<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> Since 2005, Senegal has scaled up malaria control interventions nationwide, mainly by an approach that allowed reaching people of highest needs. Activities have included vector control interventions such as Insecticide Treated Nets (ITN) and Indoor Residual Spraying (IRS), prevention of malaria in pregnant women, and diagnosis and treatment with an effective anti-malarial.</p><p> This study aims to evaluate the impact of malaria interventions on all cause mortality among children under five years following the approach of targeting people of highest needs while scaling up of malaria control in Senegal. A &ldquo;pre/post&rdquo; study design following the recommendations of the RBM Monitoring and Evaluation Reference Group (MERG) was used. This assessment of the impact of the scaling-up of malaria control interventions is based on a plausibility argument. Given that it is difficult to measure mortality resulting from malaria, the objective of the plausibility argument is to demonstrate the association between the scaling-up of malaria interventions and the reduction of all-cause mortality in children under 5 years of age in Senegal.</p><p> Efforts in vector control led to an increase in the availability of resources, and substantial improvement in intervention coverage. Use of ITN by children under 5 increased from 7 per cent to 35 percent (p&lt;0.001). The greatest increases were observed among populations most at risk of malaria, namely the poorest two quintiles, southern and central regions. Parasite prevalence decreased significantly from 6 per cent in 2008 to 3 per cent in 2010 (p&lt; 0.001). The greatest reductions in anemia and parasitaemia were observed in populations from rural areas, the poorest populations, and populations from the central and southern epidemiological zones, who also displayed the highest increase in ownership and use of ITNs. All-cause under 5 mortality decreased by 40 per cent. Kaplan-Meier survival analysis showed better child survival over the period 2005&ndash;2010 compared to 2000&ndash;2005. Except for the region of Dakar, child survival estimates were higher in areas with the lowest prevalence of malaria. In addition, All-cause mortality in children under 5 years was significantly lower during the period after the scaling-up of malaria control interventions (OR: 0 63; 95% CI: 0.46&ndash;0.86).</p><p> Other factors that might affect malaria transmission and child mortality were controlled for in the analysis. Despite increased rainfall malaria morbidity decreased, most strikingly among populations in which access to and use of ITNs increased most. While mortality declined in general during the study period, the greatest decreases in both parasitemia and child mortality were observed among the same populations that had the greatest increase in coverage of malaria control interventions. Similarly, the biggest declines in mortality occurred among the age group most likely to die of malaria, suggesting that malaria control interventions contributed substantially to the decrease in malaria morbidity, and consequently, to all-cause under 5 mortality. Based on the LiST model, the scaling-up of ITNs and IPTp from 2004&ndash;2010 averted 5,774 deaths in children under 5. The advent of home-based management to deliver malaria care at home, even in difficult to access rural areas, where the largest number of deaths usually occurs, has greatly contributed to expanding malaria case management across Senegal.</p><p> All-cause mortality in children under 5 was significantly lower in the period after the scale up of malaria control interventions by targeting people of highest needs. The declines in mortality were greater in the populations and regions where coverage of malaria interventions was highest. The associations held even after taking into account other contextual factors. We drawn the conclusion that malaria control activities reduced malaria related morbidity and mortality, thus contributing to significant declines in all-cause child mortality between 2005-2010 in Senegal.</p>

<p> While obesity is a nationwide phenomenon, African Americans &ndash; especially women &ndash; continue to be more severely affected than any other ethnic group. According to the Centers for Disease Control and Prevention, over 20% of African American women are obese compared to 15.6% of Caucasian women. The church is an important community center for many African Americans, and is often a site for health promotion programs, though little is known of the effectiveness of these programs. The purpose of this qualitative study was to study the experiences and attitudes of African American women who have gone through a church-based weight-loss program. Questions were asked about the cultural, environmental and social barriers to weight loss, and the components of effective church-based weight loss programs. Using a phenomenological approach, this study was designed to capture new data for the development of sustainable church-based weight-loss programs. The theory of social support was used as a theoretical framework. The major themes arising from the data concerned the importance of: (a) social support on all levels; (b) the involvement of the pastor, his spouse, or other church leadership; (c) the inclusion of weight-loss participants in program design; (d) a holistic program design to meet the needs of the entire family; and (e) a culturally sensitive program. The inclusion of all these elements is recommended for future programs. The social change implication is that these recommendations could be helpful in the design, development, and implementation of sustainable church-based weight-loss programs for African American women.</p><p>

