Community Health and Preventive Medicine Commons^™

Chhs October Newsletter, Wku College Of Health & Human Services, Vashon S. Wells, Editor

College of Health & Human Services Publications

No abstract provided.

Bridging The Gap: Identifying Social Factors That Affect The Knowledge Of Sexually Transmitted Infections And Use Of Prevention Methods In Young Women, Ariel Spigel

Independent Study Project (ISP) Collection

This study investigates the social factors that affect the transmission of sexually transmitted diseases (STIs) in young women, focusing on their knowledge of the subject and use of prevention methods in order to discover why STIs, though preventable, are still prevalent in the lives of young adults, and more often, young women. Sixty-one anonymous, closed questionnaires were distributed to female students of at least eighteen years at the Colegio Estadual Francisco da Conceição Menezes in Santo Antônio de Jesus, Bahia, Brazil, and six structured interviews were conducted with students from the same pool. Results showed varying levels of knowledge, educational …

The Accuracy Of Referral For Portable Lipid Analyzers In An Old Order Mennonite Population, Maria E. Main, M. Susan Jones, Cathy H. Abell

Nursing Faculty Publications

The primary purposes of this study were to: 1) examine the accuracy for referral of two portable lipid analyzers (PLAs) in an old order Mennonite population through a comparison to a national standardized reference laboratory, 2) examine the relationship of total cholesterol values with other known cardiovascular risk factors, and 3) foster the continued participatory model of health care service in this community. The self-selected sample was composed of 42 adult members of an old order Mennonite community residing in south central Kentucky. A descriptive correlational design was used in this study. There were clinically relevant variations in the total …

Preventive Care Utilization Among Black Women : Perceived Beliefs, Benefits And Barriers To Mammography Screening, Rowandalla Y. Dunbar

Loma Linda University Electronic Theses, Dissertations & Projects

Blacks, in comparison to other racial or ethnic groups, suffer higher rates of illness and death from many preventable or treatable diseases. Despite the significantly higher rates of mortality and disease, Blacks are least likely to utilize clinical preventive care services. Black women, who are more likely to have advanced breast cancer at time of diagnosis (Chu, Lamar, & Freeman, 2003) are least likely to seek mammography screening (National Health Interview Study, 2000). Allen, Bastani, Bazargan and Leonard (2002) examined predictors of mammography screening among women 40 years old and older residing in the South Central area of Los Angeles, …

Crouching Tiger Hidden Goiter Belt: A Critique Of Health Care And Universal Salt Iodization In The Tsum Valley, Julian Goetz, Vanessa Soetanto

Independent Study Project (ISP) Collection

The Tsum Valley, opened to visitors in 2008, has only recently begun the process of modernization. The health of the population is still not stable with regards to nutrition, and the health care system is still inadequate due to geographic conditions of remoteness and difficulty of access. The health condition is further exacerbated by political interactions affecting iodine consumption. This paper presents original information collected via interviewing processes throughout the valley and in Kathmandu over the course of a four-week period. The results include the inadequacy of health care facilities in treating endemic health issues and of the failure of …

The Primary Care Safety Net: Strained, Transitioning, Critical, Jessamyn Taylor

National Health Policy Forum

This background paper examines the primary care safety net. It describes key primary care safety net providers, including federally qualified health centers, free clinics, local health departments, and safety net hospital outpatient departments and clinics, among others. The paper also explores the changing role of the primary care safety net in a post–health reform marketplace.

High Hopes: Public Health Approaches To Reducing The Need For Health Care, Michele J. Orza

National Health Policy Forum

Driven in part by a desire to contain health care costs, policymakers are looking beyond medical care for opportunities to reduce the need for expensive services. This paper briefly reviews current public health concepts and strategies for improving health that emphasize nonmedical factors such as behavior, socioeconomic status, and environment. It also provides examples of how these concepts and strategies undergird many of the public health provisions of the Patient Protection and Affordable Care Act, other legislation, and several programs and initiatives. These concepts include prevention, health in all policies, global health, the One Health Initiative, and climate change and …

The Health Of Latinos In Massachusetts: A Snapshot, Dharma Cortés, Rodolfo R. Vega

