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Brannon GE, Kindratt TB, Boateng GO, Sankuratri BYV, Brown KK. Racial and Ethnic Disparities in Patient Experience and Diabetes Self-Management Among Nonpregnant Women of Childbearing Age With Diabetes in the United States: A Scoping Review, 1990 to 2020. Womens Health Issues 2024; 34:26-35. [PMID: 37802669 DOI: 10.1016/j.whi.2023.08.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVE This scoping review aimed to identify any empirical literature describing racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women (aged 18-49 years) of childbearing age with diabetes in the United States. METHODS This scoping review followed the Arksey and O'Malley methodological framework. We used a comprehensive search strategy to identify articles published from 1990 to 2021 in PubMed, CINAHL, EMBASE, Web of Science, the Cochrane Library, and Proquest Digital Dissertation and Theses. Two independent reviewers used Covidence, a web-based review management software, to screen articles by title and abstract, and then by full-text articles based on inclusion and exclusion criteria. A third reviewer arbitrated any disagreements. RESULTS Of the original 6,115 peer-reviewed studies identified, eight fit the eligibility criteria. In research on nonpregnant women of childbearing age in the United States, four studies investigated racial and ethnic disparities in patient experience, and seven of the eight eligible studies investigated racial and ethnic disparities in diabetes self-management outcomes. No eligible studies examining racial and ethnic variations in the association between patient experience and diabetes self-management were found. CONCLUSIONS This scoping review identified limited available studies examining racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women of childbearing age in the United States. Future studies should examine these relationships to fill the gap in research. These findings are relevant as the prevalence of diabetes is increasing worldwide and racially/ethnically minoritized women are disproportionately affected.
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Affiliation(s)
- Grace E Brannon
- Department of Communication, The University of Texas at Arlington, Arlington, Texas
| | - Tiffany B Kindratt
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | - Godfred O Boateng
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas
| | | | - Kyrah K Brown
- Department of Kinesiology, The University of Texas at Arlington, Arlington, Texas.
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Kindratt TB, Boateng GO, Brannon GE, Sankuratri BYV, Brown KK. Testing proximal, intermediate, and health outcomes of patient centered communication among non-pregnant women of childbearing age with diabetes mellitus: Findings from the Medical Expenditure Panel Survey 2012-2018. PEC Innov 2023; 3:100185. [PMID: 37457671 PMCID: PMC10344676 DOI: 10.1016/j.pecinn.2023.100185] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
Objective To determine associations between patient-centered communication (PCC) and overall healthcare ratings, self-efficacy, and management adherence among reproductive-age women with diabetes within the framework of Epstein and Street's conceptual model. Methods We analyzed longitudinal data from the 2012-2018 Medical Expenditure Panel Survey. The sample included 493 non-pregnant women of childbearing age (18-45 years) with diabetes. Independent variables were domains of PCC (listening, explaining, respecting, spending time, giving instructions, among others). Dependent variables were overall healthcare ratings, self-efficacy, and management adherence. Crude and adjusted associations were evaluated. Results Non-pregnant women of childbearing age who reported that their provider always listened to them, explained things, showed respect, and spent enough time with them had greater odds of reporting high overall healthcare ratings. Those who reported their provider always listened to them and spent enough time with them had greater odds of reporting better diabetes care adherence than those whose health care providers did not. Conclusion Findings demonstrate that non-pregnant women of childbearing age who report having optimal PCC are more likely to adhere to their diabetes care regimen. Innovation This is the first known study using a nationally representative sample of non-pregnant women of childbearing age to examine multiple layers of PCC.
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Affiliation(s)
- Tiffany B. Kindratt
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
| | - Godfred O. Boateng
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
- School of Global Health, York University, Toronto, ON, Canada
| | - Grace Ellen Brannon
- Department of Communication, University of Texas at Arlington, Arlington, TX, USA
| | | | - Kyrah K. Brown
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, USA
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Kindratt TB, Brannon GE, Boateng GO, Brown KK. The Influence of Racial/Ethnic and Gender Concordance on Care Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus: an Analysis of the Medical Expenditure Panel Survey, 2010-2019. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01779-z. [PMID: 37707662 DOI: 10.1007/s40615-023-01779-z] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
INTRODUCTION This study examined associations between patient-provider race/ethnicity concordance and gender concordance on overall healthcare ratings, self-efficacy, and diabetes care monitoring in non-pregnant women of childbearing age with diabetes mellitus before and after adjusting for sociodemographic factors. METHODS We analyzed longitudinal data from the 2010-2019 Medical Expenditure Panel Survey. The sample was limited to non-pregnant women of childbearing age (18-45 years) diagnosed with diabetes (unweighted n = 327; weighted n = 566,504). Bivariate analysis, logistic regression, and latent variable modeling were performed. RESULTS Few racially minoritized women reported racial/ethnic and gender concordance with their healthcare provider. Only 2.9% of Hispanic women reported having a Hispanic provider and 12.1% of non-Hispanic Black women reported seeing a non-Hispanic Black provider compared to 81.1% of non-Hispanic White women who reported seeing a non-Hispanic White provider (p < .0001). Among Hispanic women, 15.3% reported seeing a female provider compared to 25.2% of non-Hispanic Black and 53.5% of non-Hispanic White women. Patient-provider race/ethnicity and gender concordance were not statistically significantly associated with overall healthcare ratings, self-efficacy, or diabetes care monitoring. CONCLUSIONS This study revealed a large disparity in race/ethnicity and gender concordance among minority women of reproductive age with diabetes compared to their non-Hispanic White counterparts. There is a need for larger, more robust studies to examine the influence of provider and other healthcare characteristics on diabetes-related outcomes in this understudied population.
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Affiliation(s)
- Tiffany B Kindratt
- Department of Kinesiology, The University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA.
| | - Grace Ellen Brannon
- Department of Communication, The University of Texas at Arlington, 700 W. Greek Row Drive, Arlington, TX, 76019, USA
| | - Godfred O Boateng
- Department of Kinesiology, The University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
- School of Global Health, York University, 4700 Keele St, Toronto, M3J 1P3, Canada
| | - Kyrah K Brown
- Department of Kinesiology, The University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX, 76019, USA
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Balogun M, Banke-Thomas A, Galvin S, Boateng GO. Editorial: Social inequality and equity in community actions for health. Front Public Health 2023; 11:1144910. [PMID: 36860396 PMCID: PMC9969116 DOI: 10.3389/fpubh.2023.1144910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 02/15/2023] Open
Affiliation(s)
- Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine of the University of Lagos, Lagos, Nigeria,*Correspondence: Mobolanle Balogun ✉
| | - Aduragbemi Banke-Thomas
- School of Human Sciences, University of Greenwich, London, United Kingdom,Department of Infectious Diseases and Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shannon Galvin
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Radwan H, Fakhry R, Boateng GO, Metheny N, Bani Issa W, Faris ME, Obaid RS, Al Marzooqi S, Al Ghazal H, Dennis CL. Translation and Psychometric Evaluation of the Arabic Version of the Breastfeeding Self-Efficacy Scale-Short Form Among Women in the United Arab Emirates. J Hum Lact 2023; 39:40-50. [PMID: 35363102 DOI: 10.1177/08903344221084623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Breastfeeding self-efficacy as a construct has been theoretically and empirically linked to exclusive breastfeeding in studies globally using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). However, its application in the Middle East and North Africa region is limited, as it has not been validated. RESEARCH AIMS To psychometrically validate the BSES-SF among a sample of mothers in the United Arab Emirates. METHODS We psychometrically evaluated the Arabic version of the BSES-SF using a sample of mothers (N = 457) residing in the United Arab Emirates. We used translation techniques, item-test and item-total correlations, confirmatory factor analysis, tests of reliability, and tests of validity. RESULTS Item-test correlations of scale items ranged from 0.67 to 0.84, while item-total correlations ranged from 0.58 to 0.81. The confirmatory factor model assessed the 14-item scale to be unidimensional with satisfactory model fit indices. Our findings suggested the Arabic-language version of the BSES-SF was a reliable measure (α = 0.95) with strong construct and discriminant validity. BSES-SF scores significantly predicted exclusive breastfeeding (aOR = 1.04; 95% CI [1.02, 1.08]) and exclusive duration (β = .06; 95% CI [0.4, 0.08]), which suggested strong predictive, validity after adjusting for parity, maternal age, maternal education, and study site. CONCLUSIONS We have provided rigorous evidence that the BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among Arabic-speaking women in the UAE. Interventions designed specifically to increase breastfeeding self-efficacy among Arabic-speaking women may be a mechanism to increase the suboptimal rates of breastfeeding exclusivity occurring in much of the MENA region.
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Affiliation(s)
- Hadia Radwan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Randa Fakhry
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, TX, USA
| | - Nick Metheny
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA.,Affiliate Scientist, MAP Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON Canada
| | - Wegdan Bani Issa
- Department of Nursing, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Reyad Shaker Obaid
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences(RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Suad Al Marzooqi
- Department of Psychology, Al Ain, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office, Sharjah, United Arab Emirates
| | - Cindy-Lee Dennis
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Brown KK, Kindratt TB, Brannon GE, Sankuratri BYV, Boateng GO. Patient Experience with Their Health Care Provider Among Non-Pregnant Women of Childbearing Age with Diabetes Mellitus by Race and Ethnicity in the United States. Womens Health Rep (New Rochelle) 2023; 4:20-30. [PMID: 36727093 PMCID: PMC9883667 DOI: 10.1089/whr.2022.0037] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/26/2023]
Abstract
Objectives The study objective was to investigate differences in patient experiences with health care providers among non-pregnant women of childbearing age with diabetes mellitus (DM) by race/ethnicity. Design This study used cross-sectional data from the 2012-2018 Medical Expenditure Panel Survey. The sample was limited to women of childbearing age (18-45 years) who have ever been told they had diabetes (n = 763; weighted n = 903,670). The key independent variable was race/ethnicity. The variables of interest included patient experiences with health care in the past 12 months: patient-provider communication (PPC); patient-provider racial/ethnic concordance; patient-provider gender concordance; and satisfaction. Results After adjusting for age, marital status, education, poverty level, health insurance, and perceived health status, non-Hispanic (NH) Black women had lower odds (adjusted odds ratio [aOR] = 0.04; 95% confidence interval [CI] = 0.01-0.11) of receiving care from a health care provider of the same race compared with NH white women. Similar results were found among Hispanic and NH women of other or multiple races. Hispanic women had lower odds (aOR = 0.18; 95% CI = 0.06-0.50) of seeing a health care provider of the same race/ethnicity compared with NH white women in adjusted models. There were no statistically significant differences in PPC, patient-provider gender concordance, and satisfaction with their health care provider among Hispanic, NH Black, or NH women of other or multiple races in comparison to NH White women. Conclusion There is a need to improve PPC quality and satisfaction in this patient population. Patient-provider racial/ethnic discordance among women of color with DM is concerning given the existing diabetes-related disparities. More research on women with DM is needed to inform and improve patient experience and health outcomes.
