Abstract
Evaluation of a Simple Field-Based Method for Quantification of E. coli in Water
Cassi Gibson, MPH and Jason Marion, Ph.D.
Eastern Kentucky University, Richmond, KY
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Nearly 800 million persons worldwide do not have access to safe water, which results in 2,000 childhood diarrheal deaths each day. In many communities worldwide, quantitative assessment of microbial water quality rarely occurs. From 2013-2016, we performed several studies examining gastrointestinal illness frequency, water treatment effects on water quality, and microbial water quality assessment in western Kenya. In our studies, we measured E. coli in the field quantitatively using “Coliplates” made by Bluewater Biosciences. The Coliplates are shelf stable, and can be incubated under a variety of natural conditions in tropical climates. In using the Coliplates in the field in our previous studies, we observed significant increases in the odds of reporting vomiting and/or diarrhea as Coliplate-determined E. coli densities increased. During 2016, we were interested in understanding relationships between Coliplate-determined E. coli densities with more standard quantification methods, specifically EPA Method 1603 (membrane filtration with modified mTEC agar) and Idexx Colilert. We hypothesized these methods would all produce positively correlated E. coli density results. To evaluate these methods, we obtained 41 natural water samples in low-density agricultural areas in Madison County, Kentucky. We then quantified E. coli using all three methods. Statistical analysis demonstrated that the Coliplates were strongly correlated with the membrane filtration method (Rho = 0.83; p < 0.0001). Coliplate results were also correlated with Colilert-24 results (Rho = 0.66; p < 0.0001). The strength of these relationships suggest the Coliplate method may serve as an effective water quality monitoring tool for obtaining quantifiable E. coli levels in drinking water or source water located in resource-limited settings.
Environmental health sciences Epidemiology Protection of the public in relation to communicable diseases including prevention or control Public health biology Public health or related research
Abstract
Developing mHealth messages to support community-clinical linkages for management of diabetes and hypertension in Cambodia
Lesley Steinman, MSW, MPH1, Heang Hen2, Maurits Van Pelt, MSc, LL.M2, James LoGerfo Sr., MD, MPH, FACP1 and Annette Fitzpatrick, PhD1
(1)University of Washington, Seattle, WA, (2)MoPoTsyo Patient Information Center, Phnom Penh, Cambodia
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Background: In many low and middle-income countries (LMIC), heart disease and stroke are leading causes of death as cardiovascular risk factors rapidly increase. MoPoTsyo, an established NGO, uses community-based, patient-led Peer Educator (PE) Networks to deliver self-management training and medications to 21,000 people with hypertension and/or diabetes in Cambodia. MoPoTsyo is collaborating with researchers to develop interactive phone messaging (mHealth) using open-source Verboice to link MoPoTsyo’s patient database, PEs, pharmacies, clinics, and patients, to improve adherence to evidence-based treatment guidelines. Methods: To inform mHealth message development, we conducted six focus groups with 59 people with diabetes and/or hypertension and 11 interviews with PEs in five rural and one urban Cambodian province in October 2016. Atlas.ti supported thematic analysis of transcripts. Results: PE network participants desire mHealth messages to address barriers to NCD management through: reminders about medications, lab tests and doctor’s consultations, education on how to incorporate medications, exercise, and diet into their daily lives, and support for obstacles that cannot easily be overcome. MoPoTsyo clients prefer messages arrive at dinnertime since phones are often shared across family, who can help retrieve messages and learn together. Voice messages are preferred over texts to provide a familiar, trusting voice and reach lower literacy and vision populations. PEs share similar views and perceive mHealth as a tool to support their work. Discussion: We are using findings to inform the development and RCT testing of an mHealth intervention to improve NCD control in Cambodia. This study has implications for national health policies in Cambodia, other LMIC and low-resource U.S. settings, that are working to engage community health workers and build community-clinical linkages to facilitate NCD management.
Chronic disease management and prevention Public health or related research
Abstract
Dental Outreach Mission to Rural Uganda: A Retrospective Review
Brian Leibtog, BSc, DMD1, William Cherniak, BSc, MD, CCFP2, Teri Robertson, RRDH3, Caroline Szymaniak, C.D.R., C.D.T.C., C.S.S.4, Izchak Barzilay, DDS, Cert. Prostho., MS, FRCD(C)5, Mindy Levine, RDH6, Ira Sankiewicz, DDS7 and Tina Papacosmas, RRDH8
(1)Chrysalis Dental Centres, Toronto, ON, Canada, (2)Bridge to Health Medical and Dental, Toronto, ON, Canada, (3)Dr. Bacic Dental Office, Burlington, ON, Canada, (4)Prosthodontic Associates, Toronto, Canada, (5)Mount Sinai Hospital, Toronto, Canada, (6)Toronto College of Dental Hygiene and Auxiliaries Inc., North York, ON, Canada, (7)Dr. Ira Sankiewicz Dental, North York, ON, Canada, (8)Toronto College of Dental Hygiene & Aux., North York, ON, Canada
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
motivation:
Bridge to Health Medical and Dental (BTH) is a Canadian humanitarian organization operating outreach missions to rural southwestern Uganda. Financial constraints, inaccessibility, and poor education are among hurdles preventing adequate healthcare. Myriad dental outreach missions exist to low-resource settings, however, the BTH model provides distinct advantages:
1. Medical and dental interdisciplinary cooperation, fostering safer working environments, fluid triage/referrals, and treatment of large numbers of patients.
