Health-Seeking Behavioral Patterns among Refugee Groups – A Case-Study in South-central Kentucky

Each year, thousands of people get displaced from their homes due to genocide, famine, civil wars and other crises in their countries. The United States has traditionally been receptive to resettling refugees. These refugees view resettlement as an opportunity to obtain proper health care. Due to the diverse cultural identities of refugee populations, it is essential to research complex culturally dependent healthcare utilization patterns. A purposeful sample of four refugees from the Burmese, Congolese and Iraqi refugee communities in south-central Kentucky- completed interviews. They shared experiences and insights from their cultural points of view. Results showed demographic factors directly impacted access through nationality and language, while social factors and beliefs impacted access through religion, acculturation, health insurance, transportation and the level of cultural competency of a health care facility/provider. These findings would contribute to the popular health and policy-making debates that surround the well-being of this culturally diverse population

Results of the Kentucky Worksite Assessment: Utilization of the CDC’s Health ScoreCard

Study Objectives and Research Approach A Health Impact Assessment (HIA) conducted in 2011-2012 of a proposed Kentucky Worksite Wellness Tax Credit highlighted gaps in the data available on worksite wellness programs in the Commonwealth of Kentucky. Conducting a state-wide assessment of worksite wellness programs was a recommendation that resulted from this HIA. The purpose of the assessment is to: 1) Identify the number of comprehensive worksite health promotion programs in Kentucky. 2) Determine the health needs of worksites in Kentucky. By Identifying current wellness practices in Kentucky, better tools and support can be provided at a state level to assist organizations to implement results-oriented wellness programs. As worksite wellness science continues to advance and the expectations of successful outcomes continue to increase, more will be required of those in charge of these programs. Upon receiving approval from WKU’s Institutional Review Board (IRB), 1,200 randomly drawn businesses received a questionnaire via email. Two-week increments were allowed for workplaces that needed reminders or more time to complete the survey. The survey began in May 2013 and closed in October 2013. Data was analyzed for outstanding themes, which will form the bases for decisions made on the needs of worksite-wellness programs in Kentucky. Data was analyzed further — descriptively and inferentially — to determine worksite factors that contribute to the increasing trends of chronic diseases in the workplace

Second-Hand Smoke in a University Campus: Attitudes and Perceptions of Faculty, Staff and Students

Purpose: To examine the attitudes and perceptions of faculty, staff and students concerning tobacco policies at a university campus in a tobacco producing state. Methods: A questionnaire was administered to faculty, staff and students to assess knowledge, attitudes and beliefs related to smoking and exposure to second-hand smoke on campus. A 3-wave e-mailing was used to send the questionnaire. Results: A total of 2,914 individuals responded to the questionnaire. Majority (60%) of the participants believed a smoke free policy would be a positive move and could possibly improve the quality of life for the campus community, while not negatively affecting student enrollment status. Conclusion: Implementing a smoke free policy in university campuses in North America could be acceptable to faculty, staff and students and is unlikely to reduce students enrolment. Our findings have the potential to support efforts to implement smoke free policies on university campuses in North America

Persistent household food insecurity, HIV, and maternal stress in Peri-Urban Ghana

BACKGROUND: The mental health of caregivers has been shown to be important for improving HIV prevention and treatment. Household food insecurity affects hundreds of millions of individuals in Sub-Saharan Africa, a region that experiences a disproportionate burden of the HIV pandemic. Both maternal HIV diagnosis and household food insecurity may be linked with maternal stress. This in turn may lead to unhealthy coping behaviors. We examined the independent associations of HIV, persistent household food insecurity and the synergistic effect of both on maternal stress. METHODS: Ghanaian women recruited prenatally from hospitals offering voluntary counseling and testing (VCT) were followed for 12 months after childbirth (N = 232). A locally adapted 7-item version of the US Household Food Security Survey Module was applied at four time points postpartum. We dichotomized participant households as being persistently food insecure (i.e., food insecure at each time point) or not (i.e., food secure at any time point). We dichotomized participant women as not perceiving vs. perceiving stress at 12 months postpartum in reference to the median sample score on the 4-item Cohen’s stress scale. Binary multivariate logistic regression models were used to assess the independent and interactive effects of maternal HIV and persistent household food insecurity on maternal stress. RESULTS: The proportion of HIV-positive women that lived in severe food insecure households increased over time. By contrast, the HIV-negative group living in severely food insecure households experienced a steady decline across time. HIV-infection (AOR = 2.31, 95% CI 1.29-4.12) and persistent household food insecurity (AOR = 3.55, 95% CI 1.13-11.13) were independently associated with maternal stress in a multivariate model. Being both HIV-positive and persistently food insecure strongly and synergistically increased the risk for maternal perceived stress (AOR = 15.35, 95% CI 1.90-124.14). CONCLUSION: In agreement with syndemic theory there is a powerful synergism between maternal HIV diagnosis and household food insecurity on maternal stress. Comprehensive multi-dimensional intervention studies are needed to better understand how to reduce stress among HIV-positive women living in persistently food insecure households and how to reduce the likelihood of food insecurity in HIV-affected households in Sub-Saharan Africa

Nutrition for health and socioeconomic development in Sub-Saharan Africa : final technical report

Objectives to improve child nutrition in Ghana have been accomplished thus far through training activities, establishment of the University of Ghana’s Nutrition Research and Training Centre, graduate training for 5 PhD and 17 MSc students, and creation of a community-based dietetic internship for North American and Ghanaian students with research projects on child nutrition. Nutrition education through multiple sectors has improved rural diets and national awareness of the growing problem of overweight among Ghanaian children has increased. Current research and interventions build on these project results

Lipid profile and dyslipidemia among school-age children in urban Ghana

Abstract Background Dyslipidemia during childhood has been associated with higher risk of atherosclerosis later in life. Information on the lipid profile of Ghanaian children is scarce. The aim of this study was to assess the lipid profiles of school children between the ages of 9–15 years, living in urban Ghana. Methods A total of 802 randomly selected school-age children participated in the Ghana School Survey implemented in Kumasi and Accra, Ghana. A structured questionnaire was used to collect information on child and maternal socio-demographic characteristics (including age, education, and occupation), 7-day food frequency, home and school activity, as well as measurement of weight and standing height. Weight, height, and age data were converted into BMI-for-age indices to determine weight status. Finger-prick fasting blood samples were taken from the school-age children. Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) cholesterol levels were determined using the CardioChek® PA Test System. Reference lipid levels based on the US National Cholesterol Education Program 2001 guidelines were used to determine the proportion of children with dyslipidemia. Results The mean TC, LDL-C, HDL-C, and TG levels were 149.0 ± 57.0 mg/dl, 80.1 ± 38.6 mg/dl, 53.5 ± 19.4 mg/dl, and 71.4 ± 54.7 mg/dl, respectively. Mean TC/HDL-C ratio was 3.0 ± 1.0. The proportion of children with abnormal values were 12.1% for TC, 4.5% for TG, 28.4% for HDL-C, 9.2% for LDL-C, and 6.6% for TC/HDL-C ratio. The levels of dyslipidemia (HDL, LDL, and TC/HDL-C ratio) were higher among overweight/obese compared to normal-weight children. More frequent fruit consumption was also linked with lower LDL-C (p = 0.020) while watching television (TV) in the mornings was linked with both higher TC (p = 0.011) and TG (p = 0.006). Conclusions Majority of urban-dwelling Ghanaian school children had normal lipid profiles. However, the higher levels of dyslipidemia observed among overweight and obese children suggest the need for population level physical activity and dietary interventions among children to reduce risk of cardiovascular diseases in adult life

obestity data.sas7bdat

This dataset was generated from survey of school age children (9-15 years) in Two urban communities in Ghana. It includes data on socio-demographic characteristics, dietary patterns and intake, physical activity and nutritional status

Reliability of length measurements collected by community nurses and health volunteers in rural growth monitoring and promotion services

Abstract Background Length measurements are important in growth, monitoring and promotion (GMP) for the surveillance of a child’s weight-for-length and length-for-age. These two indices provide an indication of a child’s risk of becoming wasted or stunted, and are more informative about a child’s growth than the widely used weight-for-age index (underweight). Although the introduction of length measurements in GMP is recommended by the World Health Organization, concerns about the reliability of length measurements collected in rural outreach settings have been expressed by stakeholders. Our aim was to describe the reliability and challenges associated with community health personnel measuring length for rural outreach GMP activities. Methods Two reliability studies (A and B), using 10 children less than 24 months each, were conducted in the GMP services of a rural district in Ghana. Fifteen nurses and 15 health volunteers (HV) with no prior experience in length measurements were trained. Intra- and inter-observer technical error of measurement (TEM), average bias from expert anthropometrist, and coefficient of reliability (R) of length measurements were assessed and compared across sessions. Observations and interviews were used to understand the ability and experiences of health personnel with measuring length at outreach GMP. Results Inter-observer TEM was larger than intra-observer TEM for both nurses and HV at both sessions and was unacceptably (compared to error standards) high in both groups at both time points. Average biases from expert’s measurements were within acceptable limits, however, both groups tended to underestimate length measurements. The R for lengths collected by nurses (92.3%) was higher at session B compared to that of HV (87.5%). Length measurements taken by nurses and HV, and those taken by an experienced anthropometrist at GMP sessions were of moderate agreement (kappa = 0.53, p < 0.0001). Conclusions The reliability of length measurements improved after two refresher trainings for nurses but not for HV. In addition, length measurements taken during GMP sessions may be susceptible to errors due to overburdened health personnel and crowded GMP clinics. There is need for both pre- and in-service training of nurses and HV on length measurements and procedures to improve reliability of length measurements