Gastón Institute Publications

People’s health outcomes are shaped in part by non-biological factors. Most immediately, limited access to health care services can have a deleterious impact on individuals’ health outcomes (Andrulis, 1998). In turn, access to healthcare services is influenced by socioeconomic factors such as whether a person has health insurance or the financial means to pay for their health care. Familiarity with the health care system is another important factor that may influence an individual’s access to healthcare services (Morgan et al., 2008). Language also plays an important role in health outcomes. For instance, individuals with limited English proficiency may find it …

Rural America: A Look Beyond The Images, John A. Gale Ms

Access / Insurance

The issues faced by patients and providers in rural health care differ greatly from those of urban counterparts. They also differ across rural communities. Understanding these differences, and the differences among rural populations across America, is critical to providing health services to rural Americans, who are often impeded by economic factors, cultural and social differences, educational shortcomings and isolation in their efforts to lead normal, healthy lives. The challenges provide opportunities for Catholic health care to make a difference in the lives and health of some of the nation's most vulnerable citizens.

Community-Based Approaches To Reduce Toxins In Housing: Lessons Learned From Working With Diverse Communities, Erin Mcnally, Ian Blazina, Stephanie Farquhar

Community Health Faculty Publications and Presentations

This article will review lessons learned from a community-based participatory research project with Latino and Somali residents in Portland, Oregon. The aim of the Healthy Futures Collaborative (HFC) project was to reduce in-home environmental health hazards associated with childhood respiratory illness and asthma through a process that strengthened social support and civic engagement. Using a community-based approach, the HFC trained community residents as community scientists to ensure local leadership and participation. Results suggest an increase in Somali and Latino residents' knowledge of environmental stressors and changes in behavior that may improve indoor environmental quality. Especially when working with historically marginalized …

Particle Size On Respiratory Protection Provided By Two Types Of N95 Respirators On Agricultural Settings, Jacob Cho Kyungmin, M. Susan Jones, Gordon Jones, Roy Mckay, Sergey A. Grinshpun, Alok Swivedi, Rakesh Shukla, Umesh Singh, Tiina Reponen

Nursing Faculty Publications

The objective of this study was to compare size-selective workplace protection factors (WPFs) of an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR) in agricultural environments. Twenty-five healthy farm workers ranging in age from 20 to 30 years voluntarily participated in the study. Altogether eight farms were included representing three different types: two horse farms, three pig barns, and three grain handling sites. Subjects wore the ER and FFR while performing their daily activities, such as spreading hay, feeding livestock, and shoveling. Aerosol concentrations in an optical particle size range of 0.7–10 µm were determined simultaneously inside …

Combined Impact Of Lifestyle-Related Factors On Total And Cause-Specific Mortality Among Chinese Women: Prospective Cohort Study, Sarah Nechuta, Xiao-Ou Shu, Hong-Lan Li, Gong Yang, Yong-Bing Xiang, Hui Cai, Wong-Ho Chow, Butian Ji, Xianglan Zhang, Wanqing Wen, Yu-Tang Gao, Wei Zhang

Peer Reviewed Articles

Background: Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.

Methods and Findings: We used data from the Shanghai Women’s Health Study, an ongoing population-based prospective cohort study in China. Participants included …

Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky

National Health Policy Forum

The Patient Protection and Affordable Care Act significantly expands federal support for community prevention and public health. This paper describes the governmental public health infrastructure at both the state and local level in terms of organizational structure, activities, financing, workforce, partnerships, and performance improvement efforts.

The Role Of Unrealistic Optimism In Explaining Preventive Behaviors In High Versus Low Endemic Malaria Settings In Belize, Daniel G. Handysides

Loma Linda University Electronic Theses, Dissertations & Projects

Background: Of all the diseases an individual can encounter in the world, malaria is one of the most destructive. Simple measures like sleeping under a bednet would greatly reduce the burden (Abeku, 2007). When people estimate their risk relative to others, they are most often unrealistically optimistic, which may explain why those at risk often fail to perform behaviors, such as using a bednet that will reduce their risk. However, one study showed that people at high risk for malaria held pessimistic perceptions of their risk for the disease, but the reasons for this finding are unclear (Morrison, Ager, & …

Perceived Stigma Among Patients Receiving Antiretroviral Treatment: A Prospective Randomised Trial Comparing An M-Dot Strategy With Standard-Of-Care In Kenya, Susan Kaai, Sandra Bullock, Avina Sarna, Matthew Chersich, Stanley Luchters, Scott Geibel, Kishorchandra Mandaliya, Marleen Temmerman, Naomi Rutenberg

