Alla Chernenko

Stress, Coping Strategies, and Depression--Uninsured Primary Care Patients.

OBJECTIVES People of low socio-economic status (SES) are particularly at risk for developing stress-related conditions. The purpose of this study is to examine depression, stress, and coping strategies among uninsured primary care patients who live below the 150th percentile of the federal poverty level. Specifically, this study compares the experiences of impoverished US-born English speakers, non-US-born English speakers, and Spanish speakers. METHODS Uninsured primary care patients utilizing a free clinic (N = 491) completed a self-administered survey using standardized measures of depression, perceived stress, and coping strategies in the spring of 2015. RESULTS US-born English speakers reported higher levels of depression and perceived stress compared to non-US-born English speakers and Spanish speakers. US-born English speakers are more likely to use negative coping strategies than non-US-born English speakers and Spanish speakers. Perceived stress and negative coping strategies are significant predictors of depression. CONCLUSION US-born English speakers, non-US-born English speakers, and Spanish speakers reported different coping strategies, and therefore, may have different needs for addressing depression. In particular, US-born English speakers need interventions for reducing substance use and negative psychological coping strategies.

Perceived Environmental Pollution and Its Impact on Health in China, Japan, and South Korea

Objectives Environmental pollution is a significant global issue. Both objective (scientifically measured) environmental pollution and perceived levels of pollution are important predictors of self-reported health. The purpose of this study was to compare the associations between perceived environmental pollution and health in China, Japan, and South Korea. Methods Data were obtained from the East Asian Social Survey and the Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (n=7938; China, n=3866; Japan, n=2496; South Korea, n=1576). Results South Koreans perceived environmental pollution to be the most severe, while Japanese participants perceived environmental pollution to be the least severe. Although the Japanese did not perceive environmental pollution to be very severe, their self-rated physical health was significantly related to perceived environmental pollution, while the analogous relationships were not significant for the Chinese or Korean participants. Better mental health was related to lower levels of perceived air pollution in China, as well as lower levels of perceived all types of pollution in Japan and lower levels of perceived noise pollution in South Korea. Conclusions Physical and mental health and individual socio-demographic characteristics were associated with levels of perceived environmental pollution, but with different patterns among these three countries.

Perceived benefits and barriers and self-efficacy affecting the attendance of health education programs among uninsured primary care patients.

Lifestyle interventions have shown to be effective in improving health status, health behaviors, and self-efficacy. However, recruiting participants to health education programs and ensuring the continuity of health education for underserved populations is often challenging. The goals of this study are: to describe the attendance of health education programs; to identify stages of change to a healthy lifestyle; to determine cues to action; and to specify factors affecting perceived benefits and barriers to healthy food choices and physical activity among uninsured primary care patients. Uninsured primary care patients utilizing a free clinic (N=621) completed a self-administered survey from September to December of 2015. US born English speakers, non-US born English speakers, and Spanish speakers reported different kinds of cues to action in attending health education programs. While self-efficacy increases perceived benefits and decreases perceived barriers for physical activity, it increases both perceived benefits and perceived barriers for healthy food choices. The participants who had attended health education programs did not believe that there were benefits for healthy food choices and physical activity. This study adds to the body of literature on health education for underserved populations.

Knowledge and beliefs about HPV among college students in Vietnam and the United States.

Any sexually active person has the possibility of contracting the human papillomavirus (HPV) sometime in their lifetime. HPV vaccines are effective in preventing HPV if obtained prior to viral exposure. Research on knowledge and beliefs of HPV and HPV vaccination among college students in Vietnam is significantly scarce. The purpose of this study is to examine the knowledge and beliefs about HPV among college students in Vietnam compared to college students in the US. This cross-cultural comparison will fill a void in current research on this subject. Over 900 college students (N=932: n=495 in Vietnam and n=437 in the US) participated in a self-administered survey on the knowledge and beliefs about HPV in September and October 2016. Vietnamese participants reported lower levels of knowledge and experiences with the HPV virus and vaccines (p<0.01). Additionally, Vietnamese participants also exhibited more barriers in obtaining the vaccination, as well as, HPV risk denial (p<0.01). The level of knowledge is an important predictor of barriers (p<0.01; ηp2=0.022) and risk denial (p<0.01; ηp2=0.116). On average, both Vietnamese and US participants could correctly answer less than half of the survey questions regarding HPV knowledge. Additionally, provider recommendations are potentially more important than informal connections (e.g. friends, family) to reduce barriers to HPV vaccination (p<0.01; ηp2=0.035) and denial of HPV risks (p<0.05; ηp2=0.008). The increase of knowledge about HPV prevention, including and vaccination, has the potential to be improved through provider interventions. Vietnam could take action toward promoting HPV vaccinations not only at an individual level but also at a national or local level. Further research may examine the effects of a lack of knowledge on HPV-related health outcomes.

