Community Health and Preventive Medicine Commons^™

Empowerment-Based Positive Youth Development: A New Understanding Of Healthy Development For African American Youth, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

A shift occurred in research about adolescents in the general population. Research is moving away from deficits toward a resilience paradigm and understanding trajectories of positive youth development. This shift has been less consistent in research and practice with African American youth. A gap also exists in understanding whether individual youth development dimensions generate potential in other dimensions. This study presents an empowerment-based positive youth development model. It builds upon existing research to present a new vision of healthy development for African American youth that is strengths-based, developmental, culture-bound, and action-oriented. It emphasizes the relationship between person and environment, the …

Access To Primary Care: Comparing Driving Distance From Health Professional Shortage Area (Hpsa) Counties Versus Non-Hpsa Counties, Molly Cashion, Stephanie Jilcott-Pitts, Doyle Cummings, Christopher Duffrin, John Jones, Qiang Wu

Frontiers in Public Health Services and Systems Research

The criteria used to identify Health Professional Shortage Areas dates back to the 1970’s and very little has changed since then. This study examined driving distance from patient address to provider address as one component of a geographical HPSA. Primary care-related services located in adjacent areas to whole-county HPSAs are considered excessively distant when travel time exceeds 30 minutes or the equivalent of 20 miles in this study. We found similarities in travel distance to primary care-related services from patients living in HPSA counties compared to those living in non-HPSA counties. This could indicate the need to re-examine HPSA definitions …

Same Sex Marriage And The Perceived Assault On Opposite Sex Marriage, Alexis Dinno, Chelsea Whitney

Community Health Faculty Publications and Presentations

Background: Marriage benefits both individuals and societies, and is a fundamental determinant of health. Until recently same sex couples have been excluded from legally recognized marriage in the United States. Recent debate around legalization of same sex marriage has highlighted for anti-same sex marriage advocates and policy makers a concern that allowing same sex couples to marry will lead to a decrease in opposite sex marriages. Our objective is to model state trends in opposite sex marriage rates by implementation of same sex marriages and other same sex unions.

Methods and Findings: Marriage data were obtained for all …

Harnessing The Power Of Public Health Systems For Injury Prevention & Control, Glen P. Mays

Health Management and Policy Presentations

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Harnessing The Power Of Public Health Systems For Injury Prevention And Control, Glen P. Mays

Glen Mays

Efforts to improve population health hinge on a vast yet diffuse constellation of government agencies, health care providers, and community organizations that assume responsibilities in implementing prevention programs and policies across the U.S. Realizing the full health and economic benefits of injury prevention and control initiatives requires mobilizing and managing these complex and heterogeneous public health delivery systems. This session will explore the emerging science of public health delivery systems and what it tells us about improving injury prevention and control amid policy and economic change.

Screening Colonoscopy And Risk For Incident Late-Stage Colorectal Cancer Diagnosis In Average-Risk Adults: A Nested Case-Control Study, Chyke Doubeni, Sheila Weinmann, Kenneth Adams, Aruna Kamineni, Diana Buist, Arlene Ash, Carolyn Rutter, V. Paul Doria-Rose, Douglas Corley, Robert Greenlee, Jessica Chubak, Andrew Williams, Aimee Kroll-Desrosiers, Eric Johnson, Joseph Webster, Kathryn Richert-Boe, Theodore Levin, Robert Fletcher, Noel Weiss

Chyke A. Doubeni

BACKGROUND: The effectiveness of screening colonoscopy in average-risk adults is uncertain, particularly for right colon cancer. OBJECTIVE: To examine the association between screening colonoscopy and risk for incident late-stage colorectal cancer (CRC). DESIGN: Nested case-control study. SETTING: Four U.S. health plans. PATIENTS: 1039 average-risk adults enrolled for at least 5 years in one of the health plans. Case patients were aged 55 to 85 years on their diagnosis date (reference date) of stage IIB or higher (late-stage) CRC during 2006 to 2008. One or 2 control patients were selected for each case patient, matched on birth year, sex, health plan, …

The Role Of Issue Familiarity And Social Norms: Findings On New College Students' Alcohol Use Intentions, Rajiv N. Rimal, Saar Mollen

