American Journal of Public Health Research

Background: Falls among the elderly are expensive and debilitating. Falls among elders are now the leading cause of injury ED visits, the leading cause of injury hospitalizations, a leading cause of hospitalization readmissions, the leading cause of hospitalizations from nursing homes, and a major cause of nursing home admissions. But, they are preventable. Design and Methods:A representative random sample of Medicaid-eligible seniors was selected proportionately by geographic density (i.e., zip code) in Miami-Dade and Broward Counties. Subjects participated in informational workshops; non-invasive somatic fall risk factor analysis; HIPPA-compliant sharing of risk reports with their physicians; in-home environmental fall risk analysis; pre- and post-fall counseling; periodic telephone calls to the elders’ support network (including physicians) and periodic safetygrams for an average of 28 months. Using 1.3 billion claims from the Florida Medicaid Data Warehouse, the participant groups were compared with several control groups on 1.) hospitalizations for injurious falls; 2.) nursing home stays for fall-caused injuries and 3.) Medicaid savings as a proportion of program costs. The study was carried out in 2015. Results: The treatment groups had statistically significantly lower healthcare utilization due to injurious falls than did various control groups: hospitalizations were lower; nursing home stays were lower; independent audits showed a savings of $2.40 for every $1.00 invested. Conclusions: Multi-disciplinary, socio-medical fall prevention programs for community-resident elders can significantly reduce healthcare utilization due to injurious falls among dual eligible elders.

American Journal of Public Health Research. 2016, 4(2), 75-78. DOI: 10.12691/ajphr-4-2-6
Pub. Date: April 09, 2016

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Determinants of Inconsistent Condom Use among HIV Serodiscordant Couples in Cambodia

by Sovannary Tuot, Khuondyla Pal, Kouland Thin, Pheak Chhoun, Chanrith Ngin, Mengieng Ung, Kolab Chhim, Chrysanta Patio, Kelly Allbritton, Christie Blondek, Gitau Mburu and Siyan Yi

Original Research

Background: Globally, heterosexual transmission within serodiscordant relationships is a significant source of new HIV infections. In 2012, there were an estimated 1,350 incident cases of HIV in Cambodia, of which 37% were between heterosexual couples and 30% among sex workers. In combination with antiretroviral therapy (ART), consistent condom use can significantly reduce HIV transmission risk among serodiscordant couples. This study explored determinants of inconsistent condom use among serodiscordant couples in Cambodia. Methods: A cross-sectional study was conducted in Battambang, Pursat and Takeo provinces in September 2013. A structured questionnaire was used to collect data on condom use and other HIV-related risk behaviors from HIV-positive partners of 262 serodiscordant couples. A two-stage cluster sampling method was used to randomly select participants from a list of serodiscordant couples who were receiving care and support services from community-based organizations in the selected sites. Multivariate logistic regression analysis was conducted to identify factors associated with inconsistent condom use. Results: In total, 239 respondents were included in the analysis with a mean age of 41.6 years [standard deviation (SD) = 6.7 years], of whom 60.2% were male and 80.3% were consistent condom users. The mean duration of living in the serodiscordant relationship was 13.4 years (SD = 7.8 years). After controlling for other covariates, inconsistent condom users were significantly more likely to be female (OR = 2.8; 95% CI = 1.261, 6.462), to have been living in a shorter HIV serodiscordant relationship (OR = 0.89; 95% CI = 0.902, 0.998), and to be frequent alcohol users (OR = 2.9; 95% CI = 1.323, 6.483). In addition, inconsistent condom users were significantly more likely to agree that ART prevents transmission of HIV (OR = 2.7; 95% CI = 1.344, 5.443). Conclusions: Gender-sensitive interventions to promote consistent condom use and to mitigate alcohol-associated risky sexual behaviors, especially unprotected sex, should form part of HIV prevention interventions for serodiscordant couples in addition to early ART initiation. Further research is required to explore the role of pre-exposure prophylaxis among this population.

American Journal of Public Health Research. 2016, 4(2), 69-74. DOI: 10.12691/ajphr-4-2-5
Pub. Date: April 06, 2016

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Black Fever among the Ethnic Santal People in Bangladesh

by Md. Yeamin Ali, Md. Fakrul Islam, Md. Redwanur Rahman, kazi Robiul Alom, Md. Liton Hossen, Atiqur Rahman, Mahfuza Khanom Sheema, Jesmin Akhtar, Akib Javed and Mst. Rupali Akhtar

Original Research

The study tries to find out the scenario of black fever among the Santal people in Bangladesh. Santal patient health seeking behaviors related with their community people decision, free treatment consideration, preferable healthcare option. Those the entire thing is related with culture. The study is explorative and to some extent descriptive in nature that enforces to adopt mixed with qualitative and quantitative data as well as secondary and primary data. Research shows that 81% patient depend too much on treatment of indigenous physician (Kabiraj). Also barriers of accessing health care are the prevailing factor for health seeking behavior. 92% respondents said awareness and knowledge regarding black fever has too much impact. 43% people are influenced by church and Non-Governmental Organization (N.G.O) during decision making regarding treatment. 54% patients state that, skin turns into more black after taking medicine. Economic condition of lower class people has too much impact on health seeking behavior also. Santal people traditional practice is responsible attacked by black fever. If we will able to conscious ethnic people, dying and suffering regarding black fever will dissolve.

American Journal of Public Health Research. 2016, 4(2), 62-68. DOI: 10.12691/ajphr-4-2-4
Pub. Date: March 29, 2016

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Healthcare Utilization among Urban and Rural Households in Esera District: Comparative Cross-sectional Study

by Bayu Begashaw and Thomas Tesfaye

Original Research

BACKGROUND: Health care seeking behaviour of households is influenced by individuals’ characteristics, type of diseases and access of health services. This study conducted to assess the health care seeking behavior and associated factors of urban and rural households for perceived morbidity in Southwest Ethiopia. METHODS: A comparative community based cross-sectional study was conducted among urban and rural households living in the Esera district, southwest Ethiopia. 377 head of households (119 urban and 258 rural dwellers), selected via simple random sampling technique after census, were the respondents. Healthcare seeking behavior on perceived illnesses of households of the district was assessed using a pretested structured questionnaire. Descriptive statistics, and binary and multiple logistic regression analysis were applied to compare and identify independent predictors of health care seeking behavior. RESULTS: A total of 377 (119 urban and 258 rural) households were included in the analysis making a response rate of 95.7%. Health care seeking behavior was higher among urban households (80.7%) than rural households (48.1%). Being married and perceived severity of disease were significantly associated with health care seeking behavior of urban households. Health seeking behavior of rural households was statistically different with monthly income, perceived severity of disease, acute duration of disease and distance from health facilities. CONCLUSIONS: The overall health seeking behaviors of households for perceived illness was satisfactory, but urban households seek health care more than rural. Health seeking behavior of urban households differed in matrimonial status and severity of disease perception, whereas, of rural households differed in household monthly income, severity of disease perception, duration of disease and distance from health center. This cues to work on accessibility and promotion of health care on the majority of the population of the country.

American Journal of Public Health Research. 2016, 4(2), 56-61. DOI: 10.12691/ajphr-4-2-3
Pub. Date: February 29, 2016

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Developing a Policy for Workplace Violence against Nurses and Health Care Professionals in Jordan: A Plan of Action

by Ahmad Rayan, Ali Qurneh, Rana Elayyan and Omar Baker

Original Research

Violence at workplace toward health care professionals including nurses is gaining a thoughtful concern worldwide. The prevalence of workplace violence in the Middle East including Jordan is considerably high although governmental policies and legislations exist. Tackling and preventing such issue of workplace violence necessitates reinforcing and reviving existing policies. The researchers in the current study adopted a plan of action using a systematic method to establish and implement specific strategies and policies to prevent workplace violence against health care professionals in Jordan. A detailed description for developing the policy was provided in this study based on the following steps: describing context of the problem, identifying policy goals and options, weighing policy alternatives, highlighting the recommended solutions, and providing a strategy for implementation and evaluation .

American Journal of Public Health Research. 2016, 4(2), 47-55. DOI: 10.12691/ajphr-4-2-2
Pub. Date: February 26, 2016

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The Status of School Health Services: A Comparative Study of Primary Schools in a Developing Country

by Osuorah DI Chidiebere, Ulasi O Thomas, Ebenebe Joy, Onah K Stanley, Ndu K Ikenna, Ekwochi Uchenna and Asinobi N Isaac

Original Research

Background- The school health service is an important aspect of health delivery systems necessary to monitor the health of school children in other to keep them healthy and optimize their learning. Aims- This cross-sectional and descriptive study tried to ascertain the status of the school health services in 56 randomly selected schools using the school health programme evaluation scale. It also compared the extent of implementation of school health services in both private and public primary schools in Nnewi North Local Government Area (LGA) of Anambra state, Nigeria. Results- School health service is existent in the Nnewi North LGA but its implementation is suboptimal in both private and public schools. Significantly more private schools had treatment facilities within school premises (P=0.001), although routine screening of school pupils was done by more public schools (P=0.001). Overall, private schools had a significantly higher mean score (13.6±4.3 vs. 8.8±2.5) in criteria assessing school health services compared to public schools (P=0.001). Conclusion- School health service activities are present in Nnewi North LGA but implementation is suboptimal in both private and public schools. Effective policy with good monitoring and evaluation is imperative in ensuring adequate and optimal implementation of school health services in primary schools in Nnewi.

American Journal of Public Health Research. 2016, 4(2), 42-46. DOI: 10.12691/ajphr-4-2-1
Pub. Date: February 02, 2016

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