Medicine and Health Commons^™

Promoción De La Salud En La Ciudad De Buenos Aires: Un Estudio Sobre El Trabajo De Los Promotores De Salud Y Las Percepciones De Su Rol En La Comunidad. / Health Promotion In The City Of Buenos Aires: A Study Of The Work Of Community Health Workers And Perceptions Of Their Role In The Community, Elizabeth Sherwin

Independent Study Project (ISP) Collection

Contextual information: At the global level, inequities exist with respect to access and quality of healthcare. Primary Health Care is a strategy to respond to these inequities. It adopts an integral concept of health that includes no only illness but also the wellbeing of a person affected by many environmental factors. It is a strategy that aims to improve access to medical care and health information through health promotion and has the goal of giving the population more control over their health. Community health workers, people from the same neighborhood in which they work promoting health, are recognized on the …

Congestive Heart Failure Self-Management Among Us Veterans: The Role Of Personal And Professional Advocates, Eleni Skaperdas, Anaïs Tuepker, Christina Nicolaidis, Jessica K. Robb, Devan Kansagara, David H. Hickam

School of Social Work Faculty Publications and Presentations

Objective: Understand patients’ experiences with primary care services for congestive heart failure (CHF) and explore the relationship between health services and self-management.

Methods: We conducted semi-structured interviews with thirty-nine patients with CHF receiving care at one Veterans Affairs Medical Center (VA). We analyzed data using thematic content analysis.

Results: Participants acknowledged the importance of ongoing engagement in the plan of care for CHF. They attributed success in this effort to be greatly influenced by personal advocates. The advocates included both members of the healthcare team with whom they had a continuity relationship and friends or family members who assisted on …

Adolescent Perceptions Of Health Through Photovoice In Cato Manor, South Africa, Renee Lamoreau

Independent Study Project (ISP) Collection

This study will investigate how youth in Cato Manor perceive health in their community using photovoice as the primary methodology. Photovoice is a participatory action research method that gives participants the power to answer research questions through imagery. Participants take pictures in response to a question or prompt, and then describe a self-­‐selected number of pictures using the SHOWED process. This study will employ this methodology to answer the following questions: What objects, people, and events do youth associate with health? How do youth in Cato Manor define health and sickness? The following report will summarize the social and physical …

Citizenship Documentation Requirement For Medical Eligibility: Effects On Oregon Children, Brigit A. Hatch, Jennifer E. Devoe, Jodi A. Lapidus, Matthew J. Carlson, Bill J. Wright

Sociology Faculty Publications and Presentations

BACKGROUND AND OBJECTIVES: The Deficit Reduction Act (DRA) of 2005 mandated Medicaid beneficiaries to document citizenship. Using a prospective cohort (n=104,375), we aimed to (1) determine characteristics of affected children, (2) describe effects on health insurance coverage and access to needed health care, and (3) model the causal relationship between this new policy, known determinants of health care access, and receipt of needed health care.

METHODS: We identified a stratified random sample of children shortly after the DRA was implemented and used state records and surveys to compare three groups: children denied Medicaid for inability to document citizenship, children denied …

Assessing Transgender Attitudes Toward Health Care: Can These Attitudes Help Predict Health Outcomes?, Sara M. Shane

PCOM Psychology Dissertations

Research has identified the fact that race/ethnicity, sexual orientation, gender identity, socioeconomic status, education level, geographic location, help seeking behaviors, and experiences of discrimination are associated with health outcomes. In addition, attitudes towards providers can also help determine health outcomes. The transgender community experiences barriers to health care services and therefore their overall health is affected. There is not a sufficient amount of literature that assesses, using standardized measure, the attitudes of the transgender community and their health. The present study will assess the attitudes of the transgender community toward health care (mental and medical health) and, using standardized measures, …

Social Networks, Drug Use, And Drug Abuse Help-Seeking: A Test Of The Network Episode Model Among African American Women, Erin L. Pullen