Prevention and Community Health Faculty Publications

Background. Scholars in a variety of disciplines are interested in understanding the conditions under which social norms affect human behavior. Following the distinction made between descriptive and injunctive norms by the focus theory of normative conduct, the theory of normative social behavior predicts that the influence of descriptive norms on behavior is moderated by injunctive norms, outcome expectations, and group identity. We extended the theory by testing the proposition that the influence of descriptive norms on behavior would be greater under conditions of greater issue familiarity, defined as the ease with which one can cognitively access the behavior or …

Quality Of Care In Community Health Centers And Factors Associated With Performance, Peter Shin, Jessica Sharac, Sara J. Rosenbaum, Julia Paradise

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Federally funded community health centers are a key source of comprehensive primary care for medically underserved communities, serving more than 20 million patients in 2011. The Affordable Care Act (ACA) expanded the health center program significantly to help meet the increased demand for health care that is expected as millions of the uninsured gain health coverage, beginning in 2014. Especially given health centers’ growing role, evidence of the quality of care they provide is of keen interest. Most research shows high performance by health centers relative to various standards, but some gaps have also been found, and suitable benchmarks for …

Childhood Obesity And Overweight: Causes And Implications In Preschool Children, Melissa L. Sittner

Kinesiology and Public Health

The root causes of childhood obesity and overweight are currently hot topics of research. While many causes have been discovered, researchers are still weighing them against one another while taking the lifestyles of at-risk populations into account. Some of these causes include lack of physical activity, increase in screen time, and the implications of health disparities borne of a child’s socioeconomic status. These causes and more are reviewed further and applied to the population of interest: preschool aged children in the United States, and more specifically preschool aged children of San Luis Obispo County in California. The need for multi-level …

Inappropriate Boarding: Cost And Quality Issues Of Incapacitated Patients Requiring Guardianship, Margaret Kornuszko-Story Mha, Kari Jones Phd, Michelle D. Flores Rn, Hannah D. Paxton Rn, Mph, Jeffrey Etchason Md

Department of Community Health and Health Studies

No abstract provided.

Maternal Smoking, Weight Status And Preecalmpsia And Eclampsia Risk Among Women Living In San Bernardino County, Fiona Bedelia Lewis

Loma Linda University Electronic Theses, Dissertations & Projects

Preeclampsia is defined as pregnancy-induced hypertension affecting between 2% and 8% of pregnancies and accounting for about 10-15% of maternal deaths worldwide. Eclampsia is defined as the occurrence of one or more episodes of seizures in a pregnant woman related only to a preeclampsia diagnosis. Preeclampsia, if poorly managed, can progress to eclampsia resulting in injury and death to both mother and infant. The etiology of preeclampsia is not completely understood. Oxidative stress leading to abnormal placenta development and endothelial dysfunction are thought to be key components in the biological mechanism of preeclampsia.

Modifiable risk factors include maternal body weight …

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

Estimating The Effect Of A Community-Based Intervention With Two Communities, Mark Van Der Laan, Maya Petersen, Wenjing Zheng

Wenjing Zheng

Due to the need to evaluate the effectiveness of community-based programs in practice, there is substantial interest in methods to estimate the causal effects of community-level treatments or exposures on individual level outcomes. The challenge one is confronted with is that different communities have different environmental factors affecting the individual outcomes, and all individuals in a community share the same environment and intervention. In practice, data are often available from only a small number of communities, making it difficult if not impossible to adjust for these environmental confounders. In this paper we consider an extreme version of this dilemma, in …

Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra

Nisha Malhotra

Abstract Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods Data from Indian Demographic and Health survey 2005–06 (NFHS-III) was used. Mothers were asked if their children (<5-years) had suffered from diarrhoea during the two weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness, and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the “delay” in seeking advice/treatment.

Results Out of a sample of 41,287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percent of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08 – 2.54), richest (OR 1.76; 95% CI, 1.24 – 2.48) wealth index, mother's lack of knowledge of oral …

Prenatal Oral Health Education In U.S. Obstetrics And Gynecology Residencies And Dental Schools: Results Of A National Survey, Megan Weeks, Judith A. Savageau, Hugh Silk

Judith A. Savageau

Background: Pregnant women represent a special population within oral health care. Adverse pregnancy outcomes and increased infant caries can occur when prenatal oral disease is not addressed. Currently, medical and dental clinicians are not meeting the oral health needs of pregnant patients.

