PUB 540 Identify a health issue of your choice, such as an infectious disease, chronic disease or health issue prevalent in a specific target population
PUB 540 Identify a health issue of your choice, such as an infectious disease, chronic disease or health issue prevalent in a specific target population
My study examines the incidence of risk factors among women giving birth in the United States in the year 2019, primarily African American Women. Among the risk factors associated with Hypertensive Disorders in Pregnancy, according to Wheelers et al. (2022), being African American is a risk factor for the hypertensive disorder of preeclampsia. This was a retrospective cohort study that used The National Center for Health Statistics birth certificate data to determine the number of pregnant women with moderate to high risk factors. In 2019 there were 3, 695,019 births, 528,778 with no risk and 169, 540 with 1 or more high risk factors, and 2,996,701 with 1 or more moderate risk factors in thre community. Aside from being African American other risk factors included: Multifetal gestation and low socioeconomic status were the two most common factors. Low socioeconomic status had an incidence of 46.9% in the moderate risk factor category and multifetal gestation had an incidence of 3.5% in the high-risk factor for developing preeclampsia. in addition to multifetal gestation, was pregestational diabetes and chronic hypertension. Preeclampsia is the leading cause for maternal and fetal morbidity and mortality due to the fact is causes growth restriction of the fetus, increases the chances of caesarian delivery, raises the risk of long-term maternal cardiovascular health issues. in this study, not only did the clinicians want to determine the incidence of preeclampsia, but they also sought to determine whether or not low dose aspirin could decrease the risk of preeclampsia in women with two or more associated risk factors.
In using Medicaid as a payer and participation in the women Infant program as markers for low-economic status, they also determined that race measures an individuals lived experience with racism.
This study may have met in answering the question related to incidence of preeclampsia and the risk factors that are associated with it both high-risk and moderate risk but did not answer the question as to the association of African American women having a higher incidence. Instead, extrapolated low-socioeconomic with possibly being African American. Yes, African American have higher incidence of diabetes and chronic hypertension, but that association with what was presented in this article was weak. On the other hand, did low dose aspirin significantly decrease preeclampsia with there known risk factors? Yes it did , as the main measure was to examine prevalence of these risk factor alone or in combination. The 2021 guidelines for moderate and high-risk factors for preeclampsia would benefit from a low dose aspirin regimen for those that met criteria for inclusion. Low dose aspirin is most effective if started by 16 weeks of pregnancy. Of course due to this being a cohort study, it is observational. So, the study design was to observe how effective low dose aspirin would be in decreasing the preeclampsia if the participant was determined to fir criteria according to their risk factors.
Wheeler, S. M., Myers, S. O., Swamy, G. K., & Myers, E. R. (2022). Estimated Prevalence of Risk Factors for Preeclampsia Among Individuals Giving Birth in the US in 2019. JAMA Network Open, 5(1), e2142343. https://doi-org.lopes.idm.oclc.org/10.1001/jamanetworkopen.2021.42343
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS PUB 540 Identify a health issue of your choice, such as an infectious disease, chronic disease or health issue prevalent in a specific target population:
My choice of study of choice in the debilitating disease of diabetes’s within the African American Community. Studies have shown that 4.9 million African American adults or 18.7% of all African Americans who are twenty years or older have diagnosed or undiagnosed diabetes ( Spanakis and Golden, 2013). Data proves that biological risk factors are primarily responsible for high risk of diabetic diagnosis in the African American Community, but studies also suggest that making positive changes in known risk factors can aid in the reduction of racial health disparity for developing diabetes.
The study I would propose is a retrospective cohort study to depict the association of diabetes mellitus prevalence among the African American Community in southern regions. The study would place emphasis on population demographics and eating habitats. I determined that a cohort study would be the most effective, cost efficient and provide informative because the targeted population share similar socioeconomic statutes, predispose familiar genes and similar living conditions/ habitats. Diabetes’s mellitus is common in the African American Community and more prevalent in individuals with low socioeconomic status, limited access to healthcare, unhealthy eating habitats, and sedimentary lifestyles. Therefore, record review such as medical records containing diagnoses, family history and pharmacologic treatment would be relevant data. Within the geographic areas health departments, and community clinics can provide relative updated data on the population size who has or has had a diagnosis of Diabetes Mellitus who are of African American decent. Once the individuals are identified we can use the information to perform a trace history to determine the pertinent history and evaluate social and economic status. Simply the exposure is identified through self-reporting data. Outcomes will be determined by hospital admissions, increase in commodity of disease (based on affected organs/ end organ damage), hemoglobin A1C and increase in medications or dosage levels for treatment. The above proposed cohort study will be mainly observational since the data obtained will be obtained from medical records.
