participatory Research and compares and contrasts its principles and methods with what this paper terms Tribally-Driven Participatory Research. The paper analyzes current challenges and offers concepts for continuing to improve the effectiveness of Tribally-Driven Participatory Research.

Talking Glossary Of Genomics Terminology: A Genomics Education Module For American Indian Communities, Jill Peters, Pauline Davies, Naomi Lane, Kathryn Coe

Journal of Health Disparities Research and Practice

This paper describes the development of an audio visual genomics glossary that was designed as an education tool for American Indian communities. This “Talking Glossary of Genomics Terminology” is a multimedia DVD that was modeled on the “Talking Glossary of Genetics,” which was developed by the National Human Genome Research Institute (NHGRI). The NHGRI Glossary was modified and expanded with content designed to increase awareness among American Indians about cancer, genomics, and personalized medicine. Partners on the project include the Inter Tribal Council of Arizona, Inc., Phoenix Indian Medical Center, Arizona Cancer Center at the University of Arizona, the Translational …

Beyond The It Magic Bullet: Hiv Prevention Education And Public Policy, Fay C. Payton

Journal of Health Disparities Research and Practice

Analytic applications are vital in the assessments of public health and surveillance as these applications can drive resource allocation, community assessment and public policy. Using a dataset of nearly 90,000 patient hospital encounters, the number of instances with an ICD code of HIV and co-morbidities was identified. Blacks accounted for 75 percent of HIV hospital encounters in the dataset. While business analytic applications informed this study of cross-tabulations and interaction effects among race, age and gender, there appears to be a significant relationship among HIV diagnoses and substance abuse. Payer data is informed by the Healthcare Cost and Utilization Project …

Health Disparities In Kidney Transplantation: An Equity Analysis, Shirley A. Wells

Journal of Health Disparities Research and Practice

The growing incidence of end stage renal disease along with advances of the past 40 years that have improved the success rate of kidney transplantation have created an unprecedented demand for kidney transplant. Yet, certain racial and ethnic groups and women consistently have longer waiting times and lower rates of transplantation which makes a review of the kidney procurement and transplantation system in view of its equity imperative. Reasons given for these disparities have varied from cultural attitudes and beliefs on the part of patients and health care providers, socioeconomic status, rates of organ donation, and geographic location. The equity …

A Review Of Smoking Among Rural African Americans: Recommendations For Research And Cessation Interventions, Susan Hedgecock, Anita Fernander

Journal of Health Disparities Research and Practice

Objective: The purpose of this review is to synthesize the available literature on smoking among rural African Americans.

Methods: Using search terms “rural” “African American” “Black” and “smoking” 19 relevant articles were identified in the Medline data base. Findings gleaned from the 19 articles are presented in four categories: a) smoking prevalence, b) smoking behavior and patterns, c) smoking cessation interventions and quitting, and d) smoking-related outcomes.

Results: There may be gender differences, a pattern of late onset of smoking, and a preference for mentholated brands among rural African American smokers. There is no evidence that rural African Americans are …

Differential Effects Of Race And Poverty On Ambulatory Care Sensitive Conditions, Farrukh B. Hakeem, Daniel L. Howard, Timothy S. Carey, Yhenneko J. Taylor

Journal of Health Disparities Research and Practice

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in …

Inflammatory Biomarkers And Subclinical Atherosclerosis In African-American Women With Systemic Lupus Erythematosus (Sle), Edith Williams, Carlos Crespo, Joan Dorn

Journal of Health Disparities Research and Practice

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 …

A Human Capital Approach To Reduce Health Disparities, Saundra Glover, Sudha Xirasagar, Yunho Jeon, Keith Elder, Crystal N. Piper, Harris Pastides

Journal of Health Disparities Research and Practice

Objective: To introduce a human capital approach to reduce health disparities in South Carolina by increasing the number and quality of trained minority professionals in public health practice and research.