Objective: Medical and dental providers are not addressing prenatal oral health (POH) with patients despite knowledge of the risks. The objective of this study was to determine how training in dental schools and OB/Gyn residencies may contribute to this paradox.

Methods: We conducted a national survey of 60 dental school deans and 240 obstetrics and gynecology residency program …

Examining Universal Primary Healthcare Through Community-Based Initiatives, Donald E. Warden

Oglethorpe Journal of Undergraduate Research

This paper examines enacting community-based primary healthcare programs and initiatives. It looks at the weaknesses of past attempts, the successes of current attempts, and gives insight into ways everyday citizens can change the way the world does healthcare. There are social, economic, and political barriers as to why these programs are not enacted. Since 1978, Member states of the United Nations strive towards healthcare for all. The original 1978 Declaration of Alma-Ata sets the bar at achieving this goal by the year 2000. Now in the 21^st century, the world still battles inadequate healthcare. Nations continue to strive towards …

Expanding Access To Malaria Diagnosis Through Retail Shops In Western Kenya: What Do Shop Workers Think?, Andria Rusk, Catherine Goodman, Violet Naanyu, Beatrice Koech, Andrew Obala, Wendy Prudhomme O'Meara

Collected Faculty and Staff Scholarship

Background. The common symptoms of malaria reduce the specificity of clinical diagnosis. Presumptive treatment is conventional but can lead to overdiagnosis of malaria, delay of appropriate treatment, overprescription of antimalarials, and drug resistance. Routine use of diagnostic tests can address many of these concerns. Though treatment is often procured from retailers, there is low availability of rapid diagnostic tests for malaria (MRDTs), a simple, inexpensive, and accurate diagnostic solution. We know little about the challenges to expanding access to diagnostics through these outlets. Methods. To understand the perceptions of the benefits and challenges to selling rapid diagnostic tests for malaria, …

Using An Evidence Based Practice Informatics Guided Medication Safety Intervention To Improve Medication Safety Among Community Dwelling Older Adults, Raeann Leblanc

Raeann G LeBlanc

Medication safety and prevention of medication related problems are important issues in promoting and maintaining health and safety in one’s home for community dwelling older adults. Assessment of medications and management of a medication schedule are essential elements of medication safety, medication review, and medication care coordination. The Framework for Geriatric Homecare Excellence (Collaboration for Home Care Advances and Practices, 2009) is used as the foundation of this project to improve medication management, and promote and maintain health and safety at home. An in-home medication assessment was completed, using a medication management software informatics system to review medications, identify medication …

Decline In Health For Older Adults: Five-Year Change In 13 Key Measures Of Standardized Health, Paula Diehr, Stephen Thielke, Anne Newman

Paula Diehr

BACKGROUND: The health of older adults declines over time, but there are many ways of measuring health. It is unclear whether all health measures decline at the same rate or whether some aspects of health are less sensitive to aging than others. METHODS: We compared the decline in 13 measures of physical, mental, and functional health from the Cardiovascular Health Study: hospitalization, bed days, cognition, extremity strength, feelings about life as a whole, satisfaction with the purpose of life, self-rated health, depression, digit symbol substitution test, grip strength, activities of daily living, instrumental activities of daily living, and gait speed. …

Primary Care Clinicians’ Recognition And Management Of Depression: A Model Of Depression Care In Real-World Primary Care Practice, Seong-Yi Baik, Benjamin F. Crabtree, Junius Gonzales

Publications from Provost Junius J. Gonzales

BACKGROUND

Depression is prevalent in primary care (PC) practices and poses a considerable public health burden in the United States. Despite nearly four decades of efforts to improve depression care quality in PC practices, a gap remains between desired treatment outcomes and the reality of how depression care is delivered.

OBJECTIVE

This article presents a real-world PC practice model of depression care, elucidating the processes and their influencing conditions.

DESIGN

Grounded theory methodology was used for the data collection and analysis to develop a depression care model. Data were collected from 70 individual interviews (60 to 70 min each), three …