<p> Social Epidemiology has made critical contributions to understanding health inequities. However, translation of social epidemiology science into meaningful and timely action remains a challenge. With so much focus within the field on issues like social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself, and how the challenge of translation might be more readily met through re-envisioning the role of the people in the research enterprise&mdash;reimagining what &ldquo;social&rdquo; could, or even should, mean for the future of the field. Place-health research represents a particularly promising subfield within which to emphasize these principles, especially within the context of public housing. </p><p> Thus, the overall aim for my dissertation work was to conduct research at the nexus of public health and public housing by integrating participatory research methods and information communication technologies (ICTs) to democratize the research process and facilitate local action. In this spirit, my work develops, introduces, and field-tests 3 interrelated and nested concepts that, in application, represent a model for inclusive and equitable social epidemiology: A People&rsquo;s Social Epidemiology, the Placescape, and Geographies of Embodiment. (Abstract shortened by ProQuest.)</p>

<p> Despite the ongoing investments in programs to increase sexual health awareness among young adults globally, many youths remain vulnerable to sexually transmitted diseases (STDs). Two-thirds of all STDs occur among youths engaging in high-risk sexual behaviors, which put young adults at higher risk of STDs and can result in serious consequences including infertility. Additionally, the social consequences of STD affect families and communities. While a need exists for increased public awareness of STDs among young adults, extant intervention and prevention activities should be informed by a cultural perspective, including the integration of community and government roles. The purpose of this social ecological study was to investigate the perceptions of STDs and the potential factors responsible for the increased frequency of STDs based on the lived experiences of 20 young adults with STDs in Akwa Ibom State, Nigeria. Through a qualitative approach using a phenomenological research design, this study employed semi-structured interviews, and the resultant data were analyzed and coded. The findings indicated that college-aged students increasingly engaged in sexually risky behavior with multiple sexual partners for financial gain and power. Additionally, while institutions promoted abstinence as an effective strategy to reduce STD infections, the findings indicated a strong relationship between the phenomenon and individual interconnectedness with the larger society. Because the sexual behavior of young adults in Akwa Ibom State, Nigeria, is influenced at multiple ecological levels, effective and sustaining culturally appropriate STD interventions must involve the larger society including young adults in all stages of intervention development and implementation.</p>

<p> Obesity often arises from poor diet and lack of exercise. Food deserts, in particular, cause people to develop poor eating habits because of the limited healthy food options and availability to cheap fast food chains. People affected by food deserts are usually found in communities of color and low-income areas. The purpose of the study was to identify whether Fontana residents are willing to adopt healthier lifestyles based on the perceptions about their own health and the health of the community. Mixed method research was utilized for the study. The participants in the study included adult residents of both sexes and all ethnic backgrounds from the City of Fontana. Those participants ranged in ages from 18 and above. The data results proved some significance between Fontana residents' will to adopt healthier lifestyles and their perceptions on personal and community health. The bivariate correlation tests indicated a statistical significance between the tested variables despite their small correlations and large unshared variances. The ANOVA tests aided with proving the validity of the proposed hypotheses. Based on the data findings, the null hypothesis was rejected and alternative hypothesis was accepted. For future research on getting residents to be more proactive about their health and that of the community, shorter and simpler surveys were advised.</p>

<p>The lack of vaccines for emerging and re-emerging diseases highlights technical gaps and indicates a need for innovative approaches to produce new vaccines. Vaccines may be improved by knowledge of host responses to vaccination, disease pathogenesis, and the effect of age and genetics on vaccine outcome. This study?s purpose was to quantitatively assess the molecular epidemiology of Francisella tularensis (Ft) and Venezuelan Equine Encephalitis Virus (VEEV). Study results support the Epidemiology Nexus model which holds that association of changes in gene expression to vaccination facilitate understanding the mechanisms of immune development and link public health and disease epidemiology. My research questions assessed the relationship between gene expression following vaccination, the relationship between age and vaccine response, and the association between Human Leukocyte Antigen (HLA) allele and vaccine response. The study was a novel secondary analysis of human data subjected to ANOVA to measure association between treatment and outcome, correlation to measure association of age with vaccine outcome, and Mann-Whitney U tests to measure association of HLA allele with vaccine outcome. Both Ft and VEEV vaccination elicited significant changes in gene expression. A highly positive relationship between age and vaccine outcome was shown for VEEV. The results may affect positive social change by contributing to a growing compendium of evidence of vaccine efficacy mechanisms that may function to assure the public of vaccine safety, combat vaccine hesitancy, and promote vaccine acceptance, as well as contribute mechanistic knowledge to reduce developmental costs of novel vaccines.

