Medicine and Health Commons^™

Evaluating Community-Facility Linkage Models To Promote Mother-Infant Retention Along The Hiv Care Continuum, Project Soar

HIV and AIDS

In Malawi, and other resourced-constrained, sub-Saharan African countries with a high HIV burden, several service delivery models have emerged to increase prevention of mother-to-child transmission care retention by strengthening connections between health facilities and their surrounding communities. Yet there has been little documentation of the unique characteristics of each model and their comparative impact on mother-infant pair (MIP) care retention and other health outcomes. This brief describes how Project SOAR is responding to these knowledge gaps by conducting research to identify components of community-based MIP support that are associated with maternal care retention and infant HIV-free survival. This research will …

Evaluation A Depression Treatment Program On Hiv Care And Mental Health Outcomes In Malawi, Project Soar

HIV and AIDS

This brief outlines a Project SOAR study which will provide critical evidence on the feasibility, effectiveness, and cost-effectiveness of an integrated depression treatment model for improving retention in and adherence to HIV care in Malawi. Among people initiating antiretroviral therapy (ART), those with depression are a large and especially vulnerable population. Depression affects 18–30 percent of patients receiving HIV care in Africa and is an important barrier to early ART retention. Evidence revealed by the study will have implications not only for the applicability of the model in Malawi but for other countries in sub-Saharan Africa as well.

Project Yes! Youth Engaging For Success: A Peer Mentoring Program To Transition Youth To Hiv Self-Management In Zambia, Project Soar

HIV and AIDS

This activity brief describes an operational study that responds to challenges and evidence gaps in Zambia about how to support adolescents and young adults living with HIV (YLHIV) in having a greater and more effective role in the management of their own care. The study aimed to refine and test a peer-mentoring strategy in Zambia to strengthen the capacity of health systems and families to support youth as they transition to, and engage in, self-management and adult HIV care and treatment. This approach builds on previous Ministry of Health–approved research at Arthur Davison Children’s Hospital with YLHIV and their families. …

Reducing Hiv Risk Among Adolescent Girls And Young Women, And Their Partners Through The Dreams Partnership In Malawi, Project Soar

HIV and AIDS

Project SOAR is conducting implementation science research in Malawi to build needed evidence to inform decisionmaking about effective programming to reduce HIV risk among adolescent girls and young women (AGYW) and their male partners. Specifically, SOAR is: examining approaches to identify the most at-risk girls, particularly those out of school, and enroll and retain them in DREAMS programming; assessing HIV-risk and health-seeking behaviors before and after AGYW’s engagement in DREAMS interventions; exploring how to reach AGYW’s male sexual partners and increase their uptake of HIV services; and assessing facilitators and barriers to HIV service uptake by men living with HIV. …

How Participants Report Their Health Status: Cognitive Interviews Of Self-Rated Health Across Race/Ethnicity, Gender, Age, And Educational Attainment, Dana Garbarski, Jennfier Dykema, Kenneth D. Croes, Dorothy F. Edwards

Sociology: Faculty Publications and Other Works

Background

Self-rated health (SRH) is widely used to measure subjective health. Yet it is unclear what underlies health ratings, with implications for understanding the validity of SRH overall and across sociodemographic characteristics. We analyze participants’ explanations of how they formulated their SRH answer in addition to which health factors they considered and examine group differences in these processes.

Methods

Cognitive interviews were conducted with 64 participants in a convenience quota sample crossing dimensions of race/ethnicity (white, Latino, black, American Indian), gender, age, and education. Participants rated their health then described their thoughts when answering SRH. We coded participants’ answers in …

The Differential Effects Of Rural Health Care Access On Race-Specific Mortality, Jeralynn Cossman, Wesley James, Julia Kay Wolf

Faculty & Staff Scholarship

We examined the relationship between race-specific rural mortality and the health infrastructure of rural counties in light of America’s recent emergence of a rural mortality penalty. Using the Compressed Mortality File from National Center for Health Statistics (2008–2012) and county-level demographic, socioeconomic, and health care indicators from the Area Health Resource File and the US Census, we created a rural public health infrastructure index which encompasses four types of health care access (public health employees, critical access hospital/rural referral centers, rural health clinics, and emergency departments) within counties. We found that each unit increase in the index is associated with …

