NAU publications by CHER
Faculty & staff publications
NAU faculty and staff have the opportunity to publish their findings and knowledge as authors. CHER has many researchers that have been cited multiple times in major publications for their great work. The Center for Health Equity Research has accumulated all faculty publications into one, easy to navigate database.
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Curley, Caleigh; Eddie, Regina; Tallis, Kristen; Lane, Taylor S; Yazzie, Del; Sanderson, Priscilla R; Lorts, Cori; Shin, Sonya; Behrens, Timothy K; George, Carmen; Antone-Nez, Ramona; Ashley, Christine; de Heer, Hendrik D The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods Journal Article Journal of Public Health Management and Practice: JPHMP, 29(5) (00), pp. 622-632, 2023. @article{Curley2023, title = {The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods}, author = {Caleigh Curley and Regina Eddie and Kristen Tallis and Taylor S Lane and Del Yazzie and Priscilla R Sanderson and Cori Lorts and Sonya Shin and Timothy K Behrens and Carmen George and Ramona Antone-Nez and Christine Ashley and Hendrik D de Heer}, url = {https://journals.lww.com/jphmp/fulltext/2023/09000/the_navajo_nation_healthy_din__nation_act_.4.aspx}, doi = {10.1097/PHH.0000000000001753}, year = {2023}, date = {2023-05-23}, journal = {Journal of Public Health Management and Practice: JPHMP}, volume = {29(5)}, number = {00}, pages = {622-632}, abstract = {Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had … |
Oi, Katsuya; Pollitt, Amanda M The roles of non-heterosexuality outside of identity and gender non-conformity in Allostatic Load among young adults Journal Article SSM Population Health, 22 , 2023. @article{Oi2023, title = {The roles of non-heterosexuality outside of identity and gender non-conformity in Allostatic Load among young adults}, author = {Katsuya Oi and Amanda M Pollitt}, url = {https://www.sciencedirect.com/science/article/pii/S2352827323000654?via%3Dihub}, doi = {10.1016/j.ssmph.2023.101400}, year = {2023}, date = {2023-04-07}, journal = {SSM Population Health}, volume = {22}, abstract = {Using the National Longitudinal Study of Adolescent to Adult Health, this study contrasted levels of Allostatic Load at the baseline and change observed between the age 20s and 30s, among self-identified Lesbians/Gays/Bisexuals and heterosexuals with non-heterosexual attraction/behavior (discordant heterosexuals), against heterosexuals without (concordant heterosexuals). In addition, the study tested if Allostatic Load differs for each of the sexual orientation group differs jointly or independently of gender non-conformity. The study found no Allostatic Load elevation for self-identified non-heterosexual men and women. For women only, a significantly greater elevation of Allostatic Load is observed among discordant heterosexuals. Independently, Allostatic Load is found higher for females appearing more androgynous. The findings suggest expanding the current scope of sexual minority research to consider the relevance of minority stress to those without a LGB identity, who may be exposed to stress from disparate sources related to their gender identity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Using the National Longitudinal Study of Adolescent to Adult Health, this study contrasted levels of Allostatic Load at the baseline and change observed between the age 20s and 30s, among self-identified Lesbians/Gays/Bisexuals and heterosexuals with non-heterosexual attraction/behavior (discordant heterosexuals), against heterosexuals without (concordant heterosexuals). In addition, the study tested if Allostatic Load differs for each of the sexual orientation group differs jointly or independently of gender non-conformity. The study found no Allostatic Load elevation for self-identified non-heterosexual men and women. For women only, a significantly greater elevation of Allostatic Load is observed among discordant heterosexuals. Independently, Allostatic Load is found higher for females appearing more androgynous. The findings suggest expanding the current scope of sexual minority research to consider the relevance of minority stress to those without a LGB identity, who may be exposed to stress from disparate sources related to their gender identity. |
Harris, Robin B; Brown, Heidi E; Begay, Rachelle L; Sanderson, Priscilla R; Chief, Carmenlita; Monroy, Fernando P; Oren, Eyal Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona Journal Article Int. J. Environ. Res. Public Health, 19 (2), pp. 797, 2022. @article{Harris2022, title = {Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona}, author = {Robin B. Harris and Heidi E. Brown and Rachelle L. Begay and Priscilla R. Sanderson and Carmenlita Chief and Fernando P. Monroy and Eyal Oren }, url = {https://www.mdpi.com/1660-4601/19/2/797}, doi = {10.3390/ijerph19020797}, year = {2022}, date = {2022-01-12}, journal = {Int. J. Environ. Res. Public Health}, volume = {19}, number = {2}, pages = {797}, abstract = {Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment. |
Geronimus, Arline T; Bound, John; Mitchell, Colter; Martinez-Cardoso, Aresha; Evans, Linnea; Hughes, Landon; Schneper, Lisa; Notterman, Daniel A Coming up short: Comparing venous blood, dried blood spots and saliva samples for measuring telomere length in health equity research Journal Article PLOS ONE, 16 (8), 2021. @article{Geronimus2021, title = {Coming up short: Comparing venous blood, dried blood spots and saliva samples for measuring telomere length in health equity research}, author = {Arline T. Geronimus and John Bound and Colter Mitchell and Aresha Martinez-Cardoso and Linnea Evans and Landon Hughes and Lisa Schneper and Daniel A. Notterman}, url = {https://doi.org/10.1371/journal.pone.0255237}, doi = {10.1371/journal.pone.0255237}, year = {2021}, date = {2021-08-18}, journal = {PLOS ONE}, volume = {16}, number = {8}, abstract = {Telomere length (TL) in peripheral blood mononuclear cells (PBMC) from fresh venous blood is increasingly used to estimate molecular impacts of accumulated social adversity on population health. Sometimes, TL extracted from saliva or dried blood spots (DBS) are substituted as less invasive and more scalable specimen collection methods; yet, are they interchangeable with fresh blood? Studies find TL is correlated across tissues, but have not addressed the critical question for social epidemiological applications: Do different specimen types show the same association between TL and social constructs?}, keywords = {}, pubstate = {published}, tppubtype = {article} } Telomere length (TL) in peripheral blood mononuclear cells (PBMC) from fresh venous blood is increasingly used to estimate molecular impacts of accumulated social adversity on population health. Sometimes, TL extracted from saliva or dried blood spots (DBS) are substituted as less invasive and more scalable specimen collection methods; yet, are they interchangeable with fresh blood? Studies find TL is correlated across tissues, but have not addressed the critical question for social epidemiological applications: Do different specimen types show the same association between TL and social constructs? |
Trotter, Robert; Baldwin, Julie A; Buck, Charles Loren; Remiker, Mark; Aguirre, Amanda; Milner, Trudie; Torres, Emma; von Hippel, Frank Arthur JMIR Research Protocol, 10 (8), 2021. @article{Trotter2021, title = {Health Impacts of Perchlorate and Pesticide Exposure: Protocol for Community-Engaged Research to Evaluate Environmental Toxicants in a US Border Community}, author = {Robert Trotter and Julie A Baldwin and Charles Loren Buck and Mark Remiker and Amanda Aguirre and Trudie Milner and Emma Torres and Frank Arthur von Hippel}, url = {https://pubmed.ncbi.nlm.nih.gov/34383679/}, doi = {10.2196/15864}, year = {2021}, date = {2021-08-11}, journal = {JMIR Research Protocol}, volume = {10}, number = {8}, abstract = {The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving "environmental scans" in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving "environmental scans" in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions. |
Williamson, Heather J; Armin, Julie S; Stakely, Ellen; Nasimi, Bonny; Joseph, Darold H; Meyers, Jon; Baldwin, Julie A Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities Journal Article Annals of International Occupational Therapy, 4 (3), 2021. @article{Williamson2021, title = {Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities}, author = {Heather J. Williamson and Julie S. Armin and Ellen Stakely and Bonny Nasimi and Darold H. Joseph and Jon Meyers and Julie A. Baldwin}, url = {https://doi.org/10.3928/24761222-20201202-02}, doi = {10.3928/24761222-20201202-02}, year = {2021}, date = {2021-05-21}, journal = {Annals of International Occupational Therapy}, volume = {4}, number = {3}, abstract = {To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.]}, keywords = {}, pubstate = {published}, tppubtype = {article} } To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.] |