2. Educating local healthcare providers, creating lasting benefits to the community.
3. Long-term engagement, allowing strategic improvement over years of collaborative effort.
methods:
Quantitative and qualitative patient data were collected from a 2017 outreach in three segments – extractions, prevention, and prosthodontic tooth replacement.
results:
Over eight outreach clinics, 406 dental patients received 724 tooth extractions. Females accounted for 66.4% total extractions, but only 45.4% those of children. Dental disease in children revealed strong dietary correlations – decay related to sugarcane, calculus to dietary starches, and acid erosion to pineapple consumption. 53 patients receiving single-day prosthodontic tooth replacement exhibited tooth loss attributable to trauma (28), decay (24), and periodontitis (1). Self-reported questionnaires revealed low dental IQ, financial deterrents, and social disadvantages of missing teeth.
conclusions:
Age and gender discrepancies support conventional wisdom that males have comparable decay rates, but seek treatment less frequently than females. Dietary associations will allow future village-specific interventions. Tooth replacement provides considerable benefits. In each year conducting outreaches to Uganda, significant enhancements have followed, but room for improvement exists – BTH serves as a valuable model for other dental missions to low-resource settings.
Basic medical science applied in public health Implementation of health education strategies, interventions and programs Other professions or practice related to public health Planning of health education strategies, interventions, and programs Program planning Public health or related organizational policy, standards, or other guidelines
Abstract
Exploring the role of intuitive eating and the association of self-compassion, depressive symptoms, and weight bias attitudes among college students in Japan, Jordan, and the United States
Maya Miyairi, PhD1, Mingan Yang, PhD2, Julie Gast, PhD, MCHES3, Hala Madanat, PhD2, Steve Hawks, EdD, MBA4, Jason Leiker, PhD3, Hideyo Nakamura, PhD5 and Rachel Morrey, BS3
(1)Utah State University, Brigham City, UT, (2)San Diego State University, San Diego, CA, (3)Utah State University, Logan, UT, (4)Utah State University, Moab, UT, (5)Nihon University, Tokyo, Japan
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Intuitive eating status (IE) has been associated with positive health behaviors and attitudes. However, few studies have examined the role of IE in different cultures. Therefore, the current study explored the role of IE and the association of health behaviors and attitudes between Japan (n = 271), Jordan (n = 357), and the United States (US) (n = 405). Descriptive data showed Japanese participants had lower BMI, higher desire to lose weight, and more fear of becoming fat. Interestingly, Jordanian participants had higher rates of extreme dieting behaviors such as using diet pills or laxatives and/or vomiting. American participants were more frequent exercisers for weight control and showed less weight bias attitudes towards individuals in overweight or obese category. We also examined how IE played a role in behaviors and attitudes. IE had statistically significant associations with self-compassion, depression, and weight bias in the three countries. To explore which factors predict IE, we fitted linear mixed effects models for the three countries. Results showed no overlapping trends between the countries. When we looked at predictors of IE for each country individually, self-compassion was the only predictor for IE in Jordan and Japan. Low levels of depression and BMI also predicted IE for Jordanian participants, and gender played a significant role on IE among Japanese participants. To construct effective health promotion approaches, these findings suggested the importance of examining the role of IE in each culture. This presentation will discuss recommended health promotion approaches to improve IE for each country.
Chronic disease management and prevention Diversity and culture Planning of health education strategies, interventions, and programs Public health or related education Social and behavioral sciences
Abstract
Are young, urban men in Dar es Salaam, Tanzania viable targets for microfinance loans?
Peter Balvanz, MPH1, Gema Mwikoko, MIT2, Thespina Yamanis, PhD3, Deus Kajuna, PGD4, Lusajo Kajula-Maonga, MS2, Sheila Leatherman, MSW5, Marta Mulawa, PhD6, Suzanne Maman, PhD1 and Mrema Kilonzo, MS2
(1)University of North Carolina at Chapel Hill, Chapel Hill, NC, (2)Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, (3)American University, Washington, DC, DC, (4)Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of, (5)Gillings School of Global Public Health, Chapel Hill, NC, (6)Duke University, Durham
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Microfinance represents a range of programs that seek to alleviate poverty by providing access to credit, savings and business skills. Microfinance can smooth consumption levels and can help people cope with economic shocks including deaths, serious illness, and loss of assets. Despite economic challenges faced by young men in low resource settings, men have rarely been targeted by microfinance programs.
We partnered with a local microfinance agency to provide loans to young men in four wards of Dar es Salaam through a cluster-randomized controlled trial to reduce STIs. Participants received an initial $100 loan upon completion of training, application, fee payment, and loan group formation. We used mixed methods to assess repayment success and examined factors associated with complete repayment.
Among eligible men, 26% (162 of 621) took a loan: 56% repaid completely, 23% repaid half or more, and 8% repaid nothing. Most (64%) borrowers reported benefitting from loans (70% expanded business, 67% generated new income, 47% provided for family). Men who were younger (p<.0001), had lower SES (p=0.002), and were never married (p=0.03) were less likely to repay completely. Men described barriers to repayment including emergency expenses and low product demand. Motivation to repay was influenced positively by peer leaders and negatively by lax punishment for late repayment.
This microfinance initiative had mixed success with men in Dar es Salaam. Despite reported economic benefits, some members with particular characteristics struggled to repay. These men could benefit from firmer repayment rules and mentoring from peer leaders successful in business.
Social and behavioral sciences