Through this method of research participants exposure and outcomes are not manipulated. Through the use of data we identify risk factors, access to care, and the problematic issues that can lead to increase disparities in healthcare as it relates to diabetic care in the African American communities. Using the A1c Criteria can lead to pre-diagnosis and aid to prevent the increase or rises in diabetic patients (Kharroubi and Darwish, 2015).
Kharroubi, A. T., & Darwish, H. M. (2015). Diabetes mellitus: The epidemic of the century. World journal of diabetes, 6(6), 850–867. https://doi.org/10.4239/wjd.v6.i6.850ence
Song, J. W., & Chung, K. C. (2010). Observational studies: cohort and case-control studies. Plastic and reconstructive surgery, 126(6), 2234–2242. https://doi.org/10.1097/PRS.0b013e3181f44abc
Spanakis, E. K., & Golden, S. H. (2013). Race/ethnic difference in diabetes and diabetic complications. Current diabetes reports, 13(6), 814–823. https://doi.org/10.1007/s11892-013-0421-9
My choice of health issue for discussion is HIV (Human Immunodeficiency Virus). HIV is a global epidemic that rapidly spreads through body fluids via sexual intercourse. Approximately 38 million people live with HIV globally (Kaiser Family Foundation, 2021). This infectious disease is prevalent among African Americans, especially young gay men aged 13-24 years. According to the Center for Disease Control and Prevention (2022), black Americans and young gay men account for 42% of all new HIV diagnoses in 2019 in the United States. Youths aged 13-24 years accounted for 83% of new HIV diagnoses.
I would use a retrospective cohort study method to measure the association between HIV exposure and incidence among Black-American young gay men. The study would focus on population demographics and sexual behaviors. A cohort study is suitable for this study because the target population shares similar characteristics (gay; male to male sexual contact), which is the major predisposing factor for HIV. The study design is retrospective because HIV is common among young gay men. Therefore, medical records for young gay men who visit clinics for antiretroviral drugs and support services (psychotherapy) can provide relevant data. A community healthcare center can provide data on the geographical locations of people living with HIV who identify as gay or bisexual. We would then trace the individuals and evaluate their social and economic status and environment. The exposure is identified by self-reporting. Outcomes are determined by hospital admission rate for opportunistic diseases and full-blown AIDs.
The proposed cohort study is observational since data is obtained from medical records. Participants’ exposure and outcome are not manipulated (Setia, 2016). The data collected can help identify risk factors for HIV advancement to AIDs that cause the increased disparities in the prevalence of HIV among the Black American race and young gay men.
Center for Disease Control and Prevention. (2022, April 18). Basic Statistics; HIV basics. www.cdc.gov. https://www.cdc.gov/hiv/basics/statistics.html#:~:text=Young%20people %20aged%2013%20to,13%20to%2024%20in%202019
Kaiser Family Foundation. (2021, March 2). The Global HIV/AIDS Epidemic. www.kff.org. https://www.kff.org/global-health-policy/fact-sheet/the-global-hivaids- epidemic/
Setia M. S. (2016). Methodology Series Module 1: Cohort Studies. Indian journal of dermatology, 61(1), 21–25. https://doi.org/10.4103/0019-5154.174011
Posttraumatic Stress Disorder (PTSD) is described as a psychiatric disorder that may occur in individuals who suffered from traumatic event or experience such as natural disaster, accidents, war, rape, or who have been threaten with death (American Psychiatric Association, n.d.). People with PTSD may present symptoms such as nightmare, and may feel sad, anger, and fear. Military personnel are at risk for this condition due to their line of work. A study shows that military who were exposed to war has higher risk of developing PTSD compared to new soldiers (Brownlow et al., 2018). The study design I would like to utilize is the cross-sectional study and the study I would like to propose is to identify the prevalence of PTSD in military personnel (population) with individuals who went to war/combat zone compared to military personnel who were not exposed to combat zone. Being in the military I am aware of the different deployments, I have been in deployment twice. Observational study design is more appropriate with this kind of research, I would collect data from previous study and peer-reviewed articles.
