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August EM, Powell R, Morris E, Romero L, Zapata LB, Lathrop E. Impact of a Health Communication Campaign on Uptake of Contraceptive Services during the 2016-2017 Zika Virus Outbreak in Puerto Rico. Health Commun 2023; 38:252-259. [PMID: 34182847 PMCID: PMC8712614 DOI: 10.1080/10410236.2021.1945198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The Zika Contraception Access Network (Z-CAN) was established during the 2016-2017 Zika virus outbreak in Puerto Rico as a short-term emergency response program providing client-centered contraceptive counseling and same-day access to the full range of reversible contraceptive methods at no cost to women wishing to delay pregnancy. An evidence-based communication campaign, Ante La Duda, Pregunta (ALDP), was launched to encourage utilization of Z-CAN services. We assessed the effectiveness of campaign tactics in increasing awareness of Z-CAN among women in Puerto Rico. Data on campaign exposure and awareness were obtained through a self-administered online survey approximately two weeks after an initial Z-CAN visit, while the number of searches for participating clinics were obtained from monitoring the campaign website. Findings demonstrated that the most common ways survey respondents learned about Z-CAN were through friends or family (38.3%), social media (23.9%), a clinical encounter (12.7%), and website (11.7%). Nearly two-thirds (61.1%) of respondents had heard of the ALDP campaign. Over the campaign's duration, there were 27,273 searches for Z-CAN clinics. Findings suggest that evidence-based communication campaigns may increase awareness of needed public health services during emergencies. Word of mouth, social media, and digital engagement may be appropriate communication tactics for emergency response mobilization.
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Affiliation(s)
- Euna M. August
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention
| | | | - Elana Morris
- Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention
| | - Lisa Romero
- Division of Reproductive Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
| | - Lauren B. Zapata
- Division of Reproductive Health, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion
| | - Eva Lathrop
- Department of Gynecology and Obstetrics, Emory University School of Medicine
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Boehmer TK, Koumans EH, Skillen EL, Kappelman MD, Carton TW, Patel A, August EM, Bernstein R, Denson JL, Draper C, Gundlapalli AV, Paranjape A, Puro J, Rao P, Siegel DA, Trick WE, Walker CL, Block JP. Racial and Ethnic Disparities in Outpatient Treatment of COVID-19 - United States, January-July 2022. MMWR Morb Mortal Wkly Rep 2022; 71:1359-1365. [PMID: 36301738 PMCID: PMC9620572 DOI: 10.15585/mmwr.mm7143a2] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Powell R, Rosenthal J, August EM, Frey M, Garcia L, Sidibe T, Mendoza Z, Romero L, Lathrop E. Ante La Duda, Pregunta: A Social Marketing Campaign to Improve Contraceptive Access during a Public Health Emergency. Health Commun 2022; 37:177-184. [PMID: 33016136 PMCID: PMC8019432 DOI: 10.1080/10410236.2020.1828534] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
During the 2016-2017 Zika virus outbreak, preventing unintended pregnancy was recognized as a primary strategy to reduce adverse Zika-related pregnancy and birth outcomes. To increase awareness and uptake of contraceptive services provided through the Zika Contraception Access Network (Z-CAN) in Puerto Rico, a multi-strategy campaign called Ante La Duda, Pregunta (ALDP) was developed. The principal aim was to increase awareness of Z-CAN services, which included same-day access to the full range of reversible contraceptives at no cost to women living in Puerto Rico who choose to delay or avoid pregnancy during the 2016-2017 Zika virus outbreak. Using diverse strategies, ALDP increased exposure to and engagement with the campaign in order to raise awareness of Z-CAN services in Puerto Rico. The ALDP social marketing campaign played an important role in the overall Z-CAN effort. Of all the strategies utilized, Facebook appears to have reached the most people. While the importance of a social marketing campaign communicating to raise awareness and create demand has long been known, through the ALDP campaign efforts, it was shown that an effective campaign, built on formative research, can be developed and implemented rapidly in an emergency response situation without compromising on content, quality, or reach.
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Affiliation(s)
| | - Jackie Rosenthal
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Euna M. August
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
| | - Meghan Frey
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention
| | | | | | | | - Lisa Romero
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Eva Lathrop
- Department of Gynecology and Obstetrics, Emory University School of Medicine
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Jones JT, Smith DK, Wiener J, August EM, Finlayson T, Wejnert C. Assessment of PrEP Awareness, PrEP Discussion with a Provider, and PrEP Use by Transmission Risk Group with an Emphasis on the Southern United States. AIDS Behav 2021; 25:2985-2991. [PMID: 33523345 DOI: 10.1007/s10461-021-03164-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 01/30/2023]
Abstract
The number of new HIV diagnoses is highest in the South. Many persons who might benefit from pre-exposure prophylaxis (PrEP) are not engaged in the HIV PrEP continuum of care. We analyzed National HIV Behavioral Surveillance data to assess engagement in the PrEP continuum of care among persons with increased HIV risk. We compared PrEP awareness, discussion with a clinical provider, and use among persons living in the South to those living elsewhere in the United States. PrEP awareness was lowest among heterosexual persons (7%), highest among men who have sex with men (85%), and 26% among persons who inject drugs. PrEP use was low among each population (≤ 35% for all cycles). There was limited evidence of differences in PrEP use between persons in southern and non-southern U.S. Efforts are needed to increase use of PrEP among each of the groups with increased HIV risk.
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Affiliation(s)
- Jamal T Jones
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
| | - Dawn K Smith
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Jeffrey Wiener
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Euna M August
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Teresa Finlayson
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
| | - Cyprian Wejnert
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA
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Jones JT, deCastro BR, August EM, Smith DK. Pre-exposure Prophylaxis (PrEP) Awareness and Prescribing Behaviors Among Primary Care Providers: DocStyles Survey, 2016-2020, United States. AIDS Behav 2021; 25:1267-1275. [PMID: 33201428 DOI: 10.1007/s10461-020-03089-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 12/14/2022]
Abstract
Few studies have assessed providers' intent of prescribing PrEP in the future. We analyzed cross-sectional web-based surveys to estimate trends from 2016 to 2020 in PrEP awareness and prescribing behaviors in the United States among primary care providers. Multivariable logistic regression was used to estimate prevalence of PrEP awareness, prescribing behaviors, and likelihood of prescribing PrEP in the next 12 months. The adjusted prevalence for PrEP awareness was significantly higher in 2019 (93.7%, 95% CI 91.9%, 95.2%) compared to 2018 (88.1%, 95% CI 85.5%, 90.3%). The adjusted prevalence for prescribing PrEP was significantly higher in 2019 (16.4%, 95% CI 13.6%, 19.6%) and 2020 (15.6%, 95% CI 13.0%, 18.7%) compared to 2018 (12.2%, 95% CI 10.0%, 14.7%). Practicing in the West and regularly screening for HIV were associated with higher PrEP awareness and provision. Studies should examine factors associated with PrEP provision for groups with increased risk for HIV.
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Affiliation(s)
- Jamal T Jones
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop US8-4, Atlanta, GA, 30333, USA.
| | - B Rey deCastro
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Euna M August
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
| | - Dawn K Smith
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, 30333, USA
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Bui DP, See I, Hesse EM, Varela K, Harvey RR, August EM, Winquist A, Mullins S, McBee S, Thomasson E, Atkins A. Association Between CMS Quality Ratings and COVID-19 Outbreaks in Nursing Homes - West Virginia, March 17-June 11, 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1300-1304. [PMID: 32941409 PMCID: PMC7498166 DOI: 10.15585/mmwr.mm6937a5] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Jalloh MF, Sengeh P, Bunnell RE, Jalloh MB, Monasch R, Li W, Mermin J, DeLuca N, Brown V, Nur SA, August EM, Ransom RL, Namageyo-Funa A, Clements SA, Dyson M, Hageman K, Abu Pratt S, Nuriddin A, Carroll DD, Hawk N, Manning C, Hersey S, Marston BJ, Kilmarx PH, Conteh L, Ekström AM, Zeebari Z, Redd JT, Nordenstedt H, Morgan O. Evidence of behaviour change during an Ebola virus disease outbreak, Sierra Leone. Bull World Health Organ 2020; 98:330-340B. [PMID: 32514198 PMCID: PMC7265950 DOI: 10.2471/blt.19.245803] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To evaluate changes in Ebola-related knowledge, attitudes and prevention practices during the Sierra Leone outbreak between 2014 and 2015. Methods Four cluster surveys were conducted: two before the outbreak peak (3499 participants) and two after (7104 participants). We assessed the effect of temporal and geographical factors on 16 knowledge, attitude and practice outcomes. Findings Fourteen of 16 knowledge, attitude and prevention practice outcomes improved across all regions from before to after the outbreak peak. The proportion of respondents willing to: (i) welcome Ebola survivors back into the community increased from 60.0% to 89.4% (adjusted odds ratio, aOR: 6.0; 95% confidence interval, CI: 3.9–9.1); and (ii) wait for a burial team following a relative’s death increased from 86.0% to 95.9% (aOR: 4.4; 95% CI: 3.2–6.0). The proportion avoiding unsafe traditional burials increased from 27.3% to 48.2% (aOR: 3.1; 95% CI: 2.4–4.2) and the proportion believing spiritual healers can treat Ebola decreased from 15.9% to 5.0% (aOR: 0.2; 95% CI: 0.1–0.3). The likelihood respondents would wait for burial teams increased more in high-transmission (aOR: 6.2; 95% CI: 4.2–9.1) than low-transmission (aOR: 2.3; 95% CI: 1.4–3.8) regions. Self-reported avoidance of physical contact with corpses increased in high but not low-transmission regions, aOR: 1.9 (95% CI: 1.4–2.5) and aOR: 0.8 (95% CI: 0.6–1.2), respectively. Conclusion Ebola knowledge, attitudes and prevention practices improved during the Sierra Leone outbreak, especially in high-transmission regions. Behaviourally-targeted community engagement should be prioritized early during outbreaks.
