1
|
Lebron CN, Pérez-Ramos J, Cardona-Cordero N, Morales V, Rivera-Joseph S. Social Justice Is Overdue for Puerto Rican Mothers. Am J Public Health 2024; 114:S450-S452. [PMID: 39083741 PMCID: PMC11292277 DOI: 10.2105/ajph.2024.307702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Cynthia N Lebron
- Cynthia N. Lebron is with the School of Nursing and Health Studies, University of Miami, Coral Gables, FL. José Pérez-Ramos is with the School of Medicine and Dentistry, University of Rochester, Rochester, NY. Nancy Cardona-Cordero is with the Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan. Samantha Rivera-Joseph is with the Office of Children and Families, City of Philadelphia, Philadelphia, PA. Vanessa Morales is with the Miller School of Medicine Department of Public Health Sciences, University of Miami. Cynthia N. Lebron is also a guest editor for this supplemental issue
| | - José Pérez-Ramos
- Cynthia N. Lebron is with the School of Nursing and Health Studies, University of Miami, Coral Gables, FL. José Pérez-Ramos is with the School of Medicine and Dentistry, University of Rochester, Rochester, NY. Nancy Cardona-Cordero is with the Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan. Samantha Rivera-Joseph is with the Office of Children and Families, City of Philadelphia, Philadelphia, PA. Vanessa Morales is with the Miller School of Medicine Department of Public Health Sciences, University of Miami. Cynthia N. Lebron is also a guest editor for this supplemental issue
| | - Nancy Cardona-Cordero
- Cynthia N. Lebron is with the School of Nursing and Health Studies, University of Miami, Coral Gables, FL. José Pérez-Ramos is with the School of Medicine and Dentistry, University of Rochester, Rochester, NY. Nancy Cardona-Cordero is with the Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan. Samantha Rivera-Joseph is with the Office of Children and Families, City of Philadelphia, Philadelphia, PA. Vanessa Morales is with the Miller School of Medicine Department of Public Health Sciences, University of Miami. Cynthia N. Lebron is also a guest editor for this supplemental issue
| | - Vanessa Morales
- Cynthia N. Lebron is with the School of Nursing and Health Studies, University of Miami, Coral Gables, FL. José Pérez-Ramos is with the School of Medicine and Dentistry, University of Rochester, Rochester, NY. Nancy Cardona-Cordero is with the Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan. Samantha Rivera-Joseph is with the Office of Children and Families, City of Philadelphia, Philadelphia, PA. Vanessa Morales is with the Miller School of Medicine Department of Public Health Sciences, University of Miami. Cynthia N. Lebron is also a guest editor for this supplemental issue
| | - Samantha Rivera-Joseph
- Cynthia N. Lebron is with the School of Nursing and Health Studies, University of Miami, Coral Gables, FL. José Pérez-Ramos is with the School of Medicine and Dentistry, University of Rochester, Rochester, NY. Nancy Cardona-Cordero is with the Division of Cancer Control and Population Sciences, University of Puerto Rico, San Juan. Samantha Rivera-Joseph is with the Office of Children and Families, City of Philadelphia, Philadelphia, PA. Vanessa Morales is with the Miller School of Medicine Department of Public Health Sciences, University of Miami. Cynthia N. Lebron is also a guest editor for this supplemental issue
| |
Collapse
|
2
|
Petra PC, Marbán-Castro E, Matta G, Sánchez CMH, Pimentel C, Gama GL, Melo A, Daza M, Amado AM, Montoya MCM, Maxwell L, Pérez EA, Mercado M, Paiva E. Pregnant women's perceptions on Information Sources on Zika Virus: a qualitative study. PHYSIS (RIO DE JANEIRO, BRAZIL) 2024; 34:e34SP112. [PMID: 38966594 PMCID: PMC11221405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
The Zika virus (ZIKV) epidemic had a sanitary, psychosocial, and economic impact on individuals of reproductive age. The primary concern revolved around infection during pregnancy due to possible vertical transmission and its association with adverse fetal and infant outcomes, known as Congenital Zika Syndrome (CZS). This qualitative study employs phenomenology and grounded theory. This study includes interviews with 98 women, some pregnant during the ZIKV epidemic in Brazil, Colombia, and Puerto Rico, who had children with CZS or without diagnosed neurological impairment. Additionally, the study included a group of women who were pregnant during the COVID-19 pandemic in these same countries. In both groups, interviewees had varying levels of knowledge about ZIKV. The study found that messages conveyed through the media tended to be alarmist, in contrast to the information provided by healthcare professionals, which was considered more trustworthy. Pregnant women during the ZIKV epidemic reported receiving their ZIKV and CSZ infection diagnoses late, either during or after childbirth. The study underscores the needs of pregnant women in high-risk scenarios, the importance of health education processes, and the necessity to reinforce communication and continuing education.