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Affiliation(s)
- Kyrah K. Brown
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA.,Address correspondence to: Kyrah K. Brown, PhD, Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Arlington, TX 76019, USA,
| | - Tiffany B. Kindratt
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
| | - Grace Ellen Brannon
- Department of Communication, University of Texas at Arlington, Arlington, Texas, USA
| | | | - Godfred O. Boateng
- Department of Kinesiology, University of Texas at Arlington, Arlington, Texas, USA
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Miller JD, Collins SM, Boateng GO, Widen E, Natamba B, Achoko W, Achidri D, Young SL, Martin SL. Pathways linking social support, self-efficacy, and exclusive breastfeeding among women in northern Uganda. Glob Public Health 2022; 17:3506-3518. [PMID: 35960598 PMCID: PMC9898077 DOI: 10.1080/17441692.2022.2110918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
Despite improvements in infant feeding practices over the past two decades, the prevalence of exclusive breastfeeding (EBF) is below global targets. Social support can create an enabling environment for recommended infant feeding practices such as EBF, but the types of social support most important for sustained EBF and their potential mechanisms of action have not been thoroughly characterized. We therefore aimed to assess the relationship between EBF-specific social support, EBF self-efficacy, and EBF at 1 and 3 months among postpartum women in northern Uganda. Women (n = 238, 36.2% living with HIV) were recruited during pregnancy. EBF, social support, and EBF self-efficacy were assessed at 1 and 3 months postpartum. Path analysis was used to assess relationships between these factors. Most mothers exclusively breastfed to 1 (80.8%) and 3 months postpartum (62.9%). EBF-specific, but not general, social support differed by EBF status. EBF-specific social support was associated with higher odds of EBF, which was almost fully mediated by EBF self-efficacy. That is, there was evidence that social support primarily influences EBF through its association with self-efficacy. In sum, EBF-specific social support and self-efficacy likely promote EBF and are modifiable factors that can be intervened upon.
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Affiliation(s)
- Joshua D. Miller
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
| | - Shalean M. Collins
- Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Lousiana, US
| | - Godfred O. Boateng
- School of Global Health, York University, Toronto, Canada
- Dahdaleh Institute for Global Health Research, York University, Toronto, Canada
| | - Elizabeth Widen
- Department of Nutritional Sciences & Population Research Center, University of Texas at Austin, Austin, Texas, US
| | - Barnabas Natamba
- Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine, Entebbe, Uganda
| | | | | | - Sera L. Young
- Department of Anthropology, Northwestern University, Evanston, Illinois, US
- Institute for Policy Research, Northwestern University, Evanston, Illinois, US
| | - Stephanie L. Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, US
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Owusu SA, Ekumah B, Kodom RV, Ebu Enyan NI, Korkoi Aboh I, Quansah R, Boamah SA, Boateng GO, Obiri-Yeboah D, Doku DT, Nsabimana E, Jansen S, Armah FA. Parenting practices and family relationships during the COVID-19 lockdown in Ghana. J Public Health Afr 2022; 13:1849. [PMID: 36051514 PMCID: PMC9425940 DOI: 10.4081/jphia.2022.1849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/04/2022] [Indexed: 12/05/2022] Open
Abstract
The effects of the COVID-19 pandemic have been far reaching across almost every sphere of life. Families, which are the basic units of society, have not been spared the ravages of the pandemic. Changes in family daily routines as a result of COVID-19 can affect spousal relationships, parenting and childcare practices. However, the extent to which the pandemic has affected parenting practices and family relationships in Ghana is not known. The goal of this study was to assess how parenting practices and family relationships have been influenced during the COVID-19 pandemic in Ghana. Data for this paper was drawn from an online questionnaire response from 463 participants in Ghana as a subset analysis from a multi-country study on personal and family coping system with COVID-19 pandemic in the global south. The mean score for pre-COVID-19 relationship with partner (36.86) was higher (p<0.0001) than the mean score for during COVID-19 relationship with partner (35.32) indicating that COVID-19 has had negative influence on relationships. The mean score for pre-COVID-19 parenting (32.78) was higher (p<0.0001) compared to the mean score for during COVID-19 parenting (31.40) indicating negative influence on parenting. We have predicted that participants whose coping levels were “Well” on the average, are likely to be doing well in relationship with partners and parenting practices during the COVID-19 period The challenging public health containment measures of the COVID-19 pandemic have negatively influenced the relationship between partners and parenting practices in Ghana.
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Wachter K, Bunn M, Schuster RC, Boateng GO, Cameli K, Johnson-Agbakwu CE. A Scoping Review of Social Support Research among Refugees in Resettlement: Implications for Conceptual and Empirical Research. J Refug Stud 2022; 35:368-395. [PMID: 35360343 PMCID: PMC8946570 DOI: 10.1093/jrs/feab040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 02/26/2021] [Indexed: 05/13/2023]
Abstract
This study reviewed social support research with refugees in resettlement by assessing the scope of scholarship and examining methodological approaches, definitions, theoretical frameworks, domains, and sources of support. The scoping review followed a systematic approach that retained 41 articles for analysis. The findings indicate that refugee resettlement studies seldom conceptualizes social support as a central focus, defines the concept, draws from related theory, or examines multifaceted components of the construct. The review nevertheless yielded promising findings for future conceptual and empirical research. The analysis identified a wide range of relevant domains and sources of social support, laying the foundation for a socio-ecological model of social support specific to refugee experiences in resettlement. The findings also indicate an imperative to examine and theorize social support vis-à-vis diverse groups as a main outcome of interest, in connection to a range of relevant outcomes, and longitudinally in recognition of the temporal processes in resettlement.
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Affiliation(s)
| | - Mary Bunn
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, 1601 W. Taylor Street, SPHPI MC 912, Chicago, IL 60612, USA
| | - Roseanne C Schuster
- Center for Global Health, School of Human Evolution & Social Change, Arizona State University, SHESC 262, 900 Cady Mall, Tempe, AZ 85281, USA
| | - Godfred O Boateng
- College of Nursing and Health Innovation, The University of Texas at Arlington, MAC 155, 500 W Nedderman Drive, Arlington, TX 76019, USA
| | - Kaila Cameli
- School of Social Work, Arizona State University, 411 N Central Avenue #800, Phoenix, AZ 85004, USA
| | - Crista E Johnson-Agbakwu
- Obstetrics and Gynecology, Valleywise Health, 2525 E. Roosevelt Street, Phoenix, AZ 85008, USA
- Southwest Interdisciplinary Research Center, Office of Refugee Health, Arizona State University, 201 N. Central Ave, Phoenix, AZ 85004, USA
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Boateng GO, Adams EA. A multilevel, multidimensional scale for measuring housing insecurity in urban slums and informal settlements: a psychometric study. The Lancet Global Health 2022. [DOI: 10.1016/s2214-109x(22)00136-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Boateng GO, Workman CL, Miller JD, Onono M, Neilands TB, Young SL. The syndemic effects of food insecurity, water insecurity, and HIV on depressive symptomatology among Kenyan women. Soc Sci Med 2022; 295:113043. [PMID: 32482382 PMCID: PMC8869838 DOI: 10.1016/j.socscimed.2020.113043] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/28/2020] [Accepted: 05/09/2020] [Indexed: 02/06/2023]
Abstract
Depression is a leading cause of disability worldwide and a major contributor to the overall global burden of disease, especially for women of childbearing age. Social science scholarship has demonstrated significant relationships between mental health, food insecurity (FI), water insecurity (WI), and HIV. Little is known, however, about the temporal relationships between food and water insecurity or the mechanisms through which these multiple stressors may operate or interact to impact depression. We therefore used syndemic theory to explore the complex relationships between FI, WI, and HIV on depressive symptomatology among Kenyan women of mixed HIV status (n=183, NCT02979418). We sought to 1) understand the temporal relationships between time-variant risk factors for depression, i.e. FI and WI, and 2) assess how these factors potentially interacted with HIV to impact depressive symptomatology. We first assessed the bidirectional relationship between WI and FI using a cross-lagged three-wave, two-variable panel model. Next, we modeled depressive symptomatology at 21 months as a linear function of the potentially syndemic interaction between FI, WI, and HIV status, adjusting for household wealth. WI had a predominant predictive effect on FI (Bayesian posterior predictive p-value=0.13); there was no reverse causality for the influence of FI on WI. The interaction effect of FI, WI, and HIV was significantly associated with greater depressive symptomatology (β=0.06) at 21 months postpartum. These data suggest that water insecurity may be an important determinant of food insecurity. Further, the co-occurrence of FI, WI, and HIV increases the likelihood of maternal depressive symptomatology, i.e. there is a syndemic relationship. These findings suggest that the role of household WI in other adverse health outcomes beyond mental well-being should be examined, and that interventions to improve mental health will be more effective if they also consider concurrent resource insecurities, regardless of HIV status.
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Affiliation(s)
- Godfred O Boateng
- Department of Kinesiology, University of Texas at Arlington, Arlington, TX, 76019, USA; Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA
| | - Cassandra L Workman
- Department of Anthropology, University of North Carolina at Greensboro, Greensboro, NC, 27412, USA
| | - Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, IL, 60208, USA
| | | | - Torsten B Neilands
- Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Sera L Young
- Department of Anthropology & Global Health, Faculty Fellow, Institute for Policy Research, Northwestern University, Evanston, IL, 60208, USA.
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Boateng GO, Brown KK. "Go back to your country": Exploring nurses' experiences of workplace conflict involving patients and patients' family members in two Canadian cities. Nurs Inq 2021; 29:e12444. [PMID: 34268841 DOI: 10.1111/nin.12444] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
This study explores nurses' experiences of workplace conflict with patients and their family members, how it differs by ethnic/racial identity, and highlights the coping strategies engaged to lessen these conflicts. Using a qualitative research design, this study draws on phenomenology and in-depth interviews of 66 registered nurses and registered practical nurses from multiple sites in two Canadian cities to explore the experiences of nurses with multiple marginalized identities in relation to nurse-patient and nurse-patient's family member conflicts in direct care practice. The results show that horizontal conflicts, especially, ones involving nurses, patients, and their family members are quite pervasive in the nursing profession. Direct care nurses, especially, ethnic minorities relative to majority groups experience excessive physical assaults, verbal aggressive behaviors, racial stereotyping and discrimination, and sexual harassment from patients and patients' family members. Institutional support through policies and practices designed to de-escalate aggressive behavior from patients and their family members were identified as important support systems. We conclude that policies aimed at creating a safe and strong health-care system call for holding patients and th'eir family members legally responsible for uncivil and aggressive behavior against caregivers.
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Affiliation(s)
- Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, Texas, USA.,Department of Sociology, Western University, London, Ontario, Canada
| | - Kyrah K Brown
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, Texas, USA
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Ajibade I, Boateng GO. Predicting why people engage in pro-sustainable behaviors in Portland Oregon: The role of environmental self-identity, personal norm, and socio-demographics. J Environ Manage 2021; 289:112538. [PMID: 33865024 DOI: 10.1016/j.jenvman.2021.112538] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/15/2020] [Revised: 03/31/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
This study aims to identify factors influencing people's participation in frequent and effective pro-sustainable behaviors (PSB) in Portland, Oregon, using value-belief-norm theory and a modified value-identity-personal-norm (VIP) model. Drawing from a resident survey (n = 484) and applying a series of regression and mediation analyses, we tested the power of the VIP model in our sample to examine the influence of values, environmental self-identity, and personal norms on PSB while adjusting for socio-demographic factors. Our study revealed participants who held altruistic values (i.e., cared for the community, valued diversity and gender equality, and made decisions based on cooperation) had stronger environmental self-identity characterized by a belief that reflects biocentrism, ecofeminism, ecospirituality, or deep ecology. These identities were significantly associated with participation in more effective PSB after adjusting for personal norms. Participants with egoistic values had stronger anthropocentric identity and weaker personal norms which translated into lower participation in more effective PSB. Also, education increased PSB, with master's degree holders participating more than other groups. Overall, values, environmental self-identity, and higher education predicted participation in effective PSB. Our refined theoretical model is, therefore, promising for assessing multiple PSB at once, especially those that significantly reduce carbon footprint on the planet.
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Affiliation(s)
- Idowu Ajibade
- Department of Geography, Portland State University, Portland, OR, USA.
