Community Health and Preventive Medicine Commons^™

Exercise Participation During Weight Loss On A High Protein – Low Carbohydrate Diet Plan In Females Aged 15-25 Years, Margaret Mobley-Meulman

Electronic Theses and Dissertations

Weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year (U.S. Department of Health and Human Services, 2010). Obese adults have an increased risk for serious health conditions including high blood pressure and cholesterol, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers (National Cancer Institute, 2012). Participation in exercise can help control weight, strengthen muscles and bones, and reduce the incidence of cardiac events, stroke, hypertension, type 2 diabetes, colon and breast cancers, osteoporotic fractures, gallbladder disease, obesity, depression, anxiety, and delay mortality …

Barriers To Depression Treatment Among Low-Income, Latino Emergency Department Patients, Anjanette A. Wells, Isabel T. Lagomasino M.D., Lawrence A. Palinkas, Jennifer Green, Diana Gonzalez Msw

Brown School Faculty Publications

Objectives. Low-income and Latinos use the emergency department (ED) as a primary source of care. Also, the depression prevalence in ED patients is high, making the ED a compelling venue for depression screening and intervention. This study examined barriers and facilitators to depression treatment among low-income, predominantly Latino ED patients. Methods. We conducted telephone interviews with 24 ED patients (18-62 years of age, 79% female) who dropped out of a depression treatment intervention. Using grounded theory, we analyzed perceptions of depression and treatment, and barriers and facilitators to mental health treatment. Results. Although most patients acknowledged signs of depression, there …

Open Streets Initiatives In The U.S. : Closed To Traffic, Open To Physical Activity, Jill A. Kuhlberg, J. Aaron Hipp, Amy A. Eyler, Genevieve Cheng

Brown School Faculty Publications

Background: The ciclovía, or open streets concept, is a community level physical activity promotion strategy where streets are closed to motorized traffic and open for individuals to engage in PA. This paper presents an overview of such initiatives in the U.S. to understand their potential in PA promotion, comparing event and city characteristics. Methods: We searched ciclovía and open streets initiatives held in 2011 in the U.S. using internet searches, publication databases, social media, and personal contacts. We extracted data on the each initiative’s frequency, route length, attendance, evaluation procedures, and sociodemographic characteristics of host cities. Results: Our search yielded …

Medicare Advantage Update: Benefits, Enrollment, And Payments After The Aca, Kathryn Linehan

National Health Policy Forum

In 2012, the Medicare program paid private health plans $136 billion to cover about 13 million beneficiaries who received Part A and B benefits through the Medicare Advantage (MA) program rather than traditional fee-for-service (FFS) Medicare. Private plans have been a part of the program since the 1970s. Debate about the policy goals—Should they cost less per beneficiary than FFS Medicare? Should they be available to all beneficiaries? Should they be able to offer additional benefits?—has long accompanied Medicare's private plan option. This debate is reflected in the history of Medicare payment policy, and policy decisions over the …

Best Practice Use To Address Tobacco-Related Disparities By California Community Coalitions, Rodney K. Mccurdy

Frontiers in Public Health Services and Systems Research

Tobacco-related disparities (TRDs) are a major public health concern. This study surveyed community tobacco coalition project directors in California to determine the usage of 11 CDC-published best practices to address TRDs. Response rate was 80 percent. Communities had implemented, on average, one-half of the 11 practices surveyed. Differences were observed between rankings for best practice implementation and perceived level of importance in addressing TRDs in the community. Resource constraints and community context were the highest reported barriers to best practice use. Study findings could assist tobacco program officials and local coalitions in addressing TRDs in their communities.

Factors Influencing Access To Healthcare Services, Melissa Delia

Independent Study Project (ISP) Collection

Following several political upheavals, the country of Madagascar has become one of the poorest countries in the world. This level of poverty affects many aspects of life, especially access to healthcare services. The availability of both allopathic and traditional healthcare to the impoverished citizens of Madagascar was examined through discussions, interviews, and journal articles. It was found that although both the allopathic and traditional medicinal systems do not charge their patients for general consultations and care, there is a high cost for pharmaceutical medications in the allopathic system. These medications are sometimes too expensive for many Malagasy patients to afford. …

Approaches To Mental Illness In Madagascar: A Case For Reconciling Reason With Faith, Raisa Tikhtman

Independent Study Project (ISP) Collection

This paper expounds the shortcomings of the mental health provisions inherent in the current primary health care system in Madagascar in light of its limited accessibility to the Malagasy. Integrating traditional medicine with allopathic psychiatric care is proposed, with attention to prevailing Malagasy beliefs in spiritual possession as the basis for mental illness, in order to accommodate the discrepant worldviews espoused by physicians and their Malagasy patients that inhibit the efficacy of public mental health care. Through an integrated system based on the model piloted at the Clinique de Manongarivo in northwestern Madagascar, the financial, physical, and epistemological barriers that …