Collapse
Affiliation(s)
| | | | - Gustavo Matta
- Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro-RJ, Brazil
| | | | | | - Gabriela Lopes Gama
- Instituto de Pesquisa Professor Joaquim Amorim Neto. Campina Grande-PB, Brazil
| | - Adriana Melo
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | | | | | | | - Lauren Maxwell
- Heidelberg Institute for Global Health, Heidelberg University, Heidelberg Germany
| | - Edna Acosta Pérez
- University of Puerto Rico, Medical Sciences Campus, / University Albizu, San Juan, Puerto Rico
| | | | - Ester Paiva
- Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro-RJ, Brazil
| |
Collapse
|
3
|
Henry Akintobi T, Quarells RC, Bednarczyk RA, Khizer S, Taylor BD, Nwagwu MNA, Hill M, Ordóñez CE, Sabben G, Spivey S, Davis K, Best ML, Chen AZ, Lovell K, Craig LS, Mubasher M. Community-Centered Assessment to Inform Pandemic Response in Georgia (US). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095741. [PMID: 37174257 PMCID: PMC10178178 DOI: 10.3390/ijerph20095741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/08/2023] [Accepted: 03/24/2023] [Indexed: 05/15/2023]
Abstract
The Georgia Community Engagement Alliance (CEAL) Against COVID-19 Disparities Project conducts community-engaged research and outreach to address misinformation and mistrust, to promote inclusion of diverse racial and ethnic populations in clinical trials and increase testing and vaccination uptake. Guided by its Community Coalition Board, The GEORGIA CEAL Survey was administered among Black and Latinx Georgia 18 years and older to learn about community knowledge, perceptions, understandings, and behaviors regarding COVID-19 testing and vaccines. Survey dissemination occurred using survey links generated through Qualtrics and disseminated among board members and other statewide networks. Characteristics of focus counties were (a) highest proportion of 18 years and older Black and Latinx residents; (b) lowest COVID-19 testing rates; and (c) highest SVI values. The final sample included 2082 surveyed respondents. The majority of participants were men (57.1%) and Latinx (62.8%). Approximately half of the sample was aged 18-30 (49.2%); the mean age of the sample was 33.2 years (SD = 9.0), ranging from 18 to 82 years of age. Trusted sources of COVID-19 information that significantly predicted the likelihood of vaccination included their doctor/health care provider (p-value: 0.0054), a clinic (p-value: 0.006), and university hospitals (p-value: 0.0024). Latinx/non-Latinx, Blacks vs. Latinx, Whites were significantly less likely to get tested and/or vaccinated. Non-Latinx, Blacks had higher mean knowledge scores than Latinx, Whites (12.1 vs. 10.9, p < 0.001) and Latinx, Blacks (12.1 vs. 9.6, respectively, p < 0.001). The mean knowledge score was significantly lower in men compared to women (10.3 vs. 11.0, p = 0.001), in those who had been previously tested for COVID-19 compared to those who had never been tested (10.5 vs. 11.5, respectively, p = 0.005), and in those who did not receive any dose of vaccination compared to those who were fully vaccinated (10.0 vs. 11.0, respectively, p < 0.001). These data provide a benchmark for future comparisons of the trajectory of public attitudes and practices related to the COVID-19 pandemic. They also point to the importance of tailoring communication strategies to specific cultural, racial, and ethnic groups to ensure that community-specific barriers to and determinants of health-seeking behaviors are appropriately addressed.