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, TX, USA.
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Koyratty N, Jones AD, Schuster R, Kordas K, Li CS, Mbuya MNN, Boateng GO, Ntozini R, Chasekwa B, Humphrey JH, Smith LE. Food Insecurity and Water Insecurity in Rural Zimbabwe: Development of Multidimensional Household Measures. Int J Environ Res Public Health 2021; 18:6020. [PMID: 34205143 PMCID: PMC8199942 DOI: 10.3390/ijerph18116020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
Background: With millions of people experiencing malnutrition and inadequate water access, FI and WI remain topics of vital importance to global health. Existing unidimensional FI and WI metrics do not all capture similar multidimensional aspects, thus restricting our ability to assess and address food- and water-related issues. Methods: Using the Sanitation, Hygiene and Infant Nutrition Efficacy (SHINE) trial data, our study conceptualizes household FI (N = 3551) and WI (N = 3311) separately in a way that captures their key dimensions. We developed measures of FI and WI for rural Zimbabwean households based on multiple correspondence analysis (MCA) for categorical data. Results: Three FI dimensions were retained: 'poor food access', 'household shocks' and 'low food quality and availability', as were three WI dimensions: 'poor water access', 'poor water quality', and 'low water reliability'. Internal validity of the multidimensional models was assessed using confirmatory factor analysis (CFA) with test samples at baseline and 18 months. The dimension scores were associated with a group of exogenous variables (SES, HIV-status, season, depression, perceived health, food aid, water collection), additionally indicating predictive, convergent and discriminant validities. Conclusions: FI and WI dimensions are sufficiently distinct to be characterized via separate indicators. These indicators are critical for identifying specific problematic insecurity aspects and for finding new targets to improve health and nutrition interventions.
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Affiliation(s)
- Nadia Koyratty
- Department of Epidemiology and Environmental Health, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA; (N.K.); (K.K.)
| | - Andrew D. Jones
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Roseanne Schuster
- Center for Global Health, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ 85281, USA;
| | - Katarzyna Kordas
- Department of Epidemiology and Environmental Health, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA; (N.K.); (K.K.)
| | - Chin-Shang Li
- School of Nursing, The State University of New York, University at Buffalo, Buffalo, NY 14214, USA;
| | | | - Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX 76019, USA;
| | - Robert Ntozini
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
| | - Bernard Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
| | - Jean H. Humphrey
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Laura E. Smith
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; (R.N.); (B.C.); (J.H.H.)
- Department of Population Medicine and Diagnostics, Cornell University, Ithaca, NY 14853, USA
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Boateng GO, Doku DT, Enyan NIE, Owusu SA, Aboh IK, Kodom RV, Ekumah B, Quansah R, Boamah SA, Obiri-Yeboah D, Nsabimana E, Jansen S, Armah FA. Prevalence and changes in boredom, anxiety and well-being among Ghanaians during the COVID-19 pandemic: a population-based study. BMC Public Health 2021; 21:985. [PMID: 34039313 PMCID: PMC8149916 DOI: 10.1186/s12889-021-10998-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/04/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The outbreak of the COVID-19 pandemic has been associated with several adverse health outcomes. However, few studies in sub-Saharan Africa have examined its deleterious consequences on mental health. Therefore, we investigated the prevalence and changes in boredom, anxiety and psychological well-being before and during the COVID-19 pandemic in Ghana. METHODS Data for this study were drawn from an online survey of 811 participants that collected retrospective information on mental health measures including symptoms of generalized anxiety disorder, boredom, and well-being. Additional data were collected on COVID-19 related measures, biosocial (e.g. age and sex) and sociocultural factors (e.g., education, occupation, marital status). Following descriptive and psychometric evaluation of measures used, multiple linear regression was used to assess the relationships between predictor variables and boredom, anxiety and psychological well-being scores during the pandemic. Second, we assessed the effect of anxiety on psychological well-being. Next, we assessed predictors of the changes in boredom, anxiety, and well-being. RESULTS Before the COVID-19 pandemic, 63.5% reported better well-being, 11.6% symptoms of anxiety, and 29.6% symptoms of boredom. Comparing experiences before and during the pandemic, there was an increase in boredom and anxiety symptomatology, and a decrease in well-being mean scores. The adjusted model shows participants with existing medical conditions had higher scores on boredom (ß = 1.76, p < .001) and anxiety (ß = 1.83, p < .01). In a separate model, anxiety scores before the pandemic (ß = -0.25, p < .01) and having prior medical conditions (ß = -1.53, p < .001) were associated with decreased psychological well-being scores during the pandemic. In the change model, having a prior medical condition was associated with an increasing change in boredom, anxiety, and well-being. Older age was associated with decreasing changes in boredom and well-being scores. CONCLUSIONS This study is the first in Ghana to provide evidence of the changes in boredom, anxiety and psychological well-being during the COVID-19 pandemic. The findings underscore the need for the inclusion of mental health interventions as part of the current pandemic control protocol and public health preparedness towards infectious disease outbreaks.
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Affiliation(s)
- Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, USA
| | - David Teye Doku
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana.
| | | | - Samuel Asiedu Owusu
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
| | - Irene Korkoi Aboh
- School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana
| | | | - Benard Ekumah
- Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana
| | - Reginald Quansah
- Department of Biological and Environmental Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | | | - Dorcas Obiri-Yeboah
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Epaphrodite Nsabimana
- Mental Health & Behavior Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Stefan Jansen
- Mental Health & Behavior Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Frederick Ato Armah
- Directorate of Research, Innovation and Consultancy, University of Cape Coast, Cape Coast, Ghana
- Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana
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Balogun M, Banke-Thomas A, Sekoni A, Boateng GO, Yesufu V, Wright O, Ubani O, Abayomi A, Afolabi BB, Ogunsola F. Challenges in access and satisfaction with reproductive, maternal, newborn and child health services in Nigeria during the COVID-19 pandemic: A cross-sectional survey. PLoS One 2021; 16:e0251382. [PMID: 33961682 PMCID: PMC8104439 DOI: 10.1371/journal.pone.0251382] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/26/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The presence of COVID-19 has led to the disruption of health systems globally, including essential reproductive, maternal, newborn and child health (RMNCH) services. This study aimed to assess the challenges faced by women who used RMNCH services in Nigeria's epicentre, their satisfaction with care received during the COVID-19 pandemic and the factors associated with their satisfaction. METHODS This cross-sectional survey was conducted in Lagos, southwest Nigeria among 1,241 women of reproductive age who had just received RMNCH services at one of twenty-two health facilities across the primary, secondary and tertiary tiers of health care. The respondents were selected via multi-stage sampling and face to face exit interviews were conducted by trained interviewers. Client satisfaction was assessed across four sub-scales: health care delivery, health facility, interpersonal aspects of care and access to services. Bivariate and multivariate analyses were used to assess the relationship between personal characteristics and client satisfaction. RESULTS About 43.51% of respondents had at least one challenge in accessing RMNCH services since the COVID-19 outbreak. Close to a third (31.91%) could not access service because they could not leave their houses during the lockdown and 18.13% could not access service because there was no transportation. The mean clients' satisfaction score among the respondents was 43.25 (SD: 6.28) out of a possible score of 57. Satisfaction scores for the interpersonal aspects of care were statistically significantly lower in the PHCs and general hospitals compared to teaching hospitals. Being over 30 years of age was significantly associated with an increased clients' satisfaction score (ß = 1.80, 95%CI: 1.10-2.50). CONCLUSION The COVID-19 lockdown posed challenges to accessing RMNCH services for a significant proportion of women surveyed. Although overall satisfaction with care was fairly high, there is a need to provide tailored COVID-19 sensitive inter-personal care to clients at all levels of care.
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Affiliation(s)
- Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | | | - Adekemi Sekoni
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, Texas, United States of America
| | - Victoria Yesufu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Ololade Wright
- Department of Community Health and Primary Health Care, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria
| | - Osinachi Ubani
- Lagos State Primary Health Care Board, Yaba, Lagos, Nigeria
| | - Akin Abayomi
- Lagos State Ministry of Health, Ikeja, Lagos, Nigeria
| | - Bosede B. Afolabi
- Department of Obstetrics and Gynaecology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Folasade Ogunsola
- Department of Medical Microbiology, College of Medicine of the University of Lagos, Idi-Araba, Lagos, Nigeria
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Boateng GO, Lartey ST, Baiden P, Si L, Biritwum RB, Kowal P, Magnussen CG, Ben Taleb Z, Palmer AJ, Luginaah I. Measuring Hypertension Progression With Transition Probabilities: Estimates From the WHO SAGE Longitudinal Study. Front Public Health 2021; 9:571110. [PMID: 33898368 PMCID: PMC8058215 DOI: 10.3389/fpubh.2021.571110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 03/10/2021] [Indexed: 01/21/2023] Open
Abstract
This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic <80 mm Hg), stage 1 (systolic 130-139 mm Hg & diastolic 80-89 mm Hg), and stage 2 (systolic ≥140mm Hg & diastolic≥90 mm Hg) hypertension and adjusted for the individual effects of anthropometric, lifestyle, and socio-demographic factors. At baseline, 22.5% had stage 1 hypertension and 52.2% had stage 2 hypertension. The estimated seven-year transition probability for the general population was 19.0% (95% CI: 16.4, 21.8) from normal/elevated blood pressure to stage 1 hypertension, 31.6% (95% CI: 27.6, 35.4%) from stage 1 hypertension to stage 2 hypertension, and 48.5% (45.6, 52.1%) for remaining at stage 2. Other factors such as being overweight, obese, female, aged 60+ years, urban residence, low education and high income were associated with an increased probability of remaining at stage 2 hypertension. However, consumption of recommended servings of fruits and vegetables per day was associated with a delay in the onset of stage 1 hypertension and a recovery to normal/elevated blood pressure. This is the first study to show estimated transition probabilities between the stages of hypertension severity across the lifespan in sub-Saharan Africa. The results are important for understanding progression through hypertension severity and can be used in simulating cost-effective models to evaluate policies and the burden of future healthcare.
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Affiliation(s)
- Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Stella T. Lartey
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University School of Public Health-Bloomington, Bloomington, IN, United States
| | - Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, United States
| | - Lei Si
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | | | - Paul Kowal
- World Health Organization, Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, NSW, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Isaac Luginaah
- Department of Geography, University of Western Ontario, London, ON, Canada
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Brown KK, Boateng GO, Ossom-Williamson P, Haygood L. Defining, conceptualizing, and measuring perceived maternal care quality in low- to high-income countries: a scoping review protocol. Syst Rev 2021; 10:61. [PMID: 33627182 PMCID: PMC7903867 DOI: 10.1186/s13643-021-01608-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health practitioners and researchers must be able to measure and assess maternal care quality in facilities to monitor, intervene, and reduce global maternal mortality rates. On the global scale, there is a general lack of consensus on how maternal care quality is defined, conceptualized, and measured. Much of the literature addressing this problem has focused primarily on defining, conceptualizing, and measuring clinical indicators of maternal care quality. Less attention has been given in this regard to perceived maternal care quality among women which is known to influence care utilization and adherence. Therefore, there is a need to map the literature focused on defining, conceptualizing, and measuring perceived maternal care quality across low-, middle-, and high-income country contexts. METHODS This scoping review protocol will follow the Arksey and O'Malley methodological framework. A comprehensive search strategy will be used to search for articles published from inception to 2020 in Ovid MEDLINE, Embase, AMED, and WHO Global Index Medicus. Gray literature will be included. Two independent reviewers will screen articles by title and abstract, then by full-text based on pre-determined inclusion/exclusion criteria. A third reviewer will arbitrate any discrepancies. This protocol outlines a four-step analytic approach that includes numerical, graphical, tabular, and narrative summaries to provide a comprehensive description of the body of literature. DISCUSSION The findings from this scoping review will provide a comprehensive overview of the existing evidence on perceived maternal care quality. The findings are expected to inform future work on building consensus around the definition and conceptualization of perceived maternal care quality, and lay the groundwork for future research aimed at developing measures of perceived maternal care quality that can be applied across country contexts. Consequently, this review may aid in facilitating coordinated efforts to measure and improve maternal care quality across diverse country contexts (i.e., low-, middle-, and high-income country contexts). REVIEW REGISTRATION This scoping review has been registered in the Open Science Framework (osf.io/k8nqh).
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Affiliation(s)
- Kyrah K Brown
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Box 19407, Arlington, TX, 76019-0407, USA.
| | - Godfred O Boateng
- Department of Kinesiology, University of Texas at Arlington, 500 W. Nedderman Drive, Box 19407, Arlington, TX, 76019-0407, USA
| | - Peace Ossom-Williamson
- Research Data Services, UTA Libraries, University of Texas at Arlington, 702 Planetarium Place, Arlington, TX, 76019, USA
| | - Laura Haygood
- Gibson D. Lewis Health Science Library, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA
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Young SL, Miller JD, Frongillo EA, Boateng GO, Jamaluddine Z, Neilands TB. Validity of a Four-Item Household Water Insecurity Experiences Scale for Assessing Water Issues Related to Health and Well-Being. Am J Trop Med Hyg 2021; 104:391-394. [PMID: 33124535 PMCID: PMC7790094 DOI: 10.4269/ajtmh.20-0417] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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] [Indexed: 11/12/2022] Open
Abstract
We sought to determine whether a shortened version of the 12-item Household Water Insecurity Experiences (HWISE) Scale, which measures water insecurity equivalently in low- and middle-income countries (LMICs), is valid for broad use. Using data from 9,261 households in 25 LMICs, subsets of candidate items were evaluated on their predictive accuracy, criterion validity, and sensitivity–specificity. A subset with items assessing “worry,” “changing plans,” “limited drinking water,” and “inability to wash hands” because of problems with water (range: 0–12) were highly correlated with full HWISE Scale scores (correlation coefficient: 0.949–0.980) and introduced minimal additional error (root mean square error: 2.13–2.68). Criterion validity was demonstrated, and a cut point of ≥ 4 correctly classified more than 91% of households as water secure or insecure. The brief HWISE-4 can be used in LMICs to inform decisions about how to most effectively target resources and evaluate public health interventions.
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Affiliation(s)
- Sera L Young
- 1Department of Anthropology, Northwestern University, Evanston, Illinois.,2Institute for Policy Research, Northwestern University, Evanston, Illinois
| | - Joshua D Miller
- 1Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Edward A Frongillo
- 3Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Godfred O Boateng
- 4Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, Texas
| | - Zeina Jamaluddine
- 5Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - Torsten B Neilands
- 6School of Medicine, University of California San Francisco, San Francisco, California
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20
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Boateng GO, Phipps LM, Smith LE, Armah FA. Household Energy Insecurity and COVID-19 Have Independent and Synergistic Health Effects on Vulnerable Populations. Front Public Health 2021; 8:609608. [PMID: 33553095 PMCID: PMC7859644 DOI: 10.3389/fpubh.2020.609608] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/22/2020] [Indexed: 02/03/2023] Open
Abstract
Household energy insecurity (HEINS) is detrimental to the health of the poor and most vulnerable in resource-poor settings. However, this effect amidst the COVID-19 pandemic and the uneven implementation of restrictions can create a synergistic burden of diseases and health risks for the most vulnerable in low- and middle-income countries, exacerbating the health equity gap. Based on existing literature, this paper develops three key arguments: (1) COVID-19 increases the health risks of energy insecurity; (2) HEINS increases the risk of spreading COVID-19; and (3) the co-occurrence of COVID-19 and HEINS will have compounding health effects. These arguments make context-specific interventions, rather than a generic global health approach without recourse to existing vulnerabilities critical in reducing the spread of COVID-19 and mitigating the effects of energy insecurity. Targeted international efforts aimed at financing and supporting resource security, effective testing, contact tracing, and the equitable distribution of vaccines and personal protective equipment have the potential to ameliorate the synergistic effects of HEINS and COVID-19 in resource-poor countries.
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Affiliation(s)
- Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Laura M. Phipps
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Laura E. Smith
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Frederick A. Armah
- Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana
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Ali T, Boateng GO, Medeiros AP, Raj M. 11. Caregiving. Healthy Aging Through The Social Determinants of Health 2021. [DOI: 10.2105/9780875533162ch11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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22
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Ben Taleb Z, Kalan ME, Bahelah R, Boateng GO, Rahman M, Alshbool FZ. Vaping while high: Factors associated with vaping marijuana among youth in the United States. Drug Alcohol Depend 2020; 217:108290. [PMID: 32956975 DOI: 10.1016/j.drugalcdep.2020.108290] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/17/2020] [Revised: 09/03/2020] [Accepted: 09/05/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The use of e-cigarette and other vaping devices have become popular among youth in US. In addition to nicotine, vaping devices can be used to vaporize marijuana. However, factors associated with vaping marijuana among youth remain unexplored. This study examined the rates of vaping marijuana and its correlates among youth in the US. METHODS We conducted a cross-sectional analysis of survey data from the 2018 National Youth Tobacco Survey of middle-and high-schoolers who provided information regarding ever use of vaping devices to vape marijuana (n = 10,680). Multivariable regression model was conducted to assess factors associated with vaping marijuana. RESULTS Overall, 26.2 % of participants reported ever vaping marijuana. High-schoolers [vs middle-schoolers; aOR = 2.16,95 %CI:1.76-2.67], Hispanics [vs Whites; aOR = 2.30,95 %CI:1.90-2.80], and Blacks [vs Whites; aOR = 1.42,95 %CI:1.04-1.92] were more likely to ever vape marijuana. Those who perceived e-cigarette as equally addictive to cigarettes, were less likely to ever vape marijuana [aOR = 0.79, 95 %CI:0.65-0.97]. In addition, those who reported ever trying cigarettes [aOR = 1.63,95 %CI:1.29-2.06], cigars [aOR = 2.62, 95 %CI:2.08-3.30], or hookah [aOR = 2.88,95 %CI:2.14-3.89] were more likely to ever vape marijuana. Lifetime frequency of e-cigarette use was associated with greater odds of ever vaping marijuana (p-values <0.001). CONCLUSION Large numbers of youth in the US have ever vaped marijuana. Our findings indicate that sociodemographic characteristics, tobacco product use, frequency of e-cigarette use are important factors associated with vaping marijuana. Tobacco control campaigns targeted at curbing the use of e-cigarette and other vaping devices among youth in the US should be extended to address vaping substances other than nicotine such as marijuana.
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Affiliation(s)
- Ziyad Ben Taleb
- Department of Kinesiology, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA.
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Florida International University, 11200 SW 8thSt, Miami, FL, 33199, USA
| | - Raed Bahelah
- Department of Public Health & Prevention Science, Baldwin Wallace University, 275 Eastland Rd. Berea, OH, 44017, USA
| | - Godfred O Boateng
- Department of Kinesiology, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA
| | - Mashikur Rahman
- Department of Mathematics, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA
| | - Fatima Z Alshbool
- Department of Pharmacy Practice, Texas A&M University, 1010 West Avenue B, Kingsville, TX 78363, USA
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Baiden P, Xiao Y, Asiedua-Baiden G, LaBrenz CA, Boateng GO, Graaf G, Muehlenkamp JJ. Sex differences in the association between sexual violence victimization and suicidal behaviors among adolescents. Journal of Affective Disorders Reports 2020. [DOI: 10.1016/j.jadr.2020.100011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Yadav UN, Thapa TB, Mistry SK, Ghimire S, Yadav KK, Boateng GO, O’Callaghan C. Biosocial and disease conditions are associated with good quality of life among older adults in rural eastern Nepal: Findings from a cross-sectional study. PLoS One 2020; 15:e0242942. [PMID: 33253232 PMCID: PMC7704002 DOI: 10.1371/journal.pone.0242942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/12/2020] [Indexed: 12/25/2022] Open
Abstract
Background The ageing population in most low-and middle-income countries is accompanied by an increased risk of non-communicable diseases culminating in a poor quality of life (QOL). However, the factors accelerating this poor QOL have not been fully examined in Nepal. Therefore, this study examined the factors associated with the QOL of older adults residing in the rural setting of Nepal. Methods Data from a previous cross-sectional study conducted among older adults between January and April 2018 in in rural Nepal was used in this study. The analytical sample included 794 older adults aged ≥60 years, selected by a multi-stage cluster sampling approach. QOL was measured using the Older People’s Quality of Life tool; dichotomized as poor and good QOL. Other measures used included age, gender, ethnicity, religion, marital status, physical activity, and chronic diseases such as osteoarthritis, cardiovascular disease, diabetes, chronic obstructive pulmonary disease (COPD), and depression. The factors associated with QOL were examined using mixed-effects logistic regression. Results Seven in ten respondents (70.4%) reported a poor QOL. At the bivariate level, increasing age, unemployment, intake of alcohol, lack of physical activity as well as osteoarthritis, COPD and depression were significantly associated with a lower likelihood of a good QOL. The adjusted model showed that older age (AOR = 0.50, 95% CI: 0.28–0.90), the Christian religion (AOR = 0.38, 95% CI: 0.20–0.70), and of an Indigenous (AOR: 0.25; 95% CI: 0.14–0.47), Dalit (AOR: 0.23; 95% CI: 0.10–0.56), and Madheshi (AOR: 0.29; 95% CI: 0.14–0.60) ethnic background were associated with lower odds of good QOL. However, higher income of >NRs 10,000 (AOR = 3.34, 95% CI: 1.43–3.99), daily physical activity (AOR: 3.33; 95% CI: 2.55–4.34), and the absence of osteoarthritis (AOR: 1.9; 95% CI: 1.09–3.49) and depression (AOR: 3.34; 95% CI: 2.14–5.22) were associated with higher odds of good QOL. Conclusion The findings of this study reinforce the need of improving QOL of older adults through implementing programs aimed at addressing the identified biosocial and disease conditions that catalyse poor QOL in this older population residing in rural parts of Nepal.
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Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- School of Population Health, UNSW, Sydney, Australia
- Torrens University, Sydney, Australia
- Centre for Research, Policy and Implementation-Nepal, Biratnagar, Nepal
- * E-mail: ,
| | | | - Sabuj Kanti Mistry
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Saruna Ghimire
- Department of Sociology and Gerontology and Scripps Gerontology Center, Miami University, Oxford, OH, United States of America
| | | | - Godfred O. Boateng
- The University of Texas at Arlington, Arlington, Texas, United States of America
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Lartey S, Si L, Lung T, Magnussen CG, Boateng GO, Minicuci N, Kowal P, Hayes A, de Graaff B, Blizzard L, Palmer AJ. Impact of overweight and obesity on life expectancy, quality-adjusted life years and lifetime costs in the adult population of Ghana. BMJ Glob Health 2020; 5:e003332. [PMID: 32994229 PMCID: PMC7526271 DOI: 10.1136/bmjgh-2020-003332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 08/05/2020] [Accepted: 08/09/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Prior studies have revealed the increasing prevalence of obesity and its associated health effects among ageing adults in resource poor countries. However, no study has examined the long-term and economic impact of overweight and obesity in sub-Saharan Africa. Therefore, we quantified the long-term impact of overweight and obesity on life expectancy (LE), quality-adjusted life years (QALYs) and total direct healthcare costs. METHODS A Markov simulation model projected health and economic outcomes associated with three categories of body mass index (BMI): healthy weight (18.5≤BMI <25.0); overweight (25.0≤BMI < 30.0) and obese (BMI ≥30.0 kg/m2) in simulated adult cohorts over a 50-year time horizon from age fifty. Costs were estimated from government and patient perspectives, discounted 3% annually and reported in 2017 US$. Mortality rates from Ghanaian lifetables were adjusted by BMI-specific all-cause mortality HRs. Published input data were used from the 2014/2015 Ghana WHO Study on global AGEing and adult health data. Internal and external validity were assessed. RESULTS From age 50 years, average (95% CI) remaining LE for females were 25.6 (95% CI: 25.4 to 25.8), 23.5 (95% CI: 23.3 to 23.7) and 21.3 (95% CI: 19.6 to 21.8) for healthy weight, overweight and obesity, respectively. In males, remaining LE were healthy weight (23.0; 95% CI: 22.8 to 23.2), overweight (20.7; 95% CI: 20.5 to 20.9) and obesity (17.6; 95% CI: 17.5 to 17.8). In females, QALYs for healthy weight were 23.0 (95% CI: 22.8 to 23.2), overweight, 21.0 (95% CI: 20.8 to 21.2) and obesity, 19.0 (95% CI: 18.8 to 19.7). The discounted total costs per female were US$619 (95% CI: 616 to 622), US$1298 (95% CI: 1290 to 1306) and US$2057 (95% CI: 2043 to 2071) for healthy weight, overweight and obesity, respectively. QALYs and costs were lower in males. CONCLUSION Overweight and obesity have substantial health and economic impacts, hence the urgent need for cost-effective preventive strategies in the Ghanaian population.
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Affiliation(s)
- Stella Lartey
- Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
- Department of Economics, University of Calgary, Calgary, AB, Canada
- Ministry of Health, Accra, GAR, Ghana
| | - Lei Si
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Thomas Lung
- The George Institute for Global Health, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, University of Texas at Arlington, Arlington, Texas, USA
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization, Geneva, Switzerland
- Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Alison Hayes
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Menzies Institute for Medical Research, Hobart, Tasmania, Australia
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Balogun MR, Boateng GO, Adams YJ, Ransome-Kuti B, Sekoni A, Adams EA. Using mobile phones to promote maternal and child health: knowledge and attitudes of primary health care providers in southwest Nigeria. Journal of Global Health Reports 2020. [DOI: 10.29392/001c.13507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Mobolanle R Balogun
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Godfred O Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, Texas, USA
| | - Yenupini J Adams
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, Indiana, USA
| | - Bukola Ransome-Kuti
- Department of Paediatrics, Lagos State University Teaching Hospital, Lagos, Nigeria
| | - Adekemi Sekoni
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ellis A Adams
- Keough School of Global Affairs, University of Notre Dame, Notre Dame, Indiana, USA
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Boateng GO, Balogun MR, Dada FO, Armah FA. Household energy insecurity: dimensions and consequences for women, infants and children in low- and middle-income countries. Soc Sci Med 2020; 258:113068. [PMID: 32534302 DOI: 10.1016/j.socscimed.2020.113068] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/14/2020] [Accepted: 05/15/2020] [Indexed: 11/26/2022]
Abstract
Energy insecurity, the lack of access to adequate, affordable, reliable, acceptable, and clean sources of energy for a healthy and sustainable livelihood, poses a challenge to several households. However, the conceptualization of its dimensions and role in the health outcomes of women, infants, and children in most sub-Saharan African countries have rarely been investigated systematically. We assessed the dimensions and adverse consequences of household energy insecurity (HEINS) in a sample of 347 Ghanaians and 420 Nigerians, with over 80% participation of women. The majority of respondents from Ghana (57%) and Nigeria (80%) had experienced of energy insecurity, at least once in the last four weeks. Following the energy insecurity framework, the experiences of participants were classified into physical, behavioral, and economic dimensions of energy insecurity. The consequences of energy insecurity grouped into psychosocial, nutritional, and disease domains. The development of a national as well as a cross-culturally validated scale that embodies these dimensions and domains will facilitate the assessment of the prevalence, causes, and consequences of HEINS. This will eventually enable the development of interventions and policies to mitigate energy insecurity and unearth modifiable factors that influence deleterious maternal, infant and child health outcomes in low-and middle-income countries.
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Affiliation(s)
- Godfred O Boateng
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, TX, USA.
| | - Mobolanle R Balogun
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Festus O Dada
- Department of Community Health & Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Frederick A Armah
- Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana
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Baiden P, Tadeo SK, Tonui BC, Seastrunk JD, Boateng GO. Association between insufficient sleep and suicidal ideation among adolescents. Psychiatry Res 2020; 287:112579. [PMID: 31627959 DOI: 10.1016/j.psychres.2019.112579] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 06/13/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 12/28/2022]
Abstract
The objective of this study was to examine the association between insufficient sleep and suicidal ideation among adolescents. Data for this study came from the 2017 Youth Risk Behavior Surveillance System. A sample of 13,659 adolescents aged 14-18 years (51.8% female) were analyzed using logistic regression with suicidal ideation as the outcome variable and insufficient sleep as the main explanatory variable. Of the 13,659 adolescents, 2,409 representing 17.6% experienced suicidal ideation during the past 12 months and three out of four adolescents (75.2%) had insufficient sleep on an average school night. Controlling for all other predictors, the odds of experiencing suicidal ideation were 1.35 times higher for adolescents who had insufficient sleep relative to those who had sufficient sleep on an average school night (AOR = 1.35, 95% CI = 1.16-1.58). Other factors associated with suicidal ideation include female gender, sexual minority, history of traditional bullying and cyberbullying victimization, feeling sad or hopeless, being slightly or very overweight, and substance use. Physical activity was inversely associated with suicidal ideation. School counselors, clinicians, and practitioners should consider adequate sleep as an important intervention in suicide prevention.
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Affiliation(s)
- Philip Baiden
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, United States.
| | - Savarra K Tadeo
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, United States
| | - Betty C Tonui
- The University of Texas at Arlington, School of Social Work, 211 S. Cooper St., Box 19129, Arlington, TX, 76019, United States
| | - Jaylon D Seastrunk
- The University of Texas at Arlington, Department of Psychology, 501 Nedderman Dr, Box 19528, Arlington, TX, 76019, United States
| | - Godfred O Boateng
- The University of Texas at Arlington, Public Health Program, Department of Kinesiology, 500 W. Nedderman Dr, Box 19407, Arlington, TX, 76019, United States
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Lartey ST, Si L, Otahal P, de Graaff B, Boateng GO, Biritwum RB, Minicuci N, Kowal P, Magnussen CG, Palmer AJ. Annual transition probabilities of overweight and obesity in older adults: Evidence from World Health Organization Study on global AGEing and adult health. Soc Sci Med 2020; 247:112821. [PMID: 32018114 DOI: 10.1016/j.socscimed.2020.112821] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 12/02/2019] [Accepted: 01/27/2020] [Indexed: 11/19/2022]
Abstract
Overweight/obesity is becoming increasingly prevalent in sub-Saharan Africa including Ghana. However, transition probabilities, an essential component to develop cost-effective measures for weight management is lacking in this population. We estimated annual transition probabilities between three body mass index (BMI) categories: normal weight (BMI ≥18.5 and <25.0 kg/m2), overweight (BMI ≥25.0 and <30.0 kg/m2), and obesity (BMI ≥30.0 kg/m2), among older adults aged ≥50 years in Ghana. Data were used from a nationally representative, multistage sample of 1496 (44.3% females) older adults in both Waves 1 (2007/8) and 2 (2014/15) of the Ghana WHO SAGE. A multistage Markov model was used to estimate annual transition probabilities. We further examined the impact of specific socio-economic factors on the transition probabilities. At baseline, 22.8% were overweight and 11.1% were obese. The annual transition probability was 4.0% (95% CI: 3.4%, 4.8%) from normal weight to overweight, 11.1% (95% CI: 9.5%, 13.0%) from overweight to normal weight and 4.9% (95% CI: 3.8%, 6.2%) from overweight to obesity. For obese individuals, the probability of remaining obese, transitioning to overweight and completely reverting to normal weight was 90.2% (95% CI: 87.7%, 92.3%), 9.2% (95% CI: 7.2%, 11.6%) and 0.6% (95% CI: 0.4%, 0.8%) respectively. Being female, aged 50-65 years, urban residence, having high education and high wealth were associated with increased probability of transitioning into the overweight or obese categories. Our findings highlight the difficulty in transitioning away from obesity, especially among females. The estimated transition probabilities will be essential in health economic simulation models to determine sustainable weight management interventions.
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Affiliation(s)
- Stella T Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The George Institute for Global Health, University of New South Wales, Kensington, NSW, 2042, Australia
| | - Petr Otahal
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Godfred O Boateng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland; University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
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Lartey ST, de Graaff B, Magnussen CG, Boateng GO, Aikins M, Minicuci N, Kowal P, Si L, Palmer AJ. Health service utilization and direct healthcare costs associated with obesity in older adult population in Ghana. Health Policy Plan 2019; 35:199-209. [DOI: 10.1093/heapol/czz147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Obesity is a major risk factor for many chronic diseases and disabilities, with severe implications on morbidity and mortality among older adults. With an increasing prevalence of obesity among older adults in Ghana, it has become necessary to develop cost-effective strategies for its management and prevention. However, developing such strategies is challenging as body mass index (BMI)-specific utilization and costs required for cost-effectiveness analysis are not available in this population. Therefore, this study examines the associations between health services utilization as well as direct healthcare costs and overweight (BMI ≥25.00 and <30.00 kg/m2) and obesity (BMI ≥30.00 kg/m2) among older adults in Ghana. Data were used from a nationally representative, multistage sample of 3350 people aged 50+ years from the World Health Organization’s Study on global AGEing and adult health (WHO-SAGE; 2014/15). Health service utilization was measured by the number of health facility visits over a 12-month period. Direct costs (2017 US dollars) included out-of-pocket payments and the National Health Insurance Scheme (NHIS) claims. Associations between utilization and BMI were examined using multivariable zero-inflated negative binomial regressions; and between costs and BMI using multivariable two-part regressions. Twenty-three percent were overweight and 13% were obese. Compared with normal-weight participants, overweight and obesity were associated with 75% and 159% more inpatient admissions, respectively. Obesity was also associated with 53% additional outpatient visits. One in five of the overweight and obese population had at least one chronic disease, and having chronic disease was associated with increased outpatient utilization. The average per person total costs for overweight was $78 and obesity was $132 compared with $35 for normal weight. The NHIS bore approximately 60% of the average total costs per person expended in 2014/15. Overweight and obese groups had significantly higher total direct healthcare costs burden of $121 million compared with $64 million for normal weight in the entire older adult Ghanaian population. Compared with normal weight, the total costs per person associated with overweight increased by 73% and more than doubled for obesity. Even though the total prevalence of overweight and obesity was about half of that of normal weight, the sum of their cost burden was almost doubled. Implementing weight reduction measures could reduce health service utilization and costs in this population.
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Affiliation(s)
- Stella T Lartey
- Menzies Institute for Medical Research, University of Tasmania, Medical Sciences 2 Building, 17 Liverpool Street, Hobart 7000, Tasmania, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Medical Sciences 2 Building, 17 Liverpool Street, Hobart 7000, Tasmania, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Medical Sciences 2 Building, 17 Liverpool Street, Hobart 7000, Tasmania, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku FI-20014, Finland
| | - Godfred O Boateng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Moses Aikins
- School of Public Health, University of Ghana, Accra LG 13, Ghana
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Via Giustiniani, 2 35128 Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Avenue Appia 20, 1211 Genève, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales 2305, Australia
| | - Lei Si
- The George Institute for Global Health, University of New South Wales, Kensington, NSW 2042, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Medical Sciences 2 Building, 17 Liverpool Street, Hobart 7000, Tasmania, Australia
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria 3053, Australia
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Young SL, Boateng GO, Jamaluddine Z, Miller JD, Frongillo EA, Neilands TB, Collins SM, Wutich A, Jepson WE, Stoler J. The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries. BMJ Glob Health 2019; 4:e001750. [PMID: 31637027 PMCID: PMC6768340 DOI: 10.1136/bmjgh-2019-001750] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/30/2019] [Accepted: 08/18/2019] [Indexed: 11/04/2022] Open
Abstract
Objective Progress towards equitable and sufficient water has primarily been measured by population-level data on water availability. However, higher-resolution measures of water accessibility, adequacy, reliability and safety (ie, water insecurity) are needed to understand how problems with water impact health and well-being. Therefore, we developed the Household Water InSecurity Experiences (HWISE) Scale to measure household water insecurity in an equivalent way across disparate cultural and ecological settings. Methods Cross-sectional surveys were implemented in 8127 households across 28 sites in 23 low-income and middle-income countries. Data collected included 34 items on water insecurity in the prior month; socio-demographics; water acquisition, use and storage; household food insecurity and perceived stress. We retained water insecurity items that were salient and applicable across all sites. We used classical test and item response theories to assess dimensionality, reliability and equivalence. Construct validity was assessed for both individual and pooled sites using random coefficient models. Findings Twelve items about experiences of household water insecurity were retained. Items showed unidimensionality in factor analyses and were reliable (Cronbach's alpha 0.84 to 0.93). The average non-invariance rate was 0.03% (threshold <25%), indicating equivalence of measurement and meaning across sites. Predictive, convergent and discriminant validity were also established. Conclusions The HWISE Scale measures universal experiences of household water insecurity across low-income and middle-income countries. Its development ushers in the ability to quantify the prevalence, causes and consequences of household water insecurity, and can contribute an evidence base for clinical, public health and policy recommendations regarding water.
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Affiliation(s)
- Sera L Young
- Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Godfred O Boateng
- Anthropology, Northwestern University, Evanston, Illinois, USA.,Nutrition, Harvard University, Cambridge, Massachusetts, USA
| | - Zeina Jamaluddine
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - Joshua D Miller
- Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Edward A Frongillo
- Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Torsten B Neilands
- Medicine, University of California San Francisco, San Francisco, California, USA
| | | | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Wendy E Jepson
- Geography, Texas A&M University College Station, College Station, Texas, USA
| | - Justin Stoler
- Geography, University of Miami, Coral Gables, Florida, USA
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Lartey ST, Magnussen CG, Si L, Boateng GO, de Graaff B, Biritwum RB, Minicuci N, Kowal P, Blizzard L, Palmer AJ. Rapidly increasing prevalence of overweight and obesity in older Ghanaian adults from 2007-2015: Evidence from WHO-SAGE Waves 1 & 2. PLoS One 2019; 14:e0215045. [PMID: 31425568 PMCID: PMC6699701 DOI: 10.1371/journal.pone.0215045] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 07/26/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies on changes in the prevalence and determinants of obesity in older adults living in sub-Saharan Africa are scarce. We examined recent changes in obesity prevalence and associated factors for older adults in Ghana between 2007/08 and 2014/15. METHODS Data on adults aged 50 years and older in Ghana were drawn from the WHO SAGE 2007/08 (Wave 1; n = 4158) and 2014/15 (Wave 2; n = 1663). The weighted prevalence of obesity, overweight, normal weight and underweight, and of high central adiposity were compared in 2007/08 and 2014/15. Multinomial and binomial logistic regressions were used to examine whether the determinants of weight status based on objectively measured body mass index and waist circumference changed between the two time periods. RESULTS The prevalence of overweight (2007/08 = 19.6%, 95% CI: 18.0-21.4%; 2014/15 = 24.5%, 95% CI: 21.7-27.5%) and obesity (2007/08 = 10.2%, 95% CI: 8.9-11.7%; 2014/15 = 15.0%, 95% CI: 12.6-17.7%) was higher in 2014/15 than 2007/08 and more than half of the population had high central adiposity (2007/08 = 57.7%, 95% CI: 55.4-60.1%; 2014/15 = 66.9%, 95% CI: 63.7-70.0%) in both study periods. While the prevalence of overweight increased in both sexes, obesity prevalence was 16% lower in males and 55% higher in females comparing 2007/08 to 2014/15. Female sex, urban residence, and high household wealth were associated with higher odds of overweight/obesity and high central adiposity. Those aged 70+ years had lower odds of obesity in both study waves. In 2014/15, females who did not meet the recommended physical activity were more likely to be obese. CONCLUSION Over the 7-year period between the surveys, the prevalence of underweight decreased and overweight increased in both sexes, while obesity decreased in males but increased in females. The difference in obesity prevalence may point to differential impacts of past initiatives to reduce overweight and obesity, potential high-risk groups in Ghana, and the need to increase surveillance.
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Affiliation(s)
- Stella T. Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | - Godfred O. Boateng
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Miller JD, Young SL, Boateng GO, Oiye S, Owino V. Greater household food insecurity is associated with lower breast milk intake among infants in western Kenya. Matern Child Nutr 2019; 15:e12862. [PMID: 31222968 DOI: 10.1111/mcn.12862] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/31/2019] [Accepted: 06/13/2019] [Indexed: 12/28/2022]
Abstract
Household food insecurity has been hypothesized to negatively impact breastfeeding practices and breast milk intake, but this relationship has not been rigorously assessed. To generate an evidence base for breastfeeding recommendations among food-insecure mothers in settings where HIV is highly prevalent, we explored infant feeding practices among 119 mother-infant dyads in western Kenya at 6 and 24 weeks postpartum. We used the deuterium oxide dose-to-the-mother technique to determine if breastfeeding was exclusive in the prior 2 weeks, and to quantify breast milk intake. Sociodemographic data were collected at baseline and household food insecurity was measured at each time point using the Household Food Insecurity Access Scale. Average breast milk intake significantly increased from 721.3 g/day at 6 weeks postpartum to 961.1 g/day at 24 weeks postpartum. Household food insecurity at 6 or 24 weeks postpartum was not associated with maternal recall of exclusive breastfeeding (EBF) in the prior 24 hr or deuterium oxide-measured EBF in the prior 2 weeks at a significance level of 0.2 in bivariate models. In a fixed-effects model of quantity of breast milk intake across time, deuterium oxide-measured EBF in the prior 2 weeks was associated with greater breast milk intake (126.1 ± 40.5 g/day) and every one-point increase in food insecurity score was associated with a 5.6 (±2.2)-g/day decrease in breast milk intake. Given the nutritional and physical health risks of suboptimal feeding, public health practitioners should screen for and integrate programs that reduce food insecurity in order to increase breast milk intake.
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Affiliation(s)
- Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois
| | | | - Shadrack Oiye
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
| | - Victor Owino
- Nutritional and Health Related Environmental Studies Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria
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Boateng GO, Martin SL, Tuthill EL, Collins SM, Dennis CL, Natamba BK, Young SL. Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding. BMC Pregnancy Childbirth 2019; 19:73. [PMID: 30777020 PMCID: PMC6380059 DOI: 10.1186/s12884-019-2217-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 02/05/2019] [Indexed: 11/15/2022] Open
Abstract
Background Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6 months, could prevent an estimated 823,000 child deaths annually. Self-efficacy is an important determinant of breastfeeding behaviors. However, existing measures do not specifically assess exclusive breastfeeding self-efficacy, but rather self-efficacy for any breastfeeding. Hence, we sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy. Methods We modified and added items from Dennis’ Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). It was then implemented in an observational cohort in Gulu, Uganda at 1 (n = 239) and 3 (n = 238) months postpartum (clinicaltrials.gov NCT02925429). We performed inter-item and adjusted item-test correlations, as well as exploratory factor analysis and parallel analysis at 1 month postpartum to remove redundant items and determine their latent factor structure. We further applied confirmatory factor analysis to test dimensionality of the scale at 3 months postpartum. We then assessed the reliability of the scale and conducted tests of predictive and discriminant validity. Known group comparisons were made by primiparous status and correct breastfeeding knowledge. Results The modification of the original BSES-SF to target exclusive breastfeeding produced 19 items, which were reduced to 9 based on item correlations and factor loadings. Two dimensions of the adapted scale, the Breastfeeding Self-Efficacy Scale to Measure Exclusive Breastfeeding BSES-EBF emerged: Cognitive and Functional subscales, with alpha coefficients of 0.85 and 0.79 at 3 months postpartum. Predictive and discriminant validity and known group comparisons assessments supported its validity. Conclusions This version of the Breastfeeding Self-Efficacy scale, the BSES-EBF Scale, is valid and reliable for measuring exclusive breastfeeding self-efficacy in northern Uganda, and ready for adaptation and validation for clinical and programmatic use elsewhere. Electronic supplementary material The online version of this article (10.1186/s12884-019-2217-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Godfred O Boateng
- Department of Anthropology & Global Health, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, CB 7461, Chapel Hill, NC, 27599, USA
| | - Emily L Tuthill
- Department of Community Health Systems, University of California San Francisco, San Francisco, CA, USA
| | - Shalean M Collins
- Department of Anthropology & Global Health, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA
| | - Cindy-Lee Dennis
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto and St. Michael's Hospital, Toronto, ON, Canada
| | - Barnabas K Natamba
- Noncommunicable Diseases Theme, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Sera L Young
- Department of Anthropology & Global Health, Northwestern University, 1810 Hinman Avenue, Evanston, IL, 60208, USA. .,Institute for Policy Research, Northwestern University, Evanston, IL, USA.
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Young SL, Collins SM, Boateng GO, Neilands TB, Jamaluddine Z, Miller JD, Brewis AA, Frongillo EA, Jepson WE, Melgar-Quiñonez H, Schuster RC, Stoler JB, Wutich A. Development and validation protocol for an instrument to measure household water insecurity across cultures and ecologies: the Household Water InSecurity Experiences (HWISE) Scale. BMJ Open 2019; 9:e023558. [PMID: 30782708 PMCID: PMC6340431 DOI: 10.1136/bmjopen-2018-023558] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION A wide range of water-related problems contribute to the global burden of disease. Despite the many plausible consequences for health and well-being, there is no validated tool to measure individual- or household-level water insecurity equivalently across varying cultural and ecological settings. Accordingly, we are developing the Household Water Insecurity Experiences (HWISE) Scale to measure household-level water insecurity in multiple contexts. METHODS AND ANALYSIS After domain specification and item development, items were assessed for both content and face validity. Retained items are being asked in surveys in 28 sites globally in which water-related problems have been reported (eg, shortages, excess water and issues with quality), with a target of at least 250 participants from each site. Scale development will draw on analytic methods from both classical test and item response theories and include item reduction and factor structure identification. Scale evaluation will entail assessments of reliability, and predictive, convergent, and discriminant validity, as well as the assessment of differentiation between known groups. ETHICS AND DISSEMINATION Study activities received necessary ethical approvals from institutional review bodies relevant to each site. We anticipate that the final HWISE Scale will be completed by late 2018 and made available through open-access publication. Associated findings will be disseminated to public health professionals, scientists, practitioners and policymakers through peer-reviewed journals, scientific presentations and meetings with various stakeholders. Measures to quantify household food insecurity have transformed policy, research and humanitarian aid efforts globally, and we expect that an analogous measure for household water insecurity will be similarly impactful.
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Affiliation(s)
- Sera L Young
- Department of Anthropology, Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Godfred O Boateng
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Torsten B Neilands
- Department of Medicine, University of California, San Francisco, California, USA
| | - Zeina Jamaluddine
- Center for Research on Population and Health, American University of Beirut, Beirut, Lebanon
| | - Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Alexandra A Brewis
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Edward A Frongillo
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Wendy E Jepson
- Department of Geography, Texas A&M University, College Station, Texas, USA
| | | | - Roseanne C Schuster
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
| | - Justin B Stoler
- Department of Geography, University of Miami, Coral Gables, Florida, USA
| | - Amber Wutich
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona, USA
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Lartey ST, Magnussen CG, Si L, de Graaff B, Biritwum RB, Mensah G, Yawson A, Minicuci N, Kowal P, Boateng GO, Palmer AJ. The role of intergenerational educational mobility and household wealth in adult obesity: Evidence from Wave 2 of the World Health Organization's Study on global AGEing and adult health. PLoS One 2019; 14:e0208491. [PMID: 30625141 PMCID: PMC6326547 DOI: 10.1371/journal.pone.0208491] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Obesity has emerged as a major risk factor for non-communicable diseases in low and middle-income countries but may not follow typical socioeconomic status (SES)-related gradients seen in higher income countries. This study examines the associations between current and lifetime markers of SES and BMI categories (underweight, normal weight, overweight, obese) and central adiposity in Ghanaian adults. METHODS Data from 4,464 adults (2,610 women) who participated in the World Health Organization's Study on global AGEing and adult health (SAGE) Wave 2 were examined. Multilevel multinomial and binomial logistic regression models were used to examine associations. SES markers included parental education, individual education, intergenerational educational mobility and household wealth. Intergenerational educational mobility was classified: stable-low (low parental and low individual education), stable-high (high parental and high individual education), upwardly (low parental and high individual education), or downwardly mobile (high parental and low individual education). RESULTS The prevalence of obesity (12.9%) exceeded the prevalence of underweight (7.2%) in the population. High parental and individual education were significantly associated with higher odds of obesity and central adiposity in women. Compared to the stable low pattern, stable high (obesity: OR = 3.15; 95% CI: 1.96, 5.05; central adiposity: OR = 1.75; 95% CI: 1.03, 2.98) and upwardly (obesity: OR = 1.71; 95% CI: 11.13, 2.60; central adiposity: OR = 1.60; 95% CI: 1.08, 2.37) mobile education patterns were associated with higher odds of obesity and central adiposity in women, while stable high pattern was associated with higher odds of overweight (OR = 1.88; 95% CI: 1.11, 3.19) in men. Additionally, high compared to the lowest household wealth was associated with high odds of obesity and central adiposity in both sexes. CONCLUSION Stable high and upwardly mobile education patterns are associated with higher odds of obesity and central adiposity in women while the stable high pattern was associated with higher odds of overweight in men.
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Affiliation(s)
- Stella T. Lartey
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G. Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Lei Si
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- The George Institute for Global Health, University of New South Wales, Kensington, NSW, Australia
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - George Mensah
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Alfred Yawson
- Department of Community Health, University of Ghana, Accra, Ghana
| | - Nadia Minicuci
- National Research Council, Neuroscience Institute, Padova, Italy
| | - Paul Kowal
- World Health Organization (WHO), Geneva, Switzerland
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia
| | - Godfred O. Boateng
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States of America
| | - Andrew J. Palmer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
- * E-mail:
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Collins SM, Mbullo Owuor P, Miller JD, Boateng GO, Wekesa P, Onono M, Young SL. 'I know how stressful it is to lack water!' Exploring the lived experiences of household water insecurity among pregnant and postpartum women in western Kenya. Glob Public Health 2018; 14:649-662. [PMID: 30231793 DOI: 10.1080/17441692.2018.1521861] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [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: 10/28/2022]
Abstract
There is rapidly evolving literature on water insecurity in the general adult population, but the role of water insecurity during the vulnerable periods of pregnancy and postpartum, or in the context of HIV, has been largely overlooked. Therefore, we conducted an exploratory study, using Go Along interviews, photo-elicitation interviews, and pile sorts with 40 pregnant and postpartum Kenyan women living in an area of high HIV prevalence. We sought to (1) describe their lived experiences of water acquisition, prioritisation, and use and (2) explore the consequences of water insecurity. The results suggest that water insecurity is particularly acute in this period, and impacts women in far-reaching and unexpected ways. We propose a broader conceptualisation of water insecurity to include consideration of the consequences of water insecurity for maternal and infant psychosocial and physical health, nutrition, and economic well-being.
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Affiliation(s)
- Shalean M Collins
- a Department of Anthropology , Northwestern University , Evanston , IL , USA
| | | | - Joshua D Miller
- a Department of Anthropology , Northwestern University , Evanston , IL , USA
| | - Godfred O Boateng
- a Department of Anthropology , Northwestern University , Evanston , IL , USA
| | | | | | - Sera L Young
- a Department of Anthropology , Northwestern University , Evanston , IL , USA.,c Institute for Policy Research , Northwestern University , Evanston , IL , USA
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Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best Practices for Developing and Validating Scales for Health, Social, and Behavioral Research: A Primer. Front Public Health 2018; 6:149. [PMID: 29942800 PMCID: PMC6004510 DOI: 10.3389/fpubh.2018.00149] [Citation(s) in RCA: 1276] [Impact Index Per Article: 212.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/02/2018] [Indexed: 12/13/2022] Open
Abstract
Scale development and validation are critical to much of the work in the health, social, and behavioral sciences. However, the constellation of techniques required for scale development and evaluation can be onerous, jargon-filled, unfamiliar, and resource-intensive. Further, it is often not a part of graduate training. Therefore, our goal was to concisely review the process of scale development in as straightforward a manner as possible, both to facilitate the development of new, valid, and reliable scales, and to help improve existing ones. To do this, we have created a primer for best practices for scale development in measuring complex phenomena. This is not a systematic review, but rather the amalgamation of technical literature and lessons learned from our experiences spent creating or adapting a number of scales over the past several decades. We identified three phases that span nine steps. In the first phase, items are generated and the validity of their content is assessed. In the second phase, the scale is constructed. Steps in scale construction include pre-testing the questions, administering the survey, reducing the number of items, and understanding how many factors the scale captures. In the third phase, scale evaluation, the number of dimensions is tested, reliability is tested, and validity is assessed. We have also added examples of best practices to each step. In sum, this primer will equip both scientists and practitioners to understand the ontology and methodology of scale development and validation, thereby facilitating the advancement of our understanding of a range of health, social, and behavioral outcomes.
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Affiliation(s)
- Godfred O Boateng
- Department of Anthropology and Global Health, Northwestern University, Evanston, IL, United States
| | - Torsten B Neilands
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Edward A Frongillo
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Hugo R Melgar-Quiñonez
- Institute for Global Food Security, School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Sera L Young
- Department of Anthropology and Global Health, Northwestern University, Evanston, IL, United States
- Institute for Policy Research, Northwestern University, Evanston, IL, United States
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Boateng GO, Collins SM, Mbullo P, Wekesa P, Onono M, Neilands TB, Young SL. A novel household water insecurity scale: Procedures and psychometric analysis among postpartum women in western Kenya. PLoS One 2018; 13:e0198591. [PMID: 29883462 PMCID: PMC5993289 DOI: 10.1371/journal.pone.0198591] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 05/22/2018] [Indexed: 11/18/2022] Open
Abstract
Our ability to measure household-level food insecurity has revealed its critical role in a range of physical, psychosocial, and health outcomes. Currently, there is no analogous, standardized instrument for quantifying household-level water insecurity, which prevents us from understanding both its prevalence and consequences. Therefore, our objectives were to develop and validate a household water insecurity scale appropriate for use in our cohort in western Kenya. We used a range of qualitative techniques to develop a preliminary set of 29 household water insecurity questions and administered those questions at 15 and 18 months postpartum, concurrent with a suite of other survey modules. These data were complemented by data on quantity of water used and stored, and microbiological quality. Inter-item and item-total correlations were performed to reduce scale items to 20. Exploratory factor and parallel analyses were used to determine the latent factor structure; a unidimensional scale was hypothesized and tested using confirmatory factor and bifactor analyses, along with multiple statistical fit indices. Reliability was assessed using Cronbach’s alpha and the coefficient of stability, which produced a coefficient alpha of 0.97 at 15 and 18 months postpartum and a coefficient of stability of 0.62. Predictive, convergent and discriminant validity of the final household water insecurity scale were supported based on relationships with food insecurity, perceived stress, per capita household water use, and time and money spent acquiring water. The resultant scale is a valid and reliable instrument. It can be used in this setting to test a range of hypotheses about the role of household water insecurity in numerous physical and psychosocial health outcomes, to identify the households most vulnerable to water insecurity, and to evaluate the effects of water-related interventions. To extend its applicability, we encourage efforts to develop a cross-culturally valid scale using robust qualitative and quantitative techniques.
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Affiliation(s)
- Godfred O. Boateng
- Department of Anthropology, Northwestern University, Evanston, Illinois, United States of America
| | - Shalean M. Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois, United States of America
| | - Patrick Mbullo
- Department of Anthropology, Northwestern University, Evanston, Illinois, United States of America
| | | | | | - Torsten B. Neilands
- Department of Medicine, Division of Prevention Science, Center for AIDS Prevention Studies, University of California, San Francisco, California, United States of America
| | - Sera L. Young
- Department of Anthropology, Northwestern University, Evanston, Illinois, United States of America
- Institute for Policy Research, Northwestern University, Evanston, Illinois, United States of America
- * E-mail:
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Boateng GO, Martin SL, Collins SM, Natamba BK, Young SL. Measuring exclusive breastfeeding social support: Scale development and validation in Uganda. Matern Child Nutr 2018; 14:e12579. [PMID: 29356347 DOI: 10.1111/mcn.12579] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 10/26/2017] [Accepted: 11/21/2017] [Indexed: 11/30/2022]
Abstract
The World Health Organization recommends exclusive breastfeeding (EBF) for 6 months and continued breastfeeding for at least 2 years. Social support has been widely recognized to influence breastfeeding practices. However, existing scales do not measure exclusive breastfeeding social support (EBFSS), rather they assess social support for any breastfeeding. Further, they are tailored towards high-income settings. Therefore, our objectives were to develop and validate a tool to measure EBFSS in low-income settings. To develop the scale, local and international breastfeeding experts were consulted on modifications to the Hughes' Breastfeeding Social Support Scale. It was then implemented in an observational cohort in Gulu, Uganda, at 1 (n = 238) and 3 (n = 237) months post-partum (NCT02925429). We performed polychoric and polyserial correlations to remove redundant items and exploratory factor analysis at 1 month post-partum to determine the latent factor structure of EBFSS. We further applied confirmatory factor analysis to assess dimensionality of the scale at 3 months post-partum. We then conducted tests of predictive, convergent, and discriminant validity against EBF, self-efficacy, general social support, and depression. The modification of the Hughes' scale resulted in 18 items, which were reduced to 16 after examining variances and factor loadings. Three dimensions of support emerged: Instrumental, Emotional, and Informational, with alpha coefficients of 0.79, 0.85, and 0.83, respectively. Predictive, convergent, and discriminant validity of the resultant EBFSS scale was supported. The EBFSS scale is valid and reliable for measuring EBFSS in northern Uganda and may be of use in other low-income settings to assess determinants of EBF.
