Community Health and Preventive Medicine Commons^™

Substance Use Disorder Program Facilities In Detroit: A Geographic Analysis, Oksana Doubrovski

Medical Student Research Symposium

Background: Over 630,000 Michiganders have a substance use disorder (SUD) and about 80% are not receiving care (1). The rate of unmet need for SUD care in the Detroit-Dearborn-Livonia area is 81% (1). Geographic placement of facilities may serve as a barrier in patient access to SUD program services. This geographic analysis investigates current Detroit SUD program facility locations and their community demographics.

Methods: ArcGIS Pro was used to visualize and analyze data by creating 2D maps and tables. Data on SUD programs, medically underserved areas, and zip codes were retrieved from government data portals. Census tract data …

Violence As A Deterrent For Shelter Usage Among Persons Experiencing Homelessness In Detroit: A Mixed Methods Study, Trishya L. Srinivasan

Medical Student Research Symposium

Introduction: Persons experiencing homelessness (PEH) are hospitalized at rates four times higher than the US average and face significantly worse health outcomes, particularly for those residing in cities with harsh winters. Fear of violence or theft is frequently cited as a deterrent to emergency-based shelter usage among PEH; however, there is little research assessing its effects on health and safety among PEH. This project qualitatively assesses violence as a deterrent to emergency shelter usage.

Methods: A semi-structured interview guide was designed to assess experiences with, and fear of, shelter-based violence among PEH and the effect of shelter-based violence on mental …

Utility Of Student-Run Free Clinics For Underserved Individuals During Covid-19 Michigan Shelter-In-Place Order, Sara Saymuah, Hailey Heil, Janki Vaghasia, Marla Rojas Thaureaux, Victoria Badia, Paige Baal

Medical Student Research Symposium

Introduction: Cass Clinic, a student-run free clinic (SRFC) affiliated with Wayne State University School of Medicine in Detroit, Michigan, provides free healthcare to predominantly underprivileged populations. Cass Clinic remained open during Governor Whitmer’s shelter-in-place order from March 24, 2020 through June 12, 2020 and throughout the COVID-19 pandemic. The purpose of this study was to assess SRFC’s utility in meeting patient needs during the COVID-19 pandemic.

Methods: A mixed, open and closed-ended quality improvement survey was administered to patients who utilized Cass Clinic between the dates of May 2, 2020 and June 6, 2020. Qualitative analysis included descriptive statistics, while …

Employment Security In Egypt In Light Of The Covid-19 Pandemic: Rethinking Policies And Practices, Heba M. Khalil, Kareem Megahed

Faculty Journal Articles

Crises such as COVID-19’s have inequitable impacts on different countries, various population groups and diverse sectors of society and the economy. Areas of work and employment were met with a lot of challenges worldwide, and in particular in countries like Egypt with a large sector of vulnerable and precarious workers. This policy paper addresses the question of employment security both in response to crises such as COVID-19, and on the long term. To do so, the research maps ‘vulnerable work’, including informal labor, labor in the gig economy, self-employed and other types of precarious work. It then assesses Egypt’s policy …

Évaluation De La Performance Des Agents De Santé Communautaires En Haïti: Principales Conclusions D’Une Étude À Méthodologie Mixte, Frontline Health Project, Zanmi Lasante

Reproductive Health

Ce document résume les principales conclusions qualitatives et quantitatives de l'étude de référence du projet Frontline Health en Haïti. Les résultats révèlent que les ASC en Haïti sont des membres hautement fiables et appréciés de leurs communautés et fournissent des liens cruciaux vers les services d'orientation ; cependant, davantage de formation et de soutien concernant les références sont nécessaires.

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This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, …

Assessing The Performance Of Community Health Workers In Haiti: Key Findings From A Mixed-Methods Study, Frontline Health Project, Zanmi Lasante

Reproductive Health

This brief summarizes key qualitative and quantitative findings from the Frontline Health project's referral study in Haiti. Findings reveal that CHWs in Haiti are highly trusted and valued members of their communities and provide crucial links to referral services; however, more training and support around referrals is needed.

Impact Of Covid-19 On Service Utilization By Those Experiencing Homelessness In Detroit, Anneliese Petersen, Richard Bryce D.O.

Medical Student Research Symposium

Background:

Current research has demonstrated increased levels of fear and anxiety due to the Coronavirus pandemic. While fear can have a significant impact on any individual, fear among individuals experiencing homelessness is particularly impactful as this may affect service utilization and thus the ability of to access basic necessities such as food, shelter and water. This study seeks to understand the impact of fear of contracting COVID on service utilization among those experiencing homelessness in Detroit, MI.

Methods and Results:

From July-August 2020, 35 individuals who self-identified as homeless participated in a multiple-choice survey. 40% of surveyed individuals stated that …

Preferred Incentives For Improving Ugandan Community Health Worker Job Satisfaction And Retention, Frontline Health Project

Reproductive Health

This research brief summarizes key quantitative and qualitative results from the Frontline Health project's discrete choice experiment in Uganda. This study was implemented in two phases, and revealed that community health workers in Uganda are motivated by a mix of financial and non-financial incentives to perform.

"There Is Always Violence": An Exploratory Study Of Phnom Penh, Cambodia, Street-Involved Children, Jarrett D. Davis, Glenn M. Miles, Sean Blackburn, Erika Mosebach-Kornelsen

Dignity: A Journal of Analysis of Exploitation and Violence

As the economic center of Cambodia, Phnom Penh has long been a hotspot for street-involved children and families. While violence is a common facet of life on the street, risk and vulnerability among children is notoriously difficult to measure. Most large-scale surveys tend to sample children within homes and schools, which overlook street-involved children who are commonly unregistered, irregularly attend school, and live outside of houses. This research paper is one of a series of studies on such groups in Southeast Asia. The study conducted 94 semi-structured interviews with street-involved children eight to 18 years of age in Phnom Penh. …

Hiv Clinical Stage Progression Of Patients At 241 Outpatient Clinics In Democratic Republic Of Congo: Disparities By Gender, Tb Status And Rurality, Gina D. Etheredge, Raimi Ewetola, Gulzar H. Shah, L. Maluantesa, Kristie C. Waterfield, A. Mulenga, A. Kilundu

Health Policy & Community Health: Faculty Publications

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO's four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services.

Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and …

Retention And Predictors Of Attrition Among Children Living With Hiv On Antiretroviral Therapy (Art) In Côte D’Ivoire Between 2012 And 2016, F. Traore-Toure, Gina D. Etheredge, Gulzar H. Shah, C. Brennan

Health Policy & Community Health: Faculty Publications

Background: In Côte d’Ivoire a retrospective national-level cohort study conducted in 2009 indicated that 77%, 72% and 75% of children living with HIV (CLHIV) remained in care at 12, 36, and 48 months after starting ART, respectively. The CDC-sponsored Improving HIV Surveillance and Program Evaluation in Côte d’Ivoire project assessed retention progress since that study.

Methods and materials: A retrospective review of medical records was conducted using 2-stage cluster sampling. HIV care and treatment centers (CTC) were sampled based on patient caseload, then records of patients under 15 years of age who initiated ART between 2012–2016 were randomly …

Tb/Hiv Coinfection And Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Congo, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, L. Maluantesa, Kristie C. Waterfield, L.-K. Lukusa

Health Policy & Community Health: Faculty Publications

Background: To provide efficient, equitable, patient-centered, and evidence-based services to people living with HIV/AIDS (PLWH), it is critical for the intervention programs to understand the nature of barriers to effective treatment and additional risks faced by PLWH with tuberculosis (TB) coinfection. This study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes such as death, loss to follow up, and higher viral load among PLWH with TB coinfection compared to those without such coinfection.

Methods and materials: This quantitative study used …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

The Silence Of Food Insecurity: Disconnections Between Primary Care And Community Organizations, Nicole K. Runkle, David A. Nelson

Journal of Patient-Centered Research and Reviews

Purpose: Food insecurity is a prominent issue in the United States, and it is well established that food insecurity is linked to health and chronic illnesses. Studies show that screening for food insecurity is not yet part of standardized practice among all primary care physicians, nor are care providers comfortable with how to proceed with a patient who presents with this issue. Food insecurity is often handled by community-based organizations (CBOs) such as food pantries. Family medicine and pediatric clinics (FMPC) and CBOs hold unique relationships with their clients and can benefit from partnerships with each other to improve health …

Disparities In Cardiovascular Research Output And Disease Outcomes Among High-, Middle- And Low-Income Countries - An Analysis Of Global Cardiovascular Publications Over The Last Decade (2008-2017), Nada Qaisar Qureshi, Syed Hamza Mufarrih, Gerald S. Bloomfield, Wajeeha Tariq, Aysha Almas, Ali H. Mokdad, Muhammad Imran Nisar, Sameen Siddiqi, Zulfiqar Ahmed Bhutta, Zainab Samad

Department of Medicine

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Health research is crucial to managing disease burden. Previous work has highlighted marked discrepancies in research output and disease burden between high-income countries (HICs) and low- and lower-middle-income countries (LI-LMICs) and there is little data to understand whether this gap has bridged in recent years. We conducted a global, country level bibliometric analysis of CVD publications with respect to trends in disease burden and county development indicators.
Methods: A search filter with a precision and recall of 0.92 and 0.91 respectively was developed to extract cardiovascular publications …

Using Mobile Phones To Improve Young People Sexual And Reproductive Health In Low And Middle-Income Countries: A Systematic Review To Identify Barriers, Facilitators, And Range Of Mhealth Solutions, Anam Shahil Feroz, Naureen Akber Ali, Adeel Khoja, Armish Asad, Sarah Saleem

Community Health Sciences

Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions that can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people.
Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane Central, and grey literature were searched …

Covid-19 Risk For Individuals With Intellectual And/Or Developmental Disabilities Varies By Type Of Residential Setting, Ashlyn W.W.A. Wong, Scott D. Landes

Population Health Research Brief Series

COVID-19 case and fatality rates are higher for people with IDD who are living in Skilled Nursing Facilities compared with those living in other types of facilities or those living in individual residences or their family home.

Shifting Coronavirus Disease 2019 Testing Policy And Research To Include The Full Translation Pipeline, Joseph Catania, Jeffrey Martin, M. Margaret Dolcini, E. Roberto Orellana, Jeffrey Henne

School of Social Work Faculty Publications and Presentations

The current severe acute respiratory syndrome coronavirus 2 testing policy and practice limits testing as a prevention tool. Radical shifts are required to increase the scale of rapid testing strategies and improve dissemination and implementation of venue-based and self-testing approaches. Attention to the full translation pipeline is required to reach high-risk segments of the population.

Equipping Community Health Workers With Digital Tools For Pandemic Response In Lmics, Anam Shahil Feroz, Adeel Khoja, Sarah Saleem

Community Health Sciences

Background: Community health workers (CHWs) are well-positioned to play a pivotal role in fighting the pandemic at the community level. The Covid-19 outbreak has led to a lot of stress and anxiety among CHWs as they are expected to perform pandemic related tasks along with the delivery of essential healthcare services. In addition, movement restrictions, lockdowns, social distancing, and lack of protective gear have significantly affected CHWs' routine workflow and performance. To optimize CHWs' functioning, there is a renewed interest in supporting CHWs with digital technology to ensure an appropriate pandemic response.
Discussion: The current situation has necessitated the use …