Pro, George; Giano, Zach; Camplain, Ricky; Haberstroh, Shane; Camplain, Carly; Wheeler, Denna; Hubach, Randolph D; Baldwin, Julie A Community Mental Health Journal, 57 , pp. 1017–1022, 2020. @article{Pro2020g, title = {The Role of State Medicaid Expansions in Integrating Comprehensive Mental Health Services into Opioid Treatment Programs: Differences Across the Rural/Urban Continuum}, author = {George Pro and Zach Giano and Ricky Camplain and Shane Haberstroh and Carly Camplain and Denna Wheeler and Randolph D Hubach and Julie A Baldwin }, url = {https://doi.org/10.1007/s10597-020-00719-z}, doi = {10.1007/s10597-020-00719-z}, year = {2020}, date = {2020-10-08}, journal = {Community Mental Health Journal}, volume = {57}, pages = {1017–1022}, abstract = {opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states (𝛽=−0.038, SE = 0.005, p < 0.0001) than in expansion states (𝛽=−0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states (𝛽=−0.038, SE = 0.005, p < 0.0001) than in expansion states (𝛽=−0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population. |
Ingram, Maia; Sabo, Samantha; Redondo, Floribella; Soto, Yanitza; Russell, Kim; Carter, Heather; Bender, Brook; de Zapien, Jill Guernsey Establishing voluntary certification of community health workers in Arizona: a policy case study of building a unified workforce Journal Article Human Resources for Health, 18 (46), 2020. @article{Ingram2020, title = {Establishing voluntary certification of community health workers in Arizona: a policy case study of building a unified workforce}, author = {Maia Ingram and Samantha Sabo and Floribella Redondo and Yanitza Soto and Kim Russell and Heather Carter and Brook Bender and Jill Guernsey de Zapien }, url = {https://doi.org/10.1186/s12960-020-00487-7}, doi = {10.1186/s12960-020-00487-7}, year = {2020}, date = {2020-06-26}, journal = {Human Resources for Health}, volume = {18}, number = {46}, abstract = {Community health workers (CHWs) are widely recognized as essential to addressing disparities in health care delivery and outcomes in US vulnerable populations. In the state of Arizona, the sustainability of the workforce is threatened by low wages, poor job security, and limited opportunities for training and advancement within the profession. CHW voluntary certification offers an avenue to increase the recognition, compensation, training, and standardization of the workforce. However, passing voluntary certification legislation in an anti-regulatory state such as Arizona posed a major challenge that required a robust advocacy effort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community health workers (CHWs) are widely recognized as essential to addressing disparities in health care delivery and outcomes in US vulnerable populations. In the state of Arizona, the sustainability of the workforce is threatened by low wages, poor job security, and limited opportunities for training and advancement within the profession. CHW voluntary certification offers an avenue to increase the recognition, compensation, training, and standardization of the workforce. However, passing voluntary certification legislation in an anti-regulatory state such as Arizona posed a major challenge that required a robust advocacy effort. |
Baldwin, Julie A; Lowe, John; Brooks, Jada; Charbonneau-Dahlen, Barbara K; Lawrence, Gary; Johnson-Jennings, Michelle; Padgett, Gary; Kelley, Melessa; Camplain, Carolyn Health Promotion Practice, 2020. @article{Baldwin2020, title = {Formative Research and Cultural Tailoring of a Substance Abuse Prevention Program for American Indian Youth: Findings from the Intertribal Talking Circle Intervention}, author = {Julie A. Baldwin and John Lowe and Jada Brooks and Barbara K. Charbonneau-Dahlen and Gary Lawrence and Michelle Johnson-Jennings and Gary Padgett and Melessa Kelley and Carolyn Camplain}, url = {https://doi.org/10.1177/1524839920918551}, doi = {10.1177/1524839920918551}, year = {2020}, date = {2020-05-14}, journal = {Health Promotion Practice}, abstract = {Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs. |
Pro, George; Sahker, Ethan; Baldwin, Julie Incarceration as a barrier to U.S. alcohol and drug treatment completion: A multilevel analysis of racial/ethnic and sex disparities Journal Article Journal of Behavioral Health Services & Research, 2020. @article{Pro2020e, title = {Incarceration as a barrier to U.S. alcohol and drug treatment completion: A multilevel analysis of racial/ethnic and sex disparities}, author = {George Pro and Ethan Sahker and Julie Baldwin}, url = {https://doi.org/10.1007/s11414-020-09703-7}, doi = {10.1007/s11414-020-09703-7}, year = {2020}, date = {2020-04-29}, journal = {Journal of Behavioral Health Services & Research}, abstract = {Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015–2016 Treatment Episode Dataset–Discharges. Among a sample restricted to treatment non-completers (n = 306,008), 5% terminated treatment because they became incarcerated (n = 13,082), which varied widely by demographics and by state. In Idaho, 46% of African Americans terminated treatment because they became incarcerated. Women had lower odds of treatment non-completion than men, and the effect of sex was strongest among African Americans (adjusted odds ratio [aOR] = 0.30, 95% confidence interval [95% CI] = 0.26–0.34). Among men, all racial/ethnic minority groups demonstrated significantly higher odds of treatment non-completion due to incarceration compared with Whites, and the strongest effect was among African Americans (aOR = 1.37, 95% CI = 1.29–1.44). Incarceration as a reason for treatment non-completion disproportionately affects African Americans and men and varies by state. Interventions targeting incarceration alternatives should be availed to racial/ethnic minorities already participating in treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015–2016 Treatment Episode Dataset–Discharges. Among a sample restricted to treatment non-completers (n = 306,008), 5% terminated treatment because they became incarcerated (n = 13,082), which varied widely by demographics and by state. In Idaho, 46% of African Americans terminated treatment because they became incarcerated. Women had lower odds of treatment non-completion than men, and the effect of sex was strongest among African Americans (adjusted odds ratio [aOR] = 0.30, 95% confidence interval [95% CI] = 0.26–0.34). Among men, all racial/ethnic minority groups demonstrated significantly higher odds of treatment non-completion due to incarceration compared with Whites, and the strongest effect was among African Americans (aOR = 1.37, 95% CI = 1.29–1.44). Incarceration as a reason for treatment non-completion disproportionately affects African Americans and men and varies by state. Interventions targeting incarceration alternatives should be availed to racial/ethnic minorities already participating in treatment. |
Pro, George; Utter, Jeff; Haberstroh, Shane; Baldwin, Julie A Drug and Alcohol Dependence, 209 (1), 2020. @article{Pro2020f, title = {Dual mental health diagnoses predict the receipt of medication-assisted opioid treatment: Associations moderated by state Medicaid expansion status, race/ethnicity and gender, and year}, author = {George Pro and Jeff Utter and Shane Haberstroh and Julie A Baldwin}, url = {https://pubmed.ncbi.nlm.nih.gov/32172130/}, doi = {10.1016/j.drugalcdep.2020.107952}, year = {2020}, date = {2020-03-07}, journal = {Drug and Alcohol Dependence}, volume = {209}, number = {1}, abstract = { Mental health diagnoses (MHD) are common among those with opioid use disorders (OUD). Methadone/buprenorphine are effective medication-assisted treatment (MAT) strategies; however, treatment receipt is low among those with dual MHDs. Medicaid expansions have broadly increased access to OUD and mental health services over time, but MAT uptake may vary depending on multiple factors, including MHD status, state Medicaid expansion decisions, and race/ethnicity and gender. Examining clinical and policy approaches to promoting MAT uptake may improve services among marginalized groups. }, keywords = {}, pubstate = {published}, tppubtype = {article} } Mental health diagnoses (MHD) are common among those with opioid use disorders (OUD). Methadone/buprenorphine are effective medication-assisted treatment (MAT) strategies; however, treatment receipt is low among those with dual MHDs. Medicaid expansions have broadly increased access to OUD and mental health services over time, but MAT uptake may vary depending on multiple factors, including MHD status, state Medicaid expansion decisions, and race/ethnicity and gender. Examining clinical and policy approaches to promoting MAT uptake may improve services among marginalized groups. |
