Sunday, November 11, 2018
Session:2034.1: Family Influences and Breastfeeding Practices Among Black Women in Pittsburgh, PA
01:30 PM - 02:30 PM
Breastfeeding (BF) rates in the US have increased over the last decade but a Black-White disparity still exists. While approximately 68% of African American (AA) mothers initiate breastfeeding, only 41.1% are still breastfeeding at 6 months compared to 87.5% and 60% of White mothers, respectively. The contributors to racial disparities in BF are not completely understood, but include an intersection of structural, cultural, and familial influences. Some studies show that family support of BF and having a family history of BF may have a greater influence on Black women’s decisions to breastfeed than merely their own perceptions about BF. Given the lack of local data on this topic, we will recruit more than 200 women residing in Pittsburgh, PA (Allegheny County) who self-identify as Black or AA to complete an online survey about infant feeding practices. Women are eligible if they are ≥ 18 years and have a child that is 2 years or younger; having breastfed is not a requirement. The survey will examine overall infant feeding practices, workplace barriers, and familial networks of support. The analysis for this abstract will focus on how the following areas influence breastfeeding initiation and duration: partner/family support for BF; whether other family members have breastfed (history of family breastfeeding); and whether BF is seen as a positive experience within the family. This study will specifically inform local interventions and the development of a local breastfeeding center that will have long- term implications for improving BF rates among Black women.
Author:Tiffany L. Gary-Webb, PhD, MHS
Session:2034.1: Breastfeeding Poster Session: Latest Topics in Breastfeeding Research, 1:30-2:30 p.m.
Title: Family Influences and Breastfeeding Practices Among Black Women in Pittsburgh, PA
Abstract:Breastfeeding (BF) rates in the US have increased over the last decade but a Black-White disparity still exists. While approximately 68% of African American (AA) mothers initiate breastfeeding, only 41.1% are still breastfeeding at 6 months compared to 87.5% and 60% of White mothers, respectively. The contributors to racial disparities in BF are not completely understood, but include an intersection of structural, cultural, and familial influences. Some studies show that family support of BF and having a family history of BF may have a greater influence on Black women’s decisions to breastfeed than merely their own perceptions about BF. Given the lack of local data on this topic, we will recruit more than 200 women residing in Pittsburgh, PA (Allegheny County) who self-identify as Black or AA to complete an online survey about infant feeding practices. Women are eligible if they are ≥ 18 years and have a child that is 2 years or younger; having breastfed is not a requirement. The survey will examine overall infant feeding practices, workplace barriers, and familial networks of support. The analysis for this abstract will focus on how the following areas influence breastfeeding initiation and duration: partner/family support for BF; whether other family members have breastfed (history of family breastfeeding); and whether BF is seen as a positive experience within the family. This study will specifically inform local interventions and the development of a local breastfeeding center that will have long- term implications for improving BF rates among Black women.
Author:Marcus A. Poindexter, LSW, HSV
Session:2103.0: 4:30-5:30 p.m.
Title: Closing the STEM Achievement Gap with Open Source Tools: A case study examining the use of technical education and peer teaching in a youth-led community-based participatory research project
Abstract:Public high schools in Pittsburgh struggle to implement robust STEM programs to prepare students for workforce demands in our information economy. This presentation offers a case study of a peer-teaching, field-based learning model designed to fill these gaps in technical and data-related education. Methods: Through an intensive, nineweek field research program centered around toxic lead exposure in a Pittsburgh neighborhood, researchers mentored a subset of five students participating in a larger youth research team to acquire and implement skills in research data system design and geospatial analysis. We addressed limited baseline technical skills among the student subgroup by implementing a peer-teaching model which deepened students’ knowledge and reduced disengagement behaviors common in a teacher-as-expert educational model. Results: After a two-day rapid exposure process, students chose technical domains in which to develop mini-expertise including data importing, map feature digitization, and data instrument design. As domain experts, students then supported one another in creating their individualized digital outputs through side-by-side tutoring. As high-level facilitators only, the researchers helped to match peer-experts and peer learners strategically throughout the work cycle.Through this process, students successfully engineered a high-quality kernel density (“heat map”) map of social gathering patterns in the target neighborhood, a choropleth map depicting the age of the local housing stock, and a playground equipment exposure risk assessment. Conclusion: By harnessing and then channeling the varied interest and technical skill levels of the student cohort, peer teaching models significantly enhanced technical learning outcomes when implemented in an applied, community-oriented research context.