Current UK public health policy and research identifies potential health risks of physical inactivity and high levels of sitting. This is a particularly pertinent issue for office workers, who spend, on average, over two-thirds of the work day sitting. This thesis reports on the design and evaluation of a multicomponent sit-stand desk intervention, delivered within two not-for-profit office-based organisations in London, England. A mixed method study design was employed. A pilot randomised controlled trial examined the efficacy of the intervention on reducing sitting and increasing standing and physical activity, using wearable monitors to measure outcome variables at baseline, and at four additional timepoints up to 12-months following the onset of the intervention. A process evaluation, including in-depth qualitative interviews and participant observation, investigated the processes that influenced the feasibility, acceptability and efficacy of the intervention. Mixed-model ANOVA indicated that the intervention reduced workplace sitting, on average, by 38 minutes, however there was no significant influence on workplace physical activity, or any of the outcome variables across the whole day. The process evaluation revealed that discourses surrounding employee health and organisational effectiveness, and employees' health-focused occupational identities increased the acceptability of sit-stand desk provision, whereas monetary concerns, a centralised organisational structure and incompatibility of the sit-stand desks with the workplace environment negatively influenced implementation feasibility. The sit-stand desk design, expectations and outcomes related to health and productivity, and the organisational culture and interpersonal relationships positively and negatively influenced sit-stand desk experience to differing degrees between participants. Mixed method analyses of outcome and process data illustrated the potential for integrating findings to enhance understanding of 'what works' within behavioural intervention research. Sit-stand desks are not a one-size-fits-all solution to reducing sitting and increasing physical activity, however, they should be available to office-based employees as part of a wider workplace health strategy.

Thesis (M.S.)--University of Michigan, 1993. / Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1993. / Includes bibliographical references.

<p> This quantitative research study examined the frequency of street harassment and women's responses to it in terms of emotional reactions and coping mechanisms. A self-administered survey was administered to 51 female graduate students. Frequencies and percents were reported, along with ethnic and age differences in the experience of street harassment. </p><p> Verbal/stalking harassment was found to occur frequently. In addition, many participants reported negative feelings (e.g., annoyance and anger). Women also reported restricting their mobility and changing their appearance in order to avoid harassment. </p><p> These findings highlight the utility of intervening to reduce street harassment to increase women&rsquo;s safety and comfort in public. As women experience oppression due to their gender, their mental health has significant implications for our communities. In short, women&rsquo;s lives matter.</p>

<p> Water quality perception is borne out of various factors, which include taste, risk perception, water chemical and microbial parameters, trust in supplier, among others. This study addressed some of the factors that influence drinking water quality perception in the SIUE community for tap and bottled water. This was done through a survey that was delivered to the students, faculty, administration, staff, and alumni members of the university; a link to the online survey was provided via the school email, and a total number of 779 respondents participated in the survey. Some of the variables used in this study are based on general concern for taste, cost, water-chemicals (such as lead), drinking water behavior as well as demographic variables such as age, knowledge level and ethnicity. This study is based on data received from the survey conducted of the SIUE population for undergraduates, graduates, faculty, staff, administration, and alumni. Data were analyzed using several statistical methods including Spearman rank correlation coefficient and Kruskal-Wallis test. The results indicated that age and ethnicity have a significant impact on water quality perception. Drinking water behavior, age, and knowledge are well correlated in this study; therefore, they were not able to be separated.</p><p>

Neglected Tropical Diseases (NTDs) are both causes and manifestations of poverty in developing countries. Recent advocacy efforts have increased the profile of NTDs, and led to bold new control and elimination targets set for 2020 by the World Health Organisation. However there are multifaceted challenges in effectively implementing NTD interventions in resource-poor contexts that need to be understood and engaged. While there is a growing call by researchers and international agencies for a science of global health delivery to understand these complexities, the exact nature of this science remains contested. This thesis contributes to these debates by advancing a critical social science perspective on the factors that mediate intervention effectiveness for NTD control. Grounded in a social constructivist approach using mixed methods, it critiques prevailing orthodoxies by unpacking the nature, processes and outcomes of three large-scale NTD prevention programmes in Eastern Africa. Focused on different diseases, these case studies represent different types of intervention approaches: top-down, participatory and public-private partnership. The thesis traces the social, technical and environmental processes that mediate the delivery, adoption and use of particular health technologies, such as pit latrines, insecticides and vaccination. Together, these case studies reveal surprisingly similar reasons for why many interventions do not perform according to expectations. Despite new approaches that claim to overcome stereotypical challenges of top-down planning, narrow technocratic perspectives continue to play a defining role in maintaining disjunctions between global aspirations, local realities and intervention outcomes. New perspectives and changes in orientation are needed that emphasise flexibility, learning and adaptability to local contexts. Towards this end, the thesis outlines a conceptual framework based on a comparative analysis of the case studies that highlights five interrelated domains where effectiveness is determined: geographical/livelihood variation, local agency, incentives, the socio-materiality of technology and planning/governance. I argue that addressing the shortcomings of contemporary interventions requires that programme planners actively engage these domains by seeking to “order complexity.” Greater integration of social science perspectives into the management of NTD programmes would provide significant benefit. In these ways, the thesis contributes to wider debates about the nature of global health interventions and the influence of local contexts in mediating efforts to improve the health and wellbeing of the world’s poor and marginalised.