Pro, George; Camplain, Ricky; Sabo, Samantha; Baldwin, Julie; Gilbert, Paul Substance abuse treatment in correctional versus non-correctional settings: Analysis of racial/ethnic and gender disparities Journal Article Journal of Health Disparities Research and Practice, 12 (3), pp. 1-20, 2019. @article{Pro2019, title = {Substance abuse treatment in correctional versus non-correctional settings: Analysis of racial/ethnic and gender disparities}, author = {George Pro and Ricky Camplain and Samantha Sabo and Julie Baldwin and Paul Gilbert}, url = {https://digitalscholarship.unlv.edu/jhdrp/vol12/iss3/1/}, year = {2019}, date = {2019-11-01}, journal = {Journal of Health Disparities Research and Practice}, volume = {12}, number = {3}, pages = {1-20}, abstract = {Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants of treatment location (jail or prison versus non-correctional settings) among treatment-seeking adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants of treatment location (jail or prison versus non-correctional settings) among treatment-seeking adults. |
II, Robert Trotter T; Lininger, Monica R; Camplain, Ricky; Fofanov, Viacheslav Y; Camplain, Carolyn; Baldwin, Julie A International Journal of Environmental Research and Public Health, 15 (11), 2018. @article{II2018b, title = {A Survey of Health Disparities, Social Determinants of Health, and Converging Morbidities in a County Jail: A Cultural-Ecological Assessment of Health Conditions in Jail Populations}, author = {Robert Trotter T II and Monica R Lininger and Ricky Camplain and Viacheslav Y Fofanov and Carolyn Camplain and Julie A Baldwin}, url = {https://www.mdpi.com/1660-4601/15/11/2500}, year = {2018}, date = {2018-11-08}, journal = {International Journal of Environmental Research and Public Health}, volume = {15}, number = {11}, abstract = {The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population. |
Sabo, Samantha; Flores, Melissa; Wennerström, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia Community health workers promote civic engagement and organizational capacity to impact policy Journal Article Journal of Community Health, 42 (6), pp. 1197-1203, 2017. @article{Sabo2017b, title = {Community health workers promote civic engagement and organizational capacity to impact policy}, author = {Samantha Sabo and Melissa Flores and Ashley Wennerström and Melanie L Bell and Lorena Verdugo and Scott Carvajal and Maia Ingram}, url = {https://link.springer.com/article/10.1007/s10900-017-0370-3}, year = {2017}, date = {2017-06-06}, journal = {Journal of Community Health}, volume = {42}, number = {6}, pages = {1197-1203}, abstract = {Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change. |
Maness, Sarah B; Buhi, Eric R; Daley, Ellen M; Baldwin, Julie A; Kromrey, Jeffrey D Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health Journal Article Journal of Adolescent Health, 58 (6), pp. 636-643, 2016. @article{Maness2016, title = {Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health}, author = {Sarah B Maness and Eric R Buhi and Ellen M Daley and Julie A Baldwin and Jeffrey D Kromrey}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27020277}, doi = {10.1016/j.jadohealth.2016.02.006}, year = {2016}, date = {2016-06-01}, journal = {Journal of Adolescent Health}, volume = {58}, number = {6}, pages = {636-643}, abstract = {PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy. |
Sabo, Samantha; de Zapien, Jill Guernsey; Teufel-Shone, Nicolette; Rosales, Cecilia HERITAGE 2014 Proceedings of the 4th International Conference on Heritage and Sustainable Development, 1 (1), Green Lines Institute for Sustainable Development, 2014, ISBN: 978-989-98013-7. @conference{Sabo2014b, title = {Entre Fronteras (Between Borders): The Power of Service-Learning in Cultural Exchange and Social Action in the United States -Mexico Borderlands}, author = {Samantha Sabo and Jill Guernsey de Zapien and Nicolette Teufel-Shone and Cecilia Rosales}, url = {https://www.researchgate.net/profile/Laura_Demeter/publication/272677297_Assessing_the_cultural_value_of_the_communist_legacy_in_Romania/links/54eb27240cf2f7aa4d5a66a2/Assessing-the-cultural-value-of-the-communist-legacy-in-Romania.pdf}, doi = {10.14575/gl/heritage2014}, isbn = {978-989-98013-7}, year = {2014}, date = {2014-01-01}, booktitle = {HERITAGE 2014 Proceedings of the 4th International Conference on Heritage and Sustainable Development}, volume = {1}, number = {1}, pages = {749-760}, publisher = {Green Lines Institute for Sustainable Development}, keywords = {}, pubstate = {published}, tppubtype = {conference} } |
Ingram, Maia; Reinschmidt, Kerstin M; Schachter, Ken A; Davidson, Chris L; Sabo, Samantha; Zapien, Jill Guernsey De; Carvajal, Scott C Establishing a professional profile of community health workers: results from a national study of roles, activities and training Journal Article Journal of Community Health, 37 (2), pp. 529-537, 2012. @article{Ingram2012, title = {Establishing a professional profile of community health workers: results from a national study of roles, activities and training}, author = {Maia Ingram and Kerstin M Reinschmidt and Ken A Schachter and Chris L Davidson and Samantha Sabo and Jill Guernsey De Zapien and Scott C Carvajal}, url = {https://www.ncbi.nlm.nih.gov/pubmed/21964912}, doi = {10.1007/s10900-011-9475-2}, year = {2012}, date = {2012-04-01}, journal = {Journal of Community Health}, volume = {37}, number = {2}, pages = {529-537}, abstract = {Community Health Workers (CHWs) have gained national recognition for their role in addressing health disparities and are increasingly integrated into the health care delivery system. There is a lack of consensus, however, regarding empirical evidence on the impact of CHW interventions on health outcomes. In this paper, we present results from the 2010 National Community Health Worker Advocacy Survey (NCHWAS) in an effort to strengthen a generalized understanding of the CHW profession that can be integrated into ongoing efforts to improve the health care delivery system. Results indicate that regardless of geographical location, work setting, and demographic characteristics, CHWs generally share similar professional characteristics, training preparation, and job activities. CHWs are likely to be female, representative of the community they serve, and to work in community health centers, clinics, community-based organizations, and health departments. The most common type of training is on-the-job and conference training. Most CHWs work with clients, groups, other CHWs and less frequently community leaders to address health issues, the most common of which are chronic disease, prevention and health care access. Descriptions of CHW activities documented in the survey demonstrate that CHWs apply core competencies in a synergistic manner in an effort to assure that their clients get the services they need. NCHWAS findings suggest that over the past 50 years, the CHW field has become standardized in response to the unmet needs of their communities. In research and practice, the field would benefit from being considered a health profession rather than an intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community Health Workers (CHWs) have gained national recognition for their role in addressing health disparities and are increasingly integrated into the health care delivery system. There is a lack of consensus, however, regarding empirical evidence on the impact of CHW interventions on health outcomes. In this paper, we present results from the 2010 National Community Health Worker Advocacy Survey (NCHWAS) in an effort to strengthen a generalized understanding of the CHW profession that can be integrated into ongoing efforts to improve the health care delivery system. Results indicate that regardless of geographical location, work setting, and demographic characteristics, CHWs generally share similar professional characteristics, training preparation, and job activities. CHWs are likely to be female, representative of the community they serve, and to work in community health centers, clinics, community-based organizations, and health departments. The most common type of training is on-the-job and conference training. Most CHWs work with clients, groups, other CHWs and less frequently community leaders to address health issues, the most common of which are chronic disease, prevention and health care access. Descriptions of CHW activities documented in the survey demonstrate that CHWs apply core competencies in a synergistic manner in an effort to assure that their clients get the services they need. NCHWAS findings suggest that over the past 50 years, the CHW field has become standardized in response to the unmet needs of their communities. In research and practice, the field would benefit from being considered a health profession rather than an intervention. |
