Community Health and Preventive Medicine Commons^™

Factors Contributing To Domestic Violence Among Hindu Asian Indian Immigrant Women In Allegheny County, Pennsylvania: A Feasibility Study, Chelsea Pallatino, Todd Bear, Martha A. Terry

Journal of Health Disparities Research and Practice

While there is research on survivors of domestic violence in India and the United States (U.S.), little is known about the sociocultural factors related to domestic violence among Hindu Asian Indian immigrant women (AIIW) in the U.S. The objectives of this study were to a) test the feasibility of conducting domestic violence research among Hindu AIIW; b) investigate domestic violence prevalence and correlations with other characteristics; and c) test the cultural appropriateness of completed measures on social support, acculturation status, and domestic violence. Over 50% of respondents had experienced abuse, often perpetrated by family. Participants had high levels of social …

Accessing Young Black Stroke Survivors For Secondary Prevention, Mellanie V. Springer, James F. Burke, Devin L. Brown, Lesli E. Skolarus

Journal of Health Disparities Research and Practice

ABSTRACT

Background- Stroke rates and risk factors may be increasing in young adults aged 18-64, especially black individuals. We sought to identify whether young high risk stroke survivors could be found at community health centers.

Methods- This was a cross-sectional analysis of the National Ambulatory Medical Care Survey from 2006-2011. We used chi-square analyses, t-tests, and proportions to compare and describe stroke survivor visits at community health centers and private offices.

Results- Young stroke survivor visits comprise 48% of stroke survivor visits at community health centers compared to 31% of stroke survivor visits at the private office setting. Among young …

A Health Disparity Action Plan: Achieving Equity Through Clinical Trials, Affordable Care, And Professional Development, Daniel Schafer, Shefa Moten, Ayesha Khan, Mauro Ferrari, Boris Lushniak, Edwin Burkett, Asad Moten

Journal of Health Disparities Research and Practice

Given the threatened nature of affordable care in the United States, it is crucial to underscore its importance. What is more, the reason such care is so important is the presence of an oft-unacknowledged disparity in access to quality care in this country and, indeed, around the world. A world without health disparities can be achieved and will be characterized by prompt and quality care available to all and at all stages of the care continuum. Further insurance reform is needed beyond the Affordable Care Act, while local care must be more accessible in rural, urban, and other underserved areas. …

Condom Use And Related Factors Among Rural And Urban Men Who Have Sex With Men In Western China: Based On Information-Motivation-Behavioral Skills Model, Ling Hu, Yetao Luo, Xiaoni Zhong, Rongrong Lu, Yang Wang, Manoj Sharma, Mengliang Ye

Environmental & Global Health Faculty Research

This study aimed to determine the differences in condom use and related factors among rural–urban men who have sex with men (MSM) in Western China. A cross-sectional survey was conducted in Chongqing, Sichuan, and Guangxi, which recruited MSM by non-probability sampling. Data were collected through an anonymous, standardized, and self-reported questionnaire guided by an information–motivation–behavioral skills model. Structural equation model was applied to analyze the related factors. Out of the 1141 MSM included in this analysis, 856 (75%) and 285 (25%) were from urban and rural areas, respectively. The median age was 27 years for both groups. Self-reported consistent condom …

Housing With Services Evaluation Report, Hannah Cohen-Cline, Jannate Ahmed, Kyle Jones, Jb Rinaldi

Articles, Abstracts, and Reports

No abstract provided.

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Developing Countries, Sumera Aziz Ali, Umber S. Khan, Anam Shahil Feroz

Community Health Sciences

Anemia is one of the major causes of maternal mortality and morbidity across the globe, affecting around two-thirds of pregnant women in developing countries. The objective of this study was to synthesise study findings regarding the prevalence and determinants of anemia among women of reproductive age in developing countries. A total of 28 articles were reviewed by two authors for preliminary screening after removing overlapping information. Finally, 15 studies conducted from 2000 to 2015 were included in the review. The average prevalence of anemia was found to be 46.5% with a range of 18.1% to 75% in different studies. Factors …

Google-Truthing To Assess Hot Spots Of Food Retail Change: A Repeat Cross-Sectional Street View Of Food Environments In The Bronx, New York, Nevin Cohen, Michael Chrobok, Olivia Caruso

Publications and Research

Google Street View (GSV) images can be used to “ground-truth” current and historical food retail data from approximately 2007 - when GSV was launched in a few US cities - to the present, facilitating analyses of food environments over time. A review of GSV images of all food retailers listed in a government database of licensed establishments in the Bronx, New York enabled records to be verified, businesses classified, and retail change quantified. The data revealed several trends likely to affect food access and health: increasing overall numbers of food retailers; the growth of dollar stores; and numerous openings, closings, …