Theses and Dissertations--Sociology

Untreated substance use disorders are a major public health concern that has costly consequences at both the societal and individual level. Identifying the characteristics and resources of those who seek help for substance abuse problems in order to inform more effective intervention and treatment techniques is therefore an important research objective. Using the Network Episode Model (NEM) as a theoretical framework, this dissertation examines both substance abuse help-seeking (i.e. inpatient/outpatient treatment and 12-Step meeting attendance) and patterns of drug use over time among low-income African American women, with a special focus on the role of the social network system in …

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 women contacted …

The Impact Of The Chinese Rural Healthcare System On Infectious Disease: A Study Of The History And Reform Of Chinese Healthcare, And The Global Implications Of Infectious Disease Control In China, John Barbadoro

Independent Study Project (ISP) Collection

China’s healthcare system has gone through significant changes in the 20^th and 21^st centuries. These changes have mirrored not only the political focus of the time, but also the social issues facing China. The NRCMCS for rural residents is a cheap annual fee that covers a percentage of medical costs. There are two urban equivalents, the BMIUE and BMIUR for urban employees through their job, and residency respectively. Despite the focus on cheaper healthcare for rural residents, the problems of income inequality and mistrust in the medical system are major problems that affect the health of this large …

The State Of The Science Of Health And Wellness For Adults With Intellectual And Developmental Disabilities, Lynda Lahti Anderson, Kathy Humphries, Suzanne Mcdermott, Beth Marks, Jasmina Sisirak, Sheryl Larson

Rural Institute Journal Articles

Historically, people with intellectual and developmental disabilities (IDD) have experienced health disparities related to several factors including: a lack of access to high quality medical care, inadequate preparation of health care providers to meet their needs, the social determinants of health (e.g., poverty, race and gender), and the failure to include people with IDD in public health efforts and other prevention activities. Over the past decade, a greater effort has been made to both identify and begin to address myriad health disparities experienced by people with IDD through a variety of activities including programs that address health lifestyles and greater …

"Homelike" Characteristics Of Maine's Residential Services: A Survey Of Maine's Residential Service Settings (2010), Julie T. Fralich Mba, Eileen Griffin Jd, Catherine Mcguire Bs

Disability & Aging

To better understand the nature of the residential facilities serving more than 19 percent of Maine’s Long Term Services and Supports (LTSS) population, the Maine Department of Health and Human Services commissioned the Muskie School to conduct a survey of residential facilities as part of its update to Maine’s LTSS profile. The goal of the Maine Residential Settings Characteristics Survey, conducted between July and September 2010, was to measure the "homelike" characteristics of residential settings.

The survey sample comprised a total of 636 facilities which included all licensed residential care facilities or private non-medical licensed institutions. The survey response rate …

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.

Racial Disparities In Cancer Screening Among Women With Chronic Joint Pain, Edith M. Williams, Laurene Tumiel-Berhalter, Christopher Purdy, Adrianne Ransom, Judith Anderson

Journal of Health Disparities Research and Practice

Chronic pain related disorders and breast and cervical cancer are more prevalent among African-American women compared with non-Hispanic White women. However, few studies address how racial differences in the context of comorbidity may compound these disparities. This study used secondary analysis of the National Health Interview Survey (NHIS) to assess racial differences in breast and cervical cancer screening and patient education among adult women with chronic joint pain conditions. Statistical analyses included chi-square and independent samples t-tests. African-American women compared with non-Hispanic White women were less likely to receive a pap smear or mammogram within the last two years and …

Access To Healthcare For The Poor: Will The Affordable Care Act Address Income-Related Health Disparities In The United States?, Sonya Fabricant

Independent Study Project (ISP) Collection

Background: Low-income populations live shorter and less healthy lives in the United States due to a complexity of social, environmental and behavioral factors. These populations also face significant barriers in accessing health services. In 2010, the Patient Protection and Affordable Care Act (PPACA) passed, marking the first major reform of the American healthcare system since the 1960s. This paper evaluates its potential to address health disparities through changes to medical care delivery. Methodology: Results were compiled from government documents, reports from research institutes, journal articles, and an expert interview. A section-analysis was also performed, evaluating the strengths and weaknesses of …