Johnson, Jeannette; Baldwin, Julie A; Gryczynski, Jan; Wiechelt, Shelly A; Haring, Rodney C The Native American experience: From displacement and cultural trauma to resilience Book Chapter Multiethnicity and Multiethnic Families: Development, Identity, and Resilience, Chapter 14, pp. 277-302, Xlibris Corporation, 2010, ISBN: 9781450003407. @inbook{Johnson2010, title = {The Native American experience: From displacement and cultural trauma to resilience}, author = {Jeannette Johnson and Julie A Baldwin and Jan Gryczynski and Shelly A Wiechelt and Rodney C Haring}, url = {https://books.google.com/books?hl=en&lr=&id=VidnMGRDFdwC&oi=fnd&pg=PR2&dq=Multiethnicity+and+Multiethnic+Families:+Development,+Identity,+and+Resilience,+Chapter+14&ots=Z610xp1ePw&sig=8M8O6UAUJvfcnTvZO92e4atv-6c#v=onepage&q=Multiethnicity%20and%20Multiethnic%20Families%3A%20Development%2C%20Identity%2C%20and%20Resilience%2C%20Chapter%2014&f=false}, isbn = {9781450003407}, year = {2010}, date = {2010-01-01}, booktitle = {Multiethnicity and Multiethnic Families: Development, Identity, and Resilience}, pages = {277-302}, publisher = {Xlibris Corporation}, chapter = {14}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } |
Ingram, Maia; Sabo, Samantha; Rothers, Janet; Wennerstrom, Ashley; de Zapien, Jill Guernsey Community Health Workers and community advocacy: addressing health disparities Journal Article Journal of Community Health, 33 (6), pp. 417-424, 2008. @article{Ingram2008, title = {Community Health Workers and community advocacy: addressing health disparities}, author = {Maia Ingram and Samantha Sabo and Janet Rothers and Ashley Wennerstrom and Jill Guernsey de Zapien}, url = {https://www.ncbi.nlm.nih.gov/pubmed/18584315}, doi = {10.1007/s10900-008-9111-y}, year = {2008}, date = {2008-12-01}, journal = {Journal of Community Health}, volume = {33}, number = {6}, pages = {417-424}, abstract = {The Community Health Worker model is recognized nationally as a means to address glaring inequities in the burden of adverse health conditions that exist among specific population groups in the United States. This study explored Arizona CHW involvement in advocacy beyond the individual patient level into the realm of advocating for community level change as a mechanism to reduce the structural underpinnings of health disparities. A survey of CHWs in Arizona found that CHWs advocate at local, state and federal political levels as well as within health and social service agencies and business. Characteristics significantly associated with advocacy include employment in a not for profit organization, previous leadership training, and a work environment that allows flexible work hours and the autonomy to start new projects at work. Intrinsic characteristics of CHWs associated with advocacy include their belief that they can influence community decisions, self perception that they are leaders in the community, and knowledge of who to talk to in their community to make change. Community-level advocacy has been identified as a core CHW function and has the potential to address structural issues such as poverty, employment, housing, and discrimination. Agencies utilizing the CHW model could encourage community advocacy by providing a flexible working environment, ongoing leadership training, and opportunities to collaborate with both veteran CHWs and local community leaders. Further research is needed to understand the nature and impact of CHW community advocacy activities on both systems change and health outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The Community Health Worker model is recognized nationally as a means to address glaring inequities in the burden of adverse health conditions that exist among specific population groups in the United States. This study explored Arizona CHW involvement in advocacy beyond the individual patient level into the realm of advocating for community level change as a mechanism to reduce the structural underpinnings of health disparities. A survey of CHWs in Arizona found that CHWs advocate at local, state and federal political levels as well as within health and social service agencies and business. Characteristics significantly associated with advocacy include employment in a not for profit organization, previous leadership training, and a work environment that allows flexible work hours and the autonomy to start new projects at work. Intrinsic characteristics of CHWs associated with advocacy include their belief that they can influence community decisions, self perception that they are leaders in the community, and knowledge of who to talk to in their community to make change. Community-level advocacy has been identified as a core CHW function and has the potential to address structural issues such as poverty, employment, housing, and discrimination. Agencies utilizing the CHW model could encourage community advocacy by providing a flexible working environment, ongoing leadership training, and opportunities to collaborate with both veteran CHWs and local community leaders. Further research is needed to understand the nature and impact of CHW community advocacy activities on both systems change and health outcomes. |
2023 |
Curley, Caleigh; Eddie, Regina; Tallis, Kristen; Lane, Taylor S; Yazzie, Del; Sanderson, Priscilla R; Lorts, Cori; Shin, Sonya; Behrens, Timothy K; George, Carmen; Antone-Nez, Ramona; Ashley, Christine; de Heer, Hendrik D The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods Journal Article Journal of Public Health Management and Practice: JPHMP, 29(5) (00), pp. 622-632, 2023. @article{Curley2023, title = {The Navajo Nation Healthy Diné Nation Act: Community Support of a 2% Tax on Unhealthy Foods}, author = {Caleigh Curley and Regina Eddie and Kristen Tallis and Taylor S Lane and Del Yazzie and Priscilla R Sanderson and Cori Lorts and Sonya Shin and Timothy K Behrens and Carmen George and Ramona Antone-Nez and Christine Ashley and Hendrik D de Heer}, url = {https://journals.lww.com/jphmp/fulltext/2023/09000/the_navajo_nation_healthy_din__nation_act_.4.aspx}, doi = {10.1097/PHH.0000000000001753}, year = {2023}, date = {2023-05-23}, journal = {Journal of Public Health Management and Practice: JPHMP}, volume = {29(5)}, number = {00}, pages = {622-632}, abstract = {Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had …}, keywords = {}, pubstate = {published}, tppubtype = {article} } Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value (“junk foods”) on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25000 annually, and 69.7% were female. Half of the respondents said they “support”(37.4%) or “strongly support”(13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P=. 025) and education (P=. 026) and understanding of the legislation (P<. 001 for “very well” vs “not at all”) had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P<. 001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had … |
Oi, Katsuya; Pollitt, Amanda M The roles of non-heterosexuality outside of identity and gender non-conformity in Allostatic Load among young adults Journal Article SSM Population Health, 22 , 2023. @article{Oi2023, title = {The roles of non-heterosexuality outside of identity and gender non-conformity in Allostatic Load among young adults}, author = {Katsuya Oi and Amanda M Pollitt}, url = {https://www.sciencedirect.com/science/article/pii/S2352827323000654?via%3Dihub}, doi = {10.1016/j.ssmph.2023.101400}, year = {2023}, date = {2023-04-07}, journal = {SSM Population Health}, volume = {22}, abstract = {Using the National Longitudinal Study of Adolescent to Adult Health, this study contrasted levels of Allostatic Load at the baseline and change observed between the age 20s and 30s, among self-identified Lesbians/Gays/Bisexuals and heterosexuals with non-heterosexual attraction/behavior (discordant heterosexuals), against heterosexuals without (concordant heterosexuals). In addition, the study tested if Allostatic Load differs for each of the sexual orientation group differs jointly or independently of gender non-conformity. The study found no Allostatic Load elevation for self-identified non-heterosexual men and women. For women only, a significantly greater elevation of Allostatic Load is observed among discordant heterosexuals. Independently, Allostatic Load is found higher for females appearing more androgynous. The findings suggest expanding the current scope of sexual minority research to consider the relevance of minority stress to those without a LGB identity, who may be exposed to stress from disparate sources related to their gender identity.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Using the National Longitudinal Study of Adolescent to Adult Health, this study contrasted levels of Allostatic Load at the baseline and change observed between the age 20s and 30s, among self-identified Lesbians/Gays/Bisexuals and heterosexuals with non-heterosexual attraction/behavior (discordant heterosexuals), against heterosexuals without (concordant heterosexuals). In addition, the study tested if Allostatic Load differs for each of the sexual orientation group differs jointly or independently of gender non-conformity. The study found no Allostatic Load elevation for self-identified non-heterosexual men and women. For women only, a significantly greater elevation of Allostatic Load is observed among discordant heterosexuals. Independently, Allostatic Load is found higher for females appearing more androgynous. The findings suggest expanding the current scope of sexual minority research to consider the relevance of minority stress to those without a LGB identity, who may be exposed to stress from disparate sources related to their gender identity. |