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Affiliation(s)
- Mohamed F Jalloh
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B, 17165 Solna, Sweden
| | | | - Rebecca E Bunnell
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | | | | | - Wenshu Li
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Jonathan Mermin
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Nickolas DeLuca
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Vance Brown
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Sophia A Nur
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Euna M August
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Ray L Ransom
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | | | - Sara A Clements
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | | | - Kathy Hageman
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | | | - Azizeh Nuriddin
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Dianna D Carroll
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Nicole Hawk
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Craig Manning
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Sara Hersey
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Barbara J Marston
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Peter H Kilmarx
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Lansana Conteh
- Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Anna Mia Ekström
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B, 17165 Solna, Sweden
| | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B, 17165 Solna, Sweden
| | - John T Redd
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
| | - Helena Nordenstedt
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18B, 17165 Solna, Sweden
| | - Oliver Morgan
- Centers for Disease Control and Prevention, Atlanta, United States of America (USA)
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August EM, Rosenthal J, Torrez R, Romero L, Berry-Bibee EN, Frey MT, Torres R, Rivera-García B, Honein MA, Jamieson DJ, Lathrop E. Community Understanding of Contraception During the Zika Virus Outbreak in Puerto Rico. Health Promot Pract 2019; 21:133-141. [DOI: 10.1177/1524839919850764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In response to the Zika virus outbreak in Puerto Rico (2015-2016), the Zika Contraception Access Network (Z-CAN) was established to provide same-day access to the full range of reversible contraception at no cost to women. Formative research was conducted to inform the development of a communication campaign about Z-CAN. Ten focus groups with women and men, aged 18 to 49 years, in Puerto Rico were conducted to collect data on contraception awareness, use, and decision making during the Zika outbreak, as well as culturally appropriate messaging and outreach strategies. Thematic analysis was conducted using the constant comparative method. Data showed that there was community awareness regarding Zika in Puerto Rico. However, it was not a motivating factor in contraception decision making; instead, economic factors were the major drivers. Most participants preferred to receive information on contraception, potential side effects, and where to access contraceptive services via Internet-based channels and health care providers. Based on these findings, the Ante La Duda, Pregunta [When in Doubt, Ask] campaign was launched to promote awareness of Z-CAN services among those who chose to prevent pregnancy during the Zika outbreak. Our results underscore the importance of conducting formative research to develop communication initiatives, while also demonstrating that it is feasible to perform these activities as part of an emergency response.
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Affiliation(s)
- Euna M. August
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Lisa Romero
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Meghan T. Frey
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | | | | - Eva Lathrop
- Emory University School of Medicine, Atlanta, GA, USA
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Badal HJ, Boudewyns V, Uhrig JD, August EM, Ruddle P, Stryker JE. Testing Makes Us Stronger™: Evaluating the correlation between exposure and intermediate outcomes targeted by the campaign's messages. Patient Educ Couns 2019; 102:53-60. [PMID: 30217577 DOI: 10.1016/j.pec.2018.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 08/22/2018] [Accepted: 08/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To examine whether self-reported exposure to Testing Makes Us Stronger™ (TMUS), an HIV testing health communication campaign for black gay, bisexual, and other men who have sex with men (BMSM), was associated with key intermediate outcomes targeted by the campaign's messages. METHODS Data from sexually active, HIV-negative or unknown status BMSM aged 18-44 (N = 590) were collected through an anonymous Web-based survey that measured sociodemographics, campaign exposure, attitudinal beliefs, normative beliefs, self-efficacy, and HIV testing intentions, among other variables. The association between exposure to TMUS and intermediate outcomes was evaluated using propensity-score weight adjusted correlations. RESULTS Exposure to TMUS was high (43%) among the priority audience. Exposure to the campaign was correlated with 8 of 11 intermediate outcomes measured, including key attitudinal beliefs about the accessibility of the test and benefits to the individual, injunctive norms, self-efficacy, and HIV testing intention. CONCLUSION Adhering to principles of effective campaign design, such as using theory as a conceptual foundation for message design, can increase a campaign's chances for successfully meeting its goals and objectives. PRACTICE IMPLICATIONS Findings from this study can be used to inform message design for other communication efforts to promote HIV testing among BMSM.
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Affiliation(s)
- Hannah J Badal
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Vanessa Boudewyns
- Center for Communication Science, RTI International, Research Triangle Park, NC, USA
| | - Jennifer D Uhrig
- Center for Communication Science, RTI International, Research Triangle Park, NC, USA
| | - Euna M August
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Ruddle
- Center for Communication Science, RTI International, Research Triangle Park, NC, USA
| | - Jo Ellen Stryker
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, US Centers for Disease Control and Prevention, Atlanta, GA, USA
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Pitasi MA, Chavez PR, DiNenno EA, Jeffries WL, Johnson CH, Demeke H, August EM, Bradley H. Stigmatizing Attitudes Toward People Living with HIV Among Adults and Adolescents in the United States. AIDS Behav 2018; 22:3887-3891. [PMID: 29948338 DOI: 10.1007/s10461-018-2188-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Stigmatizing attitudes toward people living with HIV (PLWH) cause psychological distress for PLWH and hinder HIV prevention efforts. We estimated the prevalence of stigmatizing attitudes among 6809 adults and 885 adolescents who responded to online surveys in 2015. Fear of casual contact with PLWH was reported by 17.5% [95% confidence interval (CI) 16.3-18.6%] of adults and 31.6% (CI 27.8-35.4%) of adolescents. Among adults, 12.5% (CI 11.6-13.5%) endorsed a measure of moral judgment toward PLWH. Stigmatizing attitudes toward PLWH persist in the United States. Continued monitoring of these attitudes and efforts to reduce associated stigma are warranted.
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Chávez PRG, Wesolowski LG, Peters PJ, Johnson CH, Nasrullah M, Oraka E, August EM, DiNenno E. How well are U.S. primary care providers assessing whether their male patients have male sex partners? Prev Med 2018; 107:75-80. [PMID: 29126916 PMCID: PMC5807188 DOI: 10.1016/j.ypmed.2017.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 11/17/2022]
Abstract
Identifying patients at-risk for HIV infection, such as men who have sex with men (MSM), is an important step in providing HIV testing and prevention interventions. It is unknown how primary care providers (PCPs) assess MSM status and related HIV-risk factors. We analyzed data from a panel-derived web-based survey for healthcare providers conducted in 2014 to describe how PCPs in the U.S. determined their patients' MSM status. We calculated adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to describe PCP characteristics associated with systematically determining MSM status (i.e., PCP used "a patient-completed questionnaire" or "routine verbal review of sex history"). Among the 1008 PCPs, 56% determined MSM status by routine verbal review of sexual history; 41% by patient disclosure; 39% by questions driven by symptoms/history; 23% by using a patient-completed questionnaire, and 9% didn't determine MSM status. PCPs who systematically determined MSM status (n=665; 66%) were more likely to be female (aPR=1.16, CI=1.06-1.26), to be affiliated with a teaching hospital (aPR=1.15, CI=1.06-1.25), to routinely screen all patients aged 13-64 for HIV (aPR=1.29, CI=1.18-1.41), and to estimate that 6% or more of their male patients are MSM (aPR=1.14, CI=1.01-1.30). The majority of PCPs assessed MSM status and HIV risk factors through routine verbal reviews of sexual history. Implementing a systematic approach to identify MSM status and assess risk may allow PCPs to identify more patients needing frequent HIV testing and other preventive services, while mitigating socio-cultural barriers to obtaining such information.
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Affiliation(s)
- Pollyanna R G Chávez
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Laura G Wesolowski
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Philip J Peters
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Christopher H Johnson
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Muazzam Nasrullah
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Emeka Oraka
- ICF International at Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Euna M August
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
| | - Elizabeth DiNenno
- Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
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August EM, Steinmetz E, Gavin L, Rivera MI, Pazol K, Moskosky S, Weik T, Ku L. Projecting the Unmet Need and Costs for Contraception Services After the Affordable Care Act. Am J Public Health 2015; 106:334-41. [PMID: 26691128 DOI: 10.2105/ajph.2015.302928] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We estimated the number of women of reproductive age in need who would gain coverage for contraceptive services after implementation of the Affordable Care Act, the extent to which there would remain a need for publicly funded programs that provide contraceptive services, and how that need would vary on the basis of state Medicaid expansion decisions. METHODS We used nationally representative American Community Survey data (2009), to estimate the insurance status for women in Massachusetts and derived the numbers of adult women at or below 250% of the federal poverty level and adolescents in need of confidential services. We extrapolated findings to simulate the impact of the Affordable Care Act nationally and by state, adjusting for current Medicaid expansion and state Medicaid Family Planning Expansion Programs. RESULTS The number of low-income women at risk for unintended pregnancy is expected to decrease from 5.2 million in 2009 to 2.5 million in 2016, based on states' current Medicaid expansion plans. CONCLUSIONS The Affordable Care Act increases women's insurance coverage and improves access to contraceptive services. However, for women who remain uninsured, publicly funded family planning programs may still be needed.
