Browsing by Author "Read, Jen'nan G"
- Results Per Page
- Sort Options
Item Open Access Disparities in functional disability among Arab Americans by nativity, immigrant arrival cohort, and country of birth(SSM - Population Health, 2019-04-01) Read, Jen'nan G; Ajrouch, Kristine J; West, Jessica S© 2018 The Authors This study contributes to a growing literature that documents the importance of arrival cohort and country of birth for differentiating the health of U.S. immigrants. We use nationally-representative data from nine years of the American Community Survey (2008–2016) to examine if an immigrant health advantage exists among Arab Americans ages 40+ (n = 49,867) and test if differences among the foreign-born vary by arrival cohort (pre-1991, 1991–2000, and 2001+). Results from multivariate logistic regression models find that foreign-born Arab Americans have higher odds of physical and self-care disability, and this varies by immigrant arrival cohort. The post-2001 cohort had the highest odds of both disabilities, while the earlier two cohorts did not differ from the native-born after adjustments for covariates. Compositional differences in birthplace, particularly the large influx of immigrants from Iraq in the most recent cohort, explained these differences. Political instabilities globally have contributed to a growing number of U.S. immigrants with vulnerabilities that might be overlooked when arrival cohorts are not considered.Item Open Access Does an Immigrant Health Advantage Exist Among US Whites? Evidence from a Nationally-Representative Examination of Mental and Physical Well-Being.(Journal of immigrant and minority health, 2024-06) Read, Jen'nan GThis study examines whether an immigrant health advantage exists among US Whites, a group often used as a reference category in research on racial and ethnic health disparities. Using recent data from the National Health Interview Survey (2019-2022), I disaggregate non-Hispanic White adults (n = 41,752) by nativity status and use logistic regression models to assess differences in six measures of mental and physical health. The analysis includes self-reported conditions (depression, anxiety, fair/poor self-rated health) and diagnosed conditions that require interaction with the healthcare system (hypertension, diabetes, and chronic obstructive pulmonary disease, COPD). Foreign-born Whites have a significantly lower prevalence of each health outcome relative to US-born Whites. The immigrant health advantage remains significant for depression, anxiety, fair/poor health (i.e., self-reported conditions) and diagnosed hypertension, after adjusting for sociodemographic and healthcare characteristics. In contrast, the inclusion of these explanatory factors reduces the nativity gap in diagnosed diabetes and COPD to non-significance. Overall, the results indicate important variation in health among Whites that is missed in studies that focus on US-born Whites, alone. Scholars must continue to monitor the health of White immigrants, who are projected to grow to 20% of the US immigrant population in the years to come.Item Open Access Evaluating Medicine Retailer Knowledge and Practice in the Diagnosis and Treatment of Malaria in Western Kenya: An Opportunity for Improved Malaria Case Management(2011) Rusk, Andria ErinMalaria remains one of the world's most significant global health challenges. Claiming nearly a million lives each year in Africa alone, this continent bears an especially large part of the malaria disease burden, and with 85% of those deaths among children under the age of 5, better management of malaria cases is critical to the healthy future of the nearly 3.3 billion people at risk of malaria infection .
Improving malaria control is critical to reducing the mortality and morbidity caused by the disease. Key steps to achieving this reduction are early diagnosis, accurate and appropriate treatment, and increased access to these services. In western Kenya, as in much of East Africa, this means improving malaria case management in the informal health sector, specifically in medicine retail locations.
Understanding medicine retailer knowledge and behaviors related to malaria diagnosis and treatment is an important part of improving those practices and thereby the control of malaria in these areas. Two studies were recently conducted that focused on these goals. The first, a quantitative study, examined antimalarial recommendation and dispensing practices and antimalarial knowledge among retailers in the Bungoma East district of western Kenya. The second is a qualitative study investigating retailer diagnostic practices, and their perceptions and concerns regarding alternative diagnostic methods, specifically the use of rapid diagnostic tests for malaria, and how their use might influence medicine retailer behavior.
The quantitative survey found that, while more than half of the participants could identify the correct firstline antimalarial medication, less than half of those would recommend it to children. Customer demand, retailer training, education, and drug stocking and dispensing behaviors were all identified as factors influencing the relationship between knowing the correct antimalarial therapy and recommending it. Many opportunities were discovered to improve appropriate use of antimalarials in this setting. Ensuring that all medicine retailers have at least a basic health training and level of education would improve antimalarial drug knowledge. Educating the community on current antimalarial therapies could help alter the pressure of customer demand to align with appropriate treatment.