Role Of Environment And Sex Differences In The Development Of Autoimmune Diseases: A Roundtable Meeting Project, Monica P. Mallampalli, Erika Davies, Debra Wood, Hillary Robinson, Federica Polato, Christine L. Carter

Prevention and Community Health Faculty Publications

Autoimmune diseases (ADs) impose substantial health and financial burdens in the United States and in many parts of the world. Women are disproportionately affected by many of these disorders, which often contribute to lifelong disabilities. While the number of patients with some ADs appears to be rising, the complexities of conducting epidemiological studies prevent a thorough understanding of the prevalence and incidence of these various conditions. Research on environmental influences of these illnesses is limited, although they are generally hypothesized to result from the interaction of environmental agents in genetically susceptible individuals. Further, there is little known regarding the role …

Chhs July E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Assessing The Effectiveness Of Nutrition And Physical Activity Self-Assessment For Child Care (Nap Sacc) For Changes In Physical Activity Behavior, Policy, And Environment In Nebraska Family Child Care Homes, Katie K. Bolte

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Nebraska is the first state to utilize NAP SACC and to modify the evidence-based program for family child care homes (FCCHs). The purpose of this study was to conduct a secondary data analysis to assess the effectiveness of a modified version of the NAP SACC approach in achieving changes in physical activity behavior, policy, and environment in Nebraska FCCHs caring for children ages 2-5 years. Results from this study will be used to improve the NAP SACC physical activity components for FCCHs and will help to inform trainers and the Nebraska Department of Health and Human Services, Nutrition and Activity …

The Relevance Of Social Contexts And Social Action In Reducing Substance Use And Victimization Among Women Participating In An Hiv Prevention Intervention In Cape Town, South Africa, Elizabeth Reed, Andrea N. Emanuel, Bronwyn Myers, Kim Johnson, Wendee M. Wechsberg

Prevention and Community Health Faculty Publications

Objectives: To examine qualitatively how women's social context and community mobilization (eg, mobilizing women to take social action and engaging their community in social change) influence substance use abstinence and victimization among women participating in a human immunodeficiency virus (HIV) intervention in Cape Town, South Africa.
Methods: Thirty women who had participated in a randomized controlled trial of a group-delivered intervention to address substance use, gender-based violence, and associated risk for HIV (The Women's Health CoOp) were selected to participate in semi-structured interviews about their perceived impact of the intervention on their substance use and exposure to victimization. The Women's …

Variables To Predict Risk Of Hospital Readmission, Julie I. Carroll

Muskie School Capstones and Dissertations

As the healthcare industry transitions toward accountable care and payment reform, creative approaches to healthcare is imperative. Poorly coordinated care and shorter hospital stays have resulted in higher rates of readmissions. This has large implications for hospitals and health systems.

Cms's Proposed Rule Implementing The Aca-Mandated Medicaid Dsh Reductions, Kathryn Linehan

National Health Policy Forum

State Medicaid programs make Medicaid disproportionate share hospital (DSH) payments to hospitals to help offset costs of uncompensated care for Medicaid and uninsured patients. Unlike most Medicaid spending, annual DSH allotments for each state are capped. Under the Patient Protection and Affordable Care Act of 2010 (ACA), DSH payments will decrease starting in fiscal year (FY) 2014 and continuing through FY 2020. This paper describes the proposed rule for reducing these federal allotments, which was released on May 15, 2013, by the Centers for Medicare & Medicaid Services (CMS). Comments on the proposed rule are due July 12, 2013.

2014 …

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 …

Systematic Examination Of Infant Size And Growth Metrics As Risk Factors For Overweight In Young Adulthood, Andrew O. Odegaard, Audrey C. Choh, Ramzi W. Nahhas, Bradford Towne, Stefan A. Czerwinski, Ellen W. Demerath

Population and Public Health Sciences Faculty Publications

Objective:To systematically examine infant size and growth, according to the 2006 WHO infant growth standards, as risk factors for overweight status in young adulthood in a historical cohort. Specifically, to assess: Whether accounting for length (weight-for-length) provides a different picture of risk than weight-for-age, intervals of rapid growth in both weight-for-age and weight-for-length metrics, and what particular target ages for infant size and intervals of rapid growth associate most strongly with overweight as a young adult.Patients/Methods:Data analysis of 422 appropriate for gestational age white singleton infants enrolled in the Fels Longitudinal Study. Odds ratios (OR) for overweight and obesity in …

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.

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 …

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 …