Monday, November 12
Special Session:3144.0: Health Equity for African American Populations across the Lifespan: Research and Practice Activities at the Center for Health Equity, University of Pittsburgh Graduate School of Public Health
10:30 AM - 12:00 PM
Synopsis:Disparities in devastating outcomes such as infant mortality, homicide, diabetes, and cardiovascular disease have been documented for African American populations in the US. Consequently, research aimed at understanding the causes of such disparities, as well as practice activities which intervene to improve these outcomes, are critically needed. This session will highlight the innovative research and practice work being done on health equity for African-American populations across the lifespan at the University of Pittsburgh Graduate School of Public Health.
Learning Objectives:Identify the social determinants of health related to health disparities in African American populations Describe disparities in maternal/child, violence, and chronic disease outcomes Discuss research and practice activities related to African American populations across the lifespan at the Center for Health Equity, University of Pittsburgh Graduate School of Public Health
Moderator:Noble Maseru, PhD, MPH
3144.0 Maternal/Child Health Dara Mendez, PhD, MPH, University of Pittsburgh, Pittsburgh, PA
3144.0 Violence Prevention Richard Garland, MSW, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA
3144.0 Chronic Disease Prevention Tiffany L. Gary-Webb, PhD, MHS, University of Pittsburgh, Pittsburgh, PA
Session:3144.0: Maternal/Child Health, 10:30 AM - 10:50 AM
This presentation will focus on local research focused on infant mortality via the Infant Mortality Collaborative and other collaborations in Allegheny County and new breastfeeding research via collaborations with the Pittsburgh Black Breastfeeding Circle. The research and findings generated serve to inform local practice and policy.
Learning Objectives:Describe the historical context of local disparities in maternal and infant/child health Identify research centered on the experiences of African American/Black women and children in Allegheny County Discuss how the research has informed practice and policy aimed at addressing racial equity in maternal and child health space in Allegheny Count
Author:Mara Hollander, Health Policy and Management, PhD, expected graduation 2020
Session:Poster, 10:30-11:30 a.m.
Title: Financial Relationships with Pharmaceutical Companies are Related to Increased Opioid Prescribing
Abstract:Self-report data suggests that physicians who have financial relationships with pharmaceutical companies are more likely to prescribe the drugs promoted within those relationships. Partially as a response to this, Congress passed the Sunshine Act, which requires the reporting of any gifts provided to clinicians from pharmaceutical companies and medical device manufacturers. Companies must also track which drugs are being discussed as part of that transaction. Recently, CMS Open Payments Data collected through the Sunshine Act has been used to demonstrate that these financial relationships can increase prescribing among oral anticoagulants and non-insulin diabetes drugs, but this has not yet been explored in opioid prescribing, which has been extremely high. In 2013, providers wrote enough opioid prescriptions for every American adult to have their own bottle of pills; by 2014, nearly two million Americans abused or were dependent on prescription opioids. In Pennsylvania, the CDC recently reported an increase in emergency department visits for opioid overdose of over 80%. There has been regional variation in opioid prescribing and that that hasn't been explained by population health status alone. This study explores a possible relationship between prescribing of opioids and financial contributions from pharmaceutical companies related to opioids. Medicare Part D claims from Pennsylvania clinicians were matched to 2014 Open Payments data. The final sample included approximately 12,500 PA providers who had at least 50 opioid prescriptions and 10 beneficiaries. The dependent variable was the proportion of a provider's Part D claims filled for opioids, broken into quartiles. A generalized ordinal logistic regression model was built to test the number of records of financial exchanges between pharmaceutical companies and clinicians related to opioids, the amount the physician was paid in relation to opioids, and an interaction term for each of those adjusting for whether the physician was a specialist or a generalist. The model controlled for each clinician's total number of Part D claims, total number of financial contributions, total payment amount, and average risk score of patients. Increased financial contributions associated with opioids were related to increased opioid prescribing, each additional record increased the likelihood of moving into the next quartile of opioid prescribing by 27%. The records effect was stronger among specialists than among primary care providers at higher levels of prescribing, essentially compounding the relationship as opioid prescribing increases. State regulatory agencies and health systems may consider limiting interaction between pharmaceutical companies and clinicians, particularly with regard to opioids. Limiting overprescribing of opioids may help slow the current opioid epidemic.
