Browsing by Author "Social and Behavioral Sciences, School of Public Health"
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Item Ahonen et al. Respond(American Public Health Association, 2018-06-06) Ahonen, Emily Q.; Fujishiro, Kaori; Flynn, Michael; Cunningham, Thomas; Social and Behavioral Sciences, School of Public HealthItem Association of hemoglobin levels in the first trimester and at 26 to 30 weeks with fetal and neonatal outcomes: A secondary analyses of the Global Network for Women’s and Children’s Health’s ASPIRIN Trial(Wiley, 2021) Jessani, Saleem; Saleem, Sarah; Hoffman, Matthew K.; Goudar, Shivaprasad S.; Derman, Richard J.; Moore, Janet L.; Garces, Ana; Figueroa, Lester; Krebs, Nancy F.; Okitawutshu, Jean; Tshefu, Antoinette; Bose, Carl L.; Mwenechanya, Musaku; Chomba, Elwyn; Carlo, Waldemar A.; Das, Prabir Kumar; Patel, Archana; Hibberd, Patricia L.; Esamai, Fabian; Liechty, Edward A.; Bucher, Sherri; Nolen, Tracy L.; Koso-Thomas, Marion; Miodovnik, Menachem; McClure, Elizabeth M.; Goldenberg, Robert L.; Social and Behavioral Sciences, School of Public HealthObjective: Limited data are available from low- and middle-income countries (LMICs) on the relationship of haemoglobin levels to adverse outcomes at different times during pregnancy. We evaluated the association of haemoglobin levels in nulliparous women at two times in pregnancy with pregnancy outcomes. Design: ASPIRIN Trial data were used to study the association between haemoglobin levels measured at 6+0 -13+6 weeks and 26+0 -30+0 weeks of gestation with fetal and neonatal outcomes. Setting: Obstetric care facilities in Pakistan, India, Kenya, Zambia, The Democratic Republic of the Congo and Guatemala. Population: A total of 11 976 pregnant women. Methods: Generalised linear models were used to obtain adjusted relative risks and 95% CI for adverse outcomes. Main outcome measures: Preterm birth, stillbirth, neonatal death, small for gestational age (SGA) and birthweight <2500 g. Results: The mean haemoglobin levels at 6+0 -13+6 weeks and at 26-30 weeks of gestation were 116 g/l (SD 17) and 107 g/l (SD 15), respectively. In general, pregnancy outcomes were better with increasing haemoglobin. At 6+0 -13+6 weeks of gestation, stillbirth, SGA and birthweight <2500 g, were significantly associated with haemoglobin of 70-89 g/l compared with haemoglobin of 110-129 g/l The relationships of adverse pregnancy outcomes with various haemoglobin levels were more marked at 26-30 weeks of gestation. Conclusions: Both lower and some higher haemoglobin concentrations are associated with adverse fetal and neonatal outcomes at 6+0 -13+6 weeks and at 26-30 weeks of gestation, although the relationship with low haemoglobin levels appears more consistent and generally stronger.Item Association of severe malaria with cognitive and behavioural outcomes in low- and middle-income countries: a meta-analysis and systematic review(BMC, 2023-08-03) Ssemata, Andrew Sentoogo; Nakitende, Ann Jacquelline; Kizito, Simon; Thomas, Melissa R.; Islam, Sumaiya; Bangirana, Paul; Nakasujja, Noeline; Yang, Ziyi; Yu, Yunpeng; Tran, Tuan M.; John, Chandy C.; McHenry, Megan S.; Social and Behavioral Sciences, School of Public HealthBackground: Malaria affects 24 million children globally, resulting in nearly 500,000 child deaths annually in low- and middle-income countries (LMICs). Recent studies have provided evidence that severe malaria infection results in sustained impairment in cognition and behaviour among young children; however, a formal meta-analysis has not been published. The objective was to assess the association between severe malaria infection with cognitive and behavioural outcomes among children living in LMICs. Methods: Six online bibliographic databases were searched and reviewed in November 2022. Studies included involved children < 18 years of age living in LMICs with active or past severe malaria infection and measured cognitive and/or behaviour outcomes. The quality of studies was assessed. Definitions of severe malaria included cerebral malaria, severe malarial anaemia, and author-defined severe malaria. Results from all studies were qualitatively summarized. For studies with relevant data on attention, learning, memory, language, internalizing behaviour and externalizing behaviour, results were pooled and a meta-analysis was performed. A random-effects model was used across included cohorts, yielding a standardized mean difference between the severe malaria group and control group. Results: Out of 3,803 initial records meeting the search criteria, 24 studies were included in the review, with