Preconception Nutrition Intervention Improved Birth Length And Reduced Stunting And Wasting In Newborns In South Asia: The Women First Randomized Controlled Trial, Sangappa M. Dhaded, K. Michael Hambidge, Sumera Aziz Ali, Manjunath Somannavar, Sarah Saleem, Omrana Pasha, Umber Khan, Veena Herekar Herekar, Sunil Vernekar, Yogesh Kumar S

Community Health Sciences

South Asia has >50% of the global burden of low birth weight (LBW). The objective was to determine the extent to which maternal nutrition interventions commenced before conception or in the 1st trimester improved fetal growth in this region. This was a secondary analysis of combined newborn anthropometric data for the South Asian sites (India and Pakistan) in the Women First Preconception Maternal Nutrition Trial. Participants were 972 newborn of mothers who were poor, rural, unselected on basis of nutritional status, and had been randomized to receive a daily lipid-based micronutrient supplement commencing ≥3 months prior to conception (Arm 1), …

Effect Of 5-Minute Movies Shown Via A Mobile Phone App On Risk Factors And Mortality After Stroke In A Low- To Middle-Income Country: Randomized Controlled Trial For The Stroke Caregiver Dyad Education Intervention (Movies4stroke), Ayeesha Kamran Kamal, Adeel Khoja, Bushra Usmani, Shahvaiz Magsi, Aresha Malani, Zahra Peera, Saadia Sattar, Masood Ahmed Akram, Sumaira Shahnawaz, Maryam Zulfiqar, Abdul Muqeet, Fabiha Zaidi, Saleem Sayani, Azmina Artani, Syed Iqbal Azam, Sarah Saleem

Section of Neurology

Background: Pakistan is the sixth most populous nation in the world and has an estimated 4 million stroke survivors. Most survivors are taken care of by community-based caregivers, and there are no inpatient rehabilitation facilities.
Objective: The objective of this study was to evaluate the effectiveness and safety of locally designed 5-min movies rolled out in order of relevance that are thematically delivered in a 3-month program to deliver poststroke education to stroke survivor and caregiver dyads returning to the community.
Methods: This study was a randomized controlled, outcome assessor–blinded, parallel group, single-center superiority trial in which participants (stroke survivor-caregiver …

Enhancing Immunization Rates In Two Urban Academic Primary Care Clinics: A Before And After Assessment, Zeeshan Yacoob, Christopher Cook, Fabiana Kotovicz, Jessica J.F. Kram, Marianne Klumph, Marisa Stanley, Paul Hunter, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Immunization rates in many cities in the United States remain suboptimal compared to Healthy People 2020 Goals and are lower than national averages. This study aimed to determine whether a lecture-based educational intervention targeted at nurses and medical assistants would improve vaccination rates.

Methods: We conducted a quality improvement study in two urban academic family medicine clinics serving a predominantly Medicaid patient population as well as a sizable proportion of refugees. The intervention consisted of 3 lectures that were delivered to clinic nurses and medical assistants. Vaccinations in 1689 patients — 872 in the 3-month preintervention period, 817 in …

Cryptococcal Antigen Testing In An Integrated Medical System: Eastern Wisconsin, Marianne Klumph, Brian Hoeynck, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Cryptococcosis is a serious environmentally acquired endemic fungal infection commonly associated with immunocompromised hosts. Little is known regarding frequency or distribution in Wisconsin. We explored the geodemographic and clinical features of patients tested with cryptococcal antigen tests (CrAg) — previously shown to be >90% sensitive and >90% specific — within a large health care system located in eastern Wisconsin. To examine this, we retrospectively analyzed 1465 CrAg tests on 1211 unique patients (female: 50.2%; white race: 73.9%; mean age: 53.7 ± 16.5 years). At least one CrAg result was positive in 23 of 1211 patients (1.9%). From these, 21 of …

Appalachian Environmental Health Literacy: Building Knowledge And Skills To Protect Health, Anna G. Hoover, Annie Koempel, W. Jay Christian, Kimberly I. Tumlin, Kelly G. Pennell, Steven Evans, Malissa Mcalister, Lindell E. Ormsbee, Dawn Brewer

Journal of Appalachian Health

Environmental health literacy (EHL) is an emerging, multidisciplinary field that promotes understanding of how environmental exposures can affect human health. After discussing the regional relevance of environmental health knowledge and skills, this article describes three ongoing Appalachian projects that are focused on measuring and building EHL.