Author:Tiffany L. Gary-Webb, PhD, MHS
Session:3144.0: EPI - SPECIAL SESSION: Health Equity for African American Populations across the Lifespan: Research and Practice Activities at the Center for Health Equity, University of Pittsburgh Graduate School of Public Health, 10:30-noon
Title: 3144.0: Chronic Disease Prevention
Abstract:This presentation will focus on translation of the Diabetes Prevention Program (DPP) for African American populations. Several models with African American and other disadvantaged populations will be discussed along with future plans for models in the Pittsburgh, PA area.
Second Presenter:Elizabeth Felter, DrPH, MCHES
Third Author:Tiffany L. Gary-Webb, PhD, MHS
Session: 3255.0: Exploring Ways Food Pantries Help Combat Food Insecurity and Improve Food Systems
Session Scheduled: Monday, November 12, 2018: 1:00 p.m. - 2:30 p.m.
Title:Evaluating strategies to address prediabetes among food pantry clients: Lessons learned during Feeding America’s implementation of a national model pilot project in Oakland, CA
Abstract:The Feeding America network of 200 food banks and 60,000 meal programs reaches nearly every community in the United States, serving over 46 million Americans each year who experience, or who are at risk for, food insecurity. Food bank partnerships with healthcare organizations have evolved to promote the health of vulnerable populations disproportionately affected by nutrition sensitive chronic diseases like diabetes. Little is known about the potential effectiveness of food bank programs and partnerships for addressing chronic disease prevention. We will present our experiences to date in the planning and implementation of a diabetes prevention pilot project with a community food bank in Oakland, CA, and will focus on the “Reach” component of the RE-AIM framework. As of February 21, 2018, food bank project staff have screened 391 adults at community-based food distribution sites for prediabetes risk (approximately 66% met eligibility requirements), ultimately enrolling 199 adults with prediabetes into the project (77.1% enrolled/eligible rate). Participants are offered a year-long multipronged intervention that includes: bi-monthly food packages, text-based health education, referrals to healthcare, and referrals to formal diabetes prevention programming (DPP). We will share results from screening, baseline data on demographics (mean age 45, 66.8% of participants speak Spanish), food insecurity rates, and interest in DPP referrals, along with early six-month follow-up participant data. We will also share lessons learned around evaluation planning, data collection, developing partnerships with community based DPP providers, and implementation of health promotion and disease prevention programming within food banks for food insecure populations.
Authors: Aguiluz-Abunto M, Frank-Wilson A, Matthews C, Harris T, Chalhoub D.
Presentation Title: Percent body fat and mortality among adults with colorectal cancer in the NIH-AARP Diet and Health Study
Time and location: 1:00pm - 2:00pm Cancer Forum
Program: 3194.0 Cancer Forum
Type: Poster Session 7 - Health Behaviors and Psychosocial Factors in Oncology
Department: National Institutes of Health, National Institute on Aging, Laboratory of Epidemiology and Population Science
Job Title: Epidemiologist
Abstract:Objective Assess the relation between percent body fat and mortality among colorectal cancer (CRC) individuals.
Background To our knowledge, no study has examined the effect of body fat percentage on mortality rate among CRC cases in the NIH-AARP Diet and Health Study. We propose a retrospective cohort
study to determine the association between percent body fat and mortality rate in CRC
participants. We hypothesize CRC older adults with lower body fat percentage are at higher risk
of dying compared to CRC adults with higher body fat percentage.
Methods Population: Men and women, aged 50 to 82 years, diagnosed with CRC (n=2874) with
complete anthropometric measurements at follow-up.Cancer Ascertainment: Invasive CRC cases. If multiple cancers are diagnosed, the first malignancy is diagnosed during the follow-up period.
Mortality Assessment: Vital statistics. Primary Exposures: Risk prediction model using American Body Composition Calculator (ABCC) to measure body composition. Statistical Analysis: Kaplan-Meier survival curves, Log-Rank tests, Cox proportional hazards model, Hazard Ratios and 95% Confidence Intervals.
Results Participants with the lowest percent body fat were at a 36% higher risk of dying than those with
higher percent body fat. Older CRC women with the lowest percent body fat are at an 84% higher risk of dying compared to older CRC women with higher percent of body fat. Percent body fat is not a good predictor of mortality in older men with CRC.
Conclusion ABCC does not include equations to predict lean mass and fat mass unlike whole body DXA.
