JSI staff regularly publish their research and results from work in peer-reviewed journals. This section provides a brief abstract with a link to the journal where you can read more and either download or order the article, depending on the journal.
50 Years After Stonewall, the LGBTQ Health Movement Embodies Empowerment, Expertise, and Energy in American Journal of Public Health
In the wake of the 50th anniversary of the Stonewall riots, this article provides a retrospective on the LGBTQ health movement since 1969.
Authors: Landers, Stewart and Kapadia, Farzana
Communicating to smokers that e-cigarettes deliver lower levels of harmful chemicals than combusted cigarettes is a challenging issue. This study qualitatively explored smokers’ interpretations of messages communicating the risk of e-cigarettes relative to cigarettes (comparative risk messages). We developed 12 print comparative risk messages and evaluated them in 12 focus groups with 72 adult smokers (18+ years old) in Atlanta, Georgia.
The influence of interviewers on survey responses among female sex workers in Zambia in Medical Research Methodology
Interviewers can substantially affect self-reported data. This may be due to random variation in
interviewers’ ability to put respondents at ease or in how they frame questions. It may also be due to systematic
differences such as social distance between interviewer and respondent (e.g., by age, gender, ethnicity) or different
perceptions of what interviewers consider socially desirable responses. Exploration of such variation is limited,
especially in stigmatized populations.
Data was analyzed from a randomized controlled trial of HIV self-testing amongst 965 female sex workers
(FSWs) in Zambian towns. In the trial, 16 interviewers were randomly assigned to respondents. Hierarchical
regression models were used to examine how interviewers may both affect responses on more and less sensitive topics, and confound associations between key risk factors and HIV self-test use.
Substantial interviewer-level effects for prevalence and associational outcomes among Zambian
FSWs were found, particularly for sensitive questions. The findings highlight the importance of careful training and response monitoring to minimize inter-interviewer variation, of considering social distance when selecting interviewers and of evaluating whether interviewers are driving key findings in self-reported data.
Authors: Guy Harling, Michael M. Chandra, Katrina F. Ortblad, Magdalene Mwale, Steven Chongo, Catherine Kanchele, Nyambe Kamungoma, Leah G. Barresi, Till Bärnighausen, Catherine E. Oldenburg
To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritized by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone to content of care.
EN-BIRTH is an observational study including >20000 facility births in three countries (Tanzania, Bangladesh, and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including uterotonic administration, immediate newborn care, neonatal resuscitation, and Kangaroo mother care.
This is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform the selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths.
Authors: Louise T Day, Harriet Ruysen, Vladimir S Gordeev, Georgia R Gore-Langton, Dorothy Boggs, Simon Cousens, Sarah G Moxon, Hannah Blencowe, Angela Baschieri, Ahmed Ehsanur Rahman, Tazeen Tahsina, Sojib Bin Zaman, Tanvir Hossain, Qazi Sadeq-ur Rahman, Shafiqul Ameen, Shams El Arifeen, Ashish KC, Shree Krishna Shrestha, Naresh P KC, Dela Singh, Anjani Kumar Jha, Bijay Jha, Nisha Rana, Omkar Basnet, Elisha Joshi, Asmita Paudel, Parashu Ram Shrestha, Deepak Jha, Ram Chandra Bastola, Jagat Jeevan Ghimire, Rajendra Paudel, Nahya Salim, Donat Shamba, Karim Manji, Josephine Shabani, Kizito Shirima, Namala Mkopi, Mwifadhi Mrisho, Fatuma Manzi, Jennie Jaribu, Edward Kija, Evelyne Assenga, Rodrick Kisenge, Andrea Pembe, Claudia Hanson, Godfrey Mbaruku, Honorati Masanja, Agbessi Amouzou, Tariq Azim, Debra Jackson, Theopista John Kabuteni, Matthews Mathai, Jean-Pierre Monet, Allisyn Moran, Pavani Ram, Barbara Rawlins, Johan Ivar Sæbø, Florina Serbanescu, Lara Vaz, Nabila Zaka, Joy E Lawn
Modeling contributes to health program planning by allowing users to estimate future outcomes that are otherwise difficult to evaluate. However, modeling results are often not easily translated into practical policies. This paper examines the barriers and enabling factors that can allow models to better inform health decision-making.
Through three iterations of the DMPPT applied to VMMC, a comprehensive framework with six steps was identified: (1) identify a champion, (2) engage stakeholders early and often, (3) encourage consensus, (4) customize analyses, (5), build capacity, and (6) establish a plan for sustainability. This framework could be successfully adapted to other HIV prevention programs to translate modeling results to policy and programming.
Models can be used to mobilize support, strategically plan, and monitor key programmatic elements, but they can also help inform policy environments in which programs are conceptualized and implemented to achieve results. The ways in which modeling has informed VMMC programs and policy may be applicable to an array of other health interventions.
Authors: Emmanuel Njeuhmeli, Melissa Schnure, Andrea Vazzano, Elizabeth Gold, Peter Stegman, Katharine Kripke, Michel Tchuenche, Lori Bollingerm Steven Forsythe, Catherine Hankins.
People-Centered Innovations in Data Collection: The Oregon Experience in Am J Public Health
The ongoing evolution of both theory and practice in public health is both necessary and welcome given the highly interdisciplinary nature of the field. At the theoretical level, the expansion of frameworks to include multilevel thinking (which builds on the social ecological framework) and life course perspective is broadening our thinking and improving our science with respect to the factors that create health or prohealth conditions.
In this issue, a group of articles explore innovations in public health practice, with an emphasis on innovative research methods in health promotion.
Authors: Fiala, Steven; Landers, Stewart.
Standards represent benchmarks against which improvements can be measured. In 2016, the Federal Ministry of Health developed and endorsed a set of standards entitled the Ethiopian Health Center Reform Implementation Guidelines (EHCRIGs). This study aims to assess the effects of planned interventions on performance and quality of services in primary health care units (PHCUs).
The implementation of the standards has garnered significant improvements in performance at the primary health care level. Therefore, continuing the initiated strengthening of health system performance against the standards and evaluation of the quality of primary health services is recommended.
Authors: Argaw, Mesele; Desta, Binyam; Bele, Temesgen; Ayne, Abebe
Where Do We Go From Here? Defining an Agenda for Home-Based Records Research and Action Considering the 2018 WHO Guidelines in Global Health: Science and Practice, Vol. 6, No.4
Recent WHO guidelines point to knowledge gaps about home-based records despite their widespread use. Future research should explore their impact on health outcomes, challenges including production costs and confidentiality breaches, the role of design in their use, and the business case for investing in them.
Authors: Brown, David W.; Bosh-Calbanch, Xavier; Shimp, Lora
Worldwide, nearly 570,000 women are diagnosed with cervical cancer each year, with 85% of new cases in low- and middle-income countries. The African continent is home to 35 of 40 countries with the highest cervical cancer mortality rates. In 2014, a partnership involving a rural region of Senegal, West Africa, was facing cervical cancer screening service sustainability barriers and began adapting regional-level policy to address implementation challenges.
This manuscript reports the findings of a systematic literature review describing the implementation of decentralized cervical cancer prevention services in Africa, relevant in context to the Senegal partnership. The authors report barriers and policy-relevant recommendations through Levesque’s Patient-Centered Access to Healthcare Framework and discuss the impact of this information on the partnership’s approach to shaping Senegal’s regional cervical cancer screening policy.
Overall, there is a paucity of published literature regarding barriers to and best practices in the implementation of cervical cancer screening services in rural Africa. Many articles in this literature review did describe findings with notable policy implications. The Senegal partnership has consulted this literature when faced with various similar barriers and has developed two principal initiatives to address contextual challenges. Other initiatives implementing cervical cancer visual screening services in decentralized areas may find this contextual reporting of a literature review helpful as a construct for identifying evidence for the purpose of guiding ongoing health service policy adaptation.
Authors: R. Rahman, M D. Clark, Z. Collins, F. Traore, E. M. Dioukhane, H. Thiam, Y. Ndiaye, E. L. De Jesus, N. Dankfakha, K. E. Peters, T. Komarek, A. M. Linn, P. E. Linn, K. E. Wallner, M. Charles, M. Hasnain, C. E. Peterson, and J. A. Dykens, 2019
The Value of Tailoring Vial Sizes to Populations and Locations in Vaccine, 2018.12.10
Frequently, a country will procure a single vaccine vial size, but the question remains whether tailoring the use of different size vaccine vial presentations based on populations or location characteristics within a single country could provide additional benefits, such as reducing open vial wastage (OVW) or reducing missed vaccination opportunities. Using the Highly Extensible Resource for Modeling Supply Chains (HERMES) software, they built a simulation model of the Zambia routine vaccine supply chain and looked at measles-rubella (MR) vials.