The qualitative study found that retailers rely heavily on clinical diagnosis to detect malaria in sick customers, even though they are aware of the limitations of such methods, particularly given the symptomatic similarity of several other diseases. Rapid diagnostic tests for malaria were seen as a viable and profitable solution to achieve a more accurate diagnosis. Medicine retailers felt the tests could bring new customers to their businesses, increase sales, and result in increased patient and provider confidence in the accuracy of the diagnosis, which may increase usage and adherence.
However, there were concerns regarding cost, patient acceptance, and issues that may arise with regulatory boards concerning unregistered retail locations in the area. Overall, medicine retailers felt that most of these issues could be overcome if the regulatory bodies were involved in implementation, if their communities were educated on the importance of testing for malaria before treatment, and if they received training on the use, interpretation, and application of the tests.
Both studies identified opportunities for improvement of the management of malaria through interventions focused on retail drug locations. Training, education, and community and leadership involvement were recognized as key components to the success of future implementation efforts. By increasing access to definitive malaria diagnosis, improving the appropriate use of antimalarial therapies, and increasing access to both of these services, incidences of malaria could be better managed, treated, controlled, and eradicated.
Item Open Access Factors Motivating Emergency Department Attendance Among Patients with Non-Urgent Musculoskeletal Disorders: a Case Study in Qatar(2015) Abu Ghezaleh, ReemaBackground: The rise in the prevalence of musculoskeletal disorders (MSDs) places a high burden on healthcare services, especially in the emergency departments (EDs) of hospitals in Western and European countries. MSD-related complaints are one of the most common complaints in such EDs where 10-40% of cases are non-urgent and could be treated in a primary health care center (PHCC) instead. Findings on factors driving patients to attend the ED instead of a PHCC are known to vary in different parts of the world ranging from socio-economical factors to cultural preference; however, most studies have been based primarily on western, industrialized countries and findings are not generalizable to rapidly developing countries which exhibit the same phenomenon such as Qatar. This study aims to extend prior research and examine factors driving patients with non-urgent MSDs to attend the ED in the demographically diverse country of Qatar. Study design: Purposive sampling was used to recruit patients with musculoskeletal complaints age 18 years and older in the "See `N Treat" and "Male Fast Track" areas at the ED of Hamad General Hospital (HGH). Patients with non-urgent MSDs were interviewed about main reasons for attending the HGH ED instead of a PHCC. An applied thematic approach was used to analyze data to determine themes and trends among patient responses. Results: 97 patients were interviewed; 70% were men and 30% were women. 70% of patients interviewed were non-Qatari. The median age of all patients was 35.5 years old (IQR, 27-44.2). The main reasons given for attending an ED were: seeking immediate relief from feeling severe pain (63%), perceived severity of the condition as an emergency and believing ED use is appropriate (29%), and referral from other health facilities (9%). The main reasons for attending the ED of HGH particularly were: preference/convenience (49%), access (15%), lack of knowledge (15%), and influence by employer (15%). Conclusion: The majority of patients preferred attending the ED of HGH for the higher quality of services in comparison to other local PHCCs. Low quality MSD management in PHCCs for patients who experience recurrent pain is often a driving factor as well where it was more feasible for them to access services at the ED of HGH instead of a PHCC. A significant portion of non-Qatari patients attended the ED due to lack of knowledge of other services and misadvise from their employers. Such external factors leading to increased burden on the ED of HGH could be addressed by increasing access to alternative centers. Mandating employers to inform employees of the existence of PHCCs and provide them with health services could also reduce the burden of non-urgent ED use. Enforcement of established protocols and strategies on MSD management could also improve the quality of service in PHCCs and contribute to MSD prevention, thus lowering the burden on the healthcare system.
Item Open Access Spirituality, Religious Involvement, and Health System Utilization in Tegucigalpa, Honduras(2010) Catalino, Michael PaulBackground: Spirituality and religious practices can motivate proactive health behavior. Although beliefs and practices may lead to different health behaviors, it is important to recognize the contribution of both to allopathic and complementary and alternative health system utilization. There is a lack of empirical research in this area, especially in Honduras, containing a culture rich in spirituality and religious affiliation.