Perceptions Of Healthcare, Health Status, And Discrimination Among African-American Veterans, Nathaniel Rickles, Silvia Dominguez, Hortensia Amaro

Journal of Health Disparities Research and Practice

The Institute of Medicine identified access to healthcare and race-based discrimination as important barriers to quality healthcare that contributes to health disparities. This study (1) describes African-American veterans’ perceptions of healthcare services and perceived discrimination in healthcare and (2) investigates the relationship between perceived discrimination and patient perceptions of care, satisfaction with healthcare, and health status. A convenience sample of 141 African-American veterans in Boston completed surveys from May to June 2006.

Respondents reported an average of 16 lifetime experiences of discrimination and over half recalled a situation when they experienced discrimination in healthcare. Modest ratings of perceived quality of …

Nonclinical Development Needs And Regulatory Requirements For Multipurpose Prevention Technologies: A Primer, Joseph W. Romano, Martha Brady, Judy Manning

HIV and AIDS

This summary outlines key development elements that will be necessary for various configurations of multipurpose prevention products for the simultaneous prevention of HIV, sexually transmitted infections, and/or pregnancy.

Assessing And Improving Self-Reporting Of Male Circumcision In Zambia And Swaziland, Paul C. Hewett, Nicole Haberland, Barbara Mensch, Louis Apicella

HIV and AIDS

The Male Circumcision (MC) Partnership was established with the support of the Gates Foundation and PEPFAR to scale up MC services in Zambia, in collaboration with the Zambian government. The MC Partnership is a five-year project led by Population Services International (Society for Family Health, Zambia), in partnership with Jhpiego, Marie Stopes International (MSI), and the Population Council. The ultimate objective of this study is to provide researchers and program managers with evidence-based recommendations for the collection of self-reported data on MC status through an assessment of different methods to describe and explain MC. Specifically, the study assessed tools for …

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.

Shaping The Operations Research Agenda For Antiretroviral-Based Prevention Products For Women: Gels And Rings, Martha Brady, C. Elizabeth Mcgrory

HIV and AIDS

This report summarizes discussions from a two-day international experts consultation meeting in 2012 on preparing for the successful introduction of women-centered antiretroviral-based HIV prevention methods. It examines the limits and expectations of operations research in antiretroviral health technologies.

Getting Real With Youth-Friendly Services In Africa: Report Of A Satellite Session At The Xix International Aids Conference, Population Council

HIV and AIDS

Overview of an AIDS 2013 satellite session which aimed to engage young people with and react to the study findings and in the light of the findings, discuss and share their perspectives, experiences and concerns about how responsive existing policies, programs and services are to the HIV prevention and impact mitigation needs of young Africans.

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.

Migration, Vulnerability And Xenophobia: Central African Refugee And Asylum Seekers’ Access To Health Services In Durban, South Africa, Cathy Kaplan

Independent Study Project (ISP) Collection

In 1998, South Africa passed historic legislation that bridged international conventions on refugees and asylum seekers with the protections and rights defined in the South African Constitution and Bill of Rights. The 1998 refugees act defined specific rights that refugees and asylum seekers are entitled in South Africa, the most important of which include the provision of legal and immigration documentation, employment, adequate housing, and health and social services. When asylum seekers arrive in Durban, many are in the need of immediate health services as a result of long journeys, pre-existing conditions, pregnancy, or illnesses contracted in refugee camps throughout …

“Mind The Gap” Addressing The Gap Between Health Care Policy & Health Care Reality In Madagascar & The Way Forward Integrating Traditional Medicine & Ethical Reform Within Health Care, Laura Dillon

Independent Study Project (ISP) Collection

At first glance the health care system in Madagascar looks pretty good. No health care system is perfect, in fact most are far from perfect, but some certainly work better than others. On paper it seems that the current system in Madagascar would be among those that “work better”. Sadly, there is oftentimes a disconnect between what a government writes on paper and what happens in reality; looking around the streets of Antananarivo it quickly became apparent that Madagascar is an example of this disconnect. You do not have to be a health care professional to see the lack of …