Collapse
Affiliation(s)
- Tabia Henry Akintobi
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | - Rakale C Quarells
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | | | - Saadia Khizer
- Vaccination Trial Unit, Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | - Brittany D Taylor
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | - Michelle N A Nwagwu
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | - Mekhi Hill
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| | - Claudia E Ordóñez
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Gaëlle Sabben
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | | | - Kayla Davis
- DeKalb County Board of Health, Decatur, GA 30031, USA
| | - Michael L Best
- Sam Nunn School of International Affairs and the School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA 30308, USA
| | - Amy Z Chen
- Sam Nunn School of International Affairs and the School of Interactive Computing, Georgia Institute of Technology, Atlanta, GA 30308, USA
| | | | | | - Mohamed Mubasher
- Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, GA 30301, USA
| |
Collapse
|
4
|
Previdi IL, Vélez Vega CM, Guzzi Vasques AC, Repollet EF, Torres Zayas HR, Alshawabkeh A, Cordero JF. Lessons Learned: Community Engagement in Emergencies in Puerto Rico. Disaster Med Public Health Prep 2023; 17:e367. [PMID: 36970863 PMCID: PMC10184461 DOI: 10.1017/dmp.2022.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To describe the importance of community engagement from research projects and research centers in times of disasters or emergencies, using the case of Puerto Rico in recent years (2017 - 2022) as an example. METHODS First, research participants and stakeholders from local community and health organizations were contacted via email and phone calls after each emergency to assess their immediate needs. Second, needs were classified in categories (materials, educational resources, service referrals, and collaborations). Finally, delivery of support was coordinated in a timely manner whether in person or online. RESULTS Activities were conducted such as handing out materials, providing educational resources, contacting participants, and stakeholders, as well as coordinating collaboration with community and organizations. CONCLUSION Several lessons were learned from our experiences related to Puerto Rico's recent emergencies as well as some relevant recommendations for future disasters. The efforts presented illustrate the importance of community engagement from academic institutions in disasters. Research centers and research projects, particularly those with community engagement components, should consider providing support in the preparedness phase as well as the recovery phase if necessary. Community engagement in emergencies is crucial to recovery efforts as well as fostering empowerment and making an impact on individual and societal levels.
Collapse
Affiliation(s)
- Irene Lafarga Previdi
- Center for Collaborative Research in Health Disparities, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Carmen M. Vélez Vega
- Center for Collaborative Research in Health Disparities, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Ana C. Guzzi Vasques
- Center for Collaborative Research in Health Disparities, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | - Emma Fernández Repollet
- Center for Collaborative Research in Health Disparities, University of Puerto Rico-Medical Sciences Campus, San Juan, Puerto Rico
| | | | | | - José F. Cordero
- College of Public Health, Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| |
Collapse
|
5
|
Evans MV, Bhatnagar S, Drake JM, Murdock CC, Rice JL, Mukherjee S. The mismatch of narratives and local ecologies in the everyday governance of water access and mosquito control in an urbanizing community. Health Place 2023; 80:102989. [PMID: 36804681 DOI: 10.1016/j.healthplace.2023.102989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 02/18/2023]
Abstract
Mosquito-borne disease presents a significant threat to urban populations, but risk can be uneven across a city due to underlying environmental patterns. Urban residents rely on social and economic processes to control the environment and mediate disease risk, a phenomenon known as everyday governance. We studied how households employed everyday governance of urban infrastructure relevant to mosquito-borne disease in Bengaluru, India to examine if and how inequalities in everyday governance manifest in differences in mosquito control. We found that governance mechanisms differed for water access and mosquitoes. Economic and social capital served different roles for each, influenced by global narratives of water and vector control.
Collapse
Affiliation(s)
- M V Evans
- MIVEGEC, Univ. Montpellier, CNRS, IRD, Montpellier, France; Odum School of Ecology, University of Georgia, Athens, GA, USA; Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA.