A Multicenter Case Control Study Of Association Of Vitamin D With Breast Cancer Among Women In Karachi, Pakistan, Uzma Shamsi, Shaista Khan, Syed Iqbal Azam, Aysha Habib, Amir Maqbool, Mohammad Hanif, Tiffany Gill, Romaina Iqbal, David Callen

Community Health Sciences

Background: The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan.
Methods: A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information …

Support For Rural Practice: Female Physicians And The Life–Career Interface, Kimberly Stutzman, Ruth Ray Karpen, Pragna Naidoo, Sarah E. Toevs, Amanda Weidner, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Introduction: The need for family physicians in rural areas across the USA and Canada is a longstanding issue that has been well documented. Since family physicians constitute the largest population of rural practitioners, the problem has been exacerbated by a sharp decline in medical students’ interest in the field of family medicine and the aging of the current rural workforce. Previous research has shown that female physicians in rural areas need strong support networks to maintain a healthy work–life balance. The purpose of this study was to better understand the types of support they need and how they find it, …

Cancer Health Disparities Among African Americans: A Socioecological Approach, Seth M. Spitzley

The Hilltop Review

Research shows that health outcomes are influenced by race or ethnicity, socioeconomic status, education and literacy levels, and the physical environment (U.S. Department of Health and Human Services, 2014). The health statuses of minority groups, such as African Americans, are adversely impacted by inequality (Randall, 2009). In Kalamazoo, Michigan, the leading cause of death for all residents in Kalamazoo County was cancer, where black individuals have the highest death rate among any other racial or ethnic group. That African Americans comprise less than 11% of the population in Kalamazoo County thus suggests that African Americans are disproportionately impacted by cancer …

Context Matters: Construct Framing In Measures Of Physical Activity Engagement Among African American Women, Stephanie M. Mcclure, Travis Loux, Enbal Shacham, Eileen Gillespie, Denise Hooks-Anderson

Journal of Health Disparities Research and Practice

Assessment of psychosocial factors influencing health behavior typically privileges conceptual consistency (framing constructs similarly across contexts) over conceptual specificity (context-specific framing). Modest statistical relationships between these factors and health behaviors, and persistent racial disparities in health outcomes raise questions about whether conceptually consistent framing fully captures relevant predictors. Ethnographic studies suggest not - that perceptions influencing health behaviors are multifaceted and contextual. To test this, we added items querying contextualized predictors of intention to engage in leisure-time physical activity (LTPA) to a Theory of Planned Behavior (TPB)-based survey and examined the psychometrics of the adapted subscales. We measured internal consistency …

Effects Of Quantitative Literacy On Healthcare Decision-Making: An Aural Context, Robert G. Root, Sonia Bhala

Numeracy

We propose a relationship between sensory modality, numerical formatting, and performance on a survey simulating healthcare decision-making. We examine the current literature on aural health literacy, and specifically aural literacy coupled with health numeracy. We then create a survey instrument called the Bhala test for this purpose and demonstrate that it is moderately internally consistent and provides results that correlate with the NUMi assessment, a widely accepted measure of health numeracy. The quantitative information provided in the Bhala test has two treatments, percentage and natural frequency formats, in an effort to determine which format is easier for subjects to use …

Using Mobile Phones To Improve Community Health Workers Performance In Low-And-Middle-Income Countries, Anam Shahil Feroz, Rawshan Jabeen, Sarah Saleem

Community Health Sciences

Background: In low-and-middle-income countries community health workers are the core component of the PHC system as they act as a liaison between the communities and the healthcare facilities. Evidence suggests that the services offered by these workers have helped in the decline of maternal and child morbidity and mortality rates and the burden of communicable and non-communicable diseases. However, the coverage and the overall progress towards achieving the SDG targets is very sluggish. The recent consensus concerning this current pace of progress, is that it relates to financial and human resources constraints. CHWs are overburdened as they are expected to …

Older Adults Hospitalized For Pneumonia In The United States: Incidence, Epidemiology, And Outcomes., Forest W. Arnold, Andrea Reyes-Vega, Vidyulata Salunkhe, Stephen P. Furmanek, Christian Furman, Laura Morton, Anna Johan Faul, Pam Yankeelov, Julio A. Ramirez

Faculty and Staff Scholarship

OBJECTIVES: To define the current incidence, epidemiology, and mortality of older adult patients hospitalized with community-acquired pneumonia (CAP) in Louisville, KY and thus estimate the burden of CAP in the older adult population of the United States. To define risk factors associated with early and late outcomes. DESIGN: This was a secondary analysis of older adults (aged ≥65 years) from the University of Louisville Pneumonia Study, a prospective population-based cohort study of all hospitalized adults with CAP between June 1, 2014, and May 31, 2016. SETTING: The study took place in all nine acute care hospitals for adults in Louisville, …

Changes In Hospital Utilization By Individuals Experiencing Homelessness After Engaging With Interdisciplinary, Low-Barrier Healthcare Services In Portland, Maine, Sarah Hemphill Ba, Adam Normandin Md, Ms, Debra Rothenberg Md, Phd

Journal of Maine Medical Center

Introduction: The Maine Medical Center Preble Street Learning Collaborative (PSLC) aims to couple medical education with addressing the unmet healthcare needs of those experiencing homelessness in Portland, Maine. The PSLC provides low-barrier medical, psychiatric, dental, and case management services to all-comers and is co-located near many of the city’s social services. The purpose of this study was to evaluate the impact of the PSLC in its first 19 months by describing demographic characteristics and patterns in hospital utilization of patients served by the PSLC.

Methods: We performed a retrospective chart review of 888 patients with one or more …