2022 |
Harris, Robin B; Brown, Heidi E; Begay, Rachelle L; Sanderson, Priscilla R; Chief, Carmenlita; Monroy, Fernando P; Oren, Eyal Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona Journal Article Int. J. Environ. Res. Public Health, 19 (2), pp. 797, 2022. @article{Harris2022, title = {Helicobacter pylori Prevalence and Risk Factors in Three Rural Indigenous Communities of Northern Arizona}, author = {Robin B. Harris and Heidi E. Brown and Rachelle L. Begay and Priscilla R. Sanderson and Carmenlita Chief and Fernando P. Monroy and Eyal Oren }, url = {https://www.mdpi.com/1660-4601/19/2/797}, doi = {10.3390/ijerph19020797}, year = {2022}, date = {2022-01-12}, journal = {Int. J. Environ. Res. Public Health}, volume = {19}, number = {2}, pages = {797}, abstract = {Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Helicobacter pylori (H. pylori) is one of the most common bacterial stomach infections and is implicated in a majority of non-cardia gastric cancer. While gastric cancer has decreased in the United States (US), the incidence in the Navajo Nation is nearly four times higher than surrounding Non-Hispanic White populations. Little is known about H. pylori prevalence in this population or other Indigenous communities in the lower 48 states. In this cross-sectional study, 101 adults representing 73 households from three Navajo Nation chapter communities completed surveys and a urea breath test for active H. pylori. Accounting for intrahousehold correlation, H. pylori prevalence was 56.4% (95% CI, 45.4–66.8) and 72% of households had at least one infected person. The odds of having an active infection in households using unregulated water were 8.85 (95% CI, 1.50–53.38) that of the use of regulated water, and males had 3.26 (95% CI, 1.05–10.07) higher odds than female. The prevalence of H. pylori in Navajo is similar to that seen in Alaska Natives. Further investigation into factors associated with prevention of infection is needed as well as understanding barriers to screening and treatment. |
2021 |
Geronimus, Arline T; Bound, John; Mitchell, Colter; Martinez-Cardoso, Aresha; Evans, Linnea; Hughes, Landon; Schneper, Lisa; Notterman, Daniel A Coming up short: Comparing venous blood, dried blood spots and saliva samples for measuring telomere length in health equity research Journal Article PLOS ONE, 16 (8), 2021. @article{Geronimus2021, title = {Coming up short: Comparing venous blood, dried blood spots and saliva samples for measuring telomere length in health equity research}, author = {Arline T. Geronimus and John Bound and Colter Mitchell and Aresha Martinez-Cardoso and Linnea Evans and Landon Hughes and Lisa Schneper and Daniel A. Notterman}, url = {https://doi.org/10.1371/journal.pone.0255237}, doi = {10.1371/journal.pone.0255237}, year = {2021}, date = {2021-08-18}, journal = {PLOS ONE}, volume = {16}, number = {8}, abstract = {Telomere length (TL) in peripheral blood mononuclear cells (PBMC) from fresh venous blood is increasingly used to estimate molecular impacts of accumulated social adversity on population health. Sometimes, TL extracted from saliva or dried blood spots (DBS) are substituted as less invasive and more scalable specimen collection methods; yet, are they interchangeable with fresh blood? Studies find TL is correlated across tissues, but have not addressed the critical question for social epidemiological applications: Do different specimen types show the same association between TL and social constructs?}, keywords = {}, pubstate = {published}, tppubtype = {article} } Telomere length (TL) in peripheral blood mononuclear cells (PBMC) from fresh venous blood is increasingly used to estimate molecular impacts of accumulated social adversity on population health. Sometimes, TL extracted from saliva or dried blood spots (DBS) are substituted as less invasive and more scalable specimen collection methods; yet, are they interchangeable with fresh blood? Studies find TL is correlated across tissues, but have not addressed the critical question for social epidemiological applications: Do different specimen types show the same association between TL and social constructs? |
Trotter, Robert; Baldwin, Julie A; Buck, Charles Loren; Remiker, Mark; Aguirre, Amanda; Milner, Trudie; Torres, Emma; von Hippel, Frank Arthur JMIR Research Protocol, 10 (8), 2021. @article{Trotter2021, title = {Health Impacts of Perchlorate and Pesticide Exposure: Protocol for Community-Engaged Research to Evaluate Environmental Toxicants in a US Border Community}, author = {Robert Trotter and Julie A Baldwin and Charles Loren Buck and Mark Remiker and Amanda Aguirre and Trudie Milner and Emma Torres and Frank Arthur von Hippel}, url = {https://pubmed.ncbi.nlm.nih.gov/34383679/}, doi = {10.2196/15864}, year = {2021}, date = {2021-08-11}, journal = {JMIR Research Protocol}, volume = {10}, number = {8}, abstract = {The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving "environmental scans" in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The Northern Arizona University (NAU) Center for Health Equity Research (CHER) is conducting community-engaged health research involving "environmental scans" in Yuma County in collaboration with community health stakeholders, including the Yuma Regional Medical Center (YRMC), Regional Center for Border Health, Inc. (RCBH), Campesinos Sin Fronteras (CSF), Yuma County Public Health District, and government agencies and nongovernmental organizations (NGOs) working on border health issues. The purpose of these efforts is to address community-generated environmental health hazards identified through ongoing coalitions among NAU, and local health care and research institutions. |
Williamson, Heather J; Armin, Julie S; Stakely, Ellen; Nasimi, Bonny; Joseph, Darold H; Meyers, Jon; Baldwin, Julie A Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities Journal Article Annals of International Occupational Therapy, 4 (3), 2021. @article{Williamson2021, title = {Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities}, author = {Heather J. Williamson and Julie S. Armin and Ellen Stakely and Bonny Nasimi and Darold H. Joseph and Jon Meyers and Julie A. Baldwin}, url = {https://doi.org/10.3928/24761222-20201202-02}, doi = {10.3928/24761222-20201202-02}, year = {2021}, date = {2021-05-21}, journal = {Annals of International Occupational Therapy}, volume = {4}, number = {3}, abstract = {To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.]}, keywords = {}, pubstate = {published}, tppubtype = {article} } To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members :Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD. [Annals of International Occupational Therapy. 2021;4(3):e158–e165.] |
2020 |
Pro, George; Giano, Zach; Camplain, Ricky; Haberstroh, Shane; Camplain, Carly; Wheeler, Denna; Hubach, Randolph D; Baldwin, Julie A Community Mental Health Journal, 57 , pp. 1017–1022, 2020. @article{Pro2020g, title = {The Role of State Medicaid Expansions in Integrating Comprehensive Mental Health Services into Opioid Treatment Programs: Differences Across the Rural/Urban Continuum}, author = {George Pro and Zach Giano and Ricky Camplain and Shane Haberstroh and Carly Camplain and Denna Wheeler and Randolph D Hubach and Julie A Baldwin }, url = {https://doi.org/10.1007/s10597-020-00719-z}, doi = {10.1007/s10597-020-00719-z}, year = {2020}, date = {2020-10-08}, journal = {Community Mental Health Journal}, volume = {57}, pages = {1017–1022}, abstract = {opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states (𝛽=−0.038, SE = 0.005, p < 0.0001) than in expansion states (𝛽=−0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } opioid treatment programs (OTPs) do not provide MH services. We measured the association between state level characteristics (Medicaid expansion status and rurality) and MH/OUD services integration. We used a generalized linear model to estimate how the association between integration and Medicaid expansions varied across levels of rurality (National Survey on Substance Abuse Treatment Services; 2018; n = 1507 OTPs). The predicted probability of OTPs offering MH services decreased as rurality increased, and the strength of the negative association was greater in non-expansion states (𝛽=−0.038, SE = 0.005, p < 0.0001) than in expansion states (𝛽=−0.020, SE = 0.003, p < 0.0001). Access to integrated MH services was lowest in rural non-Medicaid expansion states, despite the high risk of opioid misuse and a high need for MAT and MH services in this population. |