The Intersection Between Masculinity And Health Among Rural Immigrant Latino Men, Jason Daniel-Ulloa, Christina J. Sun, Scott D. Rhodes

OHSU-PSU School of Public Health Faculty Publications and Presentations

Latino men experience health disparities in STI/HIV, diabetes, hypertension, and cancer. Gender roles likely play a role in risk behaviors and outcomes; however, there has been little focus on masculinity in Latino men. We conducted 20 semi-structured interviews with Latino men living in North Carolina. The interviews, conducted by a trained bilingual/bicultural Latino male, prompted discussion around work, family, and stress. Four themes were identified: masculine roles of being a family provider and protector, sources of stress, family responsibility and interconnectedness to health, and coping mechanism. For Latino men, masculinity may have both positive and negative influences on health. For …

Examining The Predictors Of Mental Health Outcomes Among Undergraduate Postsecondary Students In Canada, Brooke Linden, Rozzet Jurdi-Hage

Journal of Social, Behavioral, and Health Sciences

Symptoms consistent with mental illnesses such as anxiety and depression are dominant in both prevalence and in severity among North American post-secondary student populations over the past several years. This study examines undergraduate students’ self-reported symptoms consistent with two common mental illnesses in a Canadian context, and sheds light on several predictors of students’ mental health outcomes, including perceived contextual stressors, coping strategies, and perceived barriers to help seeking. Data for this investigation were obtained through the completion of self-administered questionnaires from a sample of 209 undergraduate students attending a public western Canadian university during the fall semester of 2014. …

Engaging Parents To Promote Children’S Nutrition And Health: Providers’ Barriers And Strategies In Head Start And Child Care Centers, Dipti A. Dev, Courtney Byrd-Williams, Samantha Ramsay, Brent A. Mcbride, Deepa Srivastava, Ashleigh L. Murriel, Chrisa Arcan, Anna M. Adachi-Mejia

Department of Child, Youth, and Family Studies: Faculty Publications

Purpose: Using the Academy of Nutrition and Dietetics benchmarks as a framework, this study examined childcare providers’ (Head Start [HS], Child and Adult Care Food Program [CACFP] funded, and non-CACFP) perspectives regarding communicating with parents about nutrition to promote children’s health.

Design: Qualitative.

Setting: State-licensed center-based childcare programs.

Participants: Full-time childcare providers (n ¼ 18) caring for children 2 to 5 years old from varying childcare contexts (HS, CACFP funded, and non-CACFP), race, education, and years of experience.

Methods: In-person interviews using semi-structured interview protocol until saturation were achieved. Thematic analysis was conducted.

Results: Two overarching themes were barriers and …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Two Approaches, One Problem: Cultural Constructions Of Type Ii Diabetes In An Indigenous Community In Yucatán, Mexico, Elizabeth Durden

Faculty Journal Articles

The emerging epidemic of obesity and type II diabetes in Mexico has recently propelled the nation into the public health spotlight. In the state of Yucata n, the experience of diabetes is greatly impacted by two cultural constructions of disease. In this setting, elements of Yucatec Mayan health practices as well as the biomedical model affect the approach to type II diabetes. Both frameworks offer unique un- derstandings of the etiology of diabetes and recommend different ways to manage the condition. Based on in-depth and semi-structured interviews with both community members and clinicians, the present study seeks to understand how …

Disease Prevalence And Health Determinants In Nevada, Takashi Yamashita, Roberto Millar

Social Health of Nevada Reports

In this report, we use recent data to describe the health of Nevada and update the previous report (Monnat, 2012) on health outcomes and health determinants in the Silver State. Data for this report are mainly obtained from the County Health Rankings, America’s Health Rankings, and the 2016 Center for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity report.

