Community Health and Preventive Medicine Commons^™

Permanent Housing And On-Site Nursing Care: Effects On Homeless Individuals With Hiv And Other Cormorbidities, Lynelle Hinden

Dissertations

Abstract

Problem. Providing housing to otherwise homeless individuals who are HIV/AIDS-positive has been demonstrated to improve control of the disease. This was a healthcare quality initiative to review the viral load and Cluster of Differentiation Protein Four positive (CD4+) counts over time of residents in an urban housing facility for HIV/AIDS-positive individuals. Also, a nurse-run clinic was introduced for residents, especially those with comorbidities such as hypertension and diabetes.

Methods. A repeated measures design was utilized. Viral loads and CD4+ counts were retrospectively reviewed from facility records at entrance into and five-years later at the facility. Additionally, measurements of blood …

Cross Jurisdictional Boundaries To Build A Health Coalition: A Kentucky Case Study, Angela L. Carman, Margaret L. Mcgladrey

Health, Behavior & Society Faculty Publications

Cross-jurisdictional sharing is accomplished through collaboration across jurisdictional boundaries to deliver essential public health services and solve problems that cannot be easily addressed by single organizations or jurisdictions. Partners across 10 counties and three public health jurisdictions of the Barren River Area Development District (BRADD) convened as Barren River Initiative to Get Healthy Together (BRIGHT), a community health improvement coalition. Focus groups and interviews with BRIGHT members indicate that the use of effective strategies to focus collaborative health improvement efforts fosters a cohesive coalition even when the group is populated by individuals from across public health jurisdictional boundaries. Focusing strategies …

Health Care Provider Personal Religious Preferences And Their Perspective On Advance Care Planning With Patients, Marjorie A. Bowman, Sarah St. Cyr, Adrienne Stolfi

Population and Public Health Sciences Faculty Publications

Objective:

To understand how health-care providers’ (HCPs) religious preferences influence their willingness to undertake advance care planning (ACP) with patients and their acceptance of other HCP’s involvement.

Methods:

Online anonymous survey distributed to HCPs in hospital, ambulatory offices, and hospice settings in Dayton, Ohio. We evaluated the associations of HCP religion with their personal ACP, willingness to facilitate ACP, and acceptance of other HCPs’ ACP participation.

Results:

704 respondents: nurses (66.2%), physicians (18.8%), other HCPs (15.0%), white (88.9%), and primarily Catholic (23.3%) or Protestant (32.0%). “No religion” was marked by 13.9%. Respondents were favorable to ACP with patients. Religious respondents …

Application Of The Gps Technology To Assess Time-Location Pattern Of Undergraduate Students At A Private Medical University In Karachi, Pakistan: A Pilot Study, Tanzil Jamali, Adeel Ahmed Khan, Asaad Ahmed Nafees, Muhammad Ahmed, Syed Iqbal Azam, Muhammad Masood Kadir, Kiyoung Lee

Community Health Sciences

To compare time-location pattern of undergraduate university students through GPS and diary method, and with level of physical activity, a cross-sectional survey was conducted from September 2012 - May 2013 involving 50 undergraduate students from Aga Khan University. Data were recorded through GPS, diary method, International Physical Activity Questionnaire (IPAQ-L) and accelerometer (ActiGraph). Median self-reported time spent in the indoor-inside the campus, indoor-outside the campus and outdoor environment was 405 (IQR:300-540), 720 (IQR:465-840) and 300 minutes (IQR:180-495) respectively, while 52% of the students were in moderate, 40% vigorous and 8% in mild categories of physical activity. Mean differences in location …

Nonlinear Associations Between Working Hours And Overwork-Related Cerebrovascular And Cardiovascular Diseases (Ccvd), Ro-Ting Lin, Lung-Chang Chien, Ichiro Kawachi

School of Public Health Faculty Research

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to …

[2018 Winner] Filipino Americans: A Health Profile Addressing Health Disparities And The Effects Of U.S. Assimilation And Discrimination, Marisol Cruz

Ethnic Studies Research Paper Award

Filipino Americans have a rich history in migrating to the U.S as well as assimilating into American culture. They have a distinct immigrant experience because of their colonial past. This paper states Filipino American U.S demographics, health statistics, and traditional health beliefs and practices to understand Filipino American culture and beliefs. Lastly, there is an emphasis in the leading health disparity among them, heart disease, and the effects of racism and discrimination and how that impacts a Filipino Americans overall physical and mental health.