Methods: The conceptual basis and elements of Project EXPORT in South Carolina are described. Project EXPORT is a community based participatory research (CBPR) translational project designed to build human capital in public health practice and research. This project involves Claflin University (CU), a Historically Black College University (HBCU) and the African American community of Orangeburg, South Carolina to reduce health disparities, utilizing resources from the University of South Carolina (USC), …

The Influence Of Neighborhood Characteristics On The Existence Of Asthma In Children, Elizabeth Adejuyigbe

Annual Undergraduate Conference on Health and Society

Asthma is one of the leading chronic diseases in children 17 years of age and under with nine million American children suffering from it. Previous studies to understand causal factors of disease including asthma tend to focus on the individual and sociocultural characteristics but there is little to no research using neighborhood characteristics, a factor that does influence health. Research shows that other community‐level environmental factors like collective efficacy, community structural factors, and neighborhood safety can affect a persons’ psychosocial well-being, and in turn increase morbidity. For this reason, researchers suggest that the need to understand asthma and its associated …

The Experiences Of Men Engaged In Transactional Sex With Other Men In Urban Nigeria—A Size Estimation And Qualitative Study, Population Council

HIV and AIDS

Reports on a mixed-method research study to estimate the population size and understand the experiences of a sub-group of men who have sex with men presumed to be at particularly high risk of infection with HIV and other sexually transmitted infections: men who engage in transactional sex with other men.

Using Capture-Recapture Methodology For Enumerating Most-At-Risk Populations (Marps), Population Council

HIV and AIDS

Populations at higher risk for HIV infection are often the most difficult to reach and this is particularly true of men who have sex with men (MSM), injecting drug users, and female sex workers in sub-Saharan Africa. These subpopulations are frequently marginalized by society because of the illicit and/or illegal activities they engage in. Estimating the size of hard-to-reach populations is important to effectively plan, implement, monitor, and evaluate HIV and AIDS prevention and care programs. “Capture-recapture” is a method of estimating the prevalence of a trait in a population or more simply it’s a method that provides a good …

An Assessment Of Individual And Institutional Research Utilization By Policy-Makers And Programme Managers At State And National Levels In Nigeria, National Agency For The Control Of Aids

HIV and AIDS

This report undertakes a systematic assessment of the need for evidence by decision-makers working on HIV and AIDS funding and policymaking, and implementing organizations at the national and subnational levels in Nigeria. The assessment identifies barriers and constraints to data use, identifies best practices, and offers recommendations for the design and prioritization of strategic approaches to address barriers and constraints in data use and production. Tools to monitor the adoption of evidence in policy and practice are also offered. The need for evidence-based practice in the national response to HIV and AIDS has been widely acknowledged and incorporated into policy …

An Ethnographic Study Of Injecting Drug Users And Men Who Have Sex With Men In Selected States In Nigeria, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

An ethnographic pre-assessment study of the behavioral dynamics of men who have sex with men (MSM) and injecting drug users (IDU) was conducted in 2009 as an integral part of the 2010 Integrated Biological and Behavioural Surveillance Survey (IBBSS). The study took place in Northern and Southern Nigeria and provided rich contextual information on the logistic and scientific factors that would aid successful conduct of the IBBSS and secure buy-in for it among study respondents. The study utilized a combination of rapid assessment procedures that were suitable to prevailing time exigencies and could foster preliminary understanding of the local contexts …

The Sociological Impact Of Cancer: Cancer Among The World, Jenna Kooy

A with Honors Projects

Cancer among ethnic groups and in high income/low income regions.

Sociological Impact On Cancer, Michelle Little

A with Honors Projects

Demographics of cancer and other sociological impacts on cancer.