More studies are needed.
Author:Marcus A. Poindexter, LSW, HSV
Session:3197.0: 1-2 p.m.
Title: University, the Health Department, and the Community partnering to address Lead Exposure and Lead Awareness in Lincoln-Lemington
Abstract:In 2016, Allegheny Front highlighted Pittsburgh as a city with higher than normal concentrations of lead in its public drinking water. They attributed this to the city’s aging infrastructure, similar to other cities along the rustic belt. While water is not the primary source of lead exposure, this concern gained significant attention from local and governmental agencies and communities about the potential risk on disenfranchised individuals and families and on children 0-6 years, who are most vulnerable to the effects of lead. Methods: A partnership with West Virginia University, the Allegheny County Health Department, Youth Enrichment Services, and the Lincoln-Lemington Community Consensus Group was forged to examine pathways to (1) lessen children's exposure to lead; (2) improve the community's awareness of lead, (3) understand the community's sanitary practices, and (4) improve the community's access to free county resources. Results:
The partnering of the university, a governmental health agency, a community group, and the nonprofit sector is not an innovative practice. However, the collaboration of these institutions to address this systematic problem is, and has shown effectiveness in meeting the project's objectives. Partners observed an increased understanding of the community’s sanitary practices and a greater awareness of lead and lead exposure prevention. Preliminary data on lessening childhood
lead exposure and increased access to county resources suggests positive improvements. Conclusion: We found that the partnership between the university, the county's health department, YES, and the community was effective at producing a community action plan to lessen Lincoln-Lemington residents' lead exposure.
Author:Marcus A. Poindexter, LSW, HSV
Session:3199.0: 1-2 p.m.
Title: Fusing Geospatial (GIS) Education and Youth-Led Participatory Action Research: A case study of urban youth engagement in open source mapping to address lead exposure in Lincoln-Lemington
Abstract:A community-based participatory research (CBPR) approach increases the impact of projects undertaken to address exposure of harmful lead levels. Few existing CBPR studies, however, center youth directly at each stage of the process as peer educators and interventionists. Additionally, increased reliance on computerization often involves communities surrendering control of pivotal phases of the research process to technical experts. Purpose: This study evaluates the effectiveness of a CBPR project focused on lead poisoning prevention coordinated by Youth Enrichment Services (YES), a non-profit organization in Pittsburgh. Teenage youth from the focus neighborhood became the study’s architects, data gatherers, and analysts thereby centering their critical perspectives in an adult-centric research regime. Methods: The researchers employed a peer-teaching model in mentoring a subset of the participants to use open-source digital mapping tools. These were used to analyze findings related to the communication patterns and built environment conditions present in the neighborhood as they relate to toxic lead exposure. The students’ final products were evaluated using a four-axis scoring rubric and post-program interviews. Results: The spatial analyzer group digitized research zone maps, created a choropleth map of home age/condition, and produced a heat map of social gathering hotspots. Students who entered the program with limited exposure to data systems achieved proficiency in both the academic and technical skills to generate and share meaningful findings related to lead exposure. Conclusion: Integrating technical skills education with youth-driven CBPR adds the critical dimension of youth experience into the research process that enables community ownership of study data.
Author:Yuae Park, MA BCHS 2020, Jennifer King, BA, Thistle Elias, DrPH, MPA
Session:Oral presentation, 2p.m., 3281.0: Promoting the Health of Women and Families to Create the Healthiest Nation (organized jointly with the Women's Caucus)
Program:Public Health Education and Health Promotion
Title: Learning what works: Listening to WISEWOMAN participants
Abstract: Twenty-eight Pennsylvania WISEWOMAN (WW) clients participated in phone interviews about their experiences over 2016 and 2017. WW provides low income, uninsured and under-insured women aged 40-65 with free health screening and free access to community-based lifestyle programs (LSPs) in order to reduce cardiovascular disease. Interviews were conducted by the University of Pittsburgh; Evaluation Institute for Public Health in order to explore participants’ experiences with the WW Program in general, and with LSPs promoted through WW specifically. Participants indicated a wide range of invaluable supports, including access to LSPs which they had not been able to afford before, and information gained through their participation in WW to promote behavior change. In particular, participants indicated the importance of having tailored information, individualized attention and social support through twice-monthly health coaching and in the clinic settings. Participants also identified key social supports they found through group participation in some LSP options, helping to maintain their motivation in a community setting. Participants cited the welcoming climate of WW clinics, staff time and attention, and the non-judgmental approach of clinic staff and health coaches in helping them change their health behaviors. Staff shared health information and resources, supported participants through making health changes in diet and exercise and quitting smoking. Researchers coded participant interviews, identified emerging themes and share representative quotes throughout this presentation to illustrate participant perspectives and lessons learned.