| | - S Bhatnagar
- Observatoire de Genève, Université de Genève, Sauverny, Switzerland; School of Arts and Sciences, Azim Premji University, Bengaluru, Karnataka, India
| | - J M Drake
- Odum School of Ecology, University of Georgia, Athens, GA, USA; Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA
| | - C C Murdock
- Odum School of Ecology, University of Georgia, Athens, GA, USA; Center for Ecology of Infectious Diseases, University of Georgia, Athens, GA, USA; Department of Entomology, College of Agriculture and Life Sciences, Cornell University, Ithaca, NY, USA; Cornell Institute of Host-Microbe Interactions and Disease, Cornell University, Ithaca, NY, USA; Northeast Regional Center for Excellence in Vector-borne Diseases, Cornell University, Ithaca, NY, USA
| | - J L Rice
- Department of Geography, University of Georgia, Athens, GA, USA
| | - S Mukherjee
- School of Arts and Sciences, Azim Premji University, Bengaluru, Karnataka, India; Biological and Life Sciences Division, School of Arts and Sciences, Ahmedabad University, Ahmedabad, Gujarat, India
| |
Collapse
|
6
|
Levis M, Ugarte R, Arana M, Ocasio C, Viera T, Ortiz S, Murrman M. Advancing Leadership Training to Address Health Equity and Respond to Public Health Emergencies. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:S254-S262. [PMID: 35867496 DOI: 10.1097/phh.0000000000001521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
CONTEXT In 2015, Impactivo developed the Advancing Leadership in Times of Crisis (ALTC) program for the Region 2 Public Health Training Center under a subaward from the Health Resources and Services Administration. Puerto Rico's (PR) government had defaulted on its debt, and public health officials needed tools to face the fiscal crisis. The ALTC has since been adapted for PR's public health emergencies, including the Zika epidemic, category 5 hurricanes, earthquakes, and the Covid-19 pandemic. PROGRAM The program incorporates Ron Heifetz's work on Adaptive Leadership and Marshall Ganz's work on community organizing to address the Centers for Disease Control and Prevention's Essential Public Health Services (EPHS) and health equity. The ALTC is a contextualized and modularized training program that has been provided in different modalities in person and online. IMPLEMENTATION The Spanish language program has been carried out with 4 cohorts (totaling 82 graduates). Participants were 80% women and 100% Hispanic, empowering underrepresented groups to achieve change. EVALUATION In the immediate postprogram survey, more than 90% strongly agree that their understanding of the subject matter improved, that they were able to identify actions that apply to their work, and that they were confident in their ability to apply it. Follow-up surveys after the COVID-19 pandemic found that 89% of respondents continue to work in public health, 25% were promoted, and 49% felt confident to train others. Participants also reported that ALTC helped them increase their public health tools (91%), expand their network (84%), and strengthen knowledge about the EPHS (90%). DISCUSSION Evidence supports that ALTC is a promising training program to increase leadership skills and EPHS competencies that can be adapted to address contextual health equity and public health emergencies. Future research should explore the expansion of ALTC to other contexts and its impact on population health and health equity.
Collapse
Affiliation(s)
- Maria Levis
- Impactivo, LLC, San Juan, Puerto Rico (Mss Levis, Ugarte, Ocasio, and Ortiz and Mr Viera); and Region 2 Public Health Training Center, Columbia University Mailman School of Public Health, New York, New York (Mss Levis, Ugarte, and Arana and Dr Murrman)
| | | | | | | | | | | | | |
Collapse
|
7
|
Abadie R, McLean K, Habecker P, Dombrowski K. Treatment trajectories and barriers in opioid agonist therapy for people who inject drugs in rural Puerto Rico. J Subst Abuse Treat 2021; 127:108347. [PMID: 34134865 DOI: 10.1016/j.jsat.2021.108347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/18/2021] [Accepted: 02/15/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Research has shown medication for opioid use disorder (MOUD) to have positive effects, including reducing HIV and HCV transmission, but important barriers to access remain among people who inject drugs (PWID). Barriers include lack of social and familial support, bureaucracy, distance to treatment, poverty, and homelessness. However, we know little about how these barriers interact with each other to shape PWID's drug treatment access and retention. METHODS We used qualitative methods with a dataset from a study conducted during 2019 with 31 active PWID residing in rural Puerto Rico. The study gathered ethnographic data and narratives about treatment trajectories to document the lived experiences of PWID as they moved in and out of treatment. RESULTS Participants were at least 18 years old; 87.7% were male, the mean age was 44.1 years, and the mean age at first injection was 22 years. Participants identified homelessness, lack of proper ID or other identifying documents, and previous negative experiences with MOUD as the main barriers to treatment entry and retention. In addition, PWID's belief that MOUD simply substitutes an illegal drug for a legal one, while furthering drug dependence by chronically subjecting patients to treatment, constitutes an additional barrier to entry. Findings from this study demonstrate that MOUD barriers to access and retention compound and are severely affected by poverty and other forms of vulnerability among PWID in rural Puerto Rico. CONCLUSION Policies to increase access and retention should consider barriers not in isolation but as an assemblage of many factors.