<p> <b>Introduction:</b> The Home-based Management of Malaria (HMM) is a cornerstone of malaria control in sub-Saharan Africa (SSA) and is recommended by WHO to provide prompt access to antimalarial treatment for children in under-served areas. Although HMM has been shown to reduce malaria morbidity and mortality with chloroquine, it has not been examined previously in the era of artemisinin-based combination therapies. The objectives of this study were to determine whether HMM reduced: 1] the time from when a mother or guardian realized her child was ill to the time when the child was brought for treatment and 2] malaria morbidity in children less than 5 years of age.</p><p> <b>Methodology:</b> This cross-sectional retrospective study (2008-2014) was performed in intervention villages (receiving HMM) and control villages (not receiving HMM) to examine the effectiveness of HMM.</p><p> <b>Key Results:</b> More mothers and guardians were informed about the malaria control activities performed (98% vs. 24%) in intervention than control villages (<i>p</i> &lt; 0.001). Consistent with that result, mothers and guardians in intervention villages sought care for their sick children earlier than mothers in control villages (<i>p</i> &lt; 0.001) and were more likely to obtain treatment from community health workers (CHWs) in their home villages. In contrast, more children were referred for malaria treatment to health posts and health centers from control than intervention villages (<i>p</i> &lt; 0.001). Likewise, more children with complicated malaria were referred for treatment from control villages (<i>p</i> &lt; 0.001), although those conclusions were limited by the small numbers of complicated (severe) malaria cases.</p><p> <b>Conclusions:</b> These results indicate HMM shortens the time mothers wait before taking their children to receive treatment. Because more children with uncomplicated or complicated malaria are referred for treatment from control than intervention villages, these results indicate that the availability of HMM treatment in the child&rsquo;s home village reduces morbidity (the risk of severe malarial disease). However, additional studies with larger numbers of subjects will be necessary to determine if HMM reduces mortality. </p>

<p> Most people have had an episode of foodborne illness at one time or another; however, the majority of those stricken with foodborne illness fails to associate ill health with something consumed within the past 72 hours. The World Health Organization (WHO) estimates that foodborne diseases affect 30% of the population in developed countries, and that in developing countries, about 2 million people die yearly due to foodborne illness. Previous researchers have indicated that food handlers with poor personal hygiene are potential sources of infection. Although public health agencies in many countries already regularly inspect food facilities to control potential foodborne illnesses to some extent, the question of the most appropriate and effective means of achieving the goal of food safety remains unanswered. Therefore, the purpose of this study was to determine whether a color-coded placard grading system is an effective tool for achieving this goal while simultaneously educating the public about food safety. This study involved 1,410 randomly selected food service establishments, consisting of traditional restaurants, take-out restaurants, grocery stores, public school cafeterias, and institutional food facilities located in Alameda County, California. Inspection data were analyzed for the first 12 months of placard grading and compared to the following 12 months during the placard grading period. Statistical analysis results did not show significant differences in the CDC major violations and in confirmed foodborne illnesses between the 2 years. However, it is expected that the new program will provide improved food handling practices in the future. Improvement in food handling practices will contribute to social change by reducing the number of foodborne illnesses, promoting better health for the community, and educating the public about food safety.</p>