Author: Jeanette Trauth, PhD. Associate Professor, Behavioral & Community Health Sciences, GSPH Session: Poster presentation, 03:00 PM - 04:00 PM.
3316.0 A review of the use of position generator instruments to collect information on individual social capital in health surveillance surveys
Abstract:Beneficial social connections are fundamental social determinants of individual-level health given their potential to provide critical resources like financial capital, knowledge, and social/emotional supports in times of stress. Prior literature exploring how social networks shape individual health have focused on qualities like network size, largely ignoring the role of compositional quality, which quantifies within-group members who possess health-promotive qualities such as intelligence, wealth, and power. Position generators are survey instruments that capture the compositional quality of individuals’ social networks and have been employed to better understand individual social capital (ISC) in business and economic-related disciplines. We conducted a comprehensive literature review to identify domestic and international health studies that used position generators to assess ISC on health, specifically addressing how network compositional quality shapes health outcomes (behaviors, disease outcomes, quality of life) and disparities. Our literature search yielded 24 articles conducted across 14 predominantly high-income countries. Twenty-two articles found health-promotive effects of ISC on health outcomes. Furthermore, eight articles accounted for differences by advantaged statuses (e.g., income/education level, gender), indicating that ISC elicited greater health-protective effects for those from disadvantaged backgrounds. Our review provided robust evidence of ISC as a health-promotive factor and elucidated the importance of diversity as a critical facet of this relationship. Prior research has demonstrated the feasibility of including position generators in national surveys, warranting our recommendation for its employment in US national health surveillance. Position generators may inform interventions that seek to reduce health disparities by enhancing ISC in individuals from disadvantaged backgrounds.
Author:Emmett Henderson, PhD BCHS 2021
Session:Poster presentation, 3:00 p.m.-4:00 p.m.
Program:A Comparison of Health-Related Quality of Life Among Transgender Individuals: Behavioral Risk Factor Surveillance System, 2014-2016
Abstract:Background: Most studies have relied on convenience samples to study transgender individuals, or have combined transgender men and women into a single group for analysis. We use a nationally-representative, probability-based sample to assess differences in sociodemographic characteristics and health-related quality of life (HRQoL) among transgender men, transgender women, and gender nonconforming individuals. methods: Data from the 2014-2016 Behavioral Risk Factor Surveillance System (BFRSS) were analyzed on 2,229 respondents age > 18 years. Weighted multivariable logistic regression analyses compared differences in HRQoL among transgender individuals controlling for sociodemographic and health-related characteristics. Lastly, separate weighted multivariable logistic regression analyses compared predictors of HRQoL by gender identity. results: Compared to transgender women, transgender men were more likely to report frequent mental distress (aOR: 1.99, 95% CI: 1.19-3.33). There were no significant differences in odds of frequent physical distress. In transgender women, being younger, unemployed, reporting a financial barrier to healthcare, tobacco use, and alcohol use were significantly associated with frequent mental distress. In transgender men, being a race other than white, being unemployed, reporting a financial barrier to healthcare, and having an annual household income $25,000-$49,999 were significantly associated with frequent mental distress. In gender nonconforming individuals, being younger, unemployed, having health insurance, reporting a financial barrier to healthcare, and being obese were significantly associated with frequent mental distress. conclusion: Transgender individuals differed significantly in risk factors for poor mental and physical health. These groups should continue to be studied separately and interventions should be targeted towards the unique needs of each subgroup.