Collapse
Affiliation(s)
- Roberto Abadie
- Department of Anthropology, University of Nebraska-Lincoln, 839 Old Father Hall, Lincoln, NE 68588, United States of America.
| | - Katherine McLean
- Department of Administration of Justice, Penn State Greater Allegheny, 400 University Drive, McKeesport, PA 15216, United States of America
| | - Patrick Habecker
- Department of Sociology, University of Nebraska-Lincoln, 430 Old Father Hall, Lincoln, NE 68588, United States of America
| | - Kirk Dombrowski
- Department of Anthropology, University of Vermont, 72 University Place, VT 05405, United States of America
| |
Collapse
|
8
|
Xu P, Gao J, Shan C, Dunn TJ, Xie X, Xia H, Zou J, Thames BH, Sajja A, Yu Y, Freiberg AN, Vasilakis N, Shi PY, Weaver SC, Wu P. Inhibition of innate immune response ameliorates Zika virus-induced neurogenesis deficit in human neural stem cells. PLoS Negl Trop Dis 2021; 15:e0009183. [PMID: 33657175 PMCID: PMC7959377 DOI: 10.1371/journal.pntd.0009183] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 03/15/2021] [Accepted: 01/26/2021] [Indexed: 12/30/2022] Open
Abstract
Global Zika virus (ZIKV) outbreaks and their strong link to microcephaly have raised major public health concerns. ZIKV has been reported to affect the innate immune responses in neural stem/progenitor cells (NS/PCs). However, it is unclear how these immune factors affect neurogenesis. In this study, we used Asian-American lineage ZIKV strain PRVABC59 to infect primary human NS/PCs originally derived from fetal brains. We found that ZIKV overactivated key molecules in the innate immune pathways to impair neurogenesis in a cell stage-dependent manner. Inhibiting the overactivated innate immune responses ameliorated ZIKV-induced neurogenesis reduction. This study thus suggests that orchestrating the host innate immune responses in NS/PCs after ZIKV infection could be promising therapeutic approach to attenuate ZIKV-associated neuropathology.
Collapse
Affiliation(s)
- Pei Xu
- Department of Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Junling Gao
- Department of Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Chao Shan
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Tiffany J. Dunn
- Department of Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Xuping Xie
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Hongjie Xia
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Jing Zou
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Beatriz H. Thames
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Amulya Sajja
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Yongjia Yu
- Department of Radiology and Oncology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Alexander N. Freiberg
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Nikos Vasilakis
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, Texas, United States of America
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Pei-Yong Shi
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Scott C. Weaver
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America
- Center for Biodefense and Emerging Infectious Diseases, University of Texas Medical Branch, Galveston, Texas, United States of America
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Ping Wu
- Department of Neuroscience, Cell Biology and Anatomy, University of Texas Medical Branch, Galveston, Texas, United States of America
| |
Collapse
|
9
|
Health Disparities Research Framework Adaptation to Reflect Puerto Rico's Socio-Cultural Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228544. [PMID: 33217956 PMCID: PMC7698747 DOI: 10.3390/ijerph17228544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 11/16/2022]
Abstract
In this article we aim to briefly describe how Puerto Rico’s living conditions influence adverse health outcomes at an individual, community and population level using the National Institute of Minority Health and Health Disparities (NIMHD) Research Framework that considers multiple factors and their intersecting influence. People living in Puerto Rico face significant levels of poverty, a deficient infrastructure, a fragile healthcare system and the continuing dismantling of the public education system as well as hazardous environmental exposures. The treatment of Puerto Ricans as second-class citizens due to the federal policies of the U.S. government and also the mismanagement of funds from local authorities impacts the prevalence of chronic health conditions and vulnerability to disasters such as hurricanes, earthquakes and pandemics. Puerto Rico’s health disparities are rooted in historical, cultural, political and economic factors that have an impact on biology, interpersonal and environmental aspects. In order to significantly reduce health disparities, systemic change is needed at a local, national and federal level. Interventions must consider how social determinants impact the quality of life and seek to impact the intersections of different contexts that have an effect at an individual, interpersonal, communal and societal level. This can be achieved through evidence-based, culturally appropriate and community based as well as translational research approaches that seek to impact behavior and social economic factors.
