Assessing the Readiness of Nairobi Deaf Youth to Accept a Best-practice HIV/AIDS Intervention

After nearly forty years of HIV/AIDS research in the global community, data on HIV/AIDS in the Deaf population is still disproportionately neglected. No surveillance system is in place to monitor prevalence, awareness or mode of HIV infection in the Deaf community. Additionally, prevention and education interventions have yet to be tailored to meet the specific needs of this highly vulnerable population. Purpose: This project attempted to assess the readiness of the Nairobi Deaf youth community to accept a best-practice HIV/AIDS intervention. The broad objective of this research was to assess HIV awareness, perceptions and behaviors of Deaf youth in regards to HIV/AIDS in Nairobi, Kenya. Method: This project used the snowball sampling method to conduct a survey using a combination of pre-coded, and open-answer questions conducted with 60 Deaf youth (18-35) in Nairobi, Kenya. Interviews included topics of HIV/AIDS knowledge, risk perception, and risk behaviors. Results: The Nairobi Deaf youth community is unequipped to accept a best practice HIV/AIDS intervention at this time. Efforts need to be made to increase risk perception and develop social support. Also, comprehensive prevalence research needs to be conducted in this population. Conclusion: Based on the data collected in this survey and a review of literature, a peer-led, extracurricular education campaign seems to be the most acceptable best-practice intervention for targeting Deaf youth. Additionally, a supplementary, video-based, multifaceted language component would be suggested

Can Law Improve Prevention and Treatment of Cancer?

The December 2011 issue of Public Health (the Journal of the Royal Society for Public Health) contains a symposium entitled: Legislate, Regulate, Litigate? Legal approaches to the prevention and treatment of cancer. This symposium explores the possibilities for using law and regulation – both internationally and at the national level – as the policy instrument for preventing and improving the treatment of cancer and other leading non-communicable diseases (NCDs). In this editorial, we argue that there is an urgent need for more legal scholarship on cancer and other leading NCDs, as well as greater dialogue between lawyers, public health practitioners and policy-makers about priorities for law reform, and feasible legal strategies for reducing the prevalence of leading risk factors. The editorial discusses two important challenges that frequently stand in the way of a more effective use of law in this area. The first is the tendency to dismiss risk factors for NCDs as purely a matter of individual \u27personal responsibility\u27; the second is the fact that effective regulatory responses to risks for cancer and NCDs will in many cases provoke conflict with the tobacco, alcohol and food industries. After briefly identifying some of the strategies that law can deploy in the prevention of NCDs, we briefly introduce each of the ten papers that make up the symposium

Social and Biological Determinants of Pregnancy-Related Mortality and Morbidity in a Rural, Underserved Population

Cases of severe maternal morbidity (SMM) and pregnancy-related mortality (PRM) are increasing in the US. Research concerning SMM and PRM has neglected women in Central Appalachia; a largely rural, health-disparate population. The aims of this study are two-fold: (1) Examine patient-level and place-based predictors of SMM/PRM via hierarchical logistic regression modeling, and (2) Elucidate Appalachian healthcare patients’ and providers’ experiences with SMM/PRM, perceptions of contributing factors, and insights on points of intervention. This study uses a mixed methods approach guided by the WHO’s conceptual framework for action on social determinants of health to identify determinants of SMM and PRM among Appalachian women. Aim 1 involved hierarchical logistic regression modeling to assess patient-level and regional predictors of SMM and PRM using the MarketScan Research Database. Aim 2 involved 30 qualitative interviews with Appalachian participants: 10 patients with histories of SMM, 10 providers, and 10 emergency medical technicians (EMTs). Quantitative results demonstrate patient-level chronic diseases and regional measures of economic security as predictive of SMM. Qualitative results echoed the effect of regional economic hardship on maternal health. Participants expressed a link between changes in the socioeconomic landscapes of their communities and more proximal determinants of maternal health, including patient nutritional status, chronic disease burden, and underutilization of healthcare. Patients with histories of SMM pointed to geographic constraints in healthcare resources and biases within healthcare surrounding patients’ reflections of class. Participants identified many points of intervention, including collaborations between EMS and obstetric care providers, partnerships with local school systems to introduce comprehensive health education curricula, and expansion of community paramedics programs. Findings warrant further investigation into how regional economic policy may influence maternal health outcomes among women living in economically insecure regions. Findings highlight the need for medical stewardship. Additionally, results reflect how current care-delivery models for medically and socially complex patients may be inadequate for women in rural communities