Author: Jordan Sang, MPH
Session: 3370.0: HIV Biomedical Prevention in the United States Roundtable
Title: 3370.0 Assessing HIV stigma among Black Men who have Sex with Men in the United States—Strategies for Prevention.Jordan Sang, MPH1, Derrick Matthews, PhD, MPH1, Steven Meanley, MPH, PhD2, Lisa Eaton, PhD3 and Ron Stall, PhD4, (1)University of Pittsburgh, Pittsburgh, PA, (2)University of Pennsylvania School of Nursing, Philadelphia, PA, (3)University of Connecticut, Storrs, CT, (4)University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
Tuesday, November 13
Session: 4082.0: Neighborhood-level housing characteristics and birth weight in Pittsburgh, PA, 2009-2013
09:00 AM - 10:00 AM
The objective of this analysis was to assess the association between neighborhood-level variables of housing and risk of low birth weight. We analyzed data on all singleton births in the city of Pittsburgh, PA from 2009-2013, inclusive (N = 17,176), in relation to neighborhood-level data from the 2010 Census. We treated the outcome, low birth weight, as both a categorical (<2,500 vs ≥2,500 grams) and a continuous variable. Individual level demographic factors (e.g. maternal and paternal race/ethnicity, maternal education level, prenatal care, and gestational age at delivery) were included as covariates in the analyses, which included linear mixed (continuous outcome) and logistic regression mixed (binary outcome) models. Our findings regarding individual-level factors are in accordance with the literature on birth weight; we observed significantly lower birth weights for infants born to mothers who were African-American (OR [95% CI] for low birth weight as compared to white mothers: 1.36 [1.16, 1.59]), of lower SES, and who received little or no prenatal care. Adjusting for these individual-level factors, we also identified several neighborhood-level factors related to housing that were significantly associated with birth weight or odds of low birth weight including percentage of homes owner-occupied (OR [95% CI] 0.15 [0.04, 0.51]), and percentage of homes built 1960-1979 (OR [95% CI]: 10.07 [1.16, 87]) and 1990-1999 (β [SE]: -328.58 [100.88]). Taken together, these results support the development of neighborhood-level housing characteristics as exposures relevant to pregnancy and birth outcomes. The results may also be interpreted as an evaluation of Pittsburgh housing policy.
Author:Thistle Elias, DrPH, MPA, Yuae Park, MA, Jennifer King, BA
Session:Poster presentation, 9-10 am, 4088.0: Understanding Barriers to Lifestyle Change in Women Participating in the Pennsylvania WISEWOMAN Program
Title: Understanding Barriers to Lifestyle Change in Women Participating in the Pennsylvania WISEWOMAN Program
Abstract:Nine Pennsylvania WISEWOMAN (WW) clients participated in phone interviews in August of 2017. Interviews were conducted by the University of Pittsburgh, Evaluation Institute for Public Health. Interviews explored the clients’ experiences with the WW Lifestyle Programs (LSPs) offered through the WW Program. Qualitative data were coded and analyzed by a research team at the Evaluation Institute. WISEWOMAN clients perceived as many as seven barriers to participating in LSPs. Overall, clients reported lack of time, transportation, and motivation as a barrier to participation. Body image, anxiety, and health issues were also reported. Clients stated the WW Program removed financial barriers related to lifestyle change. Interventions addressing risk factors for cardiovascular disease (CVD) can greatly reduce the burden of CVD in the United States. WISEWOMAN supports this by providing risk factor screenings and services to promote heart heath. Nearly half of Americans have one or more preventable, chronic disease, related to poor diet and physical inactivity. Evidence from phone interviews indicate some of the challenges women encounter when trying to improve their lifestyle. Interviewees suggest that social support is necessary. Helpful program support may be conducted individually or through a group program. Clients report the program removes the financial barrier making lifestyle modifications accessible. Patient interviews provide insight to barriers that prohibit positive lifestyle change. Interventions aimed at increasing physical activity and improving diet are much needed. Efforts to educate clients on diet and physical activity continue to play an essential role but can be strongly reinforced by advocacy and policy change.
Author:Marcus A. Poindexter, LSW, HSV
Session:4144.0: 11:30-11:50 a.m.
Title:Moving Youth-Involved Partnerships Forward in Addressing Community Health: Lessons Learned in a Community-Based Participatory Lead Research Project
Abstract:Environmentally focused health prevention programs have been identified as a highly effective strategy to engage youth in research. However, these programs rarely seek youth, staff, and community stakeholders’ feedback on lessons learned from program implementation. We report on these perspectives of a pilot lead prevention program involving low-income youth from Youth Enrichment Services (YES), a non-profit organization in Pittsburgh, Pennsylvania.Methods: Students and staffs’ perspectives were collected in three concentrated areas: training, data collection, and
dissemination. We reviewed stakeholder meeting notes and reflection reports, participatory research products, student reflections, and semi-structured interviews with project participants and instructors. Their notes were analyzed using NVivo to identify specific themes. Results: Overall, we found that students benefited from their engagement both as stakeholders and interventionists. We also found that youth participants felt overwhelmed by project goals and task responsibilities. Similar findings were observed in staff and community stakeholders. Staff reported that while the program goals were achievable, time, both with the students and the community became critically impacted. The community voiced issue with ownership of materials, including collected data. Conclusions: Youth have viability, share the interests of the targeted community, and are valuable mediators. By training youth in data collection analysis and allowing them to interpret this information in culturally and age-relevant ways, YES students worked to bridge the gap between the health department and the community, despite structural challenges. These outcomes demonstrate that youth-driven, community-based research approaches are effective mechanisms to address community health concerns.