Collapse
|
10
|
Immune Response Persistence and Safety of a Booster Dose of the Tetravalent Dengue Vaccine in Adolescents and Adults Who Previously Completed the 3-dose Schedule 4-5 Years Earlier in Latin America: A Randomized Placebo-controlled Trial. Pediatr Infect Dis J 2020; 39:961-968. [PMID: 32932330 DOI: 10.1097/inf.0000000000002830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND We previously described an increased immune response 28 days after a booster dose of the live, attenuated, tetravalent dengue vaccine (CYD-TDV) in healthy adolescents and adults in Latin America (CYD64, NCT02623725). This follow-up study evaluated immune response persistence and safety of a CYD-TDV booster dose up to Month (M) 24 post-booster. METHODS This study included 250 participants who previously received 3 primary doses of CYD-TDV in the CYD13 (NCT00993447) and CYD30 (NCT01187433) studies, and who were randomized 4-5 years later to receive a CYD-TDV booster or placebo (3:1). Dengue neutralizing antibodies against the parental dengue virus strains were assessed using the plaque reduction neutralization test (PRNT50) at M6, M12, and M24 post-booster. Post-booster memory B-cell responses were assessed in a subset of participants using the FluoroSpot assay up to M12 post-booster. RESULTS In the CYD-TDV group (n = 187), dengue neutralizing antibody geometric mean titers (GMTs) declined from the peak at day 28 through to M24 for all serotypes. GMTs at M24 were similar to those at pre-booster among baseline dengue seropositives. A similar trend was observed for baseline dengue seronegatives, albeit at a lower magnitude. Previous vaccination-induced detectable B-cell memory responses in seropositives and seronegatives that decreased to pre-booster levels at M12 post-booster. The CYD-TDV booster dose was well-tolerated. CONCLUSIONS In baseline dengue seropositives, following a CYD-TDV booster dose administered 4-5 years after primary immunization, dengue neutralizing antibody GMTs and B-cell memory responses peaked in the short-term before gradually decreasing over time. A CYD-TDV booster dose could improve protection against dengue during outbreak periods.
Collapse
|
11
|
Horan H, Cheyney M, Nako E, Bovbjerg M. Maternal stress and the ZIKV epidemic in Puerto Rico. CRITICAL PUBLIC HEALTH 2020. [DOI: 10.1080/09581596.2020.1808189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Holly Horan
- University of Alabama, Tuscaloosa, AL, United States of America (USA)
| | - Melissa Cheyney
- Department of Anthropology, Oregon State University, Corvallis, OR, United States of America (USA)
| | - Eni Nako
- School of Medicine, Oregon Health Science University, Portland, OR, United States of America (USA)
| | - Marit Bovbjerg
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States of America (USA)
| |
Collapse
|
12
|
Henry Akintobi T, Jacobs T, Sabbs D, Holden K, Braithwaite R, Johnson LN, Dawes D, Hoffman L. Community Engagement of African Americans in the Era of COVID-19: Considerations, Challenges, Implications, and Recommendations for Public Health. Prev Chronic Dis 2020; 17:E83. [PMID: 32790605 PMCID: PMC7458103 DOI: 10.5888/pcd17.200255] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
African Americans, compared with all other racial/ethnic groups, are more likely to contract coronavirus disease 2019 (COVID-19), be hospitalized for it, and die of the disease. Psychosocial, sociocultural, and environmental vulnerabilities, compounded by preexisting health conditions, exacerbate this health disparity. Interconnected historical, policy, clinical, and community factors explain and underpin community-based participatory research approaches to advance the art and science of community engagement among African Americans in the COVID-19 era. In this commentary, we detail the pandemic response strategies of the Morehouse School of Medicine Prevention Research Center. We discuss the implications of these complex factors and propose recommendations for addressing them that, adopted together, will result in community and data-informed mitigation strategies. These approaches will proactively prepare for the next pandemic and advance community leadership toward health equity.