Methods: Ethical review boards at Duke University and the National Autonomous University of Honduras approved the study protocol. A cross-sectional questionnaire survey was administered in urban Tegucigalpa, Honduras, and a final sample of 600 respondents was obtained. The primary independent measures were self-rated spirituality, religious affiliation, church attendance, and private devotion time. The primary outcome measures were: 1) hypothetical health system use, 2) an estimate of actual preventive health system use, 3) an estimate of actual curative health system use, and 4) an estimate of the relative risk of non-adherent behavior using the Medication Adherence Report Scale (MARS).
Results: Among the 600 respondents of the final sample, 499 (83.2%) had seen a physician in the previous year, either for routine check-up or for "sick use" and received some form of medication. Fewer (430/600, 72.0%) had used a complementary and alternative medical system or treatment (excluding prayer used for health reasons). The majority of respondents believed that natural medicine has no side effects (70.2%) and does not interfere with medicine from the physician (62.8%). Nearly all (93.2%) of the respondents felt that prayer was "very important" in curing sickness. Respondents were significantly more likely to prioritize the physician first, compared to natural medicine, if they were older than 25, had less than secondary education, were not a student, knew that natural medicine has harmful side effects, and knew natural medicine can interfere with medicine from a physician. Respondents were significantly more likely to use a combination first if they were 18-24 years old, had at least a secondary education, were unemployed, were students, and thought natural medicine does not interfere with medicine from the physician.
Self-rated spirituality, religious affiliation, church attendance, and private devotion time had significant crude associations with some, but not all, of the outcome measures. There were no significant associations with hypothetical health system use. Nearly two-thirds (65.9%) of those who associated with a specific religion went to a physician for a routine check-up last year compared to 43.0% of those who did not (p<0.001). Among those who attended church, 67.3% went for a routine check-up compared to 44.0% of those who did not attend (p<0.001). In addition, 64.9% of respondents who had a private devotion time, compared to 40.3% of those who did not, had a routine check-up (p<0.001). Self-rated spirituality had only a mild association with having a routine check-up (p<0.05) and using non-prayer complementary and alternative medicine (p<0.05). Those who associated with a religion were more likely to have received some form of medicine from an allopathic physician last year (80.7% vs. 61.3%, p<0.001). Likewise, 82.0% percent of churchgoers compared to 62.7% of those that did not go to church received medicine (p<0.001). Finally, 58.9% of those with a daily private devotion time, compared to 44.2% of those without one, reported adherent behavior (p<0.01).
Conclusion: Self-rated spirituality and religious involvement are significantly associated with the utilization of the preventive and curative allopathic health systems and adherence to medication in Tegucigalpa, Honduras. These findings deserve further consideration and have implications in both health policy and patient care in Honduras, a country with a thriving spiritual and religious culture.
Item Open Access The Lens of National Identity: Comparing the Structural Components of Muslim and Christian-Majority Countries(2013) Weimer, Laura ReneeIn the midst of revolutions, overthrown governments, civil wars, and large-scale migration, sociologists need to reassess the structural components of national identity. Previous research has analyzed internal dynamics of a few countries or differences between geographical regions or methods of state formation that rarely included Muslim countries in their cross-national comparisons. This paper takes a previously unaddressed approach by looking at nation-states' religious majority, comparing Muslim-majority and Christian-majority states with a large cross-national sample. My research aims to discover whether there are different sources of national identity in the two types of countries. Using multi-level models with both individual and country-level characteristics, I analyze a dichotomous measure of national pride - an indicator of shared connection to the people of the country and thus a measure of national identity - from 9 Muslim-majority and 32 Christian-majority countries in the two most recent waves of the World Values Survey (2000 and 2005). I find that while country-level heterogeneity of language, ethnicity, and religion do not seem to affect one's sense of national pride in either type of country, one's individual position within their country with respect to ethnic, religious, and language majority groups are each strong positive predictors of national pride in both types of countries. More importantly the effect of being in ethnic or religious majority groups has a significantly stronger effect in Muslim countries than in Christian countries. This multi-level cross-national approach comparing Muslim and Christian-majority countries challenges sociologists to further explore the structural meaning of this dichotomy and to pursue research including more Muslim countries.