Medical Pluralism In Morocco: The Cultural, Religious, Historical And Political-Economic Determinants Of Health And Choice., Tyler Martinson

Independent Study Project (ISP) Collection

Morocco is a culturally diverse intersection between the African continent, the Arab world and Europe. This multiplicity is mirrored in the country’s pluralistic medical system and beliefs surrounding the concepts of illness and health. Explanations of health are endorsed by culturally specific knowledge and are then naturalized and taken as objective. A synthesis of theoretical descriptions and political-economic of medical pluralism, along with historical analysis, explains the presence of multiple health practices and how a person’s choice of medical practice is heavily influenced by dynamic socio-cultural, religious, historical, political and economic factors. This study will help improve practitioner/client narratives of …

A Case Study Of Health Interventions And The Caste System: Addressing The Social Determinants Of Health Through Development At Crhp Jamkhed, Laura Kroart

Independent Study Project (ISP) Collection

In the Southeast Asian country of India, the ancient but in some cases still rigidly intact caste system plays a role in determining health status and outcomes for much of its population of over 1.2 billion people.[1] The Comprehensive Rural Health Project, located in Jamkhed in the state of Maharashtra, India, approaches health interventions from a development standpoint, addressing biomedical needs, structural and environmental concerns, and the social and economic determinants of health that impact the lives of over a million villagers in the surrounding area.[2] This independent study project was designed to analyze how the Comprehensive Rural …

Migration And Hiv In India: Study Of Select Districts, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Alka Narang, Umesh Chawla

HIV and AIDS

Report of a study assessing the important role of migration in the spread of HIV in districts with high out-migration in India. The study suggests a considerable spread of HIV linked to migrants’ extramarital sexual behaviors, and subsequent delay in treatment for infected spouses. In order to control the spread of HIV, the study provides programmatic recommendations made by the study participants and the counselors from ICTCs and ART centers. These suggestions include village-level mapping of at-risk persons, mainstreaming HIV prevention interventions within current health resources, improving various village level HIV prevention programs, and involving women left behind by migrant …

Hiv Transmission Among Married Men And Women In Districts With High Out-Migration In India: Study Brief, Niranjan Saggurti, Bidhubhusan Mahapatra, Suvakanta N. Swain, Madhusudana Battala, Umesh Chawla, Alka Narang

HIV and AIDS

This brief describes a study examining the links between male out-migration and HIV transmission among married men and women and other mechanisms by which HIV is transmitted within marital relationships in districts with high out-migration.

Facilitating Regulatory Approval Of Multipurpose Prevention Technologies For Sexual And Reproductive Health, Martha Brady

HIV and AIDS

This brief describes multipurpose prevention technologies (MPTs) that address women's sexual and reproductive health (SRH) needs, and how to go about facilitating regulatory approval of this technology. It outlines a strategic framework to examine current regulatory guidance, as well a product development pathway to bring MPTs to market.

What Regulatory Guidance Exists For Multipurpose Prevention Technologies (Mpts)? A Review Of Key Guidance Documents And Their Applicability To Mpts, Martha Brady, Heeyoung Park

HIV and AIDS

This brief reviews regulatory guidance documents and how they may apply to multi-purpose technologies (MPTs). It examines guidance documents from the Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The brief concludes by anticipating increased interactions with US regulatory agencies in hopes of finding new regulatory pathways that address MPTs specifically.

Evaluation Of The Informed Consent Process For Male Circumcision Scale-Up In Swaziland, Barbara Friedland, Louis Apicella, Katie D. Schenk, Meredith Sheehy, Paul C. Hewett

HIV and AIDS

This report evaluates the informed consent process for male circumcision conducted through the Male Circumcision Partnership for Swaziland, led by Population Services International, in partnership with Jhpiego, Marie Stopes International, and the Population Council. The study assesses participants' comprehension of the circumcision process, the informed consent process, as well as the affect of male circumcision counseling on their experience.