Collapse
Affiliation(s)
- Tabia Henry Akintobi
- Prevention Research Center, Morehouse School of Medicine, Atlanta, Georgia
- Department of Community Health and Preventive Medicine. Morehouse School of Medicine, 720 Westview Dr, Atlanta, GA 30310.
| | - Theresa Jacobs
- Georgia Primary Care Association, Decatur, Georgia
- Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia
| | - Darrell Sabbs
- Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia
- Phoebe Putney Memorial Hospital, Albany, Georgia
| | - Kisha Holden
- Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - Ronald Braithwaite
- Prevention Research Center, Morehouse School of Medicine, Atlanta, Georgia
| | - L Neicey Johnson
- Georgia Clinical and Translational Science Alliance Community Steering Board, Atlanta, Georgia
- Visions, Incorporated, Atlanta, Georgia
| | - Daniel Dawes
- Satcher Health Leadership Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - LaShawn Hoffman
- Hoffman & Associates, Atlanta, Georgia
- Morehouse School of Medicine Prevention Research Center Community Coalition Board, Atlanta, Georgia
| |
Collapse
|
13
|
Program Fidelity and Patient Satisfaction among Women Served by the Zika Contraception Access Network Program in Puerto Rico. Womens Health Issues 2020; 30:268-276. [PMID: 32376188 DOI: 10.1016/j.whi.2020.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 03/12/2020] [Accepted: 03/12/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND The Zika Contraception Access Network (Z-CAN) was designed to provide women in Puerto Rico who chose to delay or avoid pregnancy during the 2016-2017 Zika virus outbreak access to high-quality client-centered contraceptive counseling and the full range of reversible contractive methods on the same day and at no cost through a network of trained providers. We evaluated the implementation of Z-CAN from the patient perspective. METHODS An online survey, administered to a subset of women served by the Z-CAN program approximately 2 weeks after their initial Z-CAN visit, assessed patient satisfaction and receipt of services consistent with select program strategies: receipt of high-quality client-centered contraceptive counseling, same-day access to the contraceptive method they were most interested in after counseling, and no-cost contraception. RESULTS Of 3,503 respondents, 85.2% reported receiving high-quality client-centered contraceptive counseling. Among women interested in a contraceptive method after counseling (n = 3,470), most reported same-day access to that method (86.8%) and most reported receiving some method of contraception at no cost (87.4%). Women who reported receiving services according to Z-CAN program strategies were more likely than those who did not to be very satisfied with services. Women who received high-quality client-centered contraceptive counseling and same-day access to the method they were most interested in after counseling were also more likely to be very satisfied with the contraceptive method received. CONCLUSIONS A contraception access program can be rapidly implemented with high fidelity to program strategies in a fast-moving and complex public health emergency setting.
Collapse
|
14
|
Pérez-Ramos JG, McIntosh S, Barrett ES, Vélez-Vega CM, Dye TD. Qualitative Assessment of Environmental Health Risk Perceptions and Community Challenges in a Puerto Rican Community: Change and Continuity in Response to Hurricanes Irma and María. Behav Med 2020; 46:231-244. [PMID: 31860413 PMCID: PMC8783134 DOI: 10.1080/08964289.2019.1700894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Culebra, a geographically isolated island located 17 miles from the eastern coast of Puerto Rico's main island, suffers from an amalgam of significant environmental health risk and associated social determinants of health that are affecting the community. In 2017, two major Hurricanes (Irma and María) impacted Culebra, resulting in an increase of preexisting environmental health risk. The present study's primary aim was to explore community attitudes, beliefs, and perceptions of environmental health risk, and to describe the social priorities of Culebrenses in relation to these risks and challenges. Semi-structured interview guide and Rapid Qualitative Inquiry (RQI) focused on topics of environmental health risk was followed. Qualitative focus groups and individual interviews were conducted among community members in Culebra before and shortly after Hurricanes Irma and María affected the island. Environmental health factors identified included: presence of mosquitoes, trash disposal, water quality and tourism. Additionally, a strong sentiment of island pride was found potentially generating a sense of community that could facilitate solutions to the existing environmental health challenges. Preexisting environmental health risk magnified after the pass of Hurricanes Irma and María. Sustainable and community engagement approaches are needed to develop strategies that can assist in the mitigation and resolution of the identified environmental health risk and challenges, including factors associated with threats such as disasters and pollution.