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Affiliation(s)
- Godfred O Boateng
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA
| | - Stephanie L Martin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Shalean M Collins
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA
| | - Barnabas K Natamba
- Division of Public Health, Michigan State University, East Lansing, Michigan, USA
| | - Sera L Young
- Department of Anthropology and Global Health, Northwestern University, Evanston, Illinois, USA.,Institute for Policy Research, Northwestern University, Evanston, Illinois, USA
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Boateng GO, Adams EA, Odei Boateng M, Luginaah IN, Taabazuing MM. Obesity and the burden of health risks among the elderly in Ghana: A population study. PLoS One 2017; 12:e0186947. [PMID: 29117264 PMCID: PMC5695605 DOI: 10.1371/journal.pone.0186947] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 10/10/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The causes and health risks associated with obesity in young people have been extensively documented, but elderly obesity is less well understood, especially in sub-Saharan Africa. This study examines the relationship between obesity and the risk of chronic diseases, cognitive impairment, and functional disability among the elderly in Ghana. It highlights the social and cultural dimensions of elderly obesity and discusses the implications of related health risks using a socio-ecological model. METHODOLOGY We used data from wave 1 of the Ghana Study on Global Ageing and Adult Health (SAGE) survey-2007/8, with a restricted sample of 2,091 for those 65 years and older. Using random effects multinomial, ordered, and binary logit models, we examined the relationship between obesity and the risk of stage 1 and stage 2 hypertension, arthritis, difficulties with recall and learning new tasks, and deficiencies with activities of daily living and instrumental activities of daily living. FINDINGS Elderly Ghanaians who were overweight and obese had a higher risk of stage 1 and stage 2 hypertension, and were more likely to be diagnosed with arthritis and report severe deficiencies with instrumental activities of daily living. Those who were underweight were 1.71 times more likely to report severe difficulties with activities of daily living. A sub analysis using waist circumference as a measure of body fat showed elderly females with abdominal adiposity were relatively more likely to have stage 2 hypertension. CONCLUSIONS These findings call for urgent policy initiatives geared towards reducing obesity among working adults given the potentially detrimental consequences in late adulthood. Future research should explore the gendered pathways leading to health disadvantages among Ghanaian women in late adulthood.
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Affiliation(s)
- Godfred O. Boateng
- Department of Anthropology & Global Health, Northwestern University, Evanston, Illinois, United States of America
| | - Ellis A. Adams
- Global Studies Institute, Georgia State University, Atlanta, Georgia, United States of America
- Department of Geosciences, Georgia State University, Atlanta, Georgia, United States of America
| | - Mavis Odei Boateng
- Department of Social Work, University of Windsor, Windsor, Ontario, Canada
| | - Isaac N. Luginaah
- Department of Geography, Western University, London, Ontario, Canada
| | - Mary-Margaret Taabazuing
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
- Department of Medicine, London Health Sciences Centre, Victoria Campus, London, Ontario, Canada
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Brooks YM, Collins SM, Mbullo P, Boateng GO, Young SL, Richardson RE. Evaluating Human Sensory Perceptions and the Compartment Bag Test Assays as Proxies for the Presence and Concentration of Escherichia coli in Drinking Water in Western Kenya. Am J Trop Med Hyg 2017; 97:1005-1008. [PMID: 28749760 DOI: 10.4269/ajtmh.16-0878] [Citation(s) in RCA: 8] [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: 11/07/2022] Open
Abstract
We compared the concentrations of Escherichia coli quantified with Colilert™ and the compartment bag test (CBT) in the source water and household stored drinking water (SDW) of 35 households in western Kenya. We also investigated the associations of the perceptions of organoleptic properties and overall quality with ≥ 1 MPN/100 mL E. coli in SDW. Participants who rated the taste or smell of their SDW "< 5" on a 1 = "poor" to 5 = "excellent" Likert scale were 8.71 or 7.04 times more likely, respectively, to have ≥ 1 MPN/100 mL E. coli. Organoleptic properties are innate, albeit imperfect, indicators of fecal pollution in water. Within their shared quantification range, concentrations of E. coli enumerated with Colilert and CBT were similar and had a significant correlation coefficient, 0.896 (95% confidence interval = 0.691-1.101). The methods had moderate agreement within the World Health Organization's health risk levels (Cohen's Kappa coefficient = 0.640). In low-resource settings, CBT provides comparable assessments of E. coli concentrations to Colilert.
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Affiliation(s)
- Yolanda M Brooks
- School of Civil and Environmental Engineering, Cornell University, Ithaca, New York
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, Illinois.,Department of Population Medicine and Diagnostics, Program in International Nutrition, Cornell University, Ithaca, New York
| | - Patrick Mbullo
- Department of Sociology and Anthropology, Maseno University, Kisumu, Kenya.,Department of Anthropology, Northwestern University, Evanston, Illinois
| | - Godfred O Boateng
- Department of Anthropology, Northwestern University, Evanston, Illinois.,Department of Population Medicine and Diagnostics, Program in International Nutrition, Cornell University, Ithaca, New York
| | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, Illinois.,Department of Population Medicine and Diagnostics, Program in International Nutrition, Cornell University, Ithaca, New York
| | - Ruth E Richardson
- School of Civil and Environmental Engineering, Cornell University, Ithaca, New York
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Krumdieck NR, Collins SM, Wekesa P, Mbullo P, Boateng GO, Onono M, Young SL. Household water insecurity is associated with a range of negative consequences among pregnant Kenyan women of mixed HIV status. J Water Health 2016; 14:1028-1031. [PMID: 27959881 PMCID: PMC5210218 DOI: 10.2166/wh.2016.079] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 05/14/2023]
Abstract
Water insecurity (WI) is a serious and worsening problem worldwide, but its role in health outcomes among people living with HIV or pregnant women is unknown. We assessed experiences of WI in a cohort of 323 pregnant Kenyan women of mixed HIV status. The majority (77.7%) had at least one experience of WI in the previous month; it was associated with negative economic, nutrition, disease, and psychosocial outcomes. A standardized cross-culturally valid household WI scale would facilitate assessment of the prevalence and consequences of WI, and increased attention to WI could reveal an overlooked, but modifiable, cause of adverse HIV outcomes.
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Affiliation(s)
| | - Shalean M Collins
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail:
| | - Pauline Wekesa
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Patrick Mbullo
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Godfred O Boateng
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail:
| | - Maricianah Onono
- Kenya Medical Research Institute, Centre for Microbiology Research, Mbagathi Road, Nairobi, Kenya
| | - Sera L Young
- Program in International Nutrition, Cornell University, Ithaca, NY 14853, USA and Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY 14853, USA E-mail: ; Department of Anthropology, Northwestern University, Evanston, IL 60208, USA
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Boateng GO, Adams TL. "Drop dead … I need your job": An exploratory study of intra-professional conflict amongst nurses in two Ontario cities. Soc Sci Med 2016; 155:35-42. [PMID: 26986240 DOI: 10.1016/j.socscimed.2016.02.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 02/23/2016] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
Abstract
Past studies have focused on inter-professional conflict and its implication for professional status and work. However, there is a dearth of research on intra-professional conflict and its implications for professions. This study explores intra-professional conflicts among nurses in Ontario, using a qualitative research design, drawing on in-depth interviews with 66 nurses. The study identifies conflicts along race and age: Visible minority and younger nurses report more conflict, with visible minority nurses particularly vulnerable and racially marginalized. Members of Visible minorities and young nurses responded to workplace conflict by demonstrating competence, seeking support from colleagues, and either ignoring the abuse or standing up for themselves. These strategies do nothing to challenge professional unity. Nonetheless, intra-professional conflict has negative consequences for professionals and their work.
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Affiliation(s)
- Godfred O Boateng
- Department of Sociology, University of Western Ontario, London, Ontario, Canada.
| | - Tracey L Adams
- Department of Sociology, University of Western Ontario, London, Ontario, Canada.
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Sano Y, Sedziafa AP, Amoyaw JA, Boateng GO, Kuuire VZ, Boamah S, Kwon E. Exploring the linkage between exposure to mass media and HIV testing among married women and men in Ghana. AIDS Care 2016; 28:684-8. [PMID: 26753839 DOI: 10.1080/09540121.2015.1131970] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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: 10/22/2022]
Abstract
Although HIV testing is critical to the treatment and prevention of HIV/AIDS, utilization rate of HIV testing services among married women and men remains low in Ghana. Mass media, as a tool to increase overall HIV testing turnouts, has been considered one of the important strategies in promoting and enhancing behavioural changes related to HIV/AIDS prevention. Using the 2014 Ghana Demographic and Health Survey, the current study examines the relationship between levels of exposure to print media, radio, and television and the uptake of HIV testing among married women and men in Ghana. Results show that HIV testing is more prevalent among married women than their male counterparts. We also find that higher levels of exposure to radio is associated with HIV testing among women, while higher levels of exposure to print media and television are associated with HIV testing among men. Implications of these findings are discussed for Ghana's HIV/AIDS strategic framework, which aims to expanding efforts at dealing with the HIV/AIDS epidemic. Specifically, it is important for health educators and programme planners to deliver HIV-related messages through television, radio, and print media to increase the uptake of HIV testing particularly among married women and men in Ghana.
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Affiliation(s)
- Yujiro Sano
- a Department of Sociology , University of Western Ontario , Room 5306, Social Science Centre, London , ON , Canada
| | - Alice P Sedziafa
- b Department of Gender Studies , Memorial University of Newfoundland , Science Building 4082, St. John's , NL , Canada
| | - Jonathan A Amoyaw
- a Department of Sociology , University of Western Ontario , Room 5306, Social Science Centre, London , ON , Canada
| | - Godfred O Boateng
- a Department of Sociology , University of Western Ontario , Room 5306, Social Science Centre, London , ON , Canada
| | - Vincent Z Kuuire
- c Department of Geography , University of Western Ontario , Room 1424, Social Science Centre, London , ON , Canada
| | - Sheila Boamah
- d Arthur Labatt Family School of Nursing, Health Sciences Addition , University of Western Ontario , London , ON , Canada
| | - Eugena Kwon
- a Department of Sociology , University of Western Ontario , Room 5306, Social Science Centre, London , ON , Canada
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Dixon J, Tenkorang EY, Luginaah IN, Kuuire VZ, Boateng GO. National health insurance scheme enrolment and antenatal care among women in Ghana: is there any relationship? Trop Med Int Health 2013; 19:98-106. [PMID: 24219504 DOI: 10.1111/tmi.12223] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [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: 11/27/2022]
Abstract
OBJECTIVES The objective of this study was to examine whether enrolment in the National Health Insurance Scheme (NHIS) affects the likelihood and timing of utilising antenatal care among women in Ghana. METHODS Data were drawn from the Ghana Demographic and Health Survey, a nationally representative survey collected in 2008. The study used a cross-sectional design to examine the independent effects of NHIS enrolment on two dependent variables (frequency and timing of antenatal visits) among 1610 Ghanaian women. Negative binomial and logit models were fitted given that count and categorical variables were employed as outcome measures, respectively. RESULTS Regardless of socio-economic and demographic factors, women enrolled in the NHIS make more antenatal visits compared with those not enrolled; however, there was no statistical association with the timing of the crucial first visit. Women who are educated, living in urban areas and are wealthy were more likely to attend antenatal care than those living in rural areas, uneducated and from poorer households. CONCLUSION The NHIS should be strengthened and resourced as it may act as an important tool for increasing antenatal care attendance among women in Ghana.
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Affiliation(s)
- Jenna Dixon
- Department of Geography, University of Western Ontario, London, ON, Canada
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