Author:Emmett Henderson, PhD BCHS 2021
Session:Poster presentation, 3:00 p.m.-4:00 p.m.
Program:Rural-urban differences in HIV testing among US adults: Findings from the Behavioral Risk Factor Surveillance System
Abstract:Background: Individuals in rural areas face barriers to HIV-related healthcare. We aim to assess differences in frequency of lifetime and past-year HIV testing between rural and urban residents of the United States. Additionally, this paper aims to assess differences in HIV testing site location between rural and urban residents of the United States. methods: Data from the Behavioral Risk Factor Surveillance System (BRFSS) 2015 were analyzed on 441,456 respondents age >18 years. Weighted multinomial logistic regression analyses compared urban/rural differences in lifetime and past-year HIV testing. Weighted multinomial logistic regression compared urban/rural differences in HIV testing site. All analyses controlled for sex, age, race and ethnicity, marital status, education, income, census region, health insurance, and sexual or gender minority status. results: Overall, 26.9% and 24.5% of urban residents received lifetime and past-year HIV testing, respectively, compared to only 21.5% and 20.2% of rural residents. Compared to urban residents, rural residents were less likely to receive lifetime (aOR: 0.84, 95% CI: 0.77-0.91) and past-year (aOR: 0.81, 95% CI: 0.67-0.99) HIV testing. Rural residents were more likely to receive an HIV test at the hospital or emergency room (aOR: 1.24, 95% CI: 1.01-1.53) than at a doctor’s office. conclusion: This study highlights significant rural health disparities in rates of lifetime and past-year HIV testing. Targeted interventions are needed to address the unique needs of rural communities including wider use of rapid oral testing, and reduction of stigma and other barriers to care.
Author:Rosemary Hanrahan, MD,MPH, ACC
Pathologist, Weirton Medical Center
Owner and Founder, Beyond Words Wellness Resources LLC
Session: 5092.0 Social Determinants of Women's Health, 10:30 p.m.
Oral Presentation: Scientific presentation
Title: Life coaching as part of a multipronged approach to
improving social determinants of health for women in Haiti
Abstract:Programs targeting poverty alleviation among women in developing countries often employ microcredit as a tool for addressing social determinants of health with variable success. Few studies have explored the role of life coaching and mostly focus on health. Broader perspective coaching has the potential to impact on the social determinants of health such as social and economic environment, and individual characteristics and behaviors.
Utilizing microfinance and life coaching, a three-phase 18-month pilot program was designed to assist women in developing the skills and confidence necessary to secure a livelihood and sense of well-being. Ten women from an impoverished community in Port au Prince, Haiti were enrolled from August 2016 to January 2018.
Participants were granted an asset, received a small cash stipend and three microloans. Throughout all phases, women participated in workshops on life and business skills development. Supported by a professional coach from the US, a Haitian-American woman in Haiti served as coach.
Coaching tools were culturally adapted for Haiti and literacy level. Topics included: life balance, strengths, values, visioning, support, accountability and mindfulness.
At the end of each phase, objective program data was collected and women completed a questionnaire.
Nine of ten women successfully completed the 18-month program and:
- Participated in group meetings and coaching sessions
- Regularly contributed to a savings account
- Managed a net income-generating microenterprise
- Repaid all 3 microloans
- Noted subjective improvement in self-confidence, hope for the future and sense of well-being.
Coaching revealed cardiovascular disease as a common concern leading to a targeted health program intervention.
Although a small pilot program, coaching was positively received by participants. Despite a major hurricane and political unrest, the 90% success rate is higher than anticipated for this population. Potential future interventions include training community health workers in coaching and in-depth coaching around perspective taking, accountability, and empowerment dynamics.