A Geospatial Analysis of CDC-funded HIV Prevention Programs for African Americans in the United States

Given the increase in HIV/AIDS infection rates among racial and ethnic minorities, particularly African Americans, this study was undertaken as part of a larger research effort to examine the distribution of HIV prevention services focusing on African American populations within the United States. Data were gathered via a national survey of community-based organizations (CBOs) funded by the Centers for Disease Control and Prevention (CDC). A geocoded national database was constructed to identify, locate, and map these HIV prevention programs. A total of 1,020 CBOs responded to the survey, yielding a response rate of 70.3%. These CBOs administered a total of 3,028 HIV prevention programs. Data describing intervention types and persons served, combined with the address and service area of responding CBOs, were integrated with census data (2000) and analyzed by using a geographic information system (GIS). The results of our national level analysis show that HIV prevention services for African Americans have fair coverage where African Americans comprise a substantial proportion of the population in urban areas in northeastern states, but that HIV prevention services for African Americans are inadequately distributed in the southeastern states. A local-level analysis was conducted for Alabama, where 68% of HIV/AIDS cases are among African Americans. Specific interventions such as street and community outreach, health communications, and public information are fairly well provided to African Americans in more urban cities in Alabama, however, individual- and group-level interventions have poor coverage in rural areas where a large percentage of African-Americans live. Overall, our study illustrates that the use of GIS adds value when used with other data sources to provide prevention services that are accessible to the populations most in need

A GIS-based method for household recruitment in a prospective pesticide exposure study

<p>Abstract</p> <p>Background</p> <p>Recent advances in GIS technology and remote sensing have provided new opportunities to collect ecologic data on agricultural pesticide exposure. Many pesticide studies have used historical or records-based data on crops and their associated pesticide applications to estimate exposure by measuring residential proximity to agricultural fields. Very few of these studies collected environmental and biological samples from study participants. One of the reasons for this is the cost of identifying participants who reside near study fields and analyzing samples obtained from them. In this paper, we present a cost-effective, GIS-based method for crop field selection and household recruitment in a prospective pesticide exposure study in a remote location. For the most part, our multi-phased approach was carried out in a research facility, but involved two brief episodes of fieldwork for ground truthing purposes. This method was developed for a larger study designed to examine the validity of indirect pesticide exposure estimates by comparing measured exposures in household dust, water and urine with records-based estimates that use crop location, residential proximity and pesticide application data. The study focused on the pesticide atrazine, a broadleaf herbicide used in corn production and one of the most widely-used pesticides in the U.S.</p> <p>Results</p> <p>We successfully used a combination of remotely-sensed data, GIS-based methods and fieldwork to select study fields and recruit participants in Illinois, a state with high corn production and heavy atrazine use. Our several-step process consisted of the identification of potential study fields and residential areas using aerial photography; verification of crop patterns and land use via site visits; development of a GIS-based algorithm to define recruitment areas around crop fields; acquisition of geocoded household-level data within each recruitment area from a commercial vendor; and confirmation of final participant household locations via ground truthing. The use of these procedures resulted in a sufficient sample of participants from 14 recruitment areas in seven Illinois counties.</p> <p>Conclusion</p> <p>One of the challenges in pesticide research is the identification and recruitment of study participants, which is time consuming and costly, especially when the study site is in a remote location. We have demonstrated how GIS-based processes can be used to recruit participants, increase efficiency and enhance accuracy. The method that we used ultimately made it possible to collect biological samples from a specific demographic group within strictly defined exposure areas, with little advance knowledge of the location or population.</p

A national, geographic database of CDC-funded HIV prevention services: development challenges and potential applications

Abstract Background From 2000–2002, the Centers for Disease Control and Prevention (CDC) funded a study that was designed to improve the information available to program planners about the geographic distribution of CDC-funded HIV prevention services provided by community-based organizations (CBOs). Program managers at CDC recognized the potential of a geographic information system (GIS) to organize and analyze information about HIV prevention services and they made GIS a critical component of the study design. The primary objective of this study was to construct a national, geographically-referenced database of HIV prevention services provided by CDC-funded CBOs. We designed a survey instrument to collect information about the geographic service areas where CBOs provided HIV prevention services, then collected data from CBOs that received CDC funding for these services during fiscal year 2000. We developed a GIS database to link questionnaire responses with GIS map layers in a manner that would incorporate overlapping geographies, risk populations and prevention services. We collected geographic service area data in two formats: 1) geopolitical boundaries and 2) geographic distance. Results The survey response rate was 70.3%, i.e. 1,020 of 1,450 community-based organizations responded. The number of HIV prevention programs administered by each CBO ranged from 1 to 23. The survey provided information about 3,028 prevention programs, including descriptions of intervention types, risk populations, race and ethnicity, CBO location and geographic service area. We incorporated this information into a large GIS database, the HIV Prevention Services Database. The use of geopolitical boundaries provided more accurate results than geographic distance. The use of a reference map with the questionnaire improved completeness, accuracy and precision of service area data. Conclusion The survey instrument design and database development procedures that we used for this study successfully met our objective. The development of the HIV Prevention Services Database for CDC is an important step toward the implementation of a spatial decision support system. Due to the costs involved in a nationwide survey such as this, we recommend that future data collection efforts use Web-based survey methodologies that incorporate interactive maps.</p

A GIS-based method for household recruitment in a prospective pesticide exposure study-0

Blue), 500 (purple), 800 (green) and 1000 (red) meters. Potential conflict fields are to the south, with a 1000-meter buffer displayed in yellow.<p><b>Copyright information:</b></p><p>Taken from "A GIS-based method for household recruitment in a prospective pesticide exposure study"</p><p>http://www.ij-healthgeographics.com/content/7/1/18</p><p>International Journal of Health Geographics 2008;7():18-18.</p><p>Published online 30 Apr 2008</p><p>PMCID:PMC2396611.</p><p></p

A GIS-based method for household recruitment in a prospective pesticide exposure study-3

<p><b>Copyright information:</b></p><p>Taken from "A GIS-based method for household recruitment in a prospective pesticide exposure study"</p><p>http://www.ij-healthgeographics.com/content/7/1/18</p><p>International Journal of Health Geographics 2008;7():18-18.</p><p>Published online 30 Apr 2008</p><p>PMCID:PMC2396611.</p><p></p

A GIS-based method for household recruitment in a prospective pesticide exposure study-1

<p><b>Copyright information:</b></p><p>Taken from "A GIS-based method for household recruitment in a prospective pesticide exposure study"</p><p>http://www.ij-healthgeographics.com/content/7/1/18</p><p>International Journal of Health Geographics 2008;7():18-18.</p><p>Published online 30 Apr 2008</p><p>PMCID:PMC2396611.</p><p></p

A GIS-based method for household recruitment in a prospective pesticide exposure study-2

C closest to the residential area past the centroid of the 1000-meter buffer, to the edge of the 1000-meter buffer. The center point of this line was designated as the recruitment area centroid. The yellow line was created by buffering the address closest to the recruitment area centroid at a distance that included all homes in the recruitment area.<p><b>Copyright information:</b></p><p>Taken from "A GIS-based method for household recruitment in a prospective pesticide exposure study"</p><p>http://www.ij-healthgeographics.com/content/7/1/18</p><p>International Journal of Health Geographics 2008;7():18-18.</p><p>Published online 30 Apr 2008</p><p>PMCID:PMC2396611.</p><p></p