Population Health, East Africa

HIV and AIDS remain highly stigmatised. Modified directly observed therapy (m-DOT) supports antiretroviral treatment (ART) adherence but little is known about its association with perceived stigma in resource-constrained settings. In 2003, 234 HIV-infected adults enrolled in a two-arm randomised trial comparing a health centre-based m-DOT strategy with standard self-administration of ART. Data on perceived stigma were collected using Berger's HIV stigma scale prior to starting ART and after 12 months. This was a secondary analysis to examine whether perceived stigma was related to treatment delivery. Perceived stigma scores declined after 12 months of treatment from a mean of 44.9 (sd=7.6) …

Medicare Physician Fees: The Data Behind The Numbers, Laura A. Dummit

National Health Policy Forum

Medicare’s physician fee schedule distributes nearly $60 billion annually and is a critical determinant of individual physicians’ incomes, beneficiaries' access to health care services, and Medicare spending, as well as the basis for physician fees used by many private payers. The Centers for Medicare & Medicaid Services (CMS) relies on data derived from expert judgment and other sources to update the fee schedule. Although CMS’s methods and data for maintaining the fee schedule have improved over the years, concerns remain about medical specialty society involvement and the lack of an effective ”counterweight” to vested interests in establishing and updating the …

Tapping The Potential Of The Health Care Workforce: Scope-Of-Practice And Payment Policies For Advanced Practice Nurses And Physician Assistants, Robert Cunningham

National Health Policy Forum

Expanding coverage and increasing delivery of team-based care are likely to entail a growing role in the
health system for advanced practice nurses (APNs), physician assistants (PAs), and other nonphysician clinicians. These professions have already grown rapidly and have increased access to primary and specialty care, especially in rural and other underserved areas. This background paper provides an overview of the role of APNs and PAs. It reviews the primary features of the training and credentialing of these health professions, including the impact of public policies and market forces on their growth and deployment. It describes variations in state scope-of-practice …

Assessing Community Health Center (Chc) Assets And Capabilities For Recruiting And Retaining Physicians: The Chc Community Apgar Questionnaire, David Schmitz, Ed Baker, Ayaka Nukui, Benjamin Tverdy

Public and Population Health Faculty Publications and Presentations

Community factors play a key role in the recruitment and retention of physicians. While prior workforce studies often investigated characteristics of the candidate-physician, the initial Critical Access Hospital Community Apgar Questionnaire (CAH CAQ) study identified community factors at critical access hospitals which help determine the success of achieving and maintaining an adequate local physician workforce. The goals of the current study are to identify opportunities for improvement in physician retention and recruitment in Idaho’s Community Health Center (CHC) systems and to develop a better understanding of the community factors in this dynamic process.

Interpretations Of Interpretations: Combining Community-Based Participatory Research And Interpretive Inquiry To Improve Health, Jessica Gregg, Lourdes Centurion, Julio Maldonado, Raquel Aguillon, Rosemary Carmela Celaya-Alston, Stephanie Farquhar

Community Health Faculty Publications and Presentations

Background: Latina immigrants from Mexico suffer significantly increased morbidity and mortality from cervical cancer when compared with non-Hispanic White women, largely owing to lack of screening and appropriate treatment. Objectives: To demonstrate that by combining the tools of community-based participatory research (CBPR) with the tools of interpretive inquiry, it is possible to address explicit community concerns surrounding a particular problem such as cervical cancer while also examining what other, perhaps less immediately visible, matters consume the time and attention of community members. Methods: We first briefly discuss and compare CBPR as an approach to research and interpretive inquiry as a …

Strengthening Primary Care To Bend The Cost Curve: The Expansion Of Community Health Centers Through Health Reform, Leighton C. Ku, Patrick Richard, Avi Dor, Ellen Tan, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The recent enactment of health reform sets into motion important changes that will expand health insurance coverage, increase funding for community health centers and alter the way that health centers are paid. These reforms will have a major impact on two major challenges of health reform: bolstering the capacity of the nation's primary care system and reducing the long term growth in health care costs.

Our analyses examine the impact of the new health reform law on the number of patients who will receive primary care services at community health centers and the effect of the service expansions on overall …