Amanda E. Tanner

University of North Carolina at Greensboro, Greensboro, North Carolina, United States

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Publications (55)60.99 Total impact

  • Devon J. Hensel, Amanda E. Tanner
    Journal of Adolescent Health. 02/2015;
  • Amanda E. Tanner, Devon J. Hensel
    Journal of Adolescent Health. 02/2015;
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    ABSTRACT: Background: Although immigrant Latina women experience a disproportionate burden of sexual and reproductive health outcomes (e.g., cervical cancer), their utilization of health services is lower than other women in the United States (US). The study purpose was to examine immigrant Latinas’ sexual and reproductive health needs and identify strategies for potential intervention. Methods: Individual in-depth interviews were conducted with 25 immigrant Latinas living in North Carolina (mean age=32.7, range: 21-47 years). Interviews were conducted in Spanish and digitally recorded; themes were identified through constant comparison, an approach to grounded theory development. Results: Participants reported that sexual and reproductive health was important and had varying levels of health knowledge (e.g., contraception and HIV/STD testing and transmission and symptoms) and experiences with healthcare systems (e.g., free clinics, insurance access, screenings, and care during pregnancy and childbirth). Participants described dynamic processes related to sexual and reproductive health, including: communication (e.g., partners and children), gendered roles in supporting health (e.g., “I think that women take it more seriously and worry more than a man”), and contingencies for healthcare (e.g., medication sharing and use of tiendas for traditional medicine). Participants provided suggestions for sexual and reproductive health interventions (e.g., lay health advisors and intergenerational programming such as mother-daughter communication and support). Discussion: Understanding and addressing sexual and reproductive health priorities of Latinas are essential for delivery of culturally congruent services. These results can inform interventions to reduce health disparities among Latinas, particularly in regions such as the southeastern US with growing immigrant Latino communities.
    142nd APHA Annual Meeting (November 15-19, 2014), New Orleans, LA; 11/2014
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    ABSTRACT: Little is known about immigrant Latino sexual minorities’ health seeking behaviors. This study examined factors associated with perceptions of access and actual care behaviors among this population in North Carolina. Methods. A community-based participatory research partnership recruited 180 Latino sexual minority men and transgender individuals within preexisting social networks to participate in a sexual health intervention. Mixed-effects logistic regression models and GIS mapping examined factors influencing health care access perceptions and use of services (HIV testing and routine check-ups). Results. Results indicate that perceptions of access and actual care behaviors are low and affected by individual and structural factors, including: years living in NC, reported poor general health, perceptions of discrimination, micro-, meso-, and macro-level barriers, and residence in a Medically Underserved Area. Discussion. To improve Latino sexual minority health, focus must be placed on multiple levels, including: individual characteristics (e.g., demographics), clinic factors (e.g., provider competence and clinic environment), and structural factors (e.g., discrimination).
    Journal of Health Care for the Poor and Underserved 11/2014; 25(4):1679-1697. · 1.10 Impact Factor
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    ABSTRACT: Background: As priorities of the National HIV/AIDS Strategy, care linkage and engagement for HIV-positive persons are important steps in the reduction and prevention of HIV transmission. Late or lack of diagnosis of an HIV infection has public health consequences (e.g., unknown disease transmission) and misses opportunities for individuals to gain benefits from early healthcare services (e.g., antiretroviral therapy, prophylaxis for opportunistic infections). Timely care engagement has important benefits, including quicker viral suppression, reduced morbidity and mortality, and provides opportunities to utilize biomedical innovations, including treatment as prevention. A better understanding of the factors affecting HIV care linkage and engagement is essential for improved individual and community level health. Theoretical Framework Hypothesis: A social-ecological model was utilized to understand HIV-positive persons’ experiences (e.g., service access and utilizations, barriers and facilitators to care) with HIV care linkage and engagement. Methods: Six focus groups were conducted with 33 HIV-positive persons (15 women, 16 men, and 2 male-to-female transgender individuals; age range: 20–60, x̄=41; 17 parents, 73% African American) living in and around Charlotte, North Carolina. Interviews were digitally recorded, transcribed verbatim, and managed using Atlas.ti 6.2. Content analytic techniques were employed to examine factors related to care behaviors. Results: Participants described a variety of factors that influenced their care behaviors on the individual, interpersonal, and policy levels. On the individual level, participants described experiences with social injustices (e.g., “I’m a brother, a black male. It’s hard out there for us because of the fact that it can be shared. You know, they afraid they are going to get in contact, that they are going get the HIV. Or like giving a handshake, they hesitate, you know...”) and psychological distress from their HIV status (e.g., “Oh, with me in the beginning, I was depressed and didn’t want to believe I had [HIV].”). On the interpersonal level, participants reported satisfaction with HIV care (e.g., “And in this facility here, I don’t feel like a patient. I feel like a family member.”), but noted challenges utilizing supplemental programs (e.g., “Case managers, it’s hard to get in touch with them and stuff...A lot of them have a huge their caseloads are so much that they have to meet that person, go see this person, go see that person...”). On the policy level, participants described barriers related to insurance coverage (e.g., “I think I, when I was diagnosed...I had been laid off from my job, so I lost my insurance. So, um, I was just kind of, you know, was living with my head buried in the sand about it.”) and transportation access (e.g., “A lot of people lack [transportation access]...The bus here only comes like two or three times a day.”). Participants provided recommendations for addressing these care barriers. For instance, participants suggested improved integrative services (individual level), provider and staff training (interpersonal level), and dissemination of resources and funding expansion to support care services (policy level). Conclusion: This study highlights both the challenges to and opportunities for increasing HIV care linkage and engagement. While the results were presented across different levels — individual, interpersonal, and policy — the issues are crosscutting. Accordingly, HIV prevention efforts should include multiple levels and address the variety of interconnected factors (e.g., multiple identities, co-occurring health conditions) that shape HIV-positive persons’ care-seeking behaviors. Implications for Practice: HIV care linkage and engagement may be improved by addressing individual and structural issues with strategies tailored to the person’s context (i.e., urban/rural, age, gender, sexual orientation). Enhancing clinical staff and provider training could also improve care engagement. Given the changes to the healthcare environment from the Affordable Care Act, examining barriers to and potential opportunities for increasing care linkage and engagement will be especially critical to ensure HIV care continuity.
    Annual Meeting of the North Carolina Society for Public Health Education, Winston-Salem, NC; 09/2014
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    ABSTRACT: Hispanic/Latina women experience the highest cervical cancer incidence rates of any racial/ethnic group in the USA and tend to present with more severe cases and experience higher mortality compared to most other populations. The goals of this qualitative systematic review were to explore existing interventions to increase cervical cancer screening among US Hispanics/Latinas and to identify characteristics of effective interventions and research gaps. Six online databases were searched from their inception through June 30, 2013, using designated search terms and keywords. Peer-reviewed articles that documented an intervention designed to improve screening for cervical cancer among Hispanics/Latinas ages 18 years and older living in the USA were reviewed. Data were abstracted using a standardized form to document intervention characteristics and results. Forty-five articles, describing 32 unique interventions, met inclusion criteria. Identified interventions consisted primarily of educational programs and/or provision of screening. Interventions used lay health advisors (LHAs), clinic-based outreach/delivery strategies, partnerships with churches, and mass media campaigns. Twelve interventions resulted in significant increases in cervical cancer screening rates. Interventions developed utilizing theory, applying community-based participatory research approaches, and using LHAs were identified as having the greatest potential for improving cervical cancer screening among Hispanics/Latinas. There continues to be a need for the development of interventions in geographic areas with new and emerging Hispanic/Latino populations and that are comprehensive, follow participants for longer periods of time, and broaden the roles and build the capacities of LHAs.
    Journal of Cancer Education 08/2014; · 1.05 Impact Factor
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    ABSTRACT: This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.
    Social Science [?] Medicine 07/2014; 118C:52-60. · 2.56 Impact Factor
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    ABSTRACT: Background: This study explored the relationship between social and organizational characteristics of neighborhoods including social cohesion and informal social control and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Methods: Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. Results: In a series of weighted multilevel logistic regression models stratified by gender, informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.39, 95% CI 0.26, 0.59) after controlling for individual social support and other factors. The association while in a similar direction was not significant for males (AOR 0.78, 95% CI 0.37, 1.63). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.73, 95% CI 0.26, 2.07) and separately, males (OR 0.73, 95% CI 0.26, 2.07). Individual social support was associated with an almost four-fold increase in the odds of a bacterial STI among males (AOR 3.78, 95% CI 1.85, 7.71) after controlling for social cohesion and other individual and neighborhood factors, a finding which is in contrast to our hypotheses. Conclusions: The findings warrant further study regarding the causal relationship between informal social control and STIs among U.S. urban youth.
    National STD Prevention Conference 2014 Centers for Disease Control and Prevention; 06/2014
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    ABSTRACT: Introduction: Along with care linkage and engagement, treatment as prevention is being promoted as a core component of the National HIV/AIDS Strategy. The SMILE program investigated the use of outreach workers to help facilitate rapid health care linkage and engagement for newly diagnosed, HIV infected adolescents. The program design required formal partnerships between Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) clinics and local health departments. A full-time outreach worker provided linkage services and developed relationships with agencies serving HIV+ adolescents. Program evaluation occurred annually after implementation. Methods: Data collected during annual site visits at 15 ATN clinics from three primary sources were analyzed: 1) clinical outcomes (e.g., linkage rates) recorded by outreach workers; 2) semi-structured interviews (Baseline n=64, Year 1 n=60, Year 2=59) with staff (e.g., outreach workers, nurses, physicians); and 3) photographs of clinical space. The Institutional Review Boards at the Johns Hopkins Medical Institutions and all ATN sites approved study protocols. Results: 32 months after program initiation, 1071/1468 (73%) of HIV-infected youth were linked to care, of which 973/1071 (91%) were subsequently engaged in care. Most (89%) were 18-24 years old, male (78%), non-Hispanic Black (73%), and MSM (73%). 44% of youth were referred within one month of HIV test date. Through analysis of the interviews and photographs, we identified a variety of individual (e.g., developmental, mental health), clinical (e.g., youth-friendliness, outreach worker with specific youth skills) and structural (e.g., Public Health Authority for data sharing, broad coalition participation) factors affecting care linkage and engagement. Recommendations for improving retention in care (e.g., text messaging, medical home) were also identified. Conclusions: In order for the benefits of treatment innovations, including treatment as prevention, to be realized it is essential to retain HIV+ adolescents in care. Key recommendations from the SMILE program to improve linkage and engagement for HIV+ adolescents include: individually-focused tools that assess readiness for care engagement; provider education and training to improve adolescent-focused services; and the development of models that better integrate screening, testing and care organizations. At the federal level, grantors, including the CDC and NIH, can play an important role in facilitating the collaboration (e.g., data sharing) between clinics, health departments, and community agencies. These approaches will provide a critical foundation to effectively realizing the goals of the National HIV/AIDS Strategy.
    Society for Prevention Research 22nd Annual Meeting 2013; 05/2014
  • 15th Society for Research on Adolescence Biennial Meeting, Austin, TX; 03/2014
  • Amanda E. Tanner, Morgan M. Philbin, Alice Ma
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    ABSTRACT: In this chapter, we use the integrated model of continuities and transition in adolescent/youth HIV prevention, diagnosis and treatment, and the care continuum to illustrate innovative adolescent HIV-prevention interventions and programs that engage adolescents and representatives from community organizations, incorporate partnerships, and promote community participation along a continuum.
    Innovations in HIV Prevention Research and Practice through Community Engagement, Edited by Scott D. Rhodes, 01/2014: chapter 5: pages 77-104; Springer., ISBN: 978-1493908998
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    ABSTRACT: In time, microbicides may provide women with dual prevention against pregnancy and STDs. Although several microbicide dimensions have been evaluated, little is known about women's preferences for contraceptive microbicides and correlates of these preferences. Acceptability of a hypothetical contraceptive microbicide cream or jelly was examined among a -clinic-based sample of 266 women in Indianapolis from 2004 (when participants were aged 14-22) to 2008. Group conjoint analyses and individual conjoint analyses were used to compare preferences with respect to four microbicide -dimensions: contraceptive ability, efficacy in relation to condoms, timing of use and texture. Pearson's product moment correlations were used to examine the relationship between preferences for a contraceptive microbicide and selected characteristics of the women. Overall, the top-rated microbicide dimensions were efficacy in relation to that of condoms and contraceptive ability (importance scores, 40.0 and 35.4 out of 100.0, respectively). When all dimension levels were compared, contraceptive ability was the most strongly preferred (part-worth utility score, 8.9), and lower efficacy than that of -condoms was the least strongly preferred (-11.9). Preference for contraceptive microbicides was positively -associated with current contraceptive use, sexual agency, partner communication, commitment to avoiding pregnancy and -perceived partner agreement about avoiding pregnancy (coefficients, 0.07-0.18). It was negatively associated with current or past nonuse of contraceptives, seeking pregnancy and perceived partner agreement about seeking -pregnancy (-0.08 to -0.14). Microbicides with dual prevention properties may be attractive to young women. Microbicide development and subsequent clinical trials should incorporate contraceptive microbicides.
    Perspectives on Sexual and Reproductive Health 12/2013; · 1.41 Impact Factor
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    ABSTRACT: Background: To meet the National HIV/AIDS Strategy goal of rapid linkage to, and engagement in, care for HIV-infected individuals, a better understanding of the factors affecting this process is essential. Accordingly, the study's purpose was to identify multilevel factors affecting care behaviors. Methods: Six focus groups were conducted with HIV-positive individuals in urban North Carolina (15 women, 16 men, and 2 male to female transgender individuals; age: 20-60, X=41; 17 parents). Data were managed using Atlas ti 6.2; content analysis examined factors related to care behaviors within a social-ecological framework. Results: Data revealed individual and structural factors affecting HIV-related care. Individual factors included: age, gender, time since diagnosis, fertility desires/parental status, perceptions of respect from staff, and experiences with treatment side effects. Structural factors included: funding-related policies (e.g., insurance, Medicaid), access to transportation (A lot of people lack [transportation access]the bus here only comes like two or three times a day.), and provider training (A general practitioner is not going to be able to give you the same care that the likelihood of what Dr. C [infectious disease physician] can.). Discussion: Linkage to, and engagement in, care is critical for the long-term health of HIV-infected individuals and for reducing secondary transmission events. Addressing individual and structural issues specific to the individual's context and improving provider training may allow for increased engagement in care. Concentrating on the multilevel barriers to care is important as we develop and evaluate programs (e.g., test and treat) designed to meet the National HIV/AIDS Strategy goals.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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    ABSTRACT: Early linkage to care and engagement in care are critical for initiation of medical interventions. However, over 50 % of newly diagnosed persons do not receive HIV-related care within 6 months of diagnosis. We evaluated a linkage to care and engagement in care initiative for HIV-positive adolescents in 15 U.S.-based clinics. Structural and client-level factors (e.g. demographic and behavioral characteristics, clinic staff and location) were evaluated as predictors of successful linkage and engagement. Within 32 months, 1,172/1,679 (69.8 %) of adolescents were linked to care of which 1,043/1,172 (89 %) were engaged in care. Only 62.1 % (1,043/1,679) of adolescents were linked and engaged in care. Linkage to care failure was attributed to adolescent, provider, and clinic-specific factors. Many adolescents provided incomplete data during the linkage process or failed to attend appointments, both associated with failure to linkage to care. Additional improvements in HIV care will require creative approaches to coordinated data sharing, as well as continued outreach services to support newly diagnosed adolescents.
    AIDS and Behavior 10/2013; · 3.49 Impact Factor
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    ABSTRACT: Linkage and engagement in care are critical corollaries to the health of HIV-infected adolescents. The adolescent HIV epidemic and adolescents' unique barriers to care necessitates innovation in the provision of care, including the consideration of the clinical experience. Little research has addressed how "youth friendly" clinics may influence care retention for HIV-infected youth. We conducted 124 interviews with providers, outreach workers, and case managers, at 15 Adolescent Medicine Trials Network clinics. Photographs of each clinic documented the characteristics of the physical space. Constant comparison and content and visual narrative methods were utilized for data analysis. Three elements of youth friendliness were identified for clinics serving HIV-infected youth, including: (1) role of target population (e.g., pediatric, adolescent, HIV); (2) clinics' physical environment; and (3) clinics' social environment. Working to create 'youth friendly' clinics through changes in physical (e.g., space, entertainment, and educational materials) and social (e.g., staff training related to development, gender, sexual orientation) environments may help reduce HIV-infected adolescents' unique barriers to care engagement. The integration of clinic design and staff training within the organization of a clinical program is helpful in meeting the specialized needs of HIV-infected youth.
    AIDS Care 06/2013; · 1.60 Impact Factor
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    ABSTRACT: Linkage to care is a critical corollary to expanded HIV testing, but many adolescents are not successfully linked to care, in part due to fragmented care systems. Through a collaboration of the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and the Adolescent Trials Network (ATN), a linkage to care outreach worker was provided to ATN clinics. Factors related to linkage were explored to better understand how to improve retention rates and health outcomes for HIV-positive adolescents. We conducted 124 interviews with staff at 15 Adolescent Trials Network clinics to better understand linkage to care processes, barriers, and facilitators. Content analysis was conducted focusing on structural barriers to care and potential solutions, specifically at the macro-, meso-, and micro-levels. Macro-level barriers included navigating health insurance policies, transportation to appointments, and ease of collecting and sharing client-level contact information between testing agencies, local health departments and clinics; meso-level barriers included lack of youth friendliness within clinic space and staff, and duplication of linkage services; micro-level barriers included adolescents' readiness for care and adolescent developmental capacity. Staff initiated solutions included providing transportation for appointments and funding clinic visits and tests with a range of grants and clinic funds while waiting for insurance approval. However, such solutions were often ad hoc and partial, using micro-level solutions to address macro-level barriers. Comprehensive initiatives to improve linkage to care are needed to address barriers to HIV-care for adolescents, whose unique developmental needs make accessing care particularly challenging. Matching the level of structural solution to the level of structural barriers (i.e., macro-level with macro-level), such as creating policy to address needed youth healthcare entitlements versus covering uninsured patients with clinic funds is imperative to achieving the goal of increasing linkage to care rates for newly diagnosed adolescents.
    AIDS Care 06/2013; · 1.60 Impact Factor
  • Alice Ma, Amanda E. Tanner
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    ABSTRACT: Objective: Understanding the complex factors influencing adolescent sexual behaviors and pregnancy is essential to promote adolescent sexual and reproductive health. This mixed methods study examined the social-ecological environment of adolescent pregnancy in Baltimore through the integration of adolescent and adult perspectives and GIS mapping techniques. Methods: Data were collected in 2010 from adult key informant interviews, gender-stratified focus groups with adolescents aged 13 to 19, and GIS maps. Results: Themes that emerged were related to peer social norms, gendered experiences of pregnancy and birth, and environmental factors. Adults and adolescents reported common community strengths and deficits. GIS mapping demonstrated significant geographic disparities. Conclusion: Incorporating a social-ecological framework in the development of educational and policy-related programming is essential to address the complex factors that influence youths’ sexual behaviors and outcomes. The results provide a comprehensive illustration of the interaction between individual- and structural-level factors influencing adolescent pregnancy.
    Graduate Research and Creativity Expo, The University of North Carolina at Greensboro, Greensboro, NC; 04/2013
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    ABSTRACT: PURPOSE: To examine, from a youth's perspective, adolescent pregnancy and parenting in Baltimore, Maryland, a city with high rates of adolescent pregnancy. METHODS: Six gender-stratified focus groups with 13- to 19-year-olds (4 female and 2 male groups; n = 47). We recorded focus groups, transcribed them verbatim, and analyzed them using the constant comparison method. Participants completed questionnaires to collect demographic and behavioral information. RESULTS: Results fit into a social-ecological framework. Individual (e.g., contraceptive use behaviors, religion), interpersonal (e.g., peer norms, maintaining male partners), and community (e.g., clinic factors, perceptions of community) level influences on adolescent pregnancy emerged. Participants discussed contradictory messages that were often gendered in their expectations; for instance, women were responsible for not getting pregnant and raising children. Adolescents expressed beliefs both against (e.g., challenging to complete school) and supporting early childrearing (e.g., religion). Recommendations for addressing the different influences included mentors, education, and community resources. CONCLUSIONS: Adolescents' perspectives and values regarding pregnancy and parenting may not mirror traditional and expected norms for pregnancy and requirements for raising a child. These findings challenge the framing of existing interventions as they may not accurately reflect adolescents' values regarding pregnancy and parenting, and thus may need to be modified to highlight positive attitudes toward contraception and postponing pregnancy.
    Journal of Adolescent Health 03/2013; · 2.75 Impact Factor
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    ABSTRACT: BACKGROUND: Despite the rising childhood obesity rates, few studies have examined the association between access to recreational parks and facilities and obesity. METHODS: A cross-sectional study was performed among 42 278 US children who participated in the 2007 National Survey of Children's Health. Access to parks and recreational facilities was self-reported by parents, and body mass index was calculated from parents' self-report of the child's height and weight. Logistic regression was used to obtain ORs and 95% CIs. Since obesity was not a rare occurrence, an OR correction method was used to provide a more reliable estimate of the prevalence ratio (PR). RESULTS: Children with access to parks and facilities had decreased prevalence of obesity as compared to children without access (PR=0.79, 95% CI 0.69 to 0.91). After adjustment for covariates, the magnitude of the association remained unchanged; however, results were no longer statistically significant (PR=0.77, 95% CI 0.55 to 1.07). Race/ethnicity was an effect modifier of the access-obesity relationship (p<0.0001). Among Non-Hispanic White children, there was no strong association (PR=0.89, 95% CI 0.64 to 1.23). However, among Non-Hispanic Black children, those who had access to recreational parks and facilities had 0.40 times the prevalence of obesity as compared to those without access, and this result was statistically significant (95% CI 0.17 to 0.90). CONCLUSIONS: This research highlights potential health disparities in childhood obesity due to limited access to recreational parks and facilities. Additional studies are needed to further investigate this association. If confirmed, providing safe, accessible parks and facilities may be one way to combat childhood obesity, particularly among minority children.
    Journal of epidemiology and community health 01/2013; · 3.04 Impact Factor
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    ABSTRACT: Due to high cervical cancer rates and limited research on human papillomavirus (HPV) vaccine acceptability in India, the research team examined parental attitudes toward HPV vaccines. Thirty-six interviews with parents were conducted to assess sexually transmitted infection (STI)-related knowledge and HPV-specific vaccine awareness and acceptability. Despite limited knowledge, parents had positive views toward HPV vaccines. Common barriers included concerns about side effects, vaccine cost, and missing work to receive the vaccine. Parents were strongly influenced by health care providers' recommendations. Our findings suggest that addressing parental concerns, health worker training and polices, and efforts to minimize cost will be central to successful HPV vaccine implementation.
    Health Care For Women International 01/2013; · 0.63 Impact Factor

Publication Stats

189 Citations
60.99 Total Impact Points


  • 2012–2014
    • University of North Carolina at Greensboro
      • Department of Public Health Education
      Greensboro, North Carolina, United States
  • 2013
    • Georgia Regents University
      • Department of Psychology
      Augusta, Georgia, United States
  • 2010–2013
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Health, Behavior and Society
      Baltimore, MD, United States
  • 2008–2013
    • University of North Carolina at Charlotte
      • Department of Public Health Sciences
      Charlotte, North Carolina, United States
  • 2008–2011
    • Indiana University-Purdue University Indianapolis
      • Section of Adolescent Medicine
      Indianapolis, IN, United States
  • 2009
    • Johns Hopkins University
      • Department of Health, Behavior and Society
      Baltimore, MD, United States
    • Columbia University
      • Department of Population and Family Health
      New York City, New York, United States
  • 2007
    • Indiana University Bloomington
      • Department of Applied Health Science
      Bloomington, Indiana, United States