Browsing by Author "Golembiewski, Elizabeth"

Now showing 1 - 6 of 6
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    Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review
    (JMIR Public Health and Surveillance, 2019) Golembiewski, Elizabeth; Allen, Katie S.; Blackmon, Amber M.; Hinrichs, Rachel J.; Vest, Joshua R.
    Background: Nonclinical determinants of health are of increasing importance to health care delivery and health policy. Concurrent with growing interest in better addressing patients’ nonmedical issues is the exponential growth in availability of data sources that provide insight into these nonclinical determinants of health. Objective: This review aimed to characterize the state of the existing literature on the use of nonclinical health indicators in conjunction with clinical data sources. Methods: We conducted a rapid review of articles and relevant agency publications published in English. Eligible studies described the effect of, the methods for, or the need for combining nonclinical data with clinical data and were published in the United States between January 2010 and April 2018. Additional reports were obtained by manual searching. Records were screened for inclusion in 2 rounds by 4 trained reviewers with interrater reliability checks. From each article, we abstracted the measures, data sources, and level of measurement (individual or aggregate) for each nonclinical determinant of health reported. Results: A total of 178 articles were included in the review. The articles collectively reported on 744 different nonclinical determinants of health measures. Measures related to socioeconomic status and material conditions were most prevalent (included in 90% of articles), followed by the closely related domain of social circumstances (included in 25% of articles), reflecting the widespread availability and use of standard demographic measures such as household income, marital status, education, race, and ethnicity in public health surveillance. Measures related to health-related behaviors (eg, smoking, diet, tobacco, and substance abuse), the built environment (eg, transportation, sidewalks, and buildings), natural environment (eg, air quality and pollution), and health services and conditions (eg, provider of care supply, utilization, and disease prevalence) were less common, whereas measures related to public policies were rare. When combining nonclinical and clinical data, a majority of studies associated aggregate, area-level nonclinical measures with individual-level clinical data by matching geographical location. Conclusions: A variety of nonclinical determinants of health measures have been widely but unevenly used in conjunction with clinical data to support population health research.
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    Graduation and Academic Placement of Underrepresented Racial/Ethnic Minority Doctoral Recipients in Public Health Disciplines, United States, 2003-2015
    (SAGE Publications, 2018-11-30) Jackson, Joanna R.; Holmes, Ann M.; Golembiewski, Elizabeth; Brown-Podgorski, Brittany L.; Menachemi, Nir; Health Policy and Management, School of Public Health
    Objectives: Given public health’s emphasis on health disparities in underrepresented racial/ethnic minority communities, having a racially and ethnically diverse faculty is important to ensure adequate public health training. We examined trends in the number of underrepresented racial/ethnic minority (ie, non-Hispanic black, Hispanic, American Indian/Alaska Native, Native Hawaiian, and Pacific Islander) doctoral graduates from public health fields and determined the proportion of persons from underrepresented racial/ethnic minority groups who entered academia. Methods: We analyzed repeated cross-sectional data from restricted files collected by the National Science Foundation on doctoral graduates from US institutions during 2003-2015. Our dependent variables were the number of all underrepresented racial/ethnic minority public health doctoral recipients and underrepresented racial/ethnic minority graduates who had accepted academic positions. Using logistic regression models and adjusted odds ratios (aORs), we examined correlates of these variables over time, controlling for all independent variables (eg, gender, age, relationship status, number of dependents). Results: The percentage of underrepresented racial/ethnic minority doctoral graduates increased from 15.4% (91 of 592) in 2003 to 23.4% (296 of 1264) in 2015, with the largest increase occurring among black graduates (from 6.6% in 2003 to 14.1% in 2015). Black graduates (310 of 1241, 25.0%) were significantly less likely than white graduates (2258 of 5913, 38.2%) and, frequently, less likely than graduates from other underrepresented racial/ethnic minority groups to indicate having accepted an academic position (all P < .001). Conclusions: Stakeholders should consider targeted programs to increase the number of racial/ethnic minority faculty members in academic public health fields.