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Affiliation(s)
- Euna M August
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Erika Steinmetz
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Lorrie Gavin
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Maria I Rivera
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Karen Pazol
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Susan Moskosky
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Tasmeen Weik
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
| | - Leighton Ku
- Euna M. August, Maria I. Rivera, and Karen Pazol are with Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA. Erika Steinmetz and Leighton Ku are with George Washington University, Center for Health Policy Research, Washington, DC. Susan Moskosky, Lorrie Gavin, and Tasmeen Weik are with Office of Population Affairs, Washington, DC
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August EM, Salihu HM, de la Cruz CZ, Mbah AK, Alio AP, Lo Berry E. A quasi-experimental design to assess the effectiveness of the federal healthy start in reducing preterm birth among obese mothers. J Prim Prev 2015; 36:205-12. [PMID: 25762508 DOI: 10.1007/s10935-015-0389-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We assessed the impact of Central Hillsborough Healthy Start (CHHS), a federally-funded program dedicated to improving maternal and infant outcomes in a population of high-risk obese mothers in the socio-economically challenged community of East Tampa in Florida on preterm birth and very preterm birth (VPTB). We utilized hospital discharge records linked to vital statistics data in Florida (2004-2007) to study obese women with a singleton birth, matching mothers in the CHHS catchment area with those from the rest of Florida. We conducted conditional logistic regression with the matched data. Obese mothers in the CHHS service area had a 61% lower likelihood of having a VPTB infant than obese mothers in the rest of the state (AOR = 0.39, 95% CI 0.21-0.70). Obese women of reproductive age may benefit from services from federal Healthy Start programs. Study findings underscore the need for further research to explore the impact of such programs.
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Affiliation(s)
- Euna M August
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs, MDC56, Tampa, FL, 33612, USA,
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Salemi JL, Whiteman VE, August EM, Chandler K, Mbah AK, Salihu HM. Maternal hepatitis B and hepatitis C infection and neonatal neurological outcomes. J Viral Hepat 2014; 21:e144-53. [PMID: 24666386 DOI: 10.1111/jvh.12250] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 01/12/2014] [Indexed: 12/13/2022]
Abstract
To examine the associations between maternal hepatitis B (HBV) and hepatitis C (HCV) infection status and selected infant neurological outcomes diagnosed at birth, we conducted a population-based, retrospective cohort study on singleton live births in Florida from 1998 to 2009. Primary exposures included maternal HBV and HCV monoinfection. The neurological outcomes included brachial plexus injury, cephalhematoma, foetal distress, feeding difficulties, intraventricular h aemorrhage and neonatal seizures. Multivariable logistic regression models were used to generate odds ratios (OR) and 95% confidence intervals (CI) that were adjusted for socio-demographic characteristics, risky behaviours, pregnancy complications and pre-existing medical conditions, and timing of delivery. The risk of an adverse neurological outcome was higher in infants born to mothers with hepatitis viral infection (7.2% for HCV, 5.0% for HBV), compared with infants of hepatitis virus-free mothers (4.2%). After adjusting for potential confounders, women with HBV were twice as likely to have infants who suffered from brachial plexus injury (OR = 2.04, 95% CI = 1.15-3.60), while those with HCV had an elevated odds of having an infant with feeding difficulties (OR: 1.32, 95% CI = 1.06-1.64) and a borderline increased likelihood for neonatal seizures (OR = 1.74, 95% CI = 0.98-3.10). Additionally, HCV+ mothers had a 22% increased odds of having an infant with some type of adverse neurological outcome (OR: 1.22, 95% CI = 1.03-1.44). Our findings add to current understanding of the association between maternal HBV/HCV infections and infant neurological outcomes. Further research evaluating the role of maternal HBV and HCV infections (including viraemia, treatment) on pregnancy outcomes is warranted.
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Affiliation(s)
- J L Salemi
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
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Whiteman VE, August EM, Mogos M, Naik E, Garba M, Sanchez E, Weldeselasse HE, Salihu HM. Preterm birth in the first pregnancy and risk of neonatal death in the second pregnancy: a propensity score-weighted matching approach. J OBSTET GYNAECOL 2014; 35:30-6. [PMID: 25058689 DOI: 10.3109/01443615.2014.937328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study purpose was to assess the relationship between various grades of preterm birth (moderate preterm: 33-36 weeks; severe preterm: 27-32 weeks; extreme preterm: ≤ 26 weeks) in the first pregnancy and neonatal mortality (death within 28 days of birth; early: 0-7 days; late: 8-28 days) in the second pregnancy. Using the Missouri maternally-linked dataset (1989-2005), a population-based, retrospective cohort analysis with propensity score-weighted matching was conducted on mothers with two consecutive singleton live births (n = 310,653 women). Women with a prior preterm birth were more likely to subsequently experience neonatal death. The odds increased in a dose-dependent pattern with ascending severity of the preterm event in the first pregnancy (moderate preterm: AOR = 1.32; 95% CI: 1.10-1.60; severe preterm: AOR = 2.62; 95% CI: 2.01-3.41; extreme preterm: AOR = 5.84; 95% CI: 4.28-7.97; p value for trend < 0.001). However, the pathway for the relationship between prior preterm birth and subsequent neonatal mortality may be the recurrence of preterm birth.
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Affiliation(s)
- V E Whiteman
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, College of Medicine
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Salihu HM, Diamond E, August EM, Rahman S, Mogos MF, Mbah AK. Maternal pregnancy weight gain and the risk of placental abruption. Nutr Rev 2013; 71 Suppl 1:S9-17. [DOI: 10.1111/nure.12063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
| | - Elise Diamond
- University of South Florida; College of Public Health; Department of Epidemiology and Biostatistics; Tampa; Florida; USA
| | | | - Shams Rahman
- University of South Florida; College of Public Health; Department of Epidemiology and Biostatistics; Tampa; Florida; USA
| | - Mulubrhan F Mogos
- University of South Florida; College of Public Health; Department of Epidemiology and Biostatistics; Tampa; Florida; USA
| | - Alfred K Mbah
- University of South Florida; College of Public Health; Department of Epidemiology and Biostatistics; Tampa; Florida; USA
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August EM, Daley E, Kromrey J, Baldwin J, Romero-Daza N, Salmeron J, Lazcano-Ponce E, Villa LL, Bryant CA, Giuliano AR. Age-related variation in sexual behaviours among heterosexual men residing in Brazil, Mexico and the USA. ACTA ACUST UNITED AC 2013; 40:261-9. [PMID: 24099979 DOI: 10.1136/jfprhc-2012-100564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare the prevalence of demographic characteristics and sexual behaviours across age groups and to estimate their significance in predicting sexual risk factors by age cohort. METHODS This cohort study examined sexually transmitted infection (STI) prevalence among heterosexual men in Brazil, Mexico and the USA (N=3047). Participants completed a sexual risk factor questionnaire and were tested for chlamydia, gonorrhoea, syphilis and genital herpes. We examined sexual risk in the study population through a composite measure of STI positivity by age cohort (young: 18-30 years; middle-aged: 31-44 years; older: 45-70 years). Multivariable logistic regression models were used to generate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). RESULTS We found that STI positivity varied significantly by age group among heterosexual men by a number of covariates. In younger men, having more advanced education had a protective effect (16 years: AOR=0.37, 95% CI 0.15- 0.92), whereas higher numbers of sexual partners elevated the risk for STIs (20-49 partners: AOR=2.06, 95% CI 1.04-4.06; ≥ 50 partners: AOR=4.33, 95% CI 1.74-10.76). Middle-aged men who were black (AOR=1.64, 95% CI 1.10-2.42) and divorced/separated/widowed (AOR=1.91, 95% CI 1.21-3.02) had an increased risk for a positive STI test. Among older men, a younger age at first vaginal sexual encounter (AOR=3.75, 95% CI 1.45-9.74) and a history of exchanging sex for money or drugs heightened STI risk (AOR=2.30, 95% CI 1.0-5.04). CONCLUSIONS These findings demonstrate that age-related life experiences among heterosexual men influence sexual risk and STI transmission. This topic warrants further investigation to support the development and implementation of targeted interventions that may potentially reduce adverse sexual health outcomes.
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Affiliation(s)
- Euna M August
- Research Coordinator, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Ellen Daley
- Associate Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Jeffrey Kromrey
- Professor, Department of Educational Measurement and Research, College of Education, University of South Florida, Tampa, FL, USA
| | - Julie Baldwin
- Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Nancy Romero-Daza
- Associate Professor, Department of Anthropology, College of Arts and Sciences, University of South Florida, Tampa, FL, USA
| | - Jorge Salmeron
- Professor, Unidad de Investigación Epidemiológica en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
| | - Eduardo Lazcano-Ponce
- Director, Centro de Investigación Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Luisa L Villa
- Professor, Faculty of Medical Sciences of Santa Casa of São Paulo, São Paulo, Brazil
| | - Carol A Bryant
- Distinguished Professor, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Anna R Giuliano
- Director, Center for Infection Research in Cancer, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Salihu HM, August EM, De La Cruz C, Weldeselasse H, Sanchez E, Alio AP, Marty PJ. All-cause infant mortality and the risk for subsequent preterm birth. Minerva Ginecol 2013; 65:557-566. [PMID: 24096292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM The aim of this paper was to assess the association between all-cause infant mortality (death<365 days) in the first pregnancy and the risk of preterm birth (<37 weeks of gestation) in the second pregnancy. METHODS Using the Missouri maternally linked dataset from 1989 to 2005 (N.=639134 singleton live births), we conducted a population-based retrospective cohort analysis with women who had two singleton births between 1989 and 2005. We employed Cox Proportional Hazards Regression to generate adjusted hazard ratios (AHR) and 95% confidence intervals (CI) to approximate relative risks. RESULTS Prior infant mortality was associated with an increased risk for preterm birth in the second pregnancy (AHR=1.96, 95% CI=1.80-2.13). For black women, the risk of preterm birth following infant mortality was more than three-fold (AHR=3.37, 95% CI=2.92-3.89), while the risk for white women was twice as high (AHR=2.04, 95% CI=1.86-2.26) (referent=white women without infant death in the first pregnancy). CONCLUSION Women with a history of infant mortality are at risk for preterm birth in subsequent pregnancies. This risk was significantly elevated for black women. These findings provide further evidence that previous childbearing experiences play a critical role in the occurrence of adverse feto-infant outcomes.
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Affiliation(s)
- H M Salihu
- Department of Obstetrics and Gynecology, University of South Florida, College of Medicine Tampa, FL, USA -
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Alio AP, Mbah AK, Shah K, August EM, Dejoy S, Adegoke K, Marty PJ, Salihu HM, Aliyu MH. Paternal involvement and fetal morbidity outcomes in HIV/AIDS: a population-based study. Am J Mens Health 2013; 9:6-14. [PMID: 23913897 DOI: 10.1177/1557988313498890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Prior research indicates that infants with absent fathers are vulnerable to unfavorable fetal birth outcomes. HIV is a recognized risk factor for adverse birth outcomes. However, the influence of paternal involvement on fetal morbidity outcomes in women with HIV remains poorly understood. Using linked hospital discharge data and vital statistics records for the state of Florida (1998-2007), the authors assessed the association between paternal involvement and fetal growth outcomes (i.e., low birth weight [LBW], very low birth weight [VLBW], preterm birth [PTB], very preterm birth [VPTB], and small for gestational age [SGA]) among HIV-positive mothers (N=4,719). Propensity score matching was used to match cases (absent fathers) to controls (fathers involved). Conditional logistic regression was employed to generate adjusted odds ratios (OR). Mothers of infants with absent fathers were more likely to be Black, younger (<35 years old), and unmarried with at least a high school education (p<.01). They were also more likely to have a history of drug (p<.01) and alcohol (p=.02) abuse. These differences disappeared after propensity score matching. Infants of HIV-positive mothers with absent paternal involvement during pregnancy had elevated risks for adverse fetal outcomes (LBW: OR=1.30, 95% confidence interval [CI]=1.05-1.60; VLBW: OR=1.72, 95% CI=1.05-2.82; PTB: OR=1.38, 95% CI=1.13-1.69; VPTB: OR=1.81, 95% CI=1.13-2.90). Absence of fathers increases the likelihood of adverse fetal morbidity outcomes in women with HIV infection. These findings underscore the importance of paternal involvement during pregnancy, especially as an important component of programs for prevention of mother-to-child transmission of HIV.
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Affiliation(s)
- Amina P Alio
- University of Rochester Medical School, Rochester, NY, USA
| | | | - Krupa Shah
- University of Rochester Medical School, Rochester, NY, USA
| | | | | | | | | | | | - Muktar H Aliyu
- Vanderbilt Institute for Global Health, Nashville, TN, USA
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Mogos MF, August EM, Salinas-Miranda AA, Sultan DH, Salihu HM. A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers. Appl Res Qual Life 2013; 8:219-250. [PMID: 23734167 PMCID: PMC3667203 DOI: 10.1007/s11482-012-9188-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Quality of life has emerged as an essential health component that broadens the traditionally narrow concerns focused on only morbidity and life expectancy. Although a growing number of tools to measure quality of life are in circulation, there is a lack of guidelines as well as rigorous assessment for their use with pregnant and postpartum populations. It is also unclear whether these instruments could validly be employed to measure patient-reported outcomes in comparative effectiveness research of maternal care interventions. This paper reviews articles cited in CINAHL, COCHRANE, EMBASE, PSYCINFO, and PUBMED that addressed quality of life in pregnant and postpartum populations. Instruments used to measure quality of life in selected articles were assessed for their adherence to international guidelines for health outcomes instrument development and validation. The authors identified 129 articles that addressed quality of life in pregnant and/or postpartum women. Out of these, only 64 quality (generic and specific) scales were judged relevant to be included in this study. Analysis of measurement scales used in the pregnant and/or postpartum populations revealed important validity, reliability and psychometric inadequacies that negate their use in comparative effectiveness analysis in pregnant and post-partum populations. Valid, reliable, and responsive instruments to measure patient-reported outcomes in pregnant and postpartum populations are lacking. To demonstrate the effectiveness of various treatment and prevention programs, future research to develop and validate a robust and responsive quality of life measurement scale in pregnant and postpartum populations is needed.
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Affiliation(s)
- Mulubrhan F. Mogos
- Maternal & Child Health Comparative Effectiveness Research Group, Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
- Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
| | - Euna M. August
- Maternal & Child Health Comparative Effectiveness Research Group, Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
- Department of Community and Family Health, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
| | - Abraham A. Salinas-Miranda
- Maternal & Child Health Comparative Effectiveness Research Group, Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
| | - Dawood H. Sultan
- Department of Health Policy and Management, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA
| | - Hamisu M. Salihu
- Maternal & Child Health Comparative Effectiveness Research Group, Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA,
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL 33612, USA
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Salihu HM, Ghaji N, Mbah AK, Alio AP, August EM, Boubakari I. Particulate pollutants and racial/ethnic disparity in feto-infant morbidity outcomes. Matern Child Health J 2013; 16:1679-87. [PMID: 21833758 DOI: 10.1007/s10995-011-0868-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
We sought to assess the association between air particulate pollutants and feto-infant morbidity outcomes across racial/ethnic subgroups. This is a retrospective cohort study from 2000 through 2007 based on three linked databases: (1) The Florida Hospital Discharge database; (2) The vital statistics records of singleton live births in Florida; (3) Air pollution and meteorological data from the Environmental Protection Agency. Using computerized mathematical modeling, we assigned exposure values of the air pollutants of interest (PM(2.5), PM(10) and the PM coarse fraction [PM(10) - PM(2.5)]) to mothers over the period of pregnancy based on Euclidean minimum distance from the air pollution monitoring sites. The primary outcomes of interest were: low birth weight, very low birth weight, preterm birth, very preterm birth, and small for gestational age (SGA). We used adjusted odds ratios to approximate relative risks. We observed increased risk for overall feto-infant morbidity outcome in women exposed to any of the three particulate pollutants (values above the median). Exposed women had increased odds for low birth weight, very low birth weight and preterm birth with the greatest risk being that for very low birth weight (AOR = 1.27, 95% CI = 1.08-1.49). Black women exposed to any particulate pollutant had the greatest odds for all the morbidity outcomes, most pronounced for very low birth weight (AOR = 3.32, 95% CI = 2.56-4.30). Environmental particulate pollutants are associated with adverse feto-infant outcomes among exposed women, especially blacks. Black-white disparity in adverse fetal outcomes is widened in the presence of these pollutants, which provide a target for intervention.
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Affiliation(s)
- Hamisu M Salihu
- Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, 2 Tampa General Circle, Tampa, FL 33606, USA.
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Rivers D, August EM, Sehovic I, Lee Green B, Quinn GP. A systematic review of the factors influencing African Americans' participation in cancer clinical trials. Contemp Clin Trials 2013; 35:13-32. [PMID: 23557729 DOI: 10.1016/j.cct.2013.03.007] [Citation(s) in RCA: 142] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/08/2013] [Accepted: 03/22/2013] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This systematic review was conducted to synthesize the existing evidence regarding key considerations influencing African Americans' participation in cancer clinical trials (CCTs). METHODS The PubMed and PsycINFO databases were searched to identify peer-reviewed publications during the last decade (2002-2011) that met our inclusionary criteria. Our search utilized Boolean combinations of the following terms: "clinical trial"; "cancer"; "neoplasm"; "African American"; "Black"; "caregiver"; "decision making"; "recruitment"; "companion"; "family"; "significant other"; and "social support". RESULTS A total of 267 articles were identified in the database searches. Of these articles, a total of 31 were determined to meet the inclusion criteria and were retained for review. Key issues that emerged as impediments to a successful recruitment of African Americans to CCTs included negative attitudes towards clinical trials, low levels of knowledge and awareness regarding CCTs, religious beliefs, and structural barriers, such as transportation, childcare, and access to health care. Recommendations from physicians, family members, and friends may promote CCT participation. Multimedia, and culturally-appropriate recruitment approaches may also be effective in soliciting participation among African Americans. CONCLUSION Existing research underscores the importance of social support from family and friends, cultural appropriateness and sensitivity from physicians and in the design of the CCT, and enhanced education among African Americans in decision-making processes. As African Americans are underrepresented in CCTs, targeted strategies to enhance recruitment efforts and improve cancer treatment outcomes are essential.
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August EM, Salihu HM, Biroscak BJ, Rahman S, Bruder K, Whiteman VE. Systematic review on sleep disorders and obstetric outcomes: scope of current knowledge. Am J Perinatol 2013; 30:323-34. [PMID: 22893551 DOI: 10.1055/s-0032-1324703] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess the current state of knowledge regarding sleep disorders and their relationship to obstetric outcomes. STUDY DESIGN A systematic literature review of the previous two decades (1991 to 2010) was conducted. The exposure was sleep disorders during pregnancy, and the outcomes of interest were feto-infant morbidity and maternal complications. RESULTS Sleep apnea, snoring, and sleep quantity/duration were identified as the most frequently examined sleep disorders among pregnant women. Although our review found that studies examining the impact of sleep disorders on feto-infant outcomes were lacking, previous research indicates that such disorders may enhance the risk of preterm birth. Additionally, the current body of evidence suggests that sleep disorders adversely impact maternal health, increasing the likelihood of preeclampsia, and gestational diabetes. CONCLUSION Existing research points to the potentially harmful effects of sleep disorders on obstetric outcomes. The limited research in this arena highlights the need for further studies regarding the nature and strength of this relationship. Given the multiple dimensions of sleep and pregnancy, multivariate research approaches that incorporate biological and psychosocial factors are warranted.
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Affiliation(s)
- Euna M August
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida 33612, USA
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Saidu R, August EM, Alio AP, Salihu HM, Saka MJ, Jimoh AAG. An assessment of essential maternal health services in Kwara State, Nigeria. Afr J Reprod Health 2013; 17:41-48. [PMID: 24069733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The objective of this study is to evaluate the levels of emergency obstetrics care (EOC) signal functions in health facilities in a developing setting with high maternal morbidity and mortality indices and to determine if there are differences between public and private health facilities in terms of availability of these signal functions. A survey of health facilities was carried out in six of the 16 Local Government Areas (LGAs) of Kwara State Nigeria. All health facilities in these LGAs including public and private health facilities offering some services to pregnant women were surveyed using an interviewer- administered, facility-assessment questionnaire adapted from the WHO/UNFPA/UNICEF international guidelines for monitoring the availability and use of obstetric services. Frequency tables, percentages and charts were used for presenting the data. Comparing public and private facilities was done using chi-square tests. A total of 258 health facilities that provide maternal health services were surveyed in this study, out of which 76 (29.5%) were private facilities and 182 (70.5%) were public sector facilities. Most of the UN indicators were not met by the health facilities in Kwara state. The availability of EOC facilities was more among the private sector and this was statistically significant. This study shows that all stakeholders involved in reducing maternal mortality have a big challenge in the areas of availability, inequity in geographical distribution of EOC facilities and poor utilisation of these EOC services by women.
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Affiliation(s)
- Rakiya Saidu
- University of Ilorin, College of Health Sciences, Department of Obstetrivs and Gynaecology.
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Salihu HM, Mogos MF, August EM, DeJoy S, de la Cruz C, Alio AP, Marty PJ. HIV infection and its impact on fetal outcomes among women of advanced maternal age: a propensity score weighted matching approach. AIDS Res Hum Retroviruses 2013; 29:581-7. [PMID: 23074988 DOI: 10.1089/aid.2012.0242] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Advanced maternal age (AMA) and HIV status have been investigated separately for their influence on infant outcomes. Both are associated with adverse fetal growth outcomes, including low birth weight (LBW) and preterm birth (PTB). However, the impact of the cooccurrence of these factors in relation to birth outcomes remains relatively understudied. We analyzed Florida hospital discharge data linked to vital records. The study population consisted of women who had a singleton live birth between 1998 and 2007 (N=1,687,176). The exposure variables were HIV infection and maternal age, while the outcomes of interest were LBW, PTB, and small for gestational age (SGA). We matched HIV-positive women to HIV-negative women on selected variables using propensity scores. To approximate relative risks, we computed adjusted odds ratios (AOR) and 95% confidence intervals (CI) generated from logistic regression models and accounted for the matched design using the generalized estimating equations framework. After adjusting for demographic variables, clinical conditions, and route of birth, the risks of LBW, PTB, and SGA remained significant for HIV-positive women, regardless of age. HIV-positive women of AMA (≥35 years) were more likely to have infants of LBW (AOR=1.73, 95% CI=1.37-2.18), PTB (AOR=1.35, 95% CI: 1.06-1.71), and SGA (AOR=1.52, 95% CI=1.22-1.89), compared to uninfected mothers of younger age (<35 years). For women of advanced age, HIV positivity elevates their risk for LBW and PTB. The interplay of HIV status and age should be considered by healthcare providers when determining appropriate interconception strategies for women and their families.
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Affiliation(s)
- Hamisu M. Salihu
- Department of Obstetrics and Gynecology, College of Medicine, University of South Florida, Tampa Florida
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
| | - Mulubrhan F. Mogos
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
| | - Euna M. August
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
- Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, Florida
| | - Sharon DeJoy
- Department of Health, West Chester University, West Chester, Pennsylvania
| | - Cara de la Cruz
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, Florida
| | - Amina P. Alio
- Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, New York
| | - Phillip J. Marty
- USF Health Office of Research, University of South Florida, Tampa, Florida
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Wilson DS, Dapic V, Sultan DH, August EM, Green BL, Roetzheim R, Rivers B. Establishing the infrastructure to conduct comparative effectiveness research toward the elimination of disparities: a community-based participatory research framework. Health Promot Pract 2013; 14:893-900. [PMID: 23431128 DOI: 10.1177/1524839913475451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Tampa, Florida, researchers have partnered with community- and faith-based organizations to create the Comparative Effectiveness Research for Eliminating Disparities (CERED) infrastructure. Grounded in community-based participatory research, CERED acts on multiple levels of society to enhance informed decision making (IDM) of prostate cancer screening among Black men. CERED investigators combined both comparative effectiveness research and community-based participatory research to design a trial examining the effectiveness of community health workers and a digitally enhanced patient decision aid to support IDM in community settings as compared with "usual care" for prostate cancer screening. In addition, CERED researchers synthesized evidence through the development of systematic literature reviews analyzing the effectiveness of community health workers in changing knowledge, attitudes and behaviors of African American adults toward cancer prevention and education. An additional systematic review analyzed chemoprevention agents for prostate cancer as an emerging technique. Both of these reviews, and the comparative effectiveness trial supporting the IDM process, add to CERED's goal of providing evidence to eliminate cancer health disparities.
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Salihu HM, Stanley KM, August EM, Weldeselasse H, Mbah AK, Whiteman VE. The association between HIV/AIDS during pregnancy and fetal growth parameters in Florida: a population based study. Curr HIV Res 2012; 10:539-45. [PMID: 22716103 DOI: 10.2174/157016212802429839] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 05/19/2012] [Accepted: 06/08/2012] [Indexed: 11/22/2022]
Abstract
In this population-based retrospective study, we sought to investigate the association between HIV/AIDS during pregnancy and adverse birth outcomes, including low birth weight (LBW), very low birth weight (VLBW), preterm birth (PTB), very preterm birth (VPTB), and small for gestational age (SGA), among women in Florida by sociodemographic variables. Using data from Florida's maternally linked birth cohort files, we examined singleton live births in the state during 1998 to 2007 (N = 1,698,107). The study population was categorized based on the maternal HIV/AIDS status. Poisson regression models were used to generate adjusted rate ratios (ARR) to estimate the association between HIV/AIDS status and fetal growth parameters. The main outcome measures were fetal growth parameters, including LBW, VLBW, PTB, VPTB, and SGA. As compared to HIV/AIDS-negative women, mothers with HIV/AIDS had elevated risks for LBW (ARR = 1.40; 95% CI = 1.30-1.50), VLBW (ARR = 1.25; 95% CI = 1.04-1.51), SGA (ARR = 1.26; 95% CI = 1.17-1.35), PTB (ARR = 1.23; 95% CI = 1.03-1.47), and VPTB (ARR = 1.27; 95% CI = 1.20-1.36). Risk estimates for LBW and SGA were highest among Hispanics mothers with HIV/AIDS, while white mothers with HIV/AIDS had the highest risk levels for VLBW and PTB, compared to their HIV/AIDS negative counterparts. Our findings show that women with HIV/AIDS have elevated risks for inhibited fetal growth and shortened gestation with important racial/ethnic variation. This is the first known population-based study that reveals racial/ethnic differences in HIV/AIDS-related fetal growth morbidity outcomes.
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Affiliation(s)
- Hamisu M Salihu
- University of South Florida, College of Public Health, Department of Epidemiology and Biostatistics, 13201 Bruce B. Downs Blvd., MDC 56, Tampa, FL 33612, USA.
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Abstract
OBJECTIVE To determine whether female genital mutilation (FGM) is a risk factor for intimate partner violence (IPV) and its subtypes (physical, sexual and emotional). DESIGN Population-based cross-sectional study. SETTING The study used the 2006 Demographic and Health Survey (DHS) conducted in Mali. POPULATION A total of 7875 women aged 15-49 years who responded to the domestic violence and female circumcision modules in the 2006 administration of the DHS in Mali. METHODS Multivariable logistic regression was used to compute adjusted odds ratios (aOR) and 95% confidence intervals (CI) to measure risk for IPV. MAIN OUTCOME MEASURES The outcomes of interest were IPV and its subtypes. RESULTS Women with FGM were at heightened odds of IPV (aOR 2.71, 95% CI 2.17-3.38) and IPV subtypes: physical (aOR 2.85, 95% CI 2.22-3.66), sexual (aOR 3.24, 95% CI 1.80-5.82), and emotional (aOR 2.28, 95% CI 1.68-3.11). The odds of IPV increased with ascending FGM severity (P for trend <0.0001). The most elevated odds were observed among women with severe FGM, who were nearly nine times as likely to experience more than one IPV subtype (aOR 8.81, 95% CI 5.87-13.24). CONCLUSIONS Study findings underscore the need for multi-tiered strategies, incorporating policy and education, to reduce FGM and IPV, potentially improving the holistic health and wellbeing of Malian women.
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Affiliation(s)
- H M Salihu
- Department of Epidemiology & Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33612, USA.
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Salihu HM, De La Cruz C, Rahman S, August EM. Does maternal obesity cause preeclampsia? A systematic review of the evidence. Minerva Ginecol 2012; 64:259-280. [PMID: 22728572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of this paper was to assess whether maternal obesity causes preeclampsia. METHODS A systematic literature review of the previous two decades (1992-2011) was conducted. The exposure was maternal obesity while the outcome of interest was preeclampsia. RESULTS Our review revealed consistent findings showing strong association between obesity and preeclampsia. Multiple biomarkers that potentially explain the mechanistic pathway in this relationship were identified, including leptin and adiponectin, matrix metalloproteinase (MMP), C-reactive protein (CRP), and sex hormone-binding globulin (SHBG). A causative biologic linkage remains, however, elusive. CONCLUSION Epidemiologic evidence exists linking maternal obesity and preeclampsia. However, the exact causal pathway remains poorly defined. Given the minimal understanding of the nature of this relationship, research studies that utilize prospective designs and expand on the previous examination of biomarkers are recommended to determine potential causative pathways.
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Affiliation(s)
- H M Salihu
- Department of Obstetrics and Gynecology, University of South Florida, College of Medicine, Tampa, FL 33612, USA.
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Rivers BM, August EM, Quinn GP, Gwede CK, Pow-Sang JM, Green BL, Jacobsen PB. Understanding the psychosocial issues of African American couples surviving prostate cancer. J Cancer Educ 2012; 27:546-558. [PMID: 22544536 PMCID: PMC4497555 DOI: 10.1007/s13187-012-0360-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
African Americans are disproportionately affected by prostate cancer, yet less is known about the most salient psychosocial dimensions of quality of life. The purpose of this study was to explore the perceptions of African American prostate cancer survivors and their spouses of psychosocial issues related to quality of life. Twelve African American couples were recruited from a National Cancer Institute Comprehensive Cancer Center registry and a state-based non-profit organization to participate in individual interviews. The study was theoretically based on Ferrell's Quality of Life Conceptual Model. Common themes emerged regarding the psychosocial needs of African American couples. These themes were categorized into behavioral, social, psychological, and spiritual domains. Divergent perspectives were identified between male prostate cancer survivors and their female spouses. This study delineated unmet needs and areas for future in-depth investigations into psychosocial issues. The differing perspectives between patients and their spouses highlight the need for couple-centered interventions.
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Affiliation(s)
- Brian M Rivers
- Health Outcomes & Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
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Alio AP, Salihu HM, McIntosh C, August EM, Weldeselasse H, Sanchez E, Mbah AK. The effect of paternal age on fetal birth outcomes. Am J Mens Health 2012; 6:427-35. [PMID: 22564913 DOI: 10.1177/1557988312440718] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Research investigating the role of paternal age in adverse birth outcomes is limited. This population-based retrospective cohort study used the Missouri maternally linked data set from 1989 to 2005 to assess whether paternal age affects fetal birth outcomes: low birth weight (LBW), preterm birth (PTB), stillbirth, and small size for gestational age (SGA). We examined these outcomes among infants across seven paternal age-groups (<20, 20-24, 25-29, 30-34, 35-39, 40-45, and >45 years) using the generalized estimating equation framework. Compared with infants born to younger fathers (25-29 years), infants born to fathers aged 40 to 45 years had a 24% increased risk of stillbirth but a reduced risk of SGA. A 48% increased risk of late stillbirth was observed in infants born to advanced paternal age (>45 years). Moreover, advanced paternal age (>45 years) was observed to result in a 19%, 13%, and 29% greater risk for LBW, PTB, and VPTB (very preterm birth) infants, respectively. Infants born to fathers aged 30 to 39 years had a lower risk of LBW, PTB, and SGA, whereas those born to fathers aged 24 years or younger had an elevated likelihood of experiencing these same adverse outcomes. These findings demonstrate that paternal age influences birth outcomes and warrants further investigation.
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Salihu HM, August EM, Mbah AK, de Cuba RJ, Alio AP, Rowland-Mishkit V, Berry EL. The impact of birth spacing on subsequent feto-infant outcomes among community enrollees of a federal healthy start project. J Community Health 2012; 37:137-42. [PMID: 21656254 DOI: 10.1007/s10900-011-9427-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Numerous studies have shown an association between shorter birth intervals, and several adverse fetal outcomes, including low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). However, there is little evidence on the effectiveness of interconception care on fetal outcomes associated with sub-optimal interpregnancy interval (IPI). The purpose of this study is to examine the influence of the Federal Healthy Start's interconception care services on IPI and fetal growth outcomes. This is a retrospective cohort study used records from the Central Hillsborough Healthy Start program in Tampa, Florida linked to Florida vital statistics data covering the period 2002-2009. Only first and second pregnancies were considered, and interpregnancy interval (IPI), the exposure of interest, was categorized in months as 0-5, 6-17, 18-23, and ≥24. The following feto-infant morbidities were considered as primary outcomes: LBW, PTB, and SGA. A composite variable coding the presence of any of the aforementioned adverse fetal events was also created. Multivariate logistic regression modeling was applied Overall, mothers with the shortest IPI (0-5 months: AOR = 1.39, 95% CI 1.23-1.56) and longest IPI (≥60 months: AOR = 1.13, 95% CI 1.03-1.23) were at a greater risk for adverse fetal growth outcomes, compared to the referent category (18-23 months). Our findings support the need for inter conception care that addresses IPI and delayed childbearing among women.
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Affiliation(s)
- Hamisu M Salihu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33612, USA.
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Salihu HM, Ibrahimou B, August EM, Dagne G. Risk of infant mortality with weekend versus weekday births: A population-based study. J Obstet Gynaecol Res 2012; 38:973-9. [DOI: 10.1111/j.1447-0756.2011.01818.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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August EM, Quinn GP, Perales R, Closser Z, Dutil J, Puig M, Vadaparampil ST. Important considerations for recruiting women to cancer genetics studies in Puerto Rico. J Cancer Educ 2012; 27:105-11. [PMID: 21866412 PMCID: PMC4528373 DOI: 10.1007/s13187-011-0265-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
A goal of the Minority Institution/Cancer Center Partnership between the Ponce School of Medicine in Puerto Rico and the H. Lee Moffitt Cancer Center & Research Institute in Florida is to provide cross-cultural training in cancer research. This is achieved through a collaborative summer exchange program, which provides US students with an opportunity to conduct research in Puerto Rico. As part of this program, students recruited participants and collected data for a study to enhance the understanding of sociocultural factors among Puerto Rican women regarding genetic testing for hereditary breast/ovarian cancer. Limited studies have examined cancer genetics issues among Latinos, particularly those specific to the various Latino subgroups, such as Puerto Ricans. As a result of the student training experience, culturally appropriate strategies for the recruitment of women in Puerto Rico have been identified. These recommendations can inform the design of cancer research projects and interventions targeting the Puerto Rican population.
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Affiliation(s)
- Euna M August
- Health Outcomes & Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
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Salihu HM, Connell L, Salemi JL, August EM, Weldeselasse HE, Alio AP. Prevalence and temporal trends of hepatitis B, hepatitis C, and HIV/AIDS co-infection during pregnancy across the decade, 1998-2007. J Womens Health (Larchmt) 2011; 21:66-72. [PMID: 22011209 DOI: 10.1089/jwh.2011.2979] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Limited data are available on hepatitis rates during pregnancy by socio-demographic characteristics. This study examined temporal trends in hepatitis B virus (HBV) and hepatitis C virus (HCV) mono-infections and HIV/HBV and HIV/HCV co-infections in subpopulations among pregnant women in Florida between 1998 and 2007. METHODS We analyzed all Florida live births from 1998 to 2007 using hospital discharge data linked to birth records. RESULTS The total sample size was 1,700,734 singleton live births. The prevalance of HBV in pregnancy rose from 65.4 per 100,000 births to 123.5 per 100,000 births (p<0.0001 for trend), and the prevalence of HCV in pregnancy increased from 17.0 per 100,000 births to 125.1 per 100,000 births (p<0.0001 for trend). Compared with white mothers, black mothers were more than twice as likely to have HBV in pregnancy (adjusted rate ratios [ARR]=2.24; 95% CI=1.97-2.53). Black mothers were 69% (ARR=0.31, 95% CI=0.25-0.39) and Hispanic mothers were 51% (ARR=0.49, 95% CI=0.41-0.60) less likely to have HCV compared with white mothers. CONCLUSIONS Although the overall prevalence rate of HBV increased over the past decade, black women still had a noticeably higher rate of infection. Similarly, white women and those with HIV co-infection had noticeably higher rates of HCV infection over the study period. Our findings call for improved and increased HBV/HCV prevention, screening, and immunization programs among minority women of childbearing age.
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Affiliation(s)
- Hamisu M Salihu
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL 33613, USA.
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August EM, Salihu HM, Weldeselasse H, Biroscak BJ, Mbah AK, Alio AP. Infant mortality and subsequent risk of stillbirth: a retrospective cohort study. BJOG 2011; 118:1636-45. [DOI: 10.1111/j.1471-0528.2011.03137.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BACKGROUND AND AIMS To examine the association between maternal hepatitis B and C mono- and co-infections with singleton pregnancy outcomes in the state of Florida. METHODS We analysed all Florida births from 1998 to 2007 using birth certificate records linked to hospital discharge data. The main outcomes of interest were selected pregnancy outcomes including preterm birth, low birth weight (LBW), small for gestational age (SGA), fetal distress, neonatal jaundice and congenital anomaly. RESULTS The study sample consisted of 1,670,369 records. Human immunodeficiency virus co-infection and all forms of substance abuse were more frequent in mothers with hepatitis B and C infection. After using multivariable modelling to adjust for important socio-demographical variables and obstetric complications, women with hepatitis C infection were more likely to have infants born preterm [odds ratio (OR), 1.40; 95% confidence intervals (CI), 1.15-1.72], with LBW (OR, 1.39; 95% CI, 1.11-1.74) and congenital anomaly (OR, 1.55; 95% CI, 1.14-2.11). In addition, women with hepatitis B infection were less likely to have infants born SGA (OR, 0.79; 95% CI, 0.66-0.95). CONCLUSIONS Our findings provide further understanding of the association between maternal hepatitis B or C carrier status and perinatal outcomes. Infants born to women with hepatitis C infection appear to be at risk for poor birth outcomes, including preterm birth, LBW and congenital anomaly.
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Affiliation(s)
- Laura E Connell
- Department of Epidemiology and Biostatistics, University of South Florida, Tampa, FL, USA
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Salihu HM, August EM, Weldeselasse HE, Biroscak BJ, Mbah AK. Stillbirth as a risk factor for subsequent infant mortality. Early Hum Dev 2011; 87:641-6. [PMID: 21605952 DOI: 10.1016/j.earlhumdev.2011.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 04/26/2011] [Accepted: 05/03/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Infant mortality is an important indicator of the health and wellness of a society. Multiple risk factors for infant mortality have been identified and investigated; however, the influence of prior pregnancy experience on subsequent infant mortality is under-researched. AIMS To examine the association between stillbirth in the first pregnancy and risk for infant mortality in the second pregnancy in a large population-based dataset. STUDY DESIGN Population-based, retrospective cohort study SUBJECTS Missouri maternally linked cohort data files were utilized from 1989 through 2005. Analyses were restricted to women who had two singleton pregnancies during the study period. OUTCOME MEASURES The exposure was stillbirth in the first pregnancy, while the primary outcome was infant mortality in the second pregnancy. RESULTS Women who experienced stillbirth in their first pregnancy were more likely to be of advanced age, black, and obese and had higher rates of pregnancy-related complications (p<0.01). Previous stillbirth was associated with an elevated risk for subsequent infant mortality (AHR=2.51, 95% CI: 1.73-3.65) and neonatal mortality (AHR=3.04, 95% CI: 1.99-4.65), after adjustment for socio-demographic variables and pregnancy complications. Risk estimates for mortality in the second pregnancy were most profound among black mothers with a history of stillbirth in the first pregnancy [risk for infant mortality: (AHR=2.68, 95% CI: 1.41-5.09) and neonatal death: (AHR=4.25, 95% CI: 2.34-7.60)]. CONCLUSIONS Women with prior stillbirth bear elevated risks for subsequent infant mortality. Women's previous childbearing experiences could serve as important criteria in determining appropriate interconception strategies to improve subsequent feto-infant health and survival.
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Affiliation(s)
- Hamisu M Salihu
- University of South Florida, College of Public Health, Department of Epidemiology and Biostatistics, Tampa, FL 33612, USA.
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Rivers BM, August EM, Schenck A, Jackson M, Scian J, Dimaggio A, Quinn G. Abstract A33: African American men's perceptions of the informed decision-making process for prostate cancer screening: Implications for design and development. Cancer Epidemiol Biomarkers Prev 2011. [DOI: 10.1158/1055-9965.disp-11-a33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Introduction: Although prostate cancer mortality rates are on the decline, rates in African American men remain more than twice as high as those in white men. Men at risk for prostate cancer are encouraged to utilize informed decision making (IDM) to determine the most appropriate strategy for screening and prevention. However, multiple barriers exist in the provision of culturally and linguistically appropriate IDM models on prostate cancer for African American men, including mistrust of the health system, fear of cancer, and concerns about discrimination and racism. Multimedia approaches have been determined to be an effective means for the dissemination of culturally and linguistically appropriate IDM models for African Americans that minimize barriers within the community.
Methods: Focus groups were conducted with African American men in the Tampa Bay area to determine core elements for the design of a video-based patient decision aid for prostate cancer screening. Lay health advisors from the community recruited African American men to participate in this formative research. The inclusion criteria were: African American men; aged 40 to 70 years; and no diagnosis of prostate cancer or any other type of cancer. The focus groups were transcribed verbatim and analyzed using a combination of content analysis and the constant comparison method with Atlas.ti software.
Results: A total of 18 African American men, ranging in age from 41 to 65 years, were recruited (mean age=48.5 years). Overall, men had limited knowledge regarding prostate cancer, and slightly more than one-third (38.9%) of the men had previously been screened for prostate cancer. Multiple themes emerged through the conduct of focus groups, including the influence of cultural beliefs in screening, the need for more information on risk and protective factors for prostate cancer, the involvement of spouses and family members in decision-making, and the importance of culturally-appropriate educators, advocates, and role models.
Conclusions: Overall, there is a lack of information regarding prostate cancer among African American men. Cultural perceptions and beliefs play a critical role in the determination of screening practices in this community. Patient decision aids on prostate cancer for African American men require the utilization of African American health professionals and peers as purveyors of information. Furthermore, messaging should be tailored for African American men, as well as their spouses and families, to aid in the determination of appropriate prevention and screening strategies. These findings will assist in the design and development of culturally and linguistically appropriate educational resources and interventions on prostate cancer for the African American community.
Citation Information: Cancer Epidemiol Biomarkers Prev 2011;20(10 Suppl):A33.
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Affiliation(s)
- Brian M. Rivers
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,
| | - Euna M. August
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,
| | - April Schenck
- 2University of South Florida, College of Public Health, Tampa, FL
| | - Myron Jackson
- 2University of South Florida, College of Public Health, Tampa, FL
| | - Joanna Scian
- 2University of South Florida, College of Public Health, Tampa, FL
| | - Angela Dimaggio
- 2University of South Florida, College of Public Health, Tampa, FL
| | - Gwen Quinn
- 1H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL,
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Belogolovkin V, Crisan L, Lynch O, Weldeselasse H, August EM, Alio AP, Salihu HM. Neonatal outcomes of successful VBAC among obese and super-obese mothers. J Matern Fetal Neonatal Med 2011; 25:714-8. [DOI: 10.3109/14767058.2011.596594] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Whiteman VE, Salihu HM, Weldeselasse HE, August EM, Alio AP, Marty PJ. Temporal trends in cardiomyopathy in pregnancy and association with feto-infant morbidity outcomes. J Matern Fetal Neonatal Med 2011; 25:627-31. [PMID: 21777130 DOI: 10.3109/14767058.2011.594922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine temporal trends of cardiomyopathy in pregnancy and its association with feto-infant morbidity outcomes. DESIGN AND METHODS We performed a population-based retrospective cohort analysis utilizing the Florida hospital discharge data linked to vital statistics for 1998 to 2007 (N = 1 738 860). Prevalence rates and trend statistics of cardiomyopathy were computed. Conditional logistic regression models were used to generate adjusted odds ratios (AOR) and 95% confidence intervals (CI). RESULTS The annual prevalence of cardiomyopathy in pregnancy increased from 8.5/100 000 births to 32.7/100 000 (p for trend <0.0001), representing an absolute increase of 24% and a relative increase of 300% over the decade. Infants born to women with cardiomyopathy were at higher risk for feto-infant morbidities, including low birth weight (AOR = 3.49, 95% CI: 2.97-4.11), very low birth weight (AOR = 4.43, 95% CI: 2.98-6.60), preterm birth (AOR = 3.33, 95% CI: 2.88-3.85), very preterm birth (AOR = 5.22, 95% CI: 3.92-6.97) and small for gestational age (AOR = 1.57, 95% CI: 1.26-1.96). CONCLUSION The observed increasing prevalence of cardiomyopathy during pregnancy over the decade is of concern, as it is related to elevated risk for feto-infant morbidities. There is a need to delineate risk factors for this condition and to formulate appropriate preconception counseling for women with elevated risk for this diagnosis.
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Affiliation(s)
- Valerie E Whiteman
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, College of Medicine, University of South Florida, Tampa, FL 33612, USA
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Salihu HM, August EM, Mbah AK, Alio AP, de Cuba R, Jaward FM, Berry EL. Effectiveness of a Federal Healthy Start Program in Reducing the Impact of Particulate Air Pollutants on Feto-Infant Morbidity Outcomes. Matern Child Health J 2011; 16:1602-11. [DOI: 10.1007/s10995-011-0854-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Vadaparampil ST, Quinn GP, Dutil J, Puig M, Malo TL, McIntyre J, Perales R, August EM, Closser Z. A pilot study of knowledge and interest of genetic counseling and testing for hereditary breast and ovarian cancer syndrome among Puerto Rican women. J Community Genet 2011; 2:211-21. [PMID: 22109874 DOI: 10.1007/s12687-011-0058-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 06/30/2011] [Indexed: 12/31/2022] Open
Abstract
This study explored baseline levels of knowledge and attitude toward genetic testing (GT) for hereditary breast and ovarian cancer among Puerto Rican women. A secondary aim was to evaluate whether these factors differed between respondents in Puerto Rico and Tampa. Puerto Rican women with a personal or family history of breast or ovarian cancer who live in Puerto Rico (n = 25) and Tampa (n = 20) were interviewed. Both groups were interested in obtaining GT; women living in Puerto Rico were more likely to report they would get GT within 6 months (p = 0.005). The most commonly cited barrier was cost; the most commonly cited facilitator was provider recommendation. There was no difference in overall knowledge between Tampa (M = 5.15, SD = 1.63) and Puerto Rico (M = 5.00, SD = 1.87) participants (p = 0.78). Involving health care providers in recruitment and highlighting that GT may be available at minimal or no cost in the USA and Puerto Rico may facilitate participation.
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Affiliation(s)
- Susan T Vadaparampil
- Health Outcomes and Behavior Program, Moffitt Cancer Center, 12902 Magnolia Drive, MRC CANCONT, Tampa, FL, 33612, USA,
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Salihu HM, August EM, Alio AP, Jeffers D, Austin D, Berry E. Community-academic partnerships to reduce black-white disparities in infant mortality in Florida. Prog Community Health Partnersh 2011; 5:53-66. [PMID: 21441669 DOI: 10.1353/cpr.2011.0009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PROBLEM In Florida, data reveal a widening black-white disparity in infant mortality to the disadvantage of black families. Eight Florida counties have a significantly pronounced black-white infant mortality gap: Broward, Duval, Gadsden, Hillsborough, Miami-Dade, Orange, Palm Beach, and Putnam. PURPOSE The black Infant Health Community Collaborative (BIHCC) was established to address the rising racial/ethnic disparities in infant mortality. The program used a community-based participatory research (CBPR) approach to enable communities to develop sustainable initiatives to improve community health and reduce infant mortality. KEY POINTS Grounded in CBPR principles, a community-academic-state partnership was created to address the upsurge in black-white disparity in infant mortality. Community teams from each participating county underwent a 2-year period of capacity building. The culmination of this process was community-driven action plans to alleviate infant health disparities. CONCLUSION The BIHCC provides a replicable model for the development of community-academic-state partnerships to enhance capacity for improving infant health outcomes.