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

School of Public Health Faculty Research

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Sex Moderates The Impact Of Diagnosis And Amyloid Pet Positivity On Hippocampal Subfield Volume, Jessica Z. K. Caldwell, Jody-Lynn Berg, Guogen Shan, Jeffrey L. Cummings, Sarah J. Banks

School of Public Health Faculty Research

We examined moderation effects of sex and diagnosis on the effect of positive florbetapir positron emission tomography (PET) amyloid-β (Aβ) scan (A+) on hippocampus subfield volumes in 526 normal control (NC) and early mild cognitive impairment (eMCI) participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI2; ADNI-GO). Regression moderation models showed that women— but not men— with NC designation did not show reduced subiculum volumes despite A+. At the eMCI stage, A+ was detrimental across sexes. Findings were significant while accounting for the effects of age, cognition at screening, education, and APOE4 carrier status. These findings suggest that women with A+ …

Adapting Medical Guidelines To Be Patient-Centered Using A Patient-Driven Process For Individuals With Sickle Cell Disease And Their Caregivers, Robert M. Cronin, Tilicia Mayo-Gamble, Sarah-Jo Stimpson, Sherif M. Badawy, Lori E. Crosby, Jeannie Byrd, Emmanuel J. Volanakis, Adetola A. Kassim, Jean L. Raphael, Velma Mcbride Murry, Michael Debaun

Health Policy & Community Health: Faculty Publications

Background: Evidence-based guidelines for sickle cell disease (SCD) health maintenance and management have been developed for primary health care providers, but not for individuals with SCD. To improve the quality of care delivered to individuals with SCD and their caregivers, the main purposes of this study were to: (1) understand the desire for patient-centered guidelines among the SCD community; and (2) adapt guideline material to be patient-centered using community-engagement strategies involving health care providers, community -based organizations, and individuals with the disease.

Methods: From May–December 2016, a volunteer sample of 107 individuals with SCD and their caregivers gave …

Injection Partners, Hcv, And Hiv Status Among Rural Persons Who Inject Drugs In Puerto Rico, Patrick Habecker, Roberto Abadie, Melissa L. Welch-Lazoritz, Juan Carlos Reyes, Bilal Khan, Kirk Dombrowski

Department of Sociology: Faculty Publications

Background—The prevalence of hepatitis C (HCV) and HIV among persons who inject drugs (PWID) and the ability of these diseases to spread through injection networks are well documented in urban areas. However, less is known about injection behaviors in rural areas.

Objectives—This study focuses on the association between the number of self-reported injection partners with the PWID’s self-reported HCV and HIV status. Injection networks provide paths for infection and information to flow, and are important to consider when developing prevention and intervention strategies.

Methods—Respondent driven sampling was used to conduct 315 interviews with PWID in rural Puerto Rico during 2015. …

Restructuring Data Reported From State Early Hearing Detection And Intervention (Ehdi) Programs: A Pilot Study, Suhana Alam, Tammy O'Hollearn, Jim Beavers, Alyssa K. Rex, Rebekah F. Cunningham, Winnie Chung, Xidong Deng, Thuyquynh N. Do

Journal of Early Hearing Detection and Intervention

Objective: To assess the feasibility, benefits, and challenges surrounding individual-level versus aggregate data reporting by jurisdictional EHDI programs to the Centers for Disease Control and Prevention (CDC).

Methods: Using data reported to CDC by three jurisdictions in 2011, descriptive statistics were used to assess the feasibility of collecting and reporting individual-level data. Comparisons were made on what can be learned from individual-level data as opposed to CDC’s aggregate survey data.

Results: Individual-level data provided a detailed overview of the population served, services received, and variations across jurisdictions in data collection, reporting, and quality monitoring practices. Several challenges and areas needing …

Use Of A Unique Farmers’ Market Program Targeting Lower-Income Community Members, Brittany Lawrence, Anna E. Greer, Anne Marie Zimeri, Daphne C. Hernandez, Sangnam Ahn, Shaakira Jones, Matthew Lee Smith

Public Health Faculty Publications

We examined use of a farmers’ market that leverages community partnerships to provide free produce to lower-income persons. Participants (n = 422) were asked to complete a questionnaire and given an ID number, which was used to track market use from 2014 to 2015. Chi square tests were used to examine associations between 2014/2015 market use and reasons for market use, financial support received, and how attendees had learned about the market. Ordinal regression was used to identify household characteristics associated with increased market attendance. Although the proportion of lower-income attendees declined over the study period, a substantial proportion of …

