Medicine and Health Commons^™

A Toolkit For Developing Bilingual Lexicons For International Hiv Prevention Clinical Trials, Catalina B. Ramirez, Natasha Mack, Barbara Friedland

HIV and AIDS

No standardized process exists for developing a set of agreed upon terms, definitions, and translations in local languages that ensures participants understand both technical and nontechnical terms used in a clinical trial context. HIV prevention trials deal with a disease that is stigmatized and with sexual behaviors that may not be openly discussed, thus care must be taken in the selection of words to ensure terms are appropriate for use in the context of a clinical trial and understandable but not offensive. The lack of a standardized process can make it difficult for researchers to decide which words to use, …

Unmet Need And Unintended Pregnancy: The Bigger Picture, Ian Askew

Reproductive Health

No abstract provided.

Hivcore Operations Research Workshop Summary Report, Nrupa Jani

HIV and AIDS

Over the past decade, unprecedented progress has been made in the scale-up of HIV treatment, care, and support, yet substantial coverage gaps remain. Targeted operations research and program evaluation can play a significant role in ensuring efficient and effective service delivery, scaling up to reach more clients and on a broader geographical scope, enhancing quality of care, and improving the health status and health systems in developing country settings. With funding from USAID, the Population Council and partners are responding to these critical service delivery issues through HIVCore. HIVCore improves the efficiency, effectiveness, scale, and quality of HIV and AIDS …

Safe And Smart Savings Products For Vulnerable Adolescent Girls In Kenya And Uganda: Evaluation Report, Karen Austrian, Eunice N. Muthengi

Poverty, Gender, and Youth

The decision to engage in the development of girl-friendly savings accounts was made as part of the Population Council’s work with adolescent girls in Kenya. In June 2008 the Council and MicroSave Consulting started the Safe and Smart Savings Products for Vulnerable Adolescent Girls. Based on the market research and prior experience with developing programs for adolescent girls, a product concept for a group-based savings account was developed, in which the group model was used to address the legal constraints of minors not being able to hold individual accounts. In Kenya and Uganda, two financial institutions were identified, and the …

Policy Brief: Adolescent Girls And Migration In The Developing World, Population Council

Poverty, Gender, and Youth

When a migrant girl is successful, she creates a ripple effect through generations: families and future children will be better off because of her ability to finish school, get a job, and stay healthy. Despite the positive potential of migration for adolescent girls, migrant girls are largely ignored in policy and programs designed to reach migrants and adolescents. Because of their age and gender, migrant girls are especially vulnerable to risks such as exploitative employment. If these girls arrive at their destination and settle in safely, their diligence can enable them to capitalize on new opportunities and become productive, contributing …

Designing, Implementing, And Evaluating A Targeted, Evidence-Based Intervention For A Vulnerable Subgroup Of Girls: A Case Study Of The Filles Éveillées ("Girls Awakened") Pilot Program For Migrant Adolescent Girls In Domestic Service In Urban Burkina Faso, Sarah Engebretsen

Poverty, Gender, and Youth

Investing in adolescent girls is crucial in the developing world where a large and growing proportion of the population is under the age of 24. Research has demonstrated that adolescent girls face serious challenges around the time of puberty including withdrawal from (and lack of safety in) public spaces, loss of peers, leaving school, pressure for marriage or liaisons as livelihood strategies, and internalization of harmful gender norms. Investments need to be made at critical moments in early adolescence. While policymakers and development professionals have acknowledged the need to make investments in the poorest girls in the poorest communities early …

Follow-Up Study Of Migrant Adolescent Girls In Domestic Service Who Participated In The First Cohort Of The Filles Éveillées ("Girls Awakened") Program, Sarah Engebretsen