In line with the previous report by Monnat (2012), we reference Nevada’s disease prevalence in relation to the U.S. average and other states, as well as disease distribution among counties in Nevada. We also compaire health indicators in …

Addiction And Substance Abuse In Nevada, Andrea Blin

Social Health of Nevada Reports

Substance abuse is an issue with serious health and societal consequences in Nevada and throughout the nation. In 2016, drug overdoses were responsible for approximately 64,000 deaths in the United States, surpassing motor vehicle deaths by 60 percent (National Institute on Drug Abuse, 2018). Recent attention has been focused on the spike in opioid use and its implications for public health. Nationally, deaths from opioid overdoses increased from 6.1 per 100,000 in 1999 to 19.8 per 100,000 in 2016. Nevada’s experience has mirrored national trends, with the drug overdose death rate in the state increasing from 11.5 per 100,000 in …

Prescribing Change For Minority Students: Diagnosing Inequalities In Science Education In The Clark County School District, Brianna K. Cotter

Calvert Undergraduate Research Awards

Promoting entry of underrepresented minority groups into the allied health professions is paramount to developing a balanced workforce that reflects the needs of an evolving populace. Currently, significant underrepresentation of racial minority groups in health and science related fields correlates with data showing an overrepresentation of black and Latino students in Title 1 (at-risk and low-income) schools. Data suggest that students who are exposed to “higher quality” science education, such as “hands on” experiences, have increased interest in pursuing a health or science related career. These findings prompt the hypothesis that Title 1 schools face inequalities in their science education …

Depressive Symptoms Among College Students: An Exploration Of Fundamental Cause Theory, Peter A. Carrico

Theses and Dissertations

Fundamental Cause Theory suggests that socioeconomic and demographic factors are causal to various illnesses, including depression. However, no known previously existing research has used Fundamental Cause Theory to create a model of depression among college students. To do this, the present study conducted a stepwise binomial logistic regression to examine how socioeconomic status and the sociodemographic variables of Gender, Race, and Sexual Orientation, and others predict depressive symptoms in a large sample of undergraduates when controlling for stressful life events and social support (N = 2,915). Results support the hypothesis that socioeconomic disparities in depressive symptoms are the result …

The Role Of Afrocentric Features In Mental Healthcare Utilization And Counselor Preferences In Black College Students, Randl B. Dent

Theses and Dissertations

Though mental health issues are prevalent in Black young adults, they underutilize mental healthcare services. This research examined the role of feature-based discrimination in mental healthcare (under)utilization. Study 1, a secondary analysis of the National Longitudinal Study of Adolescent to Adult Health, provided no evidence supporting a link between skin tone and mental healthcare utilization, when controlling for depression diagnosis. However, when controlling for depression symptoms, there was a trend such that Black young adults with darker, as opposed to lighter, skin tone utilized healthcare less. Study 2, an experimental study with 33 Black college students, showed 73% of the …

Recovery From Design, Cassandra J. Ellison

Theses and Dissertations

Through research, inquiry, and an evaluation of Recovery By Design, a ‘design therapy’ program that serves people with mental illness, substance use disorders, and developmental disabilities, it is my assertion that the practice of design has therapeutic potential and can aid in the process of recovery. To the novice, the practices of conception, shaping form, and praxis have empowering benefit especially when guided by Conditional and Transformation Design methods together with an emphasis on materiality and vernacular form.

Towards Active Ageing: A Comparative Study Of Experiences Of Older Ghanaians In Australia And Ghana, Daniel Doh

Theses: Doctorates and Masters

Population ageing has become a central feature of the 21st century, as most countries search for economically viable strategies to support and manage their ageing populations to live in a dignified way. In 2002, the World Health Organisation (WHO) proposed the active ageing policy framework to guide countries to develop policies that promote the quality of life for their older people. However, the interpretation and application of the active ageing model in the literature and policy discussions are inconclusive on the most important elements that promote the quality of life of older people. The discussions have largely focused on health …

Mending Invisible Wounds: The Efficacy And Legality Of Mdma-Assisted Psychotherapy In United States' Veterans Suffering With Post-Traumatic Stress Disorder, Jonathan Perry

Journal of Law and Health

Though Veteran Affairs has provided crucial life sustaining—and often lifesaving—treatments to returning soldiers, the substantial and ever-increasing rates of veteran suicides, drug addictions, and criminal behavior indicate a need for broader options in treatment. One of the most profound discoveries uncovered through MDMA-assisted psychotherapy research is MDMA’s facilitation of the alleviation of addictive behavior in subjects, and, as a result, an alleviation of addictions in general. Addiction is one of the key symptoms of post-traumatic stress disorder (PTSD) and drug abuse plays a large role in the other afflictions suffered by veterans, namely criminal activity and a high rate of …

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …