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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. APPLIED RESEARCH IN QUALITY OF LIFE 2013; 8:219-250. [PMID: 23734167 PMCID: PMC3667203 DOI: 10.1007/s11482-012-9188-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [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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Salinas-Miranda AA, Salemi JL, King LM, Baldwin JA, Berry EL, Austin DA, Scarborough K, Spooner KK, Zoorob RJ, Salihu HM. Adverse childhood experiences and health-related quality of life in adulthood: revelations from a community needs assessment. Health Qual Life Outcomes 2015; 13:123. [PMID: 26260580 PMCID: PMC4530491 DOI: 10.1186/s12955-015-0323-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 06/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) have been previously linked to quality of life, health conditions, and life expectancy in adulthood. Less is known about the potential mechanisms which mediate these associations. This study examined how ACE influences adult health-related quality of life (HRQoL) in a low-income community in Florida. METHODS A community-based participatory needs assessment was conducted from November 2013 to March 2014 with 201 residents of Tampa, Florida, USA. HRQoL was measured by an excessive number of unhealthy days experienced during the previous 30-day window. Mediation analyses for dichotomous outcomes were conducted with logistic regression. Bootstrapped confidence intervals were generated for both total and specific indirect effects. RESULTS Most participants reported 'good to excellent health' (76%) and about a fourth reported 'fair to poor health' (24%). The mean of total unhealthy days was 9 days per month (SD ± 10.5). Controlling for demographic and neighborhood covariates, excessive unhealthy days was associated with ACE (AOR = 1.23; 95% CI: 1.06, 1.43), perceived stress (AOR = 1.07; 95% CI: 1.03, 1.10), and sleep disturbance (AOR = 8.86; 3.61, 21.77). Mediated effects were significant for stress (β = 0.08) and sleep disturbances (β = 0.11) as they related to the relationship between ACE and excessive unhealthy days. CONCLUSION ACE is linked to adult HRQoL. Stress and sleep disturbances may represent later consequences of childhood adversity that modulate adult quality of life.
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Research Support, N.I.H., Extramural |
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Himmelgreen D, Romero-Daza N, Heuer J, Lucas W, Salinas-Miranda AA, Stoddard T. Using syndemic theory to understand food insecurity and diet-related chronic diseases. Soc Sci Med 2020; 295:113124. [PMID: 32586635 DOI: 10.1016/j.socscimed.2020.113124] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022]
Abstract
Syndemic Theory (ST) provides a framework to examine mutually enhancing diseases/health issues under conditions of social inequality and inequity. ST has been used in multiple disciplines to address interacting infectious diseases, noncommunicable diseases, and mental health conditions. The theory has been critiqued for its inability to measure disease interactions and their individual and combined health outcomes. This article reviews literature that strongly suggests a syndemic between food insecurity (FI) and diet-related chronic diseases (DRCDs), and proposes a model to measure the extent of such interaction. The article seeks to: (1) examine the potential syndemic between FI and DRCDs; (2) illustrate how the incorporation of Life History Theory (LHT), into a syndemic framework can help to highlight critical lifeperiods when FI-DRCD interactions result in adverse health outcomes; (3) discuss the use of mixed methods to identify and measure syndemics to enhance the precision and predictive power of ST; and (4) propose an analytical model for the examination of the FI-DRCD syndemic through the life course. The proposed model is more relevant now given the significant increase in FI globally as a result of the ongoing COVID-19 pandemic. The differential impact that the pandemic appears to have among various age groups and by other demographic factors (e.g., race, gender, income) offers an opportunity to examine the potential FI-DRCD syndemic under the lens of LHT.
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Salihu HM, Dongarwar D, King LM, Yusuf KK, Ibrahimi S, Salinas-Miranda AA. Trends in the incidence of fetal macrosomia and its phenotypes in the United States, 1971-2017. Arch Gynecol Obstet 2019; 301:415-426. [PMID: 31811414 DOI: 10.1007/s00404-019-05400-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Studies have reported a surge in the prevalence of obesity among various demographic groups including pregnant women in the U.S. Given the association between maternal obesity and risk of fetal macrosomia, we hypothesized that the incidence of fetal macrosomia will be on the rise in the U.S. We examined trends in fetal macrosomia and macrosomia phenotypes in the U.S. among singleton live births within the gestational age of 28-42 weeks inclusive. METHODS This was a retrospective cohort study covering the period 1971-2017 using U.S. Natality Data files. We applied Joinpoint regression models to derive the average annual percentage change in the outcome. We measured incidence and trends of fetal macrosomia which was defined as birth weight ≥ 4000 g. We further subdivided macrosomia into its phenotypes as previously recommended: Grade 1 (4000-4499 g), Grade 2 (4500-4999 g) and Grade 3 (≥ 5000 g). RESULTS A total of 147,331,305 singleton births over the entire study period of 47 years were analyzed. From a baseline incidence of 8.84%, the rate of fetal macrosomia declined to 8.07% by the end of the study representing a drop of 8.70% in relative terms. The greatest drop was among infants with Grade 3 macrosomia, the most severe and lethal phenotype. The most impactful factors were maternal age and gestational weight gain. CONCLUSION This study is the largest population-based study conducted regarding fetal macrosomia. The rate of fetal macrosomia declined over the previous 5 decades with the most substantial drop observed in the phenotype with the worst prognosis.
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Rahman S, Chang L, Hadgu S, Salinas-Miranda AA, Corvin J. Prevalence, knowledge, and practices of hookah smoking among university students, Florida, 2012. Prev Chronic Dis 2014; 11:E214. [PMID: 25474386 PMCID: PMC4264467 DOI: 10.5888/pcd11.140099] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Although hookah smoking is becoming a source of tobacco use among college students in the United States, little is known of the students' knowledge, attitudes, and practices regarding hookah use. This cross-sectional study was aimed at determining the prevalence of hookah use and describing social and behavioral factors associated with hookah smoking among university students in a large urban university in Florida. METHODS A convenience sample of 478 undergraduate and graduate students was recruited. Lifetime use and current use was evaluated. Logistic regression modeling was used to assess the independent association between study covariates and hookah use. RESULTS Prevalence among students of having ever used hookah during their lifetime was 54.4%. Hookah use within the past 30 days was 16.3%. Hookah use was significantly associated with cigarette smoking (odds ratio [OR], 4.52; 95% confidence interval [CI], 2.13-9.60) and hookah ownership (OR, 10.67; 95% CI, 4.83-23.66) but not with alcohol use (OR, 1.73; 95% CI, 0.74-4.04). Findings also suggest hookah is perceived as a safer alternative to cigarette smoking. Almost 30% of those who never smoked hookah reported they would consider smoking hookah in the future. CONCLUSION Hookah smoking is popular among college students. Misperceptions associated with hookah use indicate a starting point for developing health behavior change interventions. Future studies should investigate social and behavioral determinants of hookah use and determine the incidence of hookah use among college and high school students. Tobacco control activities should include prevention of hookah tobacco use in university settings.
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Salihu HM, Salinas-Miranda AA, Hill L, Chandler K. Survival of pre-viable preterm infants in the United States: a systematic review and meta-analysis. Semin Perinatol 2013; 37:389-400. [PMID: 24290394 DOI: 10.1053/j.semperi.2013.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this paper is to review observational studies that addressed the survival of pre-viable gestations in the United States. We searched PubMed, Ovid, CINAHL, and Web of Knowledge for studies reporting survival of infants born at <24 gestational weeks and/or <500g in the United States and published between January 2003 and January 2013. The full texts of 70 articles were examined and a total of 15 studies qualified and were selected. We analyzed fixed-effect and random-effects models for eight studies on survival to discharge. Pooled survival to discharge in the random-effects model was 45.9% (95% CI: 41.1-51.7) and 39.7% in the fixed-effect model (95% CI: 38.8-40.7). Studies differed by pre-viable survival measures and epochs (1985-2009). Protective factors included antenatal corticosteroids, neonatal resuscitation, and intensive care. The current survival threshold for pre-viable infants warrants reconsideration of the limits of viability. Protective factors that enhance survival should be considered in the management of these infants.
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Meta-Analysis |
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Ikedionwu CA, Dongarwar D, Yusuf KK, Ibrahimi S, Salinas-Miranda AA, Salihu HM. Pre-pregnancy maternal obesity, macrosomia, and risk of stillbirth: A population-based study. Eur J Obstet Gynecol Reprod Biol 2020; 252:1-6. [PMID: 32562938 DOI: 10.1016/j.ejogrb.2020.06.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/04/2020] [Accepted: 06/06/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE An examination of the synergistic effects of maternal obesity and macrosomia on the risk of stillbirth is lacking. The purpose of this study was to determine the association between fetal macrosomia, maternal obesity, and the risk of stillbirth. METHODS This retrospective cross-sectional study used the CDC's Birth Data and Fetal Death Data files for 2014-2017 [n = 10,043,398 total births; including 48,799 stillbirths]. The exposure was fetal macrosomia stratified by obesity subtypes (I-III). The outcome was the risk of stillbirth. We also controlled for potential and known confounding factors in adjusted models. Adjusted Relative Risks (ARR) were estimated with log-binomial regression models. RESULTS The rate of stillbirth was higher among macrosomic infants born to mothers with obesity compared to those without (6.55 vs. 0.54 per 1000 total births). After controlling for confounding, women with obesity types II and III were at increased risk for stillbirth [Obesity II ARR = 2.37 (2.07-2.72); Obesity III ARR = 9.06 (7.61-10.78)]. CONCLUSIONS FOR PRACTICE Obesity-related fetal overgrowth is a significant risk factor for stillbirth, especially among women with type II and type III obesity. This finding highlights the need for more effective clinical and public health strategies to address pre-pregnancy obesity and to optimize gestational weight gain.
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Salihu HM, Dongarwar D, King LM, Yusuf KK, Ibrahimi S, Salinas-Miranda AA. Phenotypes of fetal macrosomia and risk of stillbirth among term deliveries over the previous four decades. Birth 2020; 47:202-210. [PMID: 31925852 DOI: 10.1111/birt.12479] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the association between macrosomia and stillbirth over the previous four decades and to determine the consistency of the relationship. METHODS This was a population-based retrospective cohort study using United States Natality and Fetal Death Data from 1982 to 2017 and restricted to the gestational age range of 37-41 weeks inclusive. Macrosomia was defined as birthweight ≥4000 g and subdivided into its grades as previously recommended: grade 1 (4000-4499 g), grade 2 (4500-4999 g), and grade 3 (≥5000 g). We calculated temporal trends of stillbirth among fetuses with macrosomia over the years using joinpoint regression. We generated odds ratios from adjusted binomial logistic regression models to examine the association between macrosomia and risk of stillbirth stratified by grades using normal-weight infants (2500-3999 g) as referent. RESULTS Within the fetal macrosomia group, the rate of stillbirth declined from 2.04/1000 in 1982 to 1.05/1000 by the end of the study period (2017), representing a drop of about 48.5%. For the normal-weight fetuses, stillbirth rate declined from 1.95/1000 to 0.83/1000, equivalent to a decline of 57.4%. Macrosomia was significantly associated with elevated risk for stillbirth: grade 2 (OR = 1.27; 95% CI = 1.22-1.32) and grade 3 (OR = 5.97; 95% CI = 5.69-6.22). CONCLUSIONS Fetal macrosomia is a significant risk factor for fetal demise with the worst intrauterine survival observed among those classified as grade 3. Fetal macrosomia is a heterogeneous rather than a homogeneous entity in terms of risk profiles, and this needs to be considered in future policy guidelines.
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Historical Article |
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Salihu HM, Mogos MF, Salinas-Miranda AA, Salemi JL, Whiteman VE. National trends in maternal use of opioid drugs among pregnancy-related hospitalizations in the United States, 1998 to 2009. Am J Perinatol 2015; 32:289-98. [PMID: 25077473 DOI: 10.1055/s-0034-1384642] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study is to describe national trends for opioid use among pregnancy-related hospitalizations from 1998 to 2009. STUDY DESIGN Using the Nationwide Inpatient Sample, we identified hospital discharge records associated with the diagnoses codes for the use of opioids for all eligible pregnancy-related inpatient admissions between 1998 and 2009. Joinpoint regression modeling was used to describe changes in trend of pregnancy-related opioid use. The main outcome measure was the annual percent change for opioids use among pregnancy-related hospitalizations. RESULTS From 1998 to 2009, opioid use was documented in 138,224 of 55,781,966 pregnancy-related inpatient hospitalizations (25 cases per 10,000 discharges). A statistically significant downward trend occurred from 1998 to 2001, whereas from 2002 to 2009 there was a statistically significant upward trend. The increasing trend in opioid use from 2002 to 2009 is notably higher for whites compared with blacks and Hispanics. CONCLUSIONS Our findings highlight the continuous need to monitor opioids use and to revise prescription guidelines, practices, and regulatory mechanisms to curtail the progression of the increasing opioids use during pregnancy. It is critical that health care providers weight the benefits of these medications along with their potential risks when discussing analgesic treatment options with pregnant women.
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Salihu HM, Salinas-Miranda AA, Wang W, Turner D, Berry EL, Zoorob R. Community Priority Index: Utility, Applicability and Validation for Priority Setting in Community-Based Participatory Research. J Public Health Res 2015; 4:443. [PMID: 26425490 PMCID: PMC4568419 DOI: 10.4081/jphr.2015.443] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 03/04/2015] [Accepted: 03/06/2015] [Indexed: 11/24/2022] Open
Abstract
Background Providing practitioners with an intuitive measure for priority setting that can be combined with diverse data collection methods is a necessary step to foster accountability of the decision-making process in community settings. Yet, there is a lack of easy-to-use, but methodologically robust measures, that can be feasibly implemented for reliable decision-making in community settings. To address this important gap in community based participatory research (CBPR), the purpose of this study was to demonstrate the utility, applicability, and validation of a community priority index in a community-based participatory research setting. Design and Methods Mixed-method study that combined focus groups findings, nominal group technique with six key informants, and the generation of a Community Priority Index (CPI) that integrated community importance, changeability, and target populations. Bootstrapping and simulation were performed for validation. Results For pregnant mothers, the top three highly important and highly changeable priorities were: stress (CPI=0.85; 95%CI: 0.70, 1.00), lack of affection (CPI=0.87; 95%CI: 0.69, 1.00), and nutritional issues (CPI=0.78; 95%CI: 0.48, 1.00). For non-pregnant women, top priorities were: low health literacy (CPI=0.87; 95%CI: 0.69, 1.00), low educational attainment (CPI=0.78; 95%CI: 0.48, 1.00), and lack of self-esteem (CPI=0.72; 95%CI: 0.44, 1.00). For children and adolescents, the top three priorities were: obesity (CPI=0.88; 95%CI: 0.69, 1.00), low self-esteem (CPI=0.81; 95%CI: 0.69, 0.94), and negative attitudes toward education (CPI=0.75; 95%CI: 0.50, 0.94). Conclusions This study demonstrates the applicability of the CPI as a simple and intuitive measure for priority setting in CBPR.
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Salinas-Miranda AA, Nash MC, Salemi JL, Mbah AK, Salihu HM. Cutting-edge technology for public health workforce training in comparative effectiveness research. Health Informatics J 2014; 19:101-15. [PMID: 23715210 DOI: 10.1177/1460458212461366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A critical mass of public health practitioners with expertise in analytic techniques and best practices in comparative effectiveness research is needed to fuel informed decisions and improve the quality of health care. The purpose of this case study is to describe the development and formative evaluation of a technology-enhanced comparative effectiveness research learning curriculum and to assess its potential utility to improve core comparative effectiveness research competencies among the public health workforce. Selected public health experts formed a multidisciplinary research collaborative and participated in the development and evaluation of a blended 15-week comprehensive e-comparative effectiveness research training program, which incorporated an array of health informatics technologies. Results indicate that research-based organizations can use a systematic, flexible, and rapid means of instructing their workforce using technology-enhanced authoring tools, learning management systems, survey research software, online communities of practice, and mobile communication for effective and creative comparative effectiveness research training of the public health workforce.
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Research Support, U.S. Gov't, P.H.S. |
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Occean JR, Thomas N, Lim AC, Lovett SM, Michael-Asalu A, Salinas-Miranda AA. Prevalence and Factors Associated With Intimate Partner Violence Among Women in Haiti: Understanding Household, Individual, Partner, and Relationship Characteristics. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:11356-11384. [PMID: 31928293 DOI: 10.1177/0886260519898443] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Intimate partner violence (IPV) is a significant public health issue with detrimental consequences for women's reproductive, mental, and physical health. In Haiti, IPV is a major obstacle to women's development. Yet, the determinants of IPV victimization are still not well understood. In this study, we utilized the 2016-2017 Haiti Demographic and Health Survey to determine the prevalence of IPV victimization and its subtypes (emotional, physical, and sexual abuse) among married or cohabiting women (N = 3,805) of reproductive age (15-49) by their current husband/partner. Logistic regression was conducted to explore the association between IPV and household, individual, husband/partner, and relationship characteristics. The prevalence of IPV victimization was 32.5% with the majority reporting emotional (24.7%) followed by physical (16.8%) and sexual (10.5%) violence. Increased odds of IPV victimization were found among women with children in the household (adjusted odds ratio [AOR] = 1.45, 95% confidence interval [CI] = [1.03, 2.02]), with attitudinal acceptance of wife-beating (AOR = 1.45, 95% CI = [1.05, 2.02]), and those who witnessed their father beating their mother (AOR = 1.49, 95% CI = [1.18, 2.67]). Higher odds of reporting IPV victimization were also found among women whose partner drank alcohol (AOR = 2.89, 95% CI = [2.29, 3.65]), who were in a polygynous relationship (AOR = 1.76, 95% CI = [1.23, 2.40]), and displayed one or more controlling behaviors (AOR = 1.92, 95% CI = [1.42, 2.59]). Women who reported being afraid of their partner had greater odds of IPV victimization (AOR = 16.22, 95% CI = [8.38, 31.39]). Decreased odds of reporting IPV were associated with women living in rural areas (AOR = 0.73, 95% CI = [0.53, 1.00]) and those unmarried, but living with their partner (AOR = 0.62, 95% CI = [0.43, 0.90]). Our findings identify subgroups of women in Haiti that may be vulnerable to IPV victimization. Thus, we recommend a differentiated approach to IPV prevention strategies and interventions that consider women's family structure in the household as well as individual, partner, and relationship characteristics.
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Acheampong M, Ejiofor C, Salinas-Miranda A. An Analysis of Determinants of Under-5 Mortality across Countries: Defining Priorities to Achieve Targets in Sustainable Developmental Goals. Matern Child Health J 2018; 21:1428-1447. [PMID: 28155024 DOI: 10.1007/s10995-017-2260-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objectives The end of the era of millennium development goals (MDGs) ushered in the sustainable development goals (SDGs) with a new target for the reduction of under-five mortality rates (U5MR). Although U5MR decreased globally, the reduction was insufficient to meet MDGs targets because significant socioeconomic inequities remain unaddressed across and within countries. Thus, further progress in achieving the new SDGs target will be hindered if there is no adequate prioritization of important socioeconomic, healthcare, and environmental factors. The objective of this study was to assess factors that account most for the differences in U5MR between countries around the globe. Methods We conducted an ordinary least squares (OLS) regression-based prioritization analysis of socioeconomic, healthcare, and environmental variables from 109 countries to understand which factors explain the differences in U5MR best. Results All indicators examined individually affected differences in U5MR between countries. However, the results of multivariate OLS regression showed that the most important factors that accounted for the differences were, in order: fertility rate, total health expenditure per capita, access to improved water and sanitation, and female employment rate. Conclusions To achieve the new global target for U5MR, policymakers must focus on certain priority areas, such as interventions that address access to affordable maternal healthcare services, educational programs for mothers, especially those who are adolescents, and safe drinking water and sanitation.
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Reid C, Beckstead J, Salinas-Miranda A. COVID-19 stress, social support, and coping in international students during the COVID-19 pandemic: a moderated analysis on anxiety and depression. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1617-1623. [PMID: 35728102 DOI: 10.1080/07448481.2022.2089044] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 05/12/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This study examined the associations between COVID-19 stress and anxiety and depression among international college students and assessed if this relationship was moderated by coping and social support. PARTICIPANTS 219 international students at a large US university. METHODS A cross-sectional online survey utilizing validated scales was conducted from October 1 to 25, 2020. Path analyses assessed the effects of COVID-19 stress on anxiety and depression, and whether coping and social support moderated these relationships in international students. RESULTS COVID-19 stress was significantly associated with anxiety and depression in international students. Maladaptive coping moderated the relationship between COVID-19 stress and anxiety but did not moderate the relationship with depression. Neither adaptive coping or social support moderated the relationship between COVID-19 stress and anxiety or depression. CONCLUSIONS Results confirm the need for additional mental health services to reach international college students at risk of anxiety and depression during the COVID-19 pandemic.
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Agazzi H, Hayford H, Thomas N, Ortiz C, Salinas-Miranda A. A nonrandomized trial of a behavioral parent training intervention for parents with children with challenging behaviors: In-person versus internet-HOT DOCS. Clin Child Psychol Psychiatry 2021; 26:1076-1088. [PMID: 34156883 DOI: 10.1177/13591045211027559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are the first-line interventions for childhood disruptive behaviors. In light of the COVID-19 pandemic, adapting these programs to telehealth modalities is necessary to ensure continued services to children and families. This study evaluates the use of telehealth versus in-person modality to deliver the Helping Our Toddlers, Developing Our Children's Skills (HOT DOCS) BPT. The study design was quasi-experimental with two nonequivalent groups: in-person HOT DOCS (n = 152) and internet-HOT DOCS (n = 46). Participants were caregivers of children ages 2-5 exhibiting disruptive behaviors. Pre- and post-intervention outcome measures were collected for child disruptive behavior and parenting stress and post-test only for consumer satisfaction. Multiple linear and Poisson regression models were performed to assess the effect of class modality on the outcomes. Child disruptive behavior and parenting stress post-test scores for in-person and telehealth groups were not significantly different, even after adjusting for baseline characteristics. Consumer satisfaction scores were significantly more positive for the in-person group. The results of this study provide preliminary evidence for the i-HOT DOCS modality as being as effective as the in-person program. Study findings may be beneficial to practitioners utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Clinical Trial |
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Salemi JL, Salinas-Miranda AA, Wilson RE, Salihu HM. Transformative Use of an Improved All-Payer Hospital Discharge Data Infrastructure for Community-Based Participatory Research: A Sustainability Pathway. Health Serv Res 2015; 50 Suppl 1:1322-38. [PMID: 25879276 PMCID: PMC4545334 DOI: 10.1111/1475-6773.12309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. DATA SOURCES/STUDY SETTING Population-based, longitudinal database covering over 2.3 million mother-infant dyads during a 12-year period (1998-2009) in Florida. SETTING A community-based participatory research (CBPR) project in a socioeconomically disadvantaged community in central Tampa, Florida. STUDY DESIGN Case study of the use of an enhanced state database for supporting CBPR activities. PRINCIPAL FINDINGS A federal data infrastructure award resulted in the creation of an MCH database in which over 92 percent of all birth certificate records for infants born between 1998 and 2009 were linked to maternal and infant hospital encounter-level data. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community. Data were used to facilitate a community-driven, decision-making process in which the most important priorities for intervention were identified. CONCLUSIONS Integrating statewide all-payer, hospital-based databases into CBPR can empower underserved communities with a reliable source of health data, and it can promote the sustainability of newly developed data systems.
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Salinas-Miranda AA, Shaffer-Hudkins EJ, Bradley-Klug KL, Monroe AD. Student and resident perspectives on professionalism: beliefs, challenges, and suggested teaching strategies. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2014; 5:87-94. [PMID: 25341217 PMCID: PMC4207134 DOI: 10.5116/ijme.5334.7c8d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 03/27/2014] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the views of medical students and residents regarding the practice of professionalism, their perceived challenges, and ideas for the development of a new curriculum in medical professionalism. METHODS Data were collected from four focus groups comprised of 27 residents and medical students recruited from the University of South Florida Morsani School of Medicine and Residency Programs between January and March 2012. A questioning protocol was used to guide the focus group discussion. Data were transcribed for thematic analysis. RESULTS Learners expressed beliefs regarding key attributes of professional behaviors, factors perceived to be associated with lapses of professional behavior, skills that need to be taught, and strategies to teach professionalism from the learners' perspective. Learners perceived that the values of professionalism are often disconnected from the reality evidenced in clinical training due to a myriad of personal and contextual challenges. CONCLUSIONS Residents and students need help in negotiating some of the challenges to medical professionalism that are encountered in clinical settings. We recommend a learner's centered model of curriculum development in medical professionalism that takes into consideration perceived challenges and strategies for modeling and reinforcing medical professionalism.
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Salihu HM, Salinas-Miranda AA, King LM, Dongarwar D, Yusuf KK, Ibrahimi S, Ikedionwu CA, Berry EL. Racism, Psycho-Social Stress, and Health-related Quality of Life. Int J MCH AIDS 2020; 9:73-76. [PMID: 32123630 PMCID: PMC7031886 DOI: 10.21106/ijma.339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
There is a paucity of information on the intermediate behavioral pathways linking exposure to racial discrimination with negative health outcomes among racial and ethnic minority populations in low income settings. This study examined the association between experiences of discrimination and the number of unhealthy days due to physical or mental illness and whether alcohol use influenced the association. A community needs assessment was conducted from 2013-2014 within a low-income community in Florida. Structural equation modeling was performed using maximum likelihood estimation with robust standard errors. In a total of 201 observations, path analyses uncovered significant positive indirect associations (p<0.05) between perceived discrimination and unhealthy days through perceived stress, sleep disturbances, and chronic illness. Although a maladaptive mechanism, alcohol use was a strong buffer on the effects of racism on stress.
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Acheampong M, Ejiofor C, Salinas-Miranda A, Jaward FM, Eduful M, Yu Q. Bridging the Under-Five Mortality Gap for Africa in the Era of Sustainable Development Goals: An Ordinary Least Squares (OLS) Analysis. Ann Glob Health 2018; 84:110-120. [PMID: 30873806 PMCID: PMC6748240 DOI: 10.29024/aogh.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND While Africa achieved significant progress in reducing under-five mortality rate (U5MR) in the MDGs era, it did not achieve the set target and still has the highest average of 81 deaths per 1000 live births compared to a global average of 43 deaths. The SDG number 3 has set a new target of reducing U5MR to 25 deaths per 1000 births in the world, which serves a huge challenge, especially for Africa. Socioeconomic inequities that remain unaddressed across countries account for Africa's high U5MR. Unless there is adequate prioritization of important socioeconomic, healthcare, and environmental factors, the new SDGs target will be hindered. Objectives: In this study, our primary objective was to analyse and assess factors that account most for the U5MR inequities between Africa and the rest of the world. Methods: We conducted a series of ordinary least squares (OLS) regression-based prioritization analysis of socioeconomic, healthcare, and environmental variables from 43 African countries in a pool of 109 countries from around the world to understand the most important factors that account most for the high U5MR in Africa. FINDINGS The results suggest that the most critical category for bridging the U5MR gap with the rest of the world is improved healthcare access. However, with all categories examined together, the OLS regression showed that the most important factors that accounted for Africa's high U5MR compared with the rest of the world were, in order: fertility rate, access to improved water, total health expenditure per capita, access to improved sanitation, and female employment rate. CONCLUSIONS The findings reveal that Africa will significantly benefit from interventions geared towards both the treatment and prevention of acute infectious diseases in the form of providing affordable maternal healthcare services, as well as providing access to improved drinking water and sanitation.
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Waters KA, Salinas-Miranda A, Kirby RS. The association between parent-child quality time and children's flourishing level. J Pediatr Nurs 2023; 73:e187-e196. [PMID: 37775429 DOI: 10.1016/j.pedn.2023.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/01/2023]
Abstract
PURPOSE Few studies have examined the association between parental quality time and flourishing measures in young children. This study explored the association between parental quality time and children's flourishing in a national sample of USA children 1-5 years of age. DESIGN AND METHODS A cross sectional study using data from the 2019-2020 National Survey of Children's Health (N = 17,855). Flourishing was measured with a composite score (values 0-4) derived from 4 questions on attachment with parent, resilience, learning, and contentment with life. Having all 4 items was optimal. Parent-child quality time per week was measured with 3 items: singing or storytelling, reading to child, and family meal with child; using a 4-point scale: 0 days, 1-3 days, 4-6 days, and every day/week. Multivariable logistic regression models were conducted to assess the odds of lower flourishing in SAS 9.4. RESULTS After controlling for confounding, only the lack of singing and storytelling were negatively associated with greater odds of lower levels of flourishing (0-2 items OR = 5.06, 95% CI 2.11-12.14; 3 items OR = 2.92, 95% CI 1.73-4.93). CONCLUSIONS Insufficient parent-child quality time is associated with lower flourishing levels. Fostering parental opportunities to engage in weekly quality time with their children should be a priority of child health programs seeking to improve child flourishing. PRACTICE IMPLICATIONS Nurses should provide guidance to parents on ways to nurture quality family time and promote children's psychosocial, environmental, and physical well-being. Nurses can advocate for programmatic and policy changes to ensure familial work/life balance and licensing/accreditation of all child centers.
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Joshi M, J. Rahill G, Carrington C, Mabie A, Salinas-Miranda A, Thomas N, Morales A, Grippo L, Grey A. “They are not satisfied until they see our blood”: Syndemic HIV risks for trans women in urban Haiti. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2021. [DOI: 10.1080/00207411.2021.1891364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Salihu HM, Salinas-Miranda A, Turner D, King L, Paothong A, Austin D, Berry EL. Usability of Low-Cost Android Data Collection System for Community-Based Participatory Research. Prog Community Health Partnersh 2016; 10:265-73. [PMID: 27346773 DOI: 10.1353/cpr.2016.0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Android tablet computers can be valuable tools for data collection, but their usability has not been evaluated in community-based participatory research (CBPR). OBJECTIVES This article examines the usability of a low-cost bilingual touchscreen computerized survey system using Android tablets, piloted with a sample of 201 community residents in Tampa, Florida, from November 2013 to March 2014. METHODS Needs assessment questions were designed with the droidSURVEY software, and deployed using Android tablet computers. In addition, participants were asked questions about system usability. RESULTS The mean system usability was 77.57 ± 17.66 (range, 0-100). The mean completion time for taking the 63 survey questions in the needs assessment was 23.11 ± 9.62 minutes. The survey completion rate was optimal (100%), with only 6.34% missingness per variable. We found no sociodemographic differences in usability scores. CONCLUSIONS Our findings indicate that Android tablets could serve as useful tools in CBPR studies.