Ingram, Maia; Sabo, Samantha; Redondo, Floribella; Soto, Yanitza; Russell, Kim; Carter, Heather; Bender, Brook; de Zapien, Jill Guernsey Establishing voluntary certification of community health workers in Arizona: a policy case study of building a unified workforce Journal Article Human Resources for Health, 18 (46), 2020. @article{Ingram2020, title = {Establishing voluntary certification of community health workers in Arizona: a policy case study of building a unified workforce}, author = {Maia Ingram and Samantha Sabo and Floribella Redondo and Yanitza Soto and Kim Russell and Heather Carter and Brook Bender and Jill Guernsey de Zapien }, url = {https://doi.org/10.1186/s12960-020-00487-7}, doi = {10.1186/s12960-020-00487-7}, year = {2020}, date = {2020-06-26}, journal = {Human Resources for Health}, volume = {18}, number = {46}, abstract = {Community health workers (CHWs) are widely recognized as essential to addressing disparities in health care delivery and outcomes in US vulnerable populations. In the state of Arizona, the sustainability of the workforce is threatened by low wages, poor job security, and limited opportunities for training and advancement within the profession. CHW voluntary certification offers an avenue to increase the recognition, compensation, training, and standardization of the workforce. However, passing voluntary certification legislation in an anti-regulatory state such as Arizona posed a major challenge that required a robust advocacy effort.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community health workers (CHWs) are widely recognized as essential to addressing disparities in health care delivery and outcomes in US vulnerable populations. In the state of Arizona, the sustainability of the workforce is threatened by low wages, poor job security, and limited opportunities for training and advancement within the profession. CHW voluntary certification offers an avenue to increase the recognition, compensation, training, and standardization of the workforce. However, passing voluntary certification legislation in an anti-regulatory state such as Arizona posed a major challenge that required a robust advocacy effort. |
Baldwin, Julie A; Lowe, John; Brooks, Jada; Charbonneau-Dahlen, Barbara K; Lawrence, Gary; Johnson-Jennings, Michelle; Padgett, Gary; Kelley, Melessa; Camplain, Carolyn Health Promotion Practice, 2020. @article{Baldwin2020, title = {Formative Research and Cultural Tailoring of a Substance Abuse Prevention Program for American Indian Youth: Findings from the Intertribal Talking Circle Intervention}, author = {Julie A. Baldwin and John Lowe and Jada Brooks and Barbara K. Charbonneau-Dahlen and Gary Lawrence and Michelle Johnson-Jennings and Gary Padgett and Melessa Kelley and Carolyn Camplain}, url = {https://doi.org/10.1177/1524839920918551}, doi = {10.1177/1524839920918551}, year = {2020}, date = {2020-05-14}, journal = {Health Promotion Practice}, abstract = {Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs. |
Pro, George; Sahker, Ethan; Baldwin, Julie Incarceration as a barrier to U.S. alcohol and drug treatment completion: A multilevel analysis of racial/ethnic and sex disparities Journal Article Journal of Behavioral Health Services & Research, 2020. @article{Pro2020e, title = {Incarceration as a barrier to U.S. alcohol and drug treatment completion: A multilevel analysis of racial/ethnic and sex disparities}, author = {George Pro and Ethan Sahker and Julie Baldwin}, url = {https://doi.org/10.1007/s11414-020-09703-7}, doi = {10.1007/s11414-020-09703-7}, year = {2020}, date = {2020-04-29}, journal = {Journal of Behavioral Health Services & Research}, abstract = {Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015–2016 Treatment Episode Dataset–Discharges. Among a sample restricted to treatment non-completers (n = 306,008), 5% terminated treatment because they became incarcerated (n = 13,082), which varied widely by demographics and by state. In Idaho, 46% of African Americans terminated treatment because they became incarcerated. Women had lower odds of treatment non-completion than men, and the effect of sex was strongest among African Americans (adjusted odds ratio [aOR] = 0.30, 95% confidence interval [95% CI] = 0.26–0.34). Among men, all racial/ethnic minority groups demonstrated significantly higher odds of treatment non-completion due to incarceration compared with Whites, and the strongest effect was among African Americans (aOR = 1.37, 95% CI = 1.29–1.44). Incarceration as a reason for treatment non-completion disproportionately affects African Americans and men and varies by state. Interventions targeting incarceration alternatives should be availed to racial/ethnic minorities already participating in treatment.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Incarceration may be an overlooked reason for treatment non-completion experienced disproportionately by African Americans. This study utilized multilevel logistic regression to model treatment non-completion due to incarceration using the 2015–2016 Treatment Episode Dataset–Discharges. Among a sample restricted to treatment non-completers (n = 306,008), 5% terminated treatment because they became incarcerated (n = 13,082), which varied widely by demographics and by state. In Idaho, 46% of African Americans terminated treatment because they became incarcerated. Women had lower odds of treatment non-completion than men, and the effect of sex was strongest among African Americans (adjusted odds ratio [aOR] = 0.30, 95% confidence interval [95% CI] = 0.26–0.34). Among men, all racial/ethnic minority groups demonstrated significantly higher odds of treatment non-completion due to incarceration compared with Whites, and the strongest effect was among African Americans (aOR = 1.37, 95% CI = 1.29–1.44). Incarceration as a reason for treatment non-completion disproportionately affects African Americans and men and varies by state. Interventions targeting incarceration alternatives should be availed to racial/ethnic minorities already participating in treatment. |
Pro, George; Utter, Jeff; Haberstroh, Shane; Baldwin, Julie A Drug and Alcohol Dependence, 209 (1), 2020. @article{Pro2020f, title = {Dual mental health diagnoses predict the receipt of medication-assisted opioid treatment: Associations moderated by state Medicaid expansion status, race/ethnicity and gender, and year}, author = {George Pro and Jeff Utter and Shane Haberstroh and Julie A Baldwin}, url = {https://pubmed.ncbi.nlm.nih.gov/32172130/}, doi = {10.1016/j.drugalcdep.2020.107952}, year = {2020}, date = {2020-03-07}, journal = {Drug and Alcohol Dependence}, volume = {209}, number = {1}, abstract = { Mental health diagnoses (MHD) are common among those with opioid use disorders (OUD). Methadone/buprenorphine are effective medication-assisted treatment (MAT) strategies; however, treatment receipt is low among those with dual MHDs. Medicaid expansions have broadly increased access to OUD and mental health services over time, but MAT uptake may vary depending on multiple factors, including MHD status, state Medicaid expansion decisions, and race/ethnicity and gender. Examining clinical and policy approaches to promoting MAT uptake may improve services among marginalized groups. }, keywords = {}, pubstate = {published}, tppubtype = {article} } Mental health diagnoses (MHD) are common among those with opioid use disorders (OUD). Methadone/buprenorphine are effective medication-assisted treatment (MAT) strategies; however, treatment receipt is low among those with dual MHDs. Medicaid expansions have broadly increased access to OUD and mental health services over time, but MAT uptake may vary depending on multiple factors, including MHD status, state Medicaid expansion decisions, and race/ethnicity and gender. Examining clinical and policy approaches to promoting MAT uptake may improve services among marginalized groups. |
2019 |