The Impacts Of Medicaid Expansion On Rural Low-Income Adults: Lessons From The Oregon Health Insurance Experiment., Heidi Allen, Bill J. Wright, Lauren Broffman

Articles, Abstracts, and Reports

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for …

The Impact Of Comorbidities, Depression, And Substance Use Problems On Quality Of Life Among Older Adults Living With Hiv, Brett M. Millar, Tyrel Starks, Sitaji Gurung, Jeffrey T. Parsons

Publications and Research

Older adults living with HIV (OALWH) comprise a growing population with a range of complex and interconnecting medical and psychosocial needs. Based on the biopsychosocial model with its emphasis on a holistic approach to various aspects of people’s lives, the current study explored associations between physical health, psychological health, substance use, and overall quality of life. Drawing on data from 114 substance-using OALWH (aged 50 or older), we employed linear regression to show associations between the number of current comorbid health conditions on quality of life, over and above depression, substance use problems, and demographic characteristics (age, race/ethnicity, gender, sexual …

Pink And Dude Chefs: Effectiveness Of An After-School Nutrition Knowledge And Culinary Skills Program For Middle School Students To Increase Fruit And Vegetable Consumption, Alyssa S. Vaziri

Master's Theses

The rate of overweight and obesity among adolescents aged 12-19 years has more than tripled since 1980, and disproportionately impacts low-income and marginalized populations. Reduction in adolescent obesity rates may result in decreased health risks, decrease healthcare costs, and increased quality of life. Effective intervention methods for adolescent participants have incorporated nutrition knowledge and culinary skill building into afterschool programs. This study examines whether building knowledge, skills, and confidence through a culinary intervention can improve adolescent participants’ choices of healthful foods through increased fruit and vegetable intake.

Pink and Dude Chefs (PDC) is an afterschool nutrition education and culinary skills …

Improving Pregnancy Outcomes In Low- And Middle-Income Countries, Robert L. Goldenberg, Elizabeth M. Mcclure, Sarah Saleem

Community Health Sciences

This paper reviews the very large discrepancies in pregnancy outcomes between high, low and middle-income countries and then presents the medical causes of maternal mortality, stillbirth and neonatal mortality in low-and middle-income countries. Next, we explore the medical interventions that were associated with the very rapid and very large declines in maternal, fetal and neonatal mortality rates in the last eight decades in high-income countries. The medical interventions likely to achieve similar declines in pregnancy-related mortality in low-income countries are considered. Finally, the quality of providers and the data to be collected necessary to achieve these reductions are discussed. It …

Thrive With Me: Protocol For A Randomized Controlled Trial To Test A Peer Support Intervention To Improve Antiretroviral Therapy Adherence Among Men Who Have Sex With Men, Keith J. Horvath, K. Rivet Amico, Darin Erickson, Alexandra M. Ecklund, Aldona Martinka, James Dewitt, Jeffrey Mclaughlin, Jeffrey T. Parsons

Publications and Research

Background: The suboptimal rate of viral suppression among persons aged 13 years and older and residing in 37 states and the District of Columbia leaves considerable opportunities for onward transmission and contributes to poor health outcomes. Men who have sex with men (MSM) represent one of the most at-risk groups in the United States. There is a clear and continued need for innovative adherence support programs to optimize viral suppression. To address this gap, we designed and are implementing a randomized controlled trial (RCT) to test the efficacy of the Thrive with Me intervention for MSM living with HIV. Critical …

Increasing Follow-Up In College Students With Latent Tuberculosis Infection, Emily Middleton, Dnp, Aprn, Ccrn, Kathy James, Dnsc, Aprn, Faan, Kimberly Woodruff, Md, Mph

Doctor of Nursing Practice Final Manuscripts

Around 13 million people in the United States have latent tuberculosis infection (LTBI) with a 5-10% chance of developing active tuberculosis (TB) in their lifetime if not treated (Center for Disease Control, 2015). At a University Student Health Center (SHC), there is a matriculation requirement for TB testing for students that screen as high risk. Many students have these testing requirements performed at outside clinics, including foreign clinics, and follow-up regarding education about LTBI and treatment recommendations was often missing. The purpose of this evidence-based practice (EBP) project was to increase follow-up, education, and treatment options after diagnosis of LTBI. …

Dynamical Properties Of Postural Control In Obese Community-Dwelling Older Adults, Christopher W. Frames, Rahul Soangra, Thurmon Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto, Abraham Lieberman

Physical Therapy Faculty Articles and Research

Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …