Godfred O. Boateng

York University · Faculty of Health

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 childbear...

Housing insecurity is a pervasive challenge in the cities and urban areas of low-and middle-income countries, particularly in the informal settlements where a disproportionately high number of urban residents live. Despite this persistent challenge and its impact on health and well-being, there are scarce comprehensive, standardized, and validated...

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 o...

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 t...

Several factors influence indoor air quality, including fuel burning, building materials and furnishings, household cleaning and maintenance products, central heating and cooling systems and microbial containments. While these factors are vital, they do not capture important components of housing insecurity or energy poverty. Without appropriate me...

Objectives Household food insecurity has been associated with deleterious consequences on the physical health of vulnerable populations. However, few studies have examined its effect on the individual facets of well-being in slums and informal settlements. Therefore, this study examined (1) the effect of food insecurity on the intellectual, spiritu...

Objectives Globally, an estimated 1.6 billion people live in inadequate housing, with 1 billion living in slums and informal settlements. However, there has not been a way of measuring inadequate housing or housing insecurity in the global South, neither is there an understanding of the relationship between housing insecurity and food insecurity in...

Objectives To determine associations between patient-provider communication (PPC) quality and ratings of health care received, self-efficacy, and management adherence among non-pregnant reproductive-age women with diabetes. Methods Longitudinal data from the 2012–2018 Medical Expenditure Panel Survey were analyzed. The sample included women of chi...

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 psychomet...

Background Housing insecurity is a pervasive challenge in the cities and urban areas of low-income and middle-income countries (LMICs), particularly in the informal settlements where disproportionately high number of urban residents live. Despite this persistent challenge and its impact on health and well-being, there are currently no comprehensive...

Prior studies have theorized resource insecurity in terms of human experiences of food and water insecurity and the coping mechanisms at the individual and household levels. This theorization is limited in its composition, as it does not draw adequate attention to the extent to which such insecurities exacerbate the health equity gap. Therefore, th...

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...

Background The COVID-19 pandemic and control measures adopted by countries globally can lead to stress and anxiety. Investigating the coping strategies to this unprecedented crisis is essential to guide mental health intervention and public health policy. This study examined how people are coping with the COVID-19 crisis in Ghana and identify facto...

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 re...

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...

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...

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 a...

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,...

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 t...

Objective Patient perceptions of healthcare ratings, diabetes self-efficacy, and diabetes management play a role in diabetes-related outcomes, particularly among women of childbearing age. Guided by a modified Interaction Model of Client Health Behavior framework, the objective was to compare differences in perceptions of health care ratings, diabe...

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 longitudina...

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 t...

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, exacerba...

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 adul...

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...

The objective of this study was to examine sex differences in the association between sexual violence victimization and suicidal ideation and suicide attempt among adolescents. Data for this study came from the 2017 National Youth Risk Behavior Survey. An analytic sample of 10,475 adolescents aged 14-18 years (52.3% female) was analyzed. We used bi...

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 l...

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....

Background Despite the global decline in maternal mortality ratio, the burden of this global health problem differs considerably by a country’s economic development status and geographic region. Research suggests that ensuring high-quality maternal care services is crucial for significantly reducing the global maternal mortality ratio. Health pract...

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...

Background The use of mHealth by primary health care providers is a unique opportunity to improve maternal and child health in Sub-Saharan Africa. However, few studies have examined the effects of primary health care providers’ knowledge and attitudes of mHealth for maternal and child health promotion in low-resource settings. Therefore, this study...

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 tempor...

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 hav...

This Special Issue calls for studies on the measurement of health inequities among vulnerable populations and developing tools/constructs/indicators that facilitate the study of environmental, global, and public health research targets. It also focuses on best practices, guidelines, strategies, principles, critical analysis, high-quality reviews, a...

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. However, the factors accelerating this poor quality of life (QOL) have not been fully examined. Therefore, this study examined the factors influencing the quality of life of...