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Salinas-Miranda AA, Storch EA, Nelson R, Evans-Baltodano C. Challenges for Evidence-Based Care for Children With Developmental Delays in Nicaragua. J Cogn Psychother 2014; 28:226-237. [PMID: 32759158 DOI: 10.1891/0889-8391.28.3.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Evidence of successful models for promoting early childhood development and for effectively addressing developmental delays is available, yet the adoption of evidence-based strategies is limited in low-income countries. Nicaragua, a low-income country on the Central American isthmus, faces policy-, organizational-, and community-level obstacles which prevent families from receiving the benefits of early child development programs as well as other necessary services for children at risk of or with developmental delays. Failing to address developmental delays in a timely manner leads to detrimental social and economic consequences for families and society at large. In this article, we examine existing information on early childhood development in Nicaragua and discuss some programmatic implications for the recognition and early intervention of developmental delays in Nicaragua.
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Buro AW, Salinas-Miranda A, Marshall J, Gray HL, Kirby RS. Autism Spectrum Disorder Diagnosis and Other Child, Family, and Community Risk Factors for Obesity among Children and Adolescents Aged Ten to Seventeen Years in the United States: A Mediation Analysis. Child Obes 2023; 19:57-67. [PMID: 35394360 PMCID: PMC9917309 DOI: 10.1089/chi.2021.0260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: This study explored whether there are mediated effects of child and family risk in the association between community and organizational risk and obesity among children and adolescents aged 10-17 years using 2017-2018 National Survey of Children's Health (NSCH) data, addressing autism spectrum disorder (ASD) and co-occurring conditions. Methods: This cross-sectional study (N = 27,157) used 2017-2018 NSCH data. Frequency distributions and chi-square tests were used to describe participants with and without ASD. Cumulative risk indices were created for child, family, community, and organizational level risk, and mediation analyses were conducted in a two-mediator model (X1: community risk, X2: organizational risk, M1: child risk, M2: family risk) for the dichotomous outcome (Y: obesity). Path analyses were performed using generalized structural equation modeling in Stata 16.0. Results: Direct effects for all four risk indices were associated with obesity in single index models (all p < 0.001); only child and family risk indices were associated with obesity in a full model with all four risk indices (both p < 0.001). When child and family risk indices were assessed as mediators, the indirect effects of community and organizational risk were significant (all p < 0.0001). The total effect of community risk on obesity was significant with family risk as a mediator (p = 0.002). The total effect of organizational risk was not significant with either mediator. Conclusion: Findings suggest that child and family factors play a strong role in obesity risk and that ASD contributes to this risk. Community risk may be another strong predictor of obesity, mediated by family risk. Additional research on social-ecological risk factors for obesity is needed to identify leverage points to improve obesity risk in children and adolescents with and without ASD.
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Yang Y, Liller KD, Coulter M, Salinas-Miranda A, Tyson DM, Chen H. How Community and Individual Risk Factors Mutually Impact Youth's Perceived Safety: A Syndemic Analysis Using Structural Equation Modeling. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17738-NP17757. [PMID: 34182798 DOI: 10.1177/08862605211028326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to evaluate the mutual impact of community and individual factors on youth's perceptions of community safety, using structural equation modeling (SEM) conceptualized by syndemic theory. This study used survey data collected from a county wide sample of middle and high school students (N=25,147) in West Central Florida in 2015. The outcome variable was youth's perceptions of community safety. Predictors were latent individual and community factors constructed from 14 observed variables including gun accessibility, substance use, depressive symptoms, and multiple neighborhood disadvantage questions. Three structural equation models were conceptualized based on syndemic theory and analyzed in Mplus 8 using weighted least squares (WLS) estimation. Each model's goodness of fit was assessed. Approximately seven percent of youth reported feeling unsafe in their community. After model modifications, the final model showed a good fit of the data and adhered to the theoretical assumption. In the final SEM model, an individual latent factor was implied by individual predictors measuring gun accessibility without adult's permission (β=0.70), sadness and hopelessness (β=0.52), alcohol use (β=0.79), marijuana use (β=0.94), and illegal drug use (β=0.77). Meanwhile, a community latent factor was indicated by multiple community problems including public drinking (β=0.88), drug addiction (β=0.96), drug selling (β=0.97), lack of money (β=0.83), gang activities (β=0.90), litter and trash (β=0.79), graffiti (β=0.91), deserted houses (β=0.86), and shootings (β=0.93). A second-order syndemic factor that represented the individual and community factors showed a very strong negative association with youth's safe perception (β=-0.98). This study indicates that individual risk factors and disadvantaged community conditions interacted with each other and mutually affected youth's perceptions of community safety. To reduce these co-occurring effects and improve safe perceptions among youth, researchers and practitioners should develop and implement comprehensive strategies targeting both individual and community factors.
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