American Psychiatric Association. (n.d.). What is Posttraumatic Stress Disorder (PTSD)? Retrieved from https://psychiatry.org/patients-families/ptsd/what-is-ptsd
Brownlow, J.A., Zitnik, G.A., McLean, C.P., & Gehrma, P.R.(2018) The influence of deployment stress and life stress on Post-Traumatic Stress Disorder (PTSD) diagnosis among military personnel. J Psychiatr Res. 103:26-32. doi: 10.1016/j.jpsychires.2018.05.005
Diabetes is a disease that has been a popular disease that has affected many people around the world. Diabetes isn’t a single disease it is a multi-factor disease. This disease is very serious and can have many life threatening consequences that can only be avoided if it is properly taken care of. Diabetes is most divided into two types, type 1 diabetes which is insulin dependent and type 2 diabetes which is non-insulin dependent. Ethnicity is a factor as well, if one is Latino/ Hispanic, Pacific Islander, African American or Asian they have a higher chance of getting diabetes as well. Having high blood pressure and not being active can put you at a very high risk. “Ecological models of health behavior emphasize the environmental and policy contexts of behavior, while incorporating social and psychological influences. Ecological models lead to the explicit consideration of multiple levels of influence, thereby guiding the development of more comprehensive interventions.”(McCoy, 2009) The model allows for there to be integration between behavioral and environmental change. It allows for attention to be given to the interaction between personal and environmental factors. For example education for people, as well as disease prevention.The ecological model is useful in understanding the reasons as to why we behave the way we do but, the model still possesses limitations. For example, the model may tell us what factors are contributing to a certain situation, but it does not give clearer information into how much an effect has over another. Ecological models of health behavior emphasize the environmental and policy contexts of behavior, while incorporating social and psychological influences.
- McCoy, Krisha. “The History of Diabetes.” EverydayHealth.com, 3 Nov. 2009, www.everydayhealth.com/diabetes/understanding/diabetes-mellitus-through-time.aspx.
- Curry, A. (2015). Figure 3—source data 1. Source data for plots in panels 3a, 3b, 3d, 3e, 3f. Never too late to change. doi:10.7554/elife.26414.009
- “Symptoms & Causes of Diabetes.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 1 Nov. 2016, www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes.
African American people are more likely to develop diabetes than white American people. This may be because they are more likely to experience barriers to methods that could lower their likelihood of developing it.
According to the Centers for Disease Control and Prevention (CDC), around 10.5%
of the population of the United States had diabetes in 2018.
Considering the increasing incidence and prevalence of diabetes worldwide and the high level of patient involvement it requires, diabetes self-management is a serious issue. The use of mobile health (Mobile Health) in diabetes self-management has increased, but so far research has not provided sufficient information about the uses and effectiveness of Health-based interventions. Alternative study designs and more rigorous methodologies are needed. Mixed-methods designs may be particularly useful because both diabetes self-management and M Health studies require integrating theoretical and methodological approaches.
This scoping review aimed to examine the extent of the use of mixed-methods research in mobile Health-based diabetes management studies. The methodological approaches used to conduct mixed-methods studies were analyzed, and implications for future research are provided.
Guided by Arksey and O’Malley’s framework, this scoping review implemented a comprehensive search strategy including reviewing electronic databases, key journal searches, Web-based research and knowledge centers, websites, and handsearching reference lists of the studies. The studies focusing on mobileHealth technologies and diabetes management were included in the review if they were primary research papers published in academic journals and reported using a combination of qualitative and quantitative methods. The key data extracted from the reviewed studies include purpose of mixing, design type, stage of integration, methods of legitimation, and data collection techniques.
The final sample (N=14) included studies focused on the feasibility and usability of mobile Health diabetes apps (n=7), behavioral measures related to the mobile Health apps (n=6), and challenges of intervention delivery in the mobileHealth context (n=1). Reviewed studies used advanced forms of mixed-methods designs where integration occurred at multiple points and data were collected using multiple techniques. However, the majority of studies did not identify a specific mixed-methods design or use accepted terminology; nor did they justify using this approach.
This review provided important insights into the use of mixed methods in studies focused on diabetes management via mobileHealth technologies. The prominent role of qualitative methods and tailored measures in diabetes self-management studies was confirmed, and the importance of using multiple techniques and approaches in this field was emphasized. This review suggests defining specific mixed-methods questions, using specific legitimation methods, and developing research designs that overcome sampling and other methodological problems in future studies.