It was found that replacing 10-dose MR with 5-dose MR vials everywhere led to the largest reduction in MR open vial wastage (OVW), and improving MR availability by 1%. It was concluded that in Zambia, tailoring 5-dose MR vials to rural health facilities or by average session size results in the highest total vaccine availability compared to all other scenarios by reducing open vial wastage without increasing cold chain utilization.
Authors: Patrick Wedlock, Elizabeth Mitgang, Leila Haidari, Wendy Prosser, Shawn Brown, Kirstin Krudwig, Sheryl Siegmund, Jay DePasse, Jennifer Bakal, Jim Leonard, Joel Welling, Robert Steinglass, Frances Dien Mwansa, Guissimon Phiri, Buce Lee.
Measurement and interpretation of hemoglobin concentration in clinical and field settings: A narrative review in Annals of the New York Academy of Sciences, 2019 Jan 16
Anemia affects over 800 million women and children globally. Defined as a limited or insufficient functional red blood cell supply in peripheral blood, anemia causes a reduced oxygen supply to tissues and can have serious health consequences for women and children. Hemoglobin (Hb) concentration is most commonly measured for anemia diagnosis. Methods to measure Hb are usually invasive (requiring a blood sample); however, advances in diagnostic and clinical chemistry over the past decade have led to the development of new noninvasive methods. Accurate diagnosis at the individual level is important to identify individuals who require treatment. At the population level, anemia prevalence estimates are often the impetus for national nutrition policies or programs. Thus, it is essential that methods for Hb measurement are sensitive, specific, accurate, and reproducible. The objective of this review is to describe the basic principles, advantages, limitations, and quality control issues related to methods of Hb measurement in clinical and field settings. There is also discussion of other biomarkers and tests that can help to determine the severity and underlying causes of anemia.
It was found that there are many established and emerging methods to measure Hb concentration, each with their own advantages, limitations, and factors to consider before use.
Authors: CD Karakochuk, SY Hess, D Moorthy, S Namaste, ME Parker, AI Rappaport, R Wegmuller, O Dary
PrEP Awareness in the Context of HIV/AIDS Conspiracy Beliefs Among Black/African American and Hispanic/Latino MSM in Three Urban US Cities in Journal of Homosexuality, January 11: 1-11, 2019.
HIV conspiracy beliefs and PrEP awareness were examined in a convenience sample of minority MSM. Participants in three cities completed a behavioral self-assessment on sociodemographics, PrEP awareness, and HIV/AIDS conspiracy beliefs. HIV/AIDS conspiracy beliefs were more common among Black than Latino MSM, and among younger men than older men. PrEP awareness co-occurred with conspiracy belief less than with non-belief, persisting in multivariable regression. This relationship suggests that current HIV care and prevention messaging is either inaccessible or not credible to some minority subpopulations.
Authors: E Olansky, G Mansergh, N Pitts, MJ Mimiaga, DJ Denson, S Landers, J Holman, JH Herbst
Predictors of early initiation of breastfeeding among Zimbabwean women: secondary analysis of ZDHS 2015 in Maternal Health, Neonatology and Perinatology, Vol. 5, Issue 2
The World Health Organization recommends initiation of breastfeeding within the first hour of delivery. Early initiation is beneficial for both the mother and baby. Previous Zimbabwe Demographic and Health Surveys (ZDHS) have shown reduction in early initiation of breast feeding from 68% (2005/06) to 58% (2015). This study sought to investigate factors associated with early initiation of breast feeding among women aged 15–49 years in Zimbabwe.
Early initiation of breast feeding in Zimbabwe is mainly associated with residing in the rural areas and multiparity. The 78% rate of early initiation of breastfeeding was contrary to the 58% reported in the ZDHS findings. Interventions targeting an improvement in early initiation of breastfeeding must aim at women who deliver by cesarean section, women with babies of abnormal birth weight, primi-parous women and women residing in rural areas.
Fadzai Mukora-Mutseyekwa, Hilary Gunguwo, Rugare Gilson Mandigo, Paddington Mundagowa, 2019