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    Housing First and harm reduction: a rapid review and document analysis of the US and Canadian open-access literature
    (BioMed Central, 2017-05-23) Watson, Dennis P.; Shuman, Valery; Kowalsky, James; Golembiewski, Elizabeth; Brown, Molly; Social and Behavioral Sciences, School of Public Health
    BACKGROUND: Housing First is an evidence-based practice intended to serve chronically homeless individuals with co-occurring serious mental illness and substance use disorders. Despite housing active substance users, harm reduction is an often-overlooked element during the Housing First implementation process in real-world settings. In this paper, we explore the representation of the Housing First model within the open-access scholarly literature as a potential contributing factor for this oversight. METHODS: We conducted a rapid review of the US and Canadian open-access Housing First literature. We followed a document analysis approach, to form an interpretation of the articles' content related to our primary research questions. RESULTS: A total of 55 articles on Housing First were included in the final analysis. Only 21 of these articles (38.1%) included explicit mention of harm reduction. Of the 34 articles that did not discuss harm reduction, 22 provided a description of the Housing First model indicating it does not require abstinence from substance use; however, descriptions did not all clearly indicate abstinence was not required beyond program entry. Additional Housing First descriptions focused on the low-barrier entry criteria and/or the intervention's client-centeredness. CONCLUSIONS: Our review demonstrated a lack of both explicit mention and informed discussion of harm reduction in the Housing First literature, which is likely contributing to the Housing First research-practice gap to some degree. Future Housing First literature should accurately explain the role of harm reduction when discussing it in the context of Housing First programming, and public agencies promoting Housing First uptake should provide resources for proper implementation and monitor program fidelity to prevent model drift.
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    Social Network Decay as Potential Recovery from Homelessness: A Mixed Methods Study in Housing First Programming
    (MDPI, 2017-09) Golembiewski, Elizabeth; Watson, Dennis P.; Robison, Lisa; Coberg, John W.; Social and Behavioral Sciences, School of Public Health
    The positive relationship between social support and mental health has been well documented, but individuals experiencing chronic homelessness face serious disruptions to their social networks. Housing First (HF) programming has been shown to improve health and stability of formerly chronically homeless individuals. However, researchers are only just starting to understand the impact HF has on residents’ individual social integration. The purpose of the current study was to describe and understand changes in social networks of residents living in a HF program. Researchers employed a longitudinal, convergent parallel mixed method design, collecting quantitative social network data through structured interviews (n = 13) and qualitative data through semi-structured interviews (n = 20). Quantitative results demonstrated a reduction in network size over the course of one year. However, increases in both network density and frequency of contact with network members increased. Qualitative interviews demonstrated a strengthening in the quality of relationships with family and housing providers and a shedding of burdensome and abusive relationships. These results suggest network decay is a possible indicator of participants’ recovery process as they discontinued negative relationships and strengthened positive ones.
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    Substance Use Among Young Adults in Indiana Who Are Not Enrolled in College
    (Richard M. Fairbanks School of Public Health, 2015-09) Kooreman, Harold; Kouns, Lyndy; Greene, Marion; Watson, Dennis; Golembiewski, Elizabeth
    The primary purpose of this study was to gather information on patterns and trends of substance use; reasons for using (or not using); and perceptions and beliefs regarding substance use within one’s social circle (peers) from our target population, i.e., Indiana residents ages 18 to 25 who do not attend, nor have graduated from, college.
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    Who Can I Turn To? Emotional Support Availability in African American Social Networks
    (MDPI, 2017-09-02) Hood, Sula; Golembiewski, Elizabeth; Benbow, Kyle; Sow, Hadyatoullaye; Sanders Thompson, Vetta; Social and Behavioral Sciences, School of Public Health
    African Americans disproportionately experience psychological distress, such as feelings of sadness, hopelessness, and worthlessness and are disproportionately exposed to risk factors associated with mental illness, such as racial discrimination, violence and poverty. To effectively address African Americans’ mental health needs, it is imperative to identify who African Americans turn to when they experience stressors. The purpose of this study was to assess the extent to which emotional support is provided within African Americans’ social networks and determine the characteristics of social network members who African Americans rely upon for emotional support. Results indicate that African Americans rely on social network members for spiritual and physical health support more so than emotional support. Among both male and female participants, social network members were significantly more likely to be relied upon for emotional support if they were a non-familial network contact, had a close relationship to the participant, and if they also were someone the participant spoke to about his or her physical health. Findings have implications for the development of culturally-sensitive strategies for increasing emotional support provision within African Americans’ social networks.