Poverty, Gender, and Youth

Circular migration (from rural to urban areas and back) among adolescents is common throughout West Africa, with the principle motivation being the search for economic opportunities, including domestic work. The evidence base on adolescent migration and domestic work is fairly thin. Evidence on programmatic effectiveness generally ends at program completion and does not follow adolescents over time. The current study follows a subsample of migrant adolescent girls in domestic service in urban Burkina Faso who participated in the first cohort of the Filles Éveillées (Girls Awakened) pilot program. Filles Éveillées was designed to provide migrant girls in domestic service with …

The Adolescent Girls Empowerment Program: Lessons Learned From The Pilot Test Program, Karen Austrian, Natalie Jackson Hachonda, Paul C. Hewett

Poverty, Gender, and Youth

Adolescent girls in Zambia face a range of risks and vulnerabilities that compromise their healthy development into young women, and lack the social, health, and economic assets to mitigate these risks. The issues that girls are confronted with include high rates of gender-based violence, unsafe sex that puts them at risk for unwanted pregnancy and HIV infection, school dropout, lack of economic resources and income-generating options, and lack of agency and participation. The Adolescent Girls Empowerment Program (AGEP) has three major components: safe spaces groups in which girls meet once a week over the course of two years for training …

Comprendre La Vie Des Adolescentes Avant Et Après La Migration: Enquête Réalisée Sur Les Sites D'Origine Auprès D'Anciennes Filles Migrantes Employées Comme Aide-Ménagères, Gisele Kaboré

Poverty, Gender, and Youth

Le Population Council met en œuvre un projet en direction des adolescentes migrantes travaillant comme employées de maison dans les zones urbaines au Burkina Faso (Ouagadougou et Bobo-Dioulasso). Ce programme, dénommé «Filles Éveillées», a pour objectif d’élargir les réseaux sociaux des filles et de développer leurs compétences en capacités financières, en santé et hygiène, santé de la reproduction et en compétences de la vie courante. Il offre également aux bénéficiaires l’opportunité d’accéder à l’alphabétisation. Dans un effort d’améliorer ce programme en ville, il s’est avéré opportun de mieux comprendre les circonstances de la vie des adolescentes dans le village avant …

Évaluation De Filles Éveillées : Programme Pilote Pour Adolescentes Migrantes Employées De Maison, Sarah Engebretsen

Poverty, Gender, and Youth

Le programme «Filles Éveillées» a été conçu dans le but d’accroître les réseaux sociaux et de développer les compétences des adolescentes migrantes employées de maison au Burkina Faso urbain. Il a fait l’objet de deux cycles pilotes: en 2011-2012 à Bobo-Dioulasso, puis en 2012-2013 à Ouagadougou et Bobo-Dioulasso. Une évaluation de processus a été effectuée entre les deux cycles avant d’évaluer l’efficacité du programme et d’y proposer les améliorations de structure, mise en œuvre et contenu jugées utiles avant le lancement de la seconde cohorte. Cette évaluation a donné lieu aux changements suivants: simplification du contenu programmatique sur la santé …

Conception, Mise En Oeuvre Et Évaluation D'Une Intervention Factuelle Ciblée Au Profit D'Un Sous-Groupe De Filles Vulnérables : Étude De Cas Du Programme Pilote Filles Éveillées Pour Adolescentes Migrantes Employées De Maison Au Burkina Faso Urbain, Sarah Engebretsen

Poverty, Gender, and Youth

Il est crucial d’investir dans les adolescentes du monde en développement, où une proportion déjà importante et grandissante de la population tombe dans la catégorie des moins de 24 ans. La recherche a démontré que les défis posés aux filles sont particulièrement lourds aux alentours de la puberté, qu’il s’agisse de l’exclusion des espaces publics (et du manque de sécurité dans ceux accessibles), de la perte du réseau de pairs, de la déscolarisation, de la pression du mariage ou de liaisons comme stratégies de subsistance, ou encore de l’intériorisation de normes de genre préjudiciables. Les investissements consentis doivent l’être aux …

Kalkidan ('Promise'): Addressing Marital Transmission Of Hiv In Ethiopia, Banchiamlack Dessalegn, Annabel Erulkar

Poverty, Gender, and Youth

This program brief describes a Population Council initiative in three low-income areas of Ethiopia. Kalkidan (Amharic for “Promise”) is a three-year program designed to increase discussion and information-sharing on HIV and related topics between marital partners; to promote HIV prevention and health service utilization within marriage, including prevention of mother-to-child transmission (PMTCT) of HIV; and to build husbands’ support of their wives, as well as investment in their health and that of their children. Kalkidan recruits and trains community-based mentors to lead parallel discussion groups of husbands and wives, who periodically come together for joint sessions. The Population Council is …

Evaluation Of Filles Eveillees ("Girls Awakened"): A Pilot Program For Migrant Adolescent Girls In Domestic Service, Sarah Engebretsen

Poverty, Gender, and Youth

The Filles Éveillées (Girls Awakened) program was designed to increase social networks and skill building among migrant adolescent girls in domestic service in urban Burkina Faso. The program was piloted over two cycles: 2011–2012 in Bobo Dioulasso, and 2012–2013 in Ouagadougou and Bobo Dioulasso. According to this evaluation report, process evaluation was conducted between the two cycles to assess program effectiveness and suggest improvements for program structure, implementation, and content before launching the second cohort. Changes resulting from this process evaluation included simplifying the sexual and reproductive health program content; reordering the modules and introducing financial capabilities earlier so that …

Girls On The Move: Adolescent Girls & Migration In The Developing World, Miriam Temin, Mark R. Montgomery, Sarah Engebretsen, Kathryn M. Barker

Poverty, Gender, and Youth

Adolescent girls in developing countries are migrating to urban areas in ever greater numbers. While migration can be risky, for the majority of girls, migration can increase opportunities and economic stability and provide them with the autonomy to make decisions about their lives. Preventing the worst outcomes and helping girls succeed are essential to unlocking the benefits of migration. When migrant girls can take advantage of the benefits, they can be a powerful force for change in the developing world—improving lives and reducing poverty in their communities and countries. This Girls Count report examines the social and economic determinants of …

The Adolescent Girls Vulnerability Index: Guiding Strategic Investment In Uganda, Sajeda Amin, Karen Austrian, Michelle Chau, Kimberly Glazer, Eric P. Green, David Stewart, Marie Stoner

Poverty, Gender, and Youth

Adolescence (from the ages of 10 to 19 years) is a critical stage of human development during which children experience rapid social, physical, psychological, and emotional changes on the path from childhood to adulthood. The decisions that are made during this period of life affect not only the individual well-being of young people, but also the well-being of the entire society. The Adolescent Girls Multilevel Vulnerability Index (AGI) was developed based on a growing recognition of the need to channel resources to vital—yet highly vulnerable and vastly underserved—populations of adolescent girls in Uganda specifically, and the East and Southern Africa …

Étude De Suivi Des Adolescentes Migrantes Employées De Maison Ayant Participé À La Première Cohorte Du Programme Filles Éveillées, Sarah Engebretsen

Poverty, Gender, and Youth

La migration circulaire (du milieu rural au milieu urbain et retour), est courante parmi les adolescents et adolescentes d'Afrique occidentale, la principale motivation étant la quête de débouchés économiques, y compris le travail domestique. Les données d’efficacité programmatique disponibles s’interrompent généralement au moment de la conclusion des programmes, sans suivi des adolescents à plus longue échéance. Cette étude suit un sous-échantillon d'adolescentes migrantes employées de maison au Burkina Faso après leur participation à la première cohorte du programme pilote Filles Éveillées. Ce programme a été conçu pour offrir aux filles migrantes employées de maison l’occasion de renforcer leurs réseaux sociaux …