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Salihu HM, August EM, Jeffers DF, Mbah AK, Alio AP, Berry E. Effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies: our experience over the decade. J Pediatr Adolesc Gynecol 2011; 24:153-60. [PMID: 21397532 DOI: 10.1016/j.jpag.2011.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Revised: 01/12/2011] [Accepted: 01/12/2011] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE To evaluate the effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies in a disadvantaged community. DESIGN An ecological study that compares trends in teen pregnancy in the catchment area in which the community-based intervention was administered with two ecologic controls: the county (Hillsborough) and the state (Florida). SETTING Our catchment area is East Tampa, a socio-economically disadvantaged community in Hillsborough County, Florida. PARTICIPANTS Preconception care targeted teenagers between the ages of 10 and 19 years. Interconception care involved young mothers under the age of 20 with a previous birth. The population was comprised primarily of African Americans. INTERVENTION Preconception care services for primary teen pregnancy reduction offered sex education, family planning, drug and violence prevention education, and communication and negotiation skills acquisition. Interconception care service offered young women health education through monthly home visitation or monthly peer support group meetings addressing a range of topics using the life course perspective as framework. MAIN OUTCOME MEASURE Reduction in primary teen pregnancy and repeat teen pregnancy among adolescents. RESULTS The decline in primary teen pregnancy in the catchment area was 60% and 80% greater than the reduction experienced at the county level and at the state level respectively over the period of the study. However, efforts to prevent repeat pregnancy were not successful. CONCLUSION The Federal Healthy Start Preconception Care program, in collaboration with community partners, contributed to the prevention of first-time teen pregnancy in a community faced with significant social and economic challenges.
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Affiliation(s)
- Hamisu M Salihu
- Center for Research and Evaluation, Lawton & Rhea Chiles Center for Healthy Mothers and Babies, University of South Florida, Tampa, Florida, USA.
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Rivers BM, August EM, Gwede CK, Hart A, Donovan KA, Pow-Sang JM, Quinn GP. Psychosocial issues related to sexual functioning among African-American prostate cancer survivors and their spouses. Psychooncology 2011; 20:106-10. [PMID: 20187071 DOI: 10.1002/pon.1711] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Focus on cancer survivorship and quality of life (QOL) is a growing priority. The aim of this study was to identify and describe the most salient psychosocial concerns related to sexual functioning among African-American (AA) prostate cancer survivors and their spouses. METHODS Twelve AA prostate cancer survivors and their spouses participated in semi-structured individual interviews. The interviews assessed couples' experiences with psychosocial adjustment and sexual functioning posttreatment for localized prostate cancer. The data were analyzed using the constant comparison method and content analysis. RESULTS In this qualitative study of couples surviving prostate cancer, there were divergent views between the male prostate cancer survivors and their female partners, particularly regarding sexual functioning. For the males, QOL issues emerged as the primary area of concern, whereas survival of their husbands was considered most important among the female spouses. The male respondents expressed unease with the sexual side effects of their cancer treatment, such as erectile dysfunction and decreased sexual desire and satisfaction. Female spouses recognized decreased sexual desire in their partners following treatment, but this was not considered a primary concern. CONCLUSIONS Patients and their spouses may have differing perceptions regarding QOL and the impact of sexual functioning on survivorship. This study points to the need for further research and intervention development to address these domains with a goal to improve QOL.
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Affiliation(s)
- Brian M Rivers
- Moffitt Cancer Center and Research Institute, Department of Health Outcomes and Behavior, 12902 Magnolia Drive, Tampa, FL 33612, USA.
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Salihu HM, Kornosky JL, Lynch O, Alio AP, August EM, Marty PJ. Impact of prenatal alcohol consumption on placenta-associated syndromes. Alcohol 2011; 45:73-9. [PMID: 20598485 DOI: 10.1016/j.alcohol.2010.05.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 05/21/2010] [Accepted: 05/22/2010] [Indexed: 12/13/2022]
Abstract
The biology of placental and fetal development suggests that alcohol may play a significant role in increasing the risk of feto-infant morbidity and mortality, but study results are inconsistent and the mechanism remains poorly defined. Previous studies have not examined the risk of placenta-associated syndromes (PASs: defined as the occurrence of either placental abruption, placenta previa, preeclampsia, small for gestational age, preterm, or stillbirth) as a unique entity. Therefore, we sought to examine the relationship between prenatal alcohol use and the risk of PAS among singleton births in the Missouri maternally linked data files covering the period 1989-2005. Logistic regression with adjustment for intracluster correlation was used to generate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Compared with nondrinkers, drinkers were more likely to be smokers, 35 years of age or older, black, and multiparous. Drinkers had an increased risk of PAS (OR=1.26, 95% CI=1.22,1.31) when compared with their nondrinking counterparts. The risk of PAS was progressively amplified with increasing prenatal alcohol consumption (P for trend <.01). Women who reported consuming five or more alcoholic drinks per week had more than twofold increased risk of PASs, whereas women in the lowest drinking category (one to two drinks per week) had only a slight increased risk of PAS (OR=1.09, 95% CI=1.05, 1.14). Enhanced understanding of the mechanism by which prenatal alcohol consumption leads to PAS may aid in the development of more targeted interventions designed to prevent adverse pregnancy outcomes. Screening women for alcohol use may assist providers in protecting developing fetuses from the potential dangers of prenatal alcohol use.
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Mbah AK, Kornosky JL, Kristensen S, August EM, Alio AP, Marty PJ, Belogolovkin V, Bruder K, Salihu HM. Super-obesity and risk for early and late pre-eclampsia. BJOG 2010; 117:997-1004. [PMID: 20482533 DOI: 10.1111/j.1471-0528.2010.02593.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To examine the association between obesity subtypes and risk of early and late pre-eclampsia. DESIGN Population-based retrospective study. SETTING State of Missouri maternally linked birth cohort files. POPULATION All singleton live births in the state of Missouri from 1989 to 2005. METHODS The body mass index (BMI) was used to classify women as normal weight (BMI = 18.5-24.9 kg/m(2)), class I obesity (BMI = 30-34.9 kg/m(2)), class II obesity (BMI = 35-39.9 kg/m(2)), class III obesity (BMI = 40-49.9 kg/m(2)) or super-obesity (BMI > or = 50 kg/m(2)). Adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between obesity and the risk of pre-eclampsia were obtained from logistic regression models with adjustment for intracluster correlation. RESULTS The rate of pre-eclampsia increased with increasing BMI, with super-obese women having the highest incidence (13.4%). Compared with normal weight women, obese women (BMI > or = 30 kg/m(2)) had a higher risk for pre-eclampsia (OR = 2.59, 95% CI = 2.87-3.01). This risk remained approximately the same for late-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or more of gestation) and was slightly reduced for early-onset pre-eclampsia (pre-eclampsia occurring at 34 weeks or less of gestation). Within each BMI category, the risk of pre-eclampsia increased with the rate of weight gain. Compared with normal weight mothers with moderate weight gain, super-obese women with a high rate of weight gain had the greatest risk for pre-eclampsia (OR = 7.52, 95% CI = 2.70-21.0). CONCLUSION BMI and rate of weight gain are synergistic risk factors that amplify the burden of pre-eclampsia among super-obese women.
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Affiliation(s)
- A K Mbah
- Center for Research and Evaluation, The Chiles Center, University of South Florida, 3111 E. Fletcher Avenue, Tampa, FL 33613, USA
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Quinn GP, August EM, Austin D, Keefe C, Bernadotte C, Scarborough K, Jeffers D. High Risk Community—Men’s Perceptions of Black Infant Mortality: A Qualitative Inquiry. Am J Mens Health 2009; 3:224-37. [DOI: 10.1177/1557988308319008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Infant mortality has been identified as a key public health concern in the United States. Although infant mortality rates (IMRs) in the United States have declined during the past 10 years, the rates among Blacks are more than two times higher as compared with other racial and ethnic groups. This study used focus groups to explore Black men’s awareness and perceptions of the rising IMR in their community. Twenty-five men participated in an initial and follow-up focus group, which revealed that men had limited awareness of infant mortality, reduced sense of personal responsibility for pregnancy outcomes, and perceptions that stress, the age of the mother, and the health care system were responsible for poor birth outcomes. The role of the community and possible interventions to involve and educate men were also explored.
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Affiliation(s)
- Gwendolyn P. Quinn
- Department of Interdisciplinary Oncology, University of South Florida, College of Medicine, , Moffitt Cancer Center, Health Outcomes and Behavior Program, University of South Florida
| | - Euna M. August
- Moffitt Cancer Center, Health Outcomes and Behavior Program, University of South Florida, Department of Community and Family Health, University of South Florida, College of Public Health Tampa, Florida
| | - Deborah Austin
- Department of Community and Family Health, University of South Florida, College of Public Health Tampa, Florida
| | - Candace Keefe
- Lawton and Rhea Chiles Center for Healthy Mothers and Babies
| | | | | | - Delores Jeffers
- Department of Community and Family Health, University of South Florida, College of Public Health Tampa, Florida
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Baldwin JA, Daley E, Brown EJ, August EM, Webb C, Stern R, Malow R, Dévieux JG. Knowledge and Perception of STI/HIV Risk Among Rural African-American Youth: Lessons Learned in a Faith-Based Pilot Program. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/10698370802175193] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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