Sustainable Improvement in Immunization Rates for Seniors: A Local and Community-Wide Effort

Objective: Overall: To improve influenza and pneumococcal immunization rates in patients age ≥65 years by developing relationships with community organizations that would provide opportunities for community member education about adult vaccines. Pre/post Surveys: To assess potential changes in influenza and pneumococcal immunization knowledge and opinions in community members exposed to an educational presentation. Methods: Using personal and university resources, contact was made with several organizations serving the senior, underserved population in West Dayton, Ohio. An educational presentation about adult immunizations was developed and used at ten community events. The presentation included oral and written communication, and was based on the Health Belief Model. The presentation focused on dissemination of information both verbally and through low-literacy focused written information. Written material was also distributed through community channels. The effectiveness of the oral presentations was examined through pre/post questionnaires at five of the events. Statistical analysis was both descriptive and analytical. Results: Outreach was established to more than 1,000 individuals through direct mailings, flyers and oral presentations. Presentations were made at ten community events, where more than 80% of the participants were ≥65 years of age. Feedback about the presentations was positive. There was statistically significant improvement in answers to questions dealing with adult vaccination. Conclusions: Community outreach programs were successful in increasing awareness of the importance of adult vaccination among community members. Project was supported by a grant from the AAFP

Advancing the Nation’s Health: A Guide to Public Health Research Needs, 2006-2015

The U.S. Centers for Disease Control and Prevention (CDC), which includes the Agency for Toxic Substances and Disease Registry, is recognized as a lead federal agency for protecting the health and safety of people at home and abroad, providing credible information to enhance health decisions, and promoting health through strong partnerships. Research is the foundation of CDC’s success and enables CDC to develop, improve and disseminate evidence-based interventions, programs, and decision support to improve health (Figure I-1). The primary focus of CDC’s research is to fill gaps in knowledge necessary to accomplish the agency’s Health Protection Goals (Chapter II), but it must also be CDC’s core public health mission and be responsive to new opportunities, threats, and future health needs. A recent analysis indicates that the evidence base to support much of public health practice has not kept pace with the growing requirements, and much more research is needed to demonstrate the best methods that support effective public health practices.https://www.cdc.gov/od/science/quality/docs/AdvancingTheNationsHealth.pd

Systematic Literature Review of the Evidence for Effective National Immunisation Schedule Promotional Communications

Introduction: A systematic literature review examined the published evidence on the effectiveness of European promotional communications for national immunisation schedule (NIS) vaccinations. The review was commissioned by the European Centre for Disease Prevention and Control (ECDC) and conducted by the Institute for Social Marketing at the University of Stirling.The purpose of the review: ‘Immunisation hesitancy' has negatively impacted population uptake of routine immunisation. A substantial body of evaluated communication activity promoting nationally indicated routine immunisation has been published. This systematic review of the evidence aims to: collate and map the types of promotional communication that have been used; assess the quality of the evaluative research reporting on these promotional communications; and assess the applicability of this evidence to immunisation policy, strategy and practice priorities. The analysis and findings are intended to provide a current status report on the evidence, and evidence gaps for good practice in national immunisation promotional communications, thus supporting countries in their communication activities for the prevention and control of communicable diseases.Objectives of the review: The review aimed to answer the following research questions: Which audiences have been targeted by NIS promotional communications? Which communication methods and approaches have been used to promote or reinforce NIS vaccination uptake? What theoretical underpinnings are used to inform communication methods and approaches? Which settings and communication channels have been used to promote or reinforce NIS vaccination uptake? What is the evidence for effectiveness of communication initiatives in changing or reinforcing knowledge, attitudes or behaviour towards NIS? What is the evidence for impact of NIS communication initiatives to control communicable disease? What impact have campaign communications promoting NIS had on public acceptance and vaccine uptake rates