Pro, George; Camplain, Ricky; Sabo, Samantha; Baldwin, Julie; Gilbert, Paul Substance abuse treatment in correctional versus non-correctional settings: Analysis of racial/ethnic and gender disparities Journal Article Journal of Health Disparities Research and Practice, 12 (3), pp. 1-20, 2019. @article{Pro2019, title = {Substance abuse treatment in correctional versus non-correctional settings: Analysis of racial/ethnic and gender disparities}, author = {George Pro and Ricky Camplain and Samantha Sabo and Julie Baldwin and Paul Gilbert}, url = {https://digitalscholarship.unlv.edu/jhdrp/vol12/iss3/1/}, year = {2019}, date = {2019-11-01}, journal = {Journal of Health Disparities Research and Practice}, volume = {12}, number = {3}, pages = {1-20}, abstract = {Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants of treatment location (jail or prison versus non-correctional settings) among treatment-seeking adults.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Alcohol and drug abuse are widespread in the US. Substance abuse treatment services are effective, but utilization of services is low, particularly among African Americans, Hispanics, and women. Substance abuse is strongly associated with incarceration, and African Americans and Hispanics make up a disproportionate percentage of individuals with substance abuse problems involved in the criminal justice system. High treatment need, low treatment uptake, and the association between substance abuse and incarceration have led, in part, to correctional institutions filling the treatment gap by increasingly providing safety-net treatment services. We sought to better understand racial/ethnic and gender differences in determinants of treatment location (jail or prison versus non-correctional settings) among treatment-seeking adults. |
2018 |
II, Robert Trotter T; Lininger, Monica R; Camplain, Ricky; Fofanov, Viacheslav Y; Camplain, Carolyn; Baldwin, Julie A International Journal of Environmental Research and Public Health, 15 (11), 2018. @article{II2018b, title = {A Survey of Health Disparities, Social Determinants of Health, and Converging Morbidities in a County Jail: A Cultural-Ecological Assessment of Health Conditions in Jail Populations}, author = {Robert Trotter T II and Monica R Lininger and Ricky Camplain and Viacheslav Y Fofanov and Carolyn Camplain and Julie A Baldwin}, url = {https://www.mdpi.com/1660-4601/15/11/2500}, year = {2018}, date = {2018-11-08}, journal = {International Journal of Environmental Research and Public Health}, volume = {15}, number = {11}, abstract = {The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The environmental health status of jail populations in the United States constitutes a significant public health threat for prisoners and the general population. The ecology of jails creates a dynamic condition in relation to general population health due to the concentrated potential exposure to infectious diseases, difficult access to treatment for chronic health conditions, interruption in continuity of care for serious behavioral health conditions, as well as on-going issues for the prevention and treatment of substance abuse disorders. This paper reports on elements of a cross-sectional survey embedded in a parent project, “Health Disparities in Jail Populations.” The overall project includes a comprehensive secondary data analysis of the health status of county jail populations, along with primary data collection that includes a cross-sectional health and health care services survey of incarcerated individuals, coupled with collection of biological samples to investigate infectious disease characteristics of a county jail population. This paper reports on the primary results of the survey data collection that indicate that this is a population with complex and interacting co-morbidities, as well as significant health disparities compared to the general population. |
2017 |
Sabo, Samantha; Flores, Melissa; Wennerström, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia Community health workers promote civic engagement and organizational capacity to impact policy Journal Article Journal of Community Health, 42 (6), pp. 1197-1203, 2017. @article{Sabo2017b, title = {Community health workers promote civic engagement and organizational capacity to impact policy}, author = {Samantha Sabo and Melissa Flores and Ashley Wennerström and Melanie L Bell and Lorena Verdugo and Scott Carvajal and Maia Ingram}, url = {https://link.springer.com/article/10.1007/s10900-017-0370-3}, year = {2017}, date = {2017-06-06}, journal = {Journal of Community Health}, volume = {42}, number = {6}, pages = {1197-1203}, abstract = {Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change. |
2016 |
Maness, Sarah B; Buhi, Eric R; Daley, Ellen M; Baldwin, Julie A; Kromrey, Jeffrey D Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health Journal Article Journal of Adolescent Health, 58 (6), pp. 636-643, 2016. @article{Maness2016, title = {Social Determinants of Health and Adolescent Pregnancy: An Analysis From the National Longitudinal Study of Adolescent to Adult Health}, author = {Sarah B Maness and Eric R Buhi and Ellen M Daley and Julie A Baldwin and Jeffrey D Kromrey}, url = {https://www.ncbi.nlm.nih.gov/pubmed/27020277}, doi = {10.1016/j.jadohealth.2016.02.006}, year = {2016}, date = {2016-06-01}, journal = {Journal of Adolescent Health}, volume = {58}, number = {6}, pages = {636-643}, abstract = {PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy.}, keywords = {}, pubstate = {published}, tppubtype = {article} } PURPOSE: Although rates of adolescent pregnancy are at an all-time low in the United States, racial/ethnic and geographic disparities persist. This research used National Longitudinal Study of Adolescent to Adult Health (Add Health) data to analyze empirical relationships between social determinants of health (SDoH) and adolescent pregnancy. Examining relationships between the SDoH and adolescent pregnancy provides support for funding priorities and interventions that expand on the current focus on individual and interpersonal-level factors. METHODS: On the basis of the Healthy People 2020 Social Determinants of Health Framework, the identification of proxy measures for SDoH within the Add Health study allowed for an analysis of relationships to adolescent pregnancy (N = 9,204). Logistic regression examined associations between adolescent pregnancy and each measure of SDoH. RESULTS: Results indicated that 6 of 17 measures of SDoH had an empirical relationship with adolescent pregnancy. Measures negatively associated with adolescent pregnancy included the following: feeling close to others at school, receipt of high school diploma, enrollment in higher education, participation in volunteering or community service, reporting litter or trash in the neighborhood environment as a big problem, and living in a two-parent home. CONCLUSIONS: Findings from this study support the need for increased research and intervention focus in SDoH related to areas of education and social and community context. Results of this study provide information for the allocation of resources to best address SDoH that show a link with adolescent pregnancy. Areas of future research can further explore the areas in which SDoH show a relationship with adolescent pregnancy. |
2014 |
Sabo, Samantha; de Zapien, Jill Guernsey; Teufel-Shone, Nicolette; Rosales, Cecilia HERITAGE 2014 Proceedings of the 4th International Conference on Heritage and Sustainable Development, 1 (1), Green Lines Institute for Sustainable Development, 2014, ISBN: 978-989-98013-7. @conference{Sabo2014b, title = {Entre Fronteras (Between Borders): The Power of Service-Learning in Cultural Exchange and Social Action in the United States -Mexico Borderlands}, author = {Samantha Sabo and Jill Guernsey de Zapien and Nicolette Teufel-Shone and Cecilia Rosales}, url = {https://www.researchgate.net/profile/Laura_Demeter/publication/272677297_Assessing_the_cultural_value_of_the_communist_legacy_in_Romania/links/54eb27240cf2f7aa4d5a66a2/Assessing-the-cultural-value-of-the-communist-legacy-in-Romania.pdf}, doi = {10.14575/gl/heritage2014}, isbn = {978-989-98013-7}, year = {2014}, date = {2014-01-01}, booktitle = {HERITAGE 2014 Proceedings of the 4th International Conference on Heritage and Sustainable Development}, volume = {1}, number = {1}, pages = {749-760}, publisher = {Green Lines Institute for Sustainable Development}, keywords = {}, pubstate = {published}, tppubtype = {conference} } |
2012 |