data from 14 studies eligible for meta-analysis inclusion. Studies across sub-Saharan Africa assessed 11 cohorts of children from pre-school to school age. Of all the studies, composite measures of cognition were the most affected areas of development. Overall, attention, memory, and behavioural problems were domains most commonly found to have lower scores in children with severe malaria. Meta-analysis revealed that children with severe malaria had worse scores compared to children without malaria in attention (standardized mean difference (SMD) -0.68, 95% CI -1.26 to -0.10), memory (SMD -0.52, 95% CI -0.99 to -0.06), and externalizing behavioural problems (SMD 0.45, 95% CI 0.13-0.78). Conclusion: Severe malaria is associated with worse neuropsychological outcomes for children living in LMICs, specifically in attention, memory, and externalizing behaviours. More research is needed to identify the long-term implications of these findings. Further interventions are needed to prevent cognitive and behavioural problems after severe malaria infection.Item Burning embers: towards more transparent and robust climate-change risk assessments(Nature, 2020) Zommers, Zinta; Marbaix, Philippe; Fischlin, Andreas; Ibrahim, Zelina Z.; Magnan, Alexandre K.; Pörtner, Hans-Otto; Howden, Mark; Calvin, Katherine; Warner, Koko; Thiery, Wim; Sebesvari, Zita; Davin, Edouard L.; Evans, Jason P.; Rosenzweig, Cynthia; O'Neill, Brian C.; Patwardhan, Anand; Warren, Rachel; van Aalst, Maarten; Hulbert, Margot; Social and Behavioral Sciences, School of Public HealthThe Intergovernmental Panel on Climate Change (IPCC) reports provide policy-relevant insights about climate impacts, vulnerabilities and adaptation through a process of peer-reviewed literature assessments underpinned by expert judgement. An iconic output from these assessments is the burning embers diagram, first used in the Third Assessment Report to visualize reasons for concern, which aggregate climate-change-related impacts and risks to various systems and sectors. These burning embers use colour transitions to show changes in the assessed level of risk to humans and ecosystems as a function of global mean temperature. In this Review, we outline the history and evolution of the burning embers and associated reasons for concern framework, focusing on the methodological approaches and advances. While the assessment framework and figure design have been broadly retained over time, refinements in methodology have occurred, including the consideration of different risks, use of confidence statements, more formalized protocols and standardized metrics. Comparison across reports reveals that the risk level at a given temperature has generally increased with each assessment cycle, reflecting accumulating scientific evidence. For future assessments, an explicit, transparent and systematic process of expert elicitation is needed to enhance comparability, quality and credibility of burning embers.Item Burnout in Individuals with Type D Personality: Relations to Age and Gender(2019) Kelly, Carla A.; Bigatti, Silvia M.; Social and Behavioral Sciences, School of Public HealthObjective: The purpose of this research was to examine the severity and prevalence of burnout in working adults with Type D personality (TDP) in comparison to those without TDP. TDP is defined by the presence of specific levels of both negative affectivity and social inhibition. Burnout is an extended response to chronic stressors characterized by three dimensions: exhaustion, cynicism, and inefficacy. Methods: Online surveys were used to gather responses from 333 participants to the Type D Scale-14, the standard for measure for assessing TDP, and the Burnout Measure, Short Version. Quantitative analyses included the use of t-tests, chi square tests, and regression analysis to determine: a) if there are differences in the severity and prevalence of burnout in individuals with and without TDP, and b) whether age, gender, or both moderate the relationship between burnout and TDP. Results: There were differences in the prevalence and severity of burnout between groups. Individuals with TDP were more likely to have, and to have more severe, burnout than those without TDP. Age moderated the relationship between burnout severity but not burnout prevalence and TDP. Severity of burnout worsened with age in individuals with TDP. Gender did not moderate the relationship. Conclusion: It is important to better understand TDP and its role in burnout. The results presented here highlight the importance of considering TDP in the development of interventions and preventative