Fp2020: A Research Roadmap, Population Council

Reproductive Health

The global community came together in July 2012 in pursuit of an ambitious yet essential goal: ensuring that 120 million additional women and girls have access to effective family planning information and services by 2020. National governments, civil society, and the private sector resolved to tackle the numerous supply and demand barriers that prevent many women from using contraceptives. Donors committed $2.6 billion in new funding to support these efforts, matched by pledges from many developing-country governments. To reap the benefits of family planning, clients must have easy access to a wide range of affordable contraceptive methods through multiple service …

Mainstreaming Emergency Contraception In Developing Countries: A Toolkit For Policymakers And Service Providers, Wilson Liambila, Saumya Ramarao, Joyce Wanderi Maina, Mary W. Gathitu

Reproductive Health

In late 2006, the Kenyan Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to mainstream emergency contraception (EC) in Kenya. The initiative included a core set of activities aimed at improving overall awareness of EC across the country and strengthening the quality of EC services in both the public and private sectors. It was intended to serve as a model for other countries interested in improving access to EC, and to generate in-depth knowledge on EC program strategies and utilization characteristics in sub-Saharan Africa. The MOH drew lessons and experiences from the initiative …

Access To Emergency Contraception And Safe Abortion Services For Survivors Of Rape And Defilement In Sub-Saharan Africa: A Regional Overview, Jill Thompson, Chi-Chi Undie, Ian Askew

Reproductive Health

No abstract provided.

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …

Social And Behavioral Sti Risk Factors: Comparing A Two-Year Community College Setting To A Four-Year University Setting, Oswald M. Attin

Faculty Publications and Presentations

No abstract provided.

Selective Screening Of Type 2 Diabetes For Washoe County’S Hispanic Population, Linda M. Dunn

Nevada Journal of Public Health

Hispanic Americans with unrecognized, asymptomatic diabetes are more likely to experience poor quality of life and diabetic complications such as heart, eye and kidney disease than non-Hispanic whites of similar age. Multiple factors, such as cultural beliefs, lack of knowledge and limited access to health care, contribute to the fact that one-third of total diabetes among Hispanic Americans is undiagnosed. For Washoe County, Nevada, the actual percentage of adult Hispanics with diabetes may be almost 12%. In 2003, the Defeat Diabetes Screening Project provided three screenings targeting the Hispanic population in Reno and Sparks. Seventy-one percent of 348 screened were …

How We Want To Be Treated! What Clark County African American Patients Want Their Health Providers To Know, Charlene A. Day, Joyce Woodson, Erica Archuleta

Nevada Journal of Public Health

Research continues to validate the fact that cultural values and beliefs play a major role in determining the extent to which an individual will engage in healthy behaviors, adhere to medical regimen, and seek care when necessary. A 2000 survey of 950 members of predominately African American churches in Clark County, Nevada (a county which comprises Las Vegas) conducted by the University of Nevada Cooperative Extension found members preferred healthcare providers as a source of information on health-related matters. Yet, research shows that for a variety of reasons, many African Americans do not regularly see a health care professional, and …

Screening For Mental Health Problems Among Incarcerated Youth In Nevada: Practice And Policy, Michelle Chino, Jennifer Personius-Zipoy, Denise Tanata

Nevada Journal of Public Health

Incarcerated youth in Nevada with serious mental health problems are not being effectively identified. The current study examined the utility of simple screening instruments as a mechanism for identifying incarcerated youth who may have a mental health disorder. Adjudicated youth, incarcerated at each of Nevada’s 12 juvenile detention facilities, participated in the study by completing a demographic questionnaire and a standardized mental health screening instrument: the Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2). Findings indicate a high prevalence of mental health disorders among incarcerated juveniles in Nevada. Identifying youth with mental health problems is complicated by the lack of a systematic …

Exercise Determined Promise 2003 Logandale, Nevada Plague Prophylaxis Clinic: Exercising The Strategic National Stockpile, Kay Godby, Mary Ellen Harrell, Bonnie Sorenson, Maureen Fanning, Nancy Gerken, Jane Shunney

Nevada Journal of Public Health

The Department of Defense asked the Clark County Health District (CCHD) to participate in the disaster drill entitled Determined Promise ’03 (DP ‘03) from August 18 -23, 2003. The purpose of this exercise was to test the capacities of the U.S. Northern Command (U.S.Northcom) Homeland defense/homeland security mission and integration of the Joint Task Forces-Civil Support (JTF-CS) with state and local responders. Part of the JTF-CS mission was to coordinate military support to civilian state and local authorities when it was requested.

