Medicine and Health Commons^™

Urban Family Planning Program Of Bangladesh: Issues And Challenges, Ubaidur Rob, Md. Noorunnabi Talukder, A.K.M. Zafar Ullah Khan

Reproductive Health

Extremely inadequate government primary health care (PHC) structure exists in cities in Bangladesh. Nongovernmental organizations (NGOs) play an important role in providing basic health and family planning services to a limited proportion of the urban population. However, NGO programs are time-bound and subject to the availability of development assistance. Bangladesh has one of the highest rates of growth of urban populations among developing countries. For this teeming urban population, there is no structured family planning service. To ensure continuous family planning services in urban areas it is critical to develop a sustainable primary health care structure with the thrust on …

Workshop Report: Introducing Pay-For-Performance (P4p) Approach And Increase Utilization Of Maternal, Newborn, And Child Health Services In Bangladesh, Md. Noorunnabi Talukder, Ubaidur Rob, Ismat Ara Hena, Farhana Akter, Mohammad Ataur Rahman, Md. Julkarnayeen

Reproductive Health

In Bangladesh, improving skilled birth attendance at delivery and access to facility-based obstetric and newborn care are vital to improving maternal and neonatal health. The health system in Bangladesh faces a critical challenge on the supply side: unavailability of quality services at public health facilities, due to inadequately motivated providers, vacant positions, and provider absenteeism. As well, salaries of public-sector providers do not depend on quality of work or quantity of services provided. Paying an incentive to facilities based on a performance benchmark has the potential of increasing the quantity and quality of maternal, neonatal, and child health (MNCH) care. …

Family Members' Influence On Family Meal Vegetable Choices, Tionni R. Wenrich, J. Lynne Brown, Michelle Miller-Day, Kevin J. Kelley, Eugene J. Lengerich

Communication Faculty Articles and Research

Objective—Characterize the process of family vegetable selection (especially cruciferous, deep orange, and dark green leafy vegetables); demonstrate the usefulness of Exchange Theory (how family norms and past experiences interact with rewards and costs) for interpreting the data.

Design—Eight focus groups, two with each segment (men/women vegetable-likers/dislikers based on a screening form). Participants completed a vegetable intake form.

Setting—Rural Appalachian Pennsylvania.

Participants—61 low-income, married/cohabiting men (n=28) and women (n=33).

Analysis—Thematic analysis within Exchange Theory framework for qualitative data. Descriptive analysis, t-tests and chi-square tests for quantitative data.

Results—Exchange Theory proved useful for understanding that regardless …

An Examination Of The Relationship Between Family And U.S. Latinos’ Physical Health, Georgiana Bostean

Sociology Faculty Articles and Research

Latinos, especially immigrant Latinos, have lower mortality rates and some better health outcomes than U.S.-born Latinos and whites, a situation called the Latino Paradox. One explanation for the advantage is that Latinos’ family orientation protects health. However, because few large-scale studies examine Latinos’ family relationships by nativity, the extent to which family factors contribute to Latinos’ health outcomes is unclear. Additionally, while a large literature focuses on family cohesion, fewer studies address both cohesion and conflict, which may be particularly important among immigrants, whose migration and adaptation experiences can strain family relations. This study examines the relationship between family context …

Performance Measures And Pilot Evaluation Of Georgia’S Medical Assistance Program For Population Below The Poverty Line, Tamar Chitashvili

Muskie School Capstones and Dissertations

In recent years the Georgian health care system has been undergoing fundamental reforms aimed at improving the population’s health status by increasing financial and geographic access to high-quality health care. To address limited financial access to health services of the poor, and protect them from catastrophic expenditures associated with illnesses and improve equity, the government restructured the centralized, financially and administratively unsustainable social security system, with a liberal welfare system focusing on providing a safety net for the poor.

Va Healthcare Costs Of A Collaborative Intervention For Chronic Pain In Primary Care, Kathryn C. Dickinson, Rajiv Sharma, Jonathan P. Duckart, Kathryn Corson, Martha S. Gerrity, Steven K. Dobscha

Economics Faculty Publications and Presentations

Background: Chronic pain is costly to individuals and the healthcare system, and is often undertreated. Collaborative care models show promise for improving treatment of patients with chronic pain. The objectives of this article are to report the incremental benefit and incremental health services costs of a collaborative intervention for chronic pain from a veterans affairs (VA) healthcare perspective.

Methods: Data on VA treatment costs incurred by participants were obtained from the VA's Decision Support System for all utilization except certain intervention activities which were tracked in a separate database. Outcome data were from a cluster-randomized trial of a …

Gendered Disparities In Take-Ups Of Employee Health Benefits, Jennifer Reid Keene, Anastasia H. Prokos

Sociology Faculty Research

Using a sample of 2,271 workers from the 2002 National Study of the Changing Workforce whose employers offered personal health insurance, this article investigates the gendered nature of health insurance benefit take-ups. These analyses include family and employment characteristics in addition to employers’ contributions to health insurance premiums, a measure that is unexamined in sociological analyses of health benefits. Progressive logistic regression models predict the effects of gender and family characteristics. Results indicate that women with employed spouses are less likely to take up their own health benefits than are comparable men, net of basic employment characteristics. Gender differences disappear, …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Estimating The Prevalence And Frequency Of The Adolescent Drug Use: Do The Models Fit The Measures?, John P. Hoffmann, Stephen J. Bahr

Faculty Publications

We critically review recent studies to examine the measurement schemes and empirical models used to examine adolescent drug use, with a particular eye toward determining whether differences between the prevalence and frequency of use have been addressed. Several theoretical models suggest that there are differences but we find relatively few studies that have considered prevalence versus frequency, even though selection effects that dictations these processes affect conclusions about predictors of drug use. Using data from the 2004 U.S. National Survey of Drug Use and Health (NSDUH), (n=16,235), we provide an empirical example of why distinguishing prevalence and frequency of use …

Romantic Relationships And The Physical And Mental Health Of College Students, Scott R. Braithwaite, Raquel Delevi, Frank Fincham

Faculty Publications

This study tested the hypothesis that, analogous to married individuals, college students in committed romantic relationships experience greater well-being than single college students. In a sample of 1,621 college students, individuals in committed relationships experienced fewer mental health problems and were less likely to be overweight/obese. There were no significant differences between groups in frequency of physical health problems. Examination of 2 models suggested that being in a committed romantic relationship decreases problematic outcomes largely through a reduction in sexual partners, which in turn decreases both risky behaviors and problematic outcomes. These results are discussed in the context of how …

Scaling Up, Lourdes Hernández-Cordero, Susan P. Sturm, Kathleen Klink, Allan J. Formicola

Faculty Scholarship

Moments of crisis require big, bold ideas. In this chapter we will zoom out of our close examination of the Northern Manhattan Community Voices Collaborative experience to propose ways to scale up the things that worked for us in order to make them applicable at a national level. With this chapter we honor the intent of the W. K. Kellogg Foundation in its support of learning laboratories across the nation. Our goal is to contribute to the collective dialogue on how to improve the health care system. Specifically, we propose that making a healthier nation and reducing health care costs …