measures in settings where employee burnout is high.Item Challenges Experienced by Black Women with Breast Cancer During Active Treatment: Relationship to Treatment Adherence(Springer Nature, 2023) Bigatti, Silvia M.; Weathers, Tess; Hayes, Lisa; Daggy, Joanne; Social and Behavioral Sciences, School of Public HealthBackground: Although rates of death from breast cancer have declined in the USA for both Black and White women since 1990, mortality rates for Black women remain strikingly higher - 40% higher compared to White women (American Cancer Society 1). The barriers and challenges that may be triggering unfavorable treatment-related outcomes and diminished treatment adherence among Black women are not well understood. Methods: We recruited 25 Black women with breast cancer who were to receive surgery and chemotherapy and/or radiation therapy. Through weekly electronic surveys, we assessed types and severity of challenges across various life domains. Because the participants rarely missed treatments or appointments, we examined the impact of severity of weekly challenges on thoughts of skipping treatment or appointment with their cancer care team using a mixed-effects location scale model. Results: Both a higher average severity of challenges and a higher deviation of severity reported across weeks were associated with increased thoughts on skipping treatment or appointment. The correlation between the random location and scale effects was positive; thus, those women that reported more thoughts on skipping a dose of medicine or appointment were also more unpredictable with respect to the severity of challenges reported. Conclusions: Black women with breast cancer are impacted by familial, social, work-related, and medical care factors, and these may in turn affect adherence to treatment. Providers are encouraged to actively screen and communicate with patients regarding life challenges and to build networks of support within the medical care team and social community that can help patients successfully complete treatment as planned.Item The Challenges of Conducting Intrastate Policy Surveillance: A Methods Note on County and City Laws in Indiana(APHA, 2021-06) Sanner, Lindsey; Grant, Sean; Walter-McCabe, Heather; Silverman, Ross D.; Social and Behavioral Sciences, School of Public HealthPolicy surveillance is critical in examining the ways law functions as a structural and social determinant of health. To date, little policy surveillance research has focused on examining intrastate variations in the structure and health impact of laws. Intrastate policy surveillance poses unique methodological challenges because of the complex legal architecture within states and inefficient curation of local laws. We discuss our experience with these intrastate policy surveillance challenges in Indiana, a state with 92 counties and several populous cities, a complicated history of home rule, systemically underfunded local governments, and variations in demography, geography, and technology adoption. In our case study, we expended significant time and resources to obtain county and city ordinances through online code libraries, jurisdiction Web sites, and (most notably) visits to offices to scan documents ourselves. A concerted effort is needed to ensure that local laws of all kinds are stored online in organized, searchable, and open access systems. Such an effort is vital to achieve the aspirational goals of policy surveillance at the intrastate level.Item Clinical and Non-Clinical Variables Associated With Preventive and Curative Dental Service Utilisation: A Cross-Sectional Study Among Adolescents and Young Adults in Central Mexico(BMJ Publishing Group, 2019-09-18) Medina-Solís, Carlo Eduardo; García-Cortés, José Obed; Robles-Minaya, José Luis; Casanova-Rosado, Juan Fernando; Mariel-Cárdenas, Jairo; Ruiz-Rodríguez, María del Socorro; Navarrete-Hernández, José de Jesús; Ávila-Burgos, Leticia; Maupomé, Gerardo; Social and Behavioral Sciences, School of Public HealthObjective The present study aimed to identify preventive and curative dental health service utilisation (DHSU) in the context of associated clinical and non-clinical factors among adolescents and young adults in Mexico. Design Cross-sectional study. Setting Applicants to a public university in Mexico. Participants Participants were 638 adolescents and young adults aged 16–25 randomly selected from university applicants. Interventions Data were collected using a self-administered questionnaire filled out by the students. For assessment of dental caries experience, we used the index of decayed, missing