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...

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. However, the factors accelerating this poor quality of life (QOL) have not been fully examined. Therefore, this study examined the factors influencing the quality of life of...

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 i...

The burden of disease from direct environmental causes is significantly higher in developing countries, where solid fuel use is predominant than in developed countries. However, the mechanism by which this happens has not been thoroughly examined. Therefore, this study examined the multiple health effects associated with the use of solid fuel stove...

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 va...

Understanding the drivers of nurses' poor health and the implications for quality of care are important in sustaining a healthy workforce, stimulating professional nursing practice, and ensuring healthy lives while promoting the wellbeing of nurses of all ages. Previous scholarship has identified factors influencing nurses' wellbeing, but have negl...

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 develop...

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...

The Madagascar Health and Environmental Research-Antongil (MAHERY-Antongil) study cohort was set up in September 2015 to assess the nutritional value of seafood for the coastal Malagasy population living along Antongil Bay in northeastern Madagascar. Over 28 months of surveillance, we aimed to understand the relationships among different marine res...

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...

This study examined the effects of household food insecurity on school absenteeism among Junior High School students in Ghana. Data for this study were drawn from the 2012 Ghana Global School-based Health Survey. A sample of 1,121 students aged 11–18 years were analyzed using binary logistic regression with school absenteeism as the outcome variabl...

Objective: This study aimed to develop and validate a household energy poverty index (HEPI) that measures the energy problems associated with accessibility, affordability, and resource constraints. Methods: A series of interrelated steps including item identification, content validity, item reduction, factor and parallel analyses, and tests of reli...

This study examines whether agroecological farming practices, when employed by highly vulnerable households in sub-Saharan Africa, can improve food security and dietary diversity. The research involved a four-year study with 425 smallholder households, selected purposively based on high levels of food insecurity and/or positive HIV status. The hous...

Background: Studies on changes in the prevalence and determinants of obesity in older adults living in sub-Saharan Africa are limited. 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 collected in the WHO SAGE...

Background: Increasing the prevalence of optimal breastfeeding practices, including exclusive breastfeeding for 6months, 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 rath...

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 Hous...

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 weigh...

Sub-analyses between SES variables and BMI as well as central adiposity in Model 3. ‡ WC: Waist circumference. (DOCX)

What forces drive regional economic divergence? This study identifies colonial-era missions as an institutional force in shaping economic relations in Ghana. We conceptualize Christian missions as an institution, in its solid form, as the educational infrastructure and trade networks developed, and in its formal form, as advancing new rules that go...

Although various studies have investigated and found a significant link between age at first alcohol use and health risk behaviors, few studies have investigated the effect of age at first alcohol use on suicidal ideation among adolescents. The objective of this study was to investigate the effect of age at first alcohol use on suicidal ideation....

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 s...

The failure of the conventional public and private (market-based) water policies to improve urban water access in the global South has prompted growing interest in alternative models such as community–state co-production. However, there is little evidence of whether co-production can improve water service delivery in the informal settlements of sub...

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 c...

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 objecti...

Integration of Delphi method with focus group discussions. (PDF)

Scree plot showing cut-off point for retained scale factors using parallel analysis. (PDF)

Description of model fit indices and thresholds used in evaluating scale development results. (PDF)

Scree plot showing cut-off point for retained scale factors using exploratory factor analysis (Geomin Oblique Rotation). (PDF)

Delphi questions on household water insecurity. (PDF)

Initial and final household water insecurity scale items for use among postpartum women in Kenya. (PDF)

The role of indoor air pollutants and their association with anemia are not fully understood. Therefore, we examined if cleaner cooking fuel (electricity/biogas/natural gas) was associated with less risk of anemia than fuel mix (i.e., charcoal, kerosene) or biomass (i.e. wood, straw, shrubs, crop residue) among women in Ghana. Data were drawn from...

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 objecti...

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 breast...