Marps Sensitization: A Diversity Training Guide For Health Care Providers In Nigeria, Enhancing Nigeria's Hiv/Aids Response (Enr) Programme

HIV and AIDS

Men who have sex with men (MSM) present specific diagnostic and management challenges to counselors and health-care providers. High prevalence of HIV infection has been reported among MSM in Nigeria, driven partly by stigma, discrimination, lack of appropriate prevention strategies, limited research evidence, little recognition by policymakers, and inadequate knowledge and skills in dealing with MSM clients. In Nigeria, where homosexuality is illegal, the risk embodied in same-sex activities is high and makes hiding MSM activities almost a norm. Currently, health-care provider training materials that address most at-risk populations’ (MARPs) specific health needs are nonexistent in Nigeria. Knowledge of these …

Le Consensus De Bellagio : Recommandations Pour Améliorer L'Accès Aux Méthodes De Contraception Efficaces, Réversibles À Longue Durée D'Action, Population Council

Reproductive Health

Ce communiqué et cette déclaration proposent des recommandations pour améliorer l'accès aux méthodes de contraception efficaces, réversibles à longue durée d'action (LARC) et accélérer les progrès vers la réalisation de l'Objectif du Millénaire pour le développement relatif à l'accès universel aux services de santé reproductive.

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This brief and statement offers recommendations for action to increase access to highly effective, long-acting, reversible contraception (LARCs) and accelerate progress toward meeting the Millennium Development Goal of universal access to reproductive health services.

Prevalence And Correlates Of Hiv Infection In A Cohort Of Male Injection Drug Users In Delhi, Waimar Tun, Vartika Sharma, Mary Philip Sebastian, Ira Madan, Amita Yadav, Meredith Sheehy, Dean Lewis, Ibou Thior, Avina Sarna

HIV and AIDS

Baseline assessment of HIV infection among male injection drug users to understand the correlates of HIV infection and high risk injection practices and sexual behavior in Delhi, India.

Hiv/Aids In The Muslim-Majority Countries: Formula For Low Prevalence, Kaoru Yamaguchi

Political Science Theses and Capstones

The Muslim-majority countries long had been considered to be free of HIV/AIDS epidemic because of their strict religious and moral codes. However, the HIV prevalence rates are increasing in some Islamic states, and even more or so rapidly in a several cases that it is no longer valid to assume the Islamic religion protects its followers from the risks of contracting HIV. Contrary to the popular belief concerning the prevention of the HIV/AIDs epidemic, data collected from well-recognized international organizations such as the WHO and Freedom House indicate that democratization, strong government leadership, and wider and equal human rights for …

Household Survey To Evaluate The Zambia-Led Prevention Initiative: Baseline Report, Zambia-Led Prevention Initiative

HIV and AIDS

With an estimated HIV prevalence of 14.3 percent among men and women age 15–49, Zambia is one of the sub-Saharan African countries most affected by the HIV and AIDS pandemic. The Zambia-led Prevention Initiative Program (ZPI) was developed by a consortium led by FHI360, with the Population Council as the evaluation partner. This study determined baseline levels of key indicators related to HIV, gender-based violence, and reproductive health. Additionally, the baseline findings provide critical insights into key areas for interventions in Zambia and highlights variability in the populations across provinces and between males and females that provide valuable guidance for …

Study Guide For United In Anger: A History Of Act Up, Matt Brim

Open Educational Resources

The United in Anger Study Guide facilitates classroom and activist engagement with Jim Hubbard’s 2012 documentary, United in Anger: A History of ACT UP. The Study Guide contains discussion sections, projects and exercises, and resources for further research about the activism of the New York chapter of ACT UP (AIDS Coalition to Unleash Power). The Study Guide is a free, interactive, multimedia resource for understanding the legacy of ACT UP, the film’s role in preserving that legacy, and its meaning for viewers' lives.

Filles Eveillées ('Girls Awakened'): A Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen, Gisele Kaboré, Leah Jarvis

Poverty, Gender, and Youth

Young people in Burkina Faso, especially adolescent girls, have few economic opportunities, particularly in rural areas. This drives migration to urban areas in search of employment. In 2010, the Population council conducted formative research on migrant adolescent girls in domestic service in urban Burkina Faso. Findings revealed that girls typically live with their employers and spend long days performing arduous work, leaving little time for schooling, building social networks, and developing skills necessary for adulthood. Most programs designed for this population intervene after something has gone wrong rather than building girls’ protective assets. In response to these findings, the Population …