Protecting Children From Overexposure To Lead In Candy And Protecting Children By Lowering The Blood Lead “Level Of Concern” Standard, Bryan Wagner, Colleen C. Hughes, Robert Sobsey

Nevada Journal of Public Health

The American Public Health Association: Recognizing that in April 2004, the Orange County Register in an investigative report, published for the first time information that the state of California had been testing for lead in candies for decades but had not informed the public about the high lead levels in many candies, candy wrappers and seasonings (sold as a snack item and consumed as candy) imported from Mexico, the Philippines and other countries.

Oral Health Needs And Parental Attitudes, Behavior, And Knowledge Of Lower Ses Children, Mildred Mcclain, Clifford R. Mcclain, Anthony Paventy

Nevada Journal of Public Health

Despite the declining prevalence of dental caries over recent decades, caries remain the most common chronic childhood disease, especially in high-risk (low socio-economic status) populations. This appears to be true even when parents are aware of good oral health habits. The purpose of this study was to gather oral hygiene data on high-risk children in Nevada and to assess parental attitudes and education concerning their children’s oral health. Using visual examinations and a dmft (decayed, missing, filled, teeth) severity index, 235 lower SES children were screened and given treatment recommendations. The screenings showed larger than expected prevalence in both caries …

Findings From The Nutrition Challenge Program, Rayleen Earney, Nicole Bungum, Timothy J. Bungum

Nevada Journal of Public Health

Obesity is an epidemic in the United States. Over 61% of U.S. adults and 58% of Nevada adults have Body Mass Index’s (BMI) that classify them as either overweight or obese (Behavioral Risk Factor Surveillance System [BRFSS], 2005). According to a recent article published in the Journal of the American Medical Association, obesity was the second leading cause of preventable death in the United States behind tobacco use (Mokdad, Marks, Stroup & Gerberding, 2004).

While obesity and overweight are complex, multi-factorial health conditions, an important contributor to the overweight and obesity epidemic is poor dietary habits. One of the major …

Evaluation Of The Impact Of A Health Care Administration Student Practicum, Christopher R. Cochran, Michelle Sotero

Nevada Journal of Public Health

As the health care industry becomes increasingly complex, many leaders and practitioners in the field are worried about the quality and preparation of health care administration graduates (Robbins, Bradley, & Spicer, 2001). Academic health care administration programs prepare students for a professional career in the health care field. One of the biggest challenges for university health care administration programs is to meet industry needs by effectively incorporating practical skills and knowledge into the academic curricula. For students, coursework provides some insight into the demands of the industry, but they also require hands-on experience to be relevant in a highly competitive …

Lead Shot Deposition And Distribution In Southern Nevada, Shawn Gerstenberger, Darren D. Divine

Nevada Journal of Public Health

Densities of lead (Pb) shot in soil and the presence of Pb shot in waterfowl gizzards from past hunting activities at the Overton Wildlife Management Area (OWMA) in southern Nevada were determined. Soil shot densities in fields managed for doves, pheasants and geese, and adjacent fields strictly managed as waterfowl habitat were examined. Soil shot densities ranged from 2,691 to 107,642 Pb shot/ha in waterfowl areas to 649,085 to 862,275 Pb shot/ha in dove management areas. Pb shot deposition rates for the 1998-1999 dove hunting season were also calculated and ranged from 8,970 to 22,559 shot/ha in fields managed primarily …