Conway N, Campbell I, Forbes P, Cunningham S, Wake D. mobileHealth applications for diabetes: user preference and implications for app development. Health Informatics J 2016 Dec;22(4):1111-1120
There are so many health issues that plague society. The target population I choose is African American teens and sexually transmitted diseases. Epidemiologic research and data from the Center for Disease Control and Prevention (CDC) clearly show a disproportionately higher burden of STDs in African American communities compared with white communities and any other cultures, (CDC, 2020). It is important to understand that these higher rates are not caused by ethnicity or heritage, but by social conditions that are more likely to affect minority groups. Factors such as poverty, large gaps between the rich and the poor, fewer jobs, and low education levels can make it more difficult for people to stay sexually healthy, (Newman & Berman, 2008).
This study will be a cross-sectional case-controlled study, observational in nature. What put African American teens at risk. Social determinants of health play an important role in sexually transmitted disease (STD) transmission and acquisition; consequently, racial, and ethnic disparities among social determinants influence disparities in STD rates, (Morris et al., 2014). Seeking to identify predictors of risk factors can help in formulating effective strategies and preventive measures to reduce the high incidence of infection. A questionnaire-based cross-sectional case-control survey, where participants answered questions on demographic details, sexual behaviors, and awareness of STIs in low-income, high STIs neighborhoods. Compare groups retrospectively in different communities with good outcomes, from education on STI awareness and preventive measures.
Risk-behavior patterns in individuals with STIs could be modified to reduce the burden of these diseases. Increasing knowledge about STI awareness, condom usage, access to health care services, and decreasing delays in seeking care. Integrated services in this context may lead to raised awareness, increased uptake and frequency of testing, and greater uptake and success of partner notification and treatment programs.
Center for Disease Control and Prevention, (2020). Sexually transmitted diseases: STD health equity. Retrieved From: https://www.cdc.gov/std/health-disparities/default.htm
Morris, J. L., Lippman, S. A., Philip, S., Bernstein, K., Neilands, T. B., & Lightfoot, M. (2014). Sexually transmitted infection-related stigma and shame among African American male youth: implications for testing practices, partner notification, and treatment. AIDS patient care and STDs, 28(9), 499–506. https://doi.org/10.1089/apc.2013.0316
Newman, L. M., & Berman, S. M. (2008). Epidemiology of STD disparities in African American communities. Sexually transmitted diseases, 35(12 Suppl), S4–S12. https://doi.org/10.1097/OLQ.0b013e31818eb90e
African American negatively affected by lead water poisoning in their community in Flint, MI, in 2014. I proposed a retrospective cohort study by interviewing a cohort of people in the years of 2018 to 2020; that were living in Flint, MI in 2014 and drank the lead latent water and developed lead poisoning. This study would focus on the muscle weakness and lifestyle changes they had to make after the event.
The reason I choose Retrospective Cohort Study design is due to the fact that it is “a type of study whereby investigators design the study, recruit subjects, and collect background information of the subject after the outcome of interest has been developed.” (Formplus, 2022)
“In recent years, the unsafe water situation at occurred in Flint, MI, — which has a population that is 57 percent Black and 42 percent below the poverty line — is a prime example of how these institutional policies can impact communities that experience lower socioeconomic conditions. In 2014, the city of Flint changed the water supply from Lake Huron (via the Detroit water system) to the Flint River. Although this move was done in an effort to save money during a state-appointed financial emergency, the pollution of the Flint River led to extreme levels of lead in the water supply. By 2015, Flint’s water lead levels were found to be 13,200 parts per billion (PPB) — far surpassing both the EPA’s federal lead level of 15 PPB and toxic waste categorization. Although the situation in Flint was so severe that it received nationwide media coverage, the citizens of Flint were exposed to this unsafe drinking water for years before the city addressed and rectified the issue.” (Lockett, 2022).
This will be an observational study and the measure of association would be that the relative risk is high due to the people directly exposed to the lead poisoning continuing living in the Flint, MI community.
Causal Inference – Co-variation “which states that if A causes B, then A and B should co-vary should be associated. That is, any change in A should produce a change in B. (Trivedi, 2020). If Lead exists in the drinking water, then that directly causes muscle weakness and lifestyle changes in the community. If Lead is not in the drinking water, then no muscle weakness and no lifestyle changes.
Formplus. (2022). 11 retrospective vs prospective cohort study differences.
Lockett, E. (2022). The history of lead poisoning in black communities.
Trivedi, C. (2020). Causality or causal inference or conditions for causal inference