Collapse
Affiliation(s)
- José G. Pérez-Ramos
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center
| | | | | | - Timothy D. Dye
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry
| |
Collapse
|
15
|
Rodríguez-Díaz CE. Maria in Puerto Rico: Natural Disaster in a Colonial Archipelago. Am J Public Health 2019; 108:30-32. [PMID: 29211541 DOI: 10.2105/ajph.2017.304198] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Carlos E Rodríguez-Díaz
- Carlos E. Rodríguez-Díaz is with the Doctoral Program in Public Health with specialty in Social Determinants of Health and the Center for Evaluation and Sociomedical Research, Graduate School of Public Health, University of Puerto Rico-Medical Sciences Campus, San Juan
| |
Collapse
|
16
|
Martinez-Velez JJ, Melin K, Rodriguez-Diaz CE. A Preliminary Assessment of Selected Social Determinants of Health in a Sample of Transgender and Gender Nonconforming Individuals in Puerto Rico. Transgend Health 2019; 4:9-17. [PMID: 30719502 PMCID: PMC6360392 DOI: 10.1089/trgh.2018.0045] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose: Transgender and gender nonconforming (GNC) people continue to experience suboptimal health care, social exclusion, and lower quality of life. Globally, lack of access to services, institutional violence, and public harassment have been reported. However, there is limited data on transgender health in Puerto Rico and the Caribbean. The purpose of this study is to assess the social determinants of health and wellbeing of transgender and GNC people living in Puerto Rico. Methods: Utilizing a community-based participatory research approach, 52 self-identified transgender and GNC individuals living in Puerto Rico completed a survey, which included questions on access to health care services, social support, and violence, among others. Data were collected from March to Ma y of 2015 and descriptive statistical analysis was conducted. Results: Most of the participants reported experiences of discrimination across multiple social settings, most commonly at school (70.6%) and work (67.4%). Regarding experiences of violence, more than half (65.4%) had been verbally attacked in a public space. Many reported that access to gender-affirming health care services is difficult in Puerto Rico (88.5%) due to lack of knowledgeable providers (59.6%) and discomfort during the encounter (55.8%). The main perceived priority for their wellbeing was a transgender health care center. Conclusion: Although the LGBT equality movement has reached great milestones, access to gender-affirming health services and safe educational and work spaces are still needed. Findings from the study provide guidance for actions to reduce health disparities by addressing the needs for health and wellbeing among transgender and GNC individuals.
Collapse
Affiliation(s)
- Jose J. Martinez-Velez
- University of Puerto Rico-Medical Sciences Campus, School of Public Health, Center for Sociomedical Research and Evaluation, San Juan, Puerto Rico
| | - Kyle Melin
- University of Puerto Rico-Medical Sciences Campus, School of Pharmacy, Department of Pharmacy Practice, San Juan, Puerto Rico
| | - Carlos E. Rodriguez-Diaz
- University of Puerto Rico-Medical Sciences Campus, School of Public Health, Center for Sociomedical Research and Evaluation, San Juan, Puerto Rico
- The George Washington University, Milken Institute School of Public Health, Department of Prevention and Community Health, Washington, District of Columbia
| |
Collapse
|
17
|
Academic Response to Storm-Related Natural Disasters-Lessons Learned. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081768. [PMID: 30126101 PMCID: PMC6122070 DOI: 10.3390/ijerph15081768] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/12/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022]
Abstract
On 30 October 2017, selected faculty and administrators from Research Centers in Minority Institutions (RCMI) grantee institutions gathered to share first-hand accounts of the devastating impact of Hurricanes Harvey, Irma, and Maria, which had interrupted academic activities, including research, education, and training in Puerto Rico, Florida, and Texas. The presenters reviewed emergency response measures taken by their institutions to maintain community health care access and delivery, the storm-related impact on clinical and research infrastructure, and strategies to retain locally grown clinical expertise and translational science research talent in the aftermath of natural disasters. A longer-term perspective was provided through a comparative review of lessons learned by one New Orleans-based institution (now more than a decade post-storm) in the aftermath of Hurricane Katrina. Caring for the internal and external communities associated with each institution and addressing the health disparities exacerbated by storm-related events is one key strategy that will pay long-term dividends in the survival of the academic institutions and the communities they serve.
Collapse
|
18
|
Akanda AS, Johnson K. Growing water insecurity and dengue burden in the Americas. Lancet Planet Health 2018; 2:e190-e191. [PMID: 29709277 DOI: 10.1016/s2542-5196(18)30063-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 03/28/2018] [Indexed: 05/15/2023]
Affiliation(s)
- Ali S Akanda
- Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, RI 02881, USA.
| | - Kristin Johnson
- Department of Political Science, University of Rhode Island, Kingston, RI 02881, USA
| |
Collapse
|