and filled teeth. Primary outcome The dependent variable was DHSU in the previous 12 months, coded as 0=non-use, 1=use of curative services and 2=use of preventive services. Results The mean age was 18.76±1.76 years, and 49.2% were women. The prevalence of DHSU was 40.9% (95% CI 37.1 to 44.8) for curative services and 22.9% (95% CI 19.7 to 26.3) for preventive services. The variables associated with curative services were age, sex, mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and oral health knowledge. For preventive services, the variables associated were mother’s education, dental pain in the previous 12 months, caries experience, use of self-care devices and self-perception of oral health. Conclusions While differences emerged by type of service, a number of variables (sociodemographic and socioeconomic characteristics as well as dental factors) remained in the final model. Greater oral health needs and socioeconomic inequalities remained as predictors of both types of DHSU. Given the differences revealed by our study, oral health policies should refer those seeking dental care for oral diseases to preventive services, and promote the use of such services among the poorer and less educated population groups.Item Common Traditions, Practices, and Beliefs Related to Safe Motherhood and Newborn Health in Morocco(MDPI, 2023-03-06) Moujahid, Chaimae; Turman, Jack E., Jr.; Amahdar, Loubna; Social and Behavioral Sciences, School of Public HealthThe cultural context influences women's antenatal care and postpartum knowledge. This study aims to determine the traditional practices related to maternal health in Morocco. We conducted in-depth qualitative interviews with 37 women from three different Moroccan regions on the first postpartum day. We used thematic content to analyze data, and an a priori coding framework was created utilizing the pertinent literature. Beliefs regarding pregnancy and postpartum positively affect maternal health, such as family support, prolonged rest for health recovery, and specific dietary precautions according to the mode of delivery of the new mother. However, some practices may negatively affect maternal health, such as cold postpartum treatment through traditional medicine and not seeking prenatal care after the first pregnancy experience. Such practices include painting newborns with henna, using kohl and oil to hasten the umbilical cord's descent, and producing solutions based on chicken throat to cure respiratory ailments in newborns that might harm their health.Item Comparative Effectiveness of Brief Alcohol Interventions for College Students: Results from a Network Meta-Analysis(Springer, 2019-01-02) Hennessy, Emily Alden; Tanner-Smith, Emily E.; Mavridis, Dimitris; Social and Behavioral Sciences, School of Public HealthBackground Late adolescence is a time of increased drinking, and alcohol plays a predominant role in college social experiences. Colleges seeking to prevent students’ hazardous drinking may elect to implement brief alcohol interventions (BAIs). However, numerous manualized BAIs exist, so an important question remains regarding the comparative effectiveness of these different types of BAIs for college students. Aim This study uses network meta-analyses (NMA) to compare seven manualized BAIs for reducing problematic alcohol use among college students. Methods We systematically searched multiple sources for literature, and we screened studies and extracted data in duplicate. For the quantitative synthesis, we employed a random-effects frequentist NMA to determine the effectiveness of different BAIs compared to controls, and estimated the relative effectiveness ranking of each BAI. Results A systematic literature search resulted in 52 included studies: on average, 58% of participants were male, 75% were binge drinkers, and 20% were fraternity/sorority-affiliated students. Consistency models demonstrated that BASICS was consistently effective in reducing students’ problematic alcohol use (ES range: g=−0.23, 95%CI [−0.36,−0.16] to g=−0.36, 95% CI [−0.55,−0.18]), but AlcoholEDU (g=−0.13, 95%CI [−0.22,−0.04]), e-CHUG (g=−0.35, 95%CI [−0.45,−0.05]), and THRIVE (g=−0.47, 95%CI [−0.60,−0.33]) were also effective for some outcomes. Intervention rankings indicated that BASICS, THRIVE, and AlcoholEDU hold the most promise for future trials. Conclusions Several BAIs appear effective for college students. BASICS was the most effective but is resource intensive and may be better suited for higher risk students; THRIVE and e-CHUG are less resource intensive and show promise for universal prevention efforts.