<p> North West Nigeria has the lowest vaccination rate of the geopolitical regions of the country. The purpose of this cross-sectional study was to examine associations between the parents&rsquo;/caregivers&rsquo; biological, cultural, and socioeconomic factors and the completion or noncompletion of routine immunization schedules. Andersen&rsquo;s behavioral model provided the framework for the study. Data were obtained from the 2013 National Demographic Health Survey. Descriptive statistics were calculated for all variables. Chi-square tests were used for categorical predictor variables, simple logistic regression models were used for the age variable, and multiple linear regression models were used for the biological, cultural, and socioeconomic variables to assess the relative importance of factors within each category. Findings indicated a statistically significant association between 4 factors (education, wealth index, religious affiliation, and cost of healthcare) and completion of immunization schedules. Findings may be used to improve the likelihood of immunization of children in North West Nigeria and reduce the levels of childhood morbidity and mortality. Policy makers and immunization programmers can strengthen social services such as women&rsquo;s education, income generation, especially in the agricultural sector and other culturally sensitive interventions with community collaboration to bring the required social change.</p><p>

<p> The use of pharmaceutical products has steadily increased in the United States from 2 billion prescriptions in 1999 to 3.9 billion in 2009. Half of patients do not comply with the recommended prescription regimen and dispose of unused drugs in the environment. The U.S. Environmental Protection Agency and many researchers have highlighted the human-health risks associated with improperly disposing of pharmaceutical products. This quantitative cross-sectional study examined the potential correlations between people&rsquo;s actual disposal practices and their knowledge of the impact of disposal practices on the environment and human health, and availability of disposal options. The conceptual framework selected for this study comprised 2 models: the health belief model and the theory of planned behavior. Respondents to an online survey were 485 residents of the northeast United States, polled from the general population. Descriptive statistics and logistic regression were used to model responses from the dependent variable actual disposal practice (ADP) across the independent variables, and analysis of variance explored whether ADP differed across demographic variables. Statistically significant associations emerged among individuals&rsquo; knowledge of environment and human-health impact, recommended disposal practices, disposal options, and that person&rsquo;s likelihood to practice recommended disposal. Demographic variables did not impact disposal behavior. To promote positive social change, it is recommended that policymakers plan and implement the expansion of convenient drug disposal options, as well as information campaigns on proper disposal practices. In parallel, health care professionals should stress to their patients the importance of complying with prescribed regimens, thus minimizing the amount of unused or expired medications.</p><p>

<p> Pancreatic cancer (PC) remains a significant, unresolved issue because of its complex genetic blueprint and lack of reliable detection markers. The purpose of this study was to examine the possible correlation between tobacco use, gender, and age in the etiopathogenesis of PC and other cancer types with a shared-gene association (CTSG-A). The unified paradigm of cancer causation was used to understand the pathopoiesis mechanism of smoking and shared genes in PC. A cross-sectional study was performed using secondary data from the cancer survivorship module of the 2014 Behavioral Risk Factor Surveillance System survey. Results of ordinal logistic regression analyses indicated no correlation between smoking and prevalence of PC and CTSG-A, but gender and age were significant predictors. Gender has a statistically significant effect on the prediction of PC/ CTSG-A induction and promotion. Increased probability of developing the disease was found as the person reach the age between 62 and 69 years of age. Findings may enhance the understanding of environmental, genetic, and biodemographic interactions in disease evolution (induction, promotion, and expression periods). Findings may also be used to promote population health and improve health behaviors for individuals in vulnerable, high-risk groups.</p><p>

<p> Drug injection is an increasingly important risk factor in the transmission of blood-borne pathogens, including the hepatitis C virus (HCV) and human immunodeficiency virus (HIV). The purpose of the study was to examine the influence of social network factors on HCV and HIV. The study was grounded in social network theory and sought to determine whether social network characteristics affect high-risk sexual and drug injection behavior as well as self-reported HIV and HCV status. The study design was a quantitative cross-sectional survey. A total of 181 participants in a needle exchange program completed a survey in Spanish assessing individual drug and sex risk practices as well as gathering information to describe the characteristics of participants&rsquo; personal networks from an egocentric perspective. General estimating equation techniques were used to analyze the data. Results showed that only social network size was related to risky sexual behavior. Injecting risk behaviors were only impacted by personal network exposures, measured by the average number of years network members had injected. HIV self-reported serum status was correlated with trust, closeness, and number of family members named among the closest 5 network members. Last, HCV self-reported serum status was only related to the years that network members had been injecting drugs. This study has implications for positive social change in that public health practitioners may gain a better understanding of the social network characteristics associated with high-risk behaviors of those infected with HCV and HIV in order to develop health promotion programs to lower infections and mortality.</p>