Ingram, Maia; Reinschmidt, Kerstin M; Schachter, Ken A; Davidson, Chris L; Sabo, Samantha; Zapien, Jill Guernsey De; Carvajal, Scott C Establishing a professional profile of community health workers: results from a national study of roles, activities and training Journal Article Journal of Community Health, 37 (2), pp. 529-537, 2012. @article{Ingram2012, title = {Establishing a professional profile of community health workers: results from a national study of roles, activities and training}, author = {Maia Ingram and Kerstin M Reinschmidt and Ken A Schachter and Chris L Davidson and Samantha Sabo and Jill Guernsey De Zapien and Scott C Carvajal}, url = {https://www.ncbi.nlm.nih.gov/pubmed/21964912}, doi = {10.1007/s10900-011-9475-2}, year = {2012}, date = {2012-04-01}, journal = {Journal of Community Health}, volume = {37}, number = {2}, pages = {529-537}, abstract = {Community Health Workers (CHWs) have gained national recognition for their role in addressing health disparities and are increasingly integrated into the health care delivery system. There is a lack of consensus, however, regarding empirical evidence on the impact of CHW interventions on health outcomes. In this paper, we present results from the 2010 National Community Health Worker Advocacy Survey (NCHWAS) in an effort to strengthen a generalized understanding of the CHW profession that can be integrated into ongoing efforts to improve the health care delivery system. Results indicate that regardless of geographical location, work setting, and demographic characteristics, CHWs generally share similar professional characteristics, training preparation, and job activities. CHWs are likely to be female, representative of the community they serve, and to work in community health centers, clinics, community-based organizations, and health departments. The most common type of training is on-the-job and conference training. Most CHWs work with clients, groups, other CHWs and less frequently community leaders to address health issues, the most common of which are chronic disease, prevention and health care access. Descriptions of CHW activities documented in the survey demonstrate that CHWs apply core competencies in a synergistic manner in an effort to assure that their clients get the services they need. NCHWAS findings suggest that over the past 50 years, the CHW field has become standardized in response to the unmet needs of their communities. In research and practice, the field would benefit from being considered a health profession rather than an intervention.}, keywords = {}, pubstate = {published}, tppubtype = {article} } Community Health Workers (CHWs) have gained national recognition for their role in addressing health disparities and are increasingly integrated into the health care delivery system. There is a lack of consensus, however, regarding empirical evidence on the impact of CHW interventions on health outcomes. In this paper, we present results from the 2010 National Community Health Worker Advocacy Survey (NCHWAS) in an effort to strengthen a generalized understanding of the CHW profession that can be integrated into ongoing efforts to improve the health care delivery system. Results indicate that regardless of geographical location, work setting, and demographic characteristics, CHWs generally share similar professional characteristics, training preparation, and job activities. CHWs are likely to be female, representative of the community they serve, and to work in community health centers, clinics, community-based organizations, and health departments. The most common type of training is on-the-job and conference training. Most CHWs work with clients, groups, other CHWs and less frequently community leaders to address health issues, the most common of which are chronic disease, prevention and health care access. Descriptions of CHW activities documented in the survey demonstrate that CHWs apply core competencies in a synergistic manner in an effort to assure that their clients get the services they need. NCHWAS findings suggest that over the past 50 years, the CHW field has become standardized in response to the unmet needs of their communities. In research and practice, the field would benefit from being considered a health profession rather than an intervention. |
2010 |
Johnson, Jeannette; Baldwin, Julie A; Gryczynski, Jan; Wiechelt, Shelly A; Haring, Rodney C The Native American experience: From displacement and cultural trauma to resilience Book Chapter Multiethnicity and Multiethnic Families: Development, Identity, and Resilience, Chapter 14, pp. 277-302, Xlibris Corporation, 2010, ISBN: 9781450003407. @inbook{Johnson2010, title = {The Native American experience: From displacement and cultural trauma to resilience}, author = {Jeannette Johnson and Julie A Baldwin and Jan Gryczynski and Shelly A Wiechelt and Rodney C Haring}, url = {https://books.google.com/books?hl=en&lr=&id=VidnMGRDFdwC&oi=fnd&pg=PR2&dq=Multiethnicity+and+Multiethnic+Families:+Development,+Identity,+and+Resilience,+Chapter+14&ots=Z610xp1ePw&sig=8M8O6UAUJvfcnTvZO92e4atv-6c#v=onepage&q=Multiethnicity%20and%20Multiethnic%20Families%3A%20Development%2C%20Identity%2C%20and%20Resilience%2C%20Chapter%2014&f=false}, isbn = {9781450003407}, year = {2010}, date = {2010-01-01}, booktitle = {Multiethnicity and Multiethnic Families: Development, Identity, and Resilience}, pages = {277-302}, publisher = {Xlibris Corporation}, chapter = {14}, keywords = {}, pubstate = {published}, tppubtype = {inbook} } |
2008 |
Ingram, Maia; Sabo, Samantha; Rothers, Janet; Wennerstrom, Ashley; de Zapien, Jill Guernsey Community Health Workers and community advocacy: addressing health disparities Journal Article Journal of Community Health, 33 (6), pp. 417-424, 2008. @article{Ingram2008, title = {Community Health Workers and community advocacy: addressing health disparities}, author = {Maia Ingram and Samantha Sabo and Janet Rothers and Ashley Wennerstrom and Jill Guernsey de Zapien}, url = {https://www.ncbi.nlm.nih.gov/pubmed/18584315}, doi = {10.1007/s10900-008-9111-y}, year = {2008}, date = {2008-12-01}, journal = {Journal of Community Health}, volume = {33}, number = {6}, pages = {417-424}, abstract = {The Community Health Worker model is recognized nationally as a means to address glaring inequities in the burden of adverse health conditions that exist among specific population groups in the United States. This study explored Arizona CHW involvement in advocacy beyond the individual patient level into the realm of advocating for community level change as a mechanism to reduce the structural underpinnings of health disparities. A survey of CHWs in Arizona found that CHWs advocate at local, state and federal political levels as well as within health and social service agencies and business. Characteristics significantly associated with advocacy include employment in a not for profit organization, previous leadership training, and a work environment that allows flexible work hours and the autonomy to start new projects at work. Intrinsic characteristics of CHWs associated with advocacy include their belief that they can influence community decisions, self perception that they are leaders in the community, and knowledge of who to talk to in their community to make change. Community-level advocacy has been identified as a core CHW function and has the potential to address structural issues such as poverty, employment, housing, and discrimination. Agencies utilizing the CHW model could encourage community advocacy by providing a flexible working environment, ongoing leadership training, and opportunities to collaborate with both veteran CHWs and local community leaders. Further research is needed to understand the nature and impact of CHW community advocacy activities on both systems change and health outcomes.}, keywords = {}, pubstate = {published}, tppubtype = {article} } The Community Health Worker model is recognized nationally as a means to address glaring inequities in the burden of adverse health conditions that exist among specific population groups in the United States. This study explored Arizona CHW involvement in advocacy beyond the individual patient level into the realm of advocating for community level change as a mechanism to reduce the structural underpinnings of health disparities. A survey of CHWs in Arizona found that CHWs advocate at local, state and federal political levels as well as within health and social service agencies and business. Characteristics significantly associated with advocacy include employment in a not for profit organization, previous leadership training, and a work environment that allows flexible work hours and the autonomy to start new projects at work. Intrinsic characteristics of CHWs associated with advocacy include their belief that they can influence community decisions, self perception that they are leaders in the community, and knowledge of who to talk to in their community to make change. Community-level advocacy has been identified as a core CHW function and has the potential to address structural issues such as poverty, employment, housing, and discrimination. Agencies utilizing the CHW model could encourage community advocacy by providing a flexible working environment, ongoing leadership training, and opportunities to collaborate with both veteran CHWs and local community leaders. Further research is needed to understand the nature and impact of CHW community advocacy activities on both systems change and health outcomes. |