Perceived concern about the new strain of the influenza and obtaining the vaccine in China, Japan and South Korea

This study compares the factors, which influence individuals from the countries of China, Japan and South Korea to obtain any type of influenza vaccines and their perceived concerns about the new strain of the influenza - pandemic (H1N1) 2009. The data analyzed was from the East Asian Social Survey (EASS), Cross-National Survey Data Sets: Health and Society in East Asia, 2010 (ICPSR 34608) (N=7938). The results of this study suggest that individuals who are concerned about the new strain of influenza are more likely to have obtained influenza vaccine. In these countries, perceived concerns may be directly related to vaccine-related behaviors. The results of this study also indicate that there are variations within each country regarding as to why individuals do or do not obtain the influenza vaccine. Over all, this project provides new insights about the acquisition of the influenza vaccine within China, Japan and South Korea, which will be useful for medical practice within these countries and future research.

Motivations and Outcomes of Volunteers at a Non-Student-Run Free Clinic

The un- or underinsured population in the United States (US) receives free or reduced fee health care services through free clinics. The primary human resource of free clinics are often volunteers. Little is known about volunteering at non-student-run free clinics as the majority of previous studies have been done at student-run clinics. This study aims to add valuable literature to volunteer motivations at non-student-run clinics by identifying interests, motivations, and outcomes of volunteers of a non-student-run free clinic. The volunteers (N=184) took a self-administered paper or online survey from January to May of 2016. The study revealed values to be the most important motivation and outcome. Lower levels of motivation for career was associated with older age, as well as motivation and outcome for understanding and protective function. Longer periods of time spent volunteering were associated with lower levels of motivation for values and career as well as of outcomes for understanding. Undergraduate students were less likely to be motivated values, as compared to non-students, while graduate students were more likely to be motivated by career. Non-student-run free clinics offer valuable resources to the underserved population while providing educational opportunities to undergraduate, graduate students, and any interested in community health.

Home Dental Care Education for RefugeeBackground Adults in the United States

Objective: The purpose of this study was to provide and evaluate oral health care education programs for refugees resettled in the US. Methods: This project consisted of six sessions, which were held from February to April 2017. Each session included the following components: 1) a short survey that included demographic questions and oral health-related questions; 2) a class on oral health home care class; 3) a focus group; and 4) a post-class survey on class satisfaction. Participants were individuals who had a refugee background and were ages 18 and older at the time of the session. Results: Twenty-seven refugees from diverse ethnic backgrounds participated in this study. Refugees that have resettled in the US may not have had opportunities to learn about oral health care, but seem to be interested in oral health education, and find the information useful. While brushing teeth seems to be commonly practiced (though their methods of brushing may not be appropriate), flossing teeth is not. Before resettlement, participants had poor oral health practices and habits, lacked resources, and also maintained cultural norms that negatively affected their oral health. Conclusion: It is important to develop and provide educational programs to promote proper oral health practices for refugees. The changes in their environment after migration to the US such as unfamiliarity to dental health practice and the addition of sugary food/drinks to their lives should be considered in oral health education.

Barriers and Facilitators to Healthy Lifestyle among Refugees Resettled in the United States

Objective: The purpose of this project included: to provide health education for refugees and to gather perspectives on barriers; and facilitators toward healthy eating and regular physical activity. Methods: Six health promotion classes were held between February and June, 2017. Data were collected using a pre-class survey, focus groups, and field notes. Qualitative data were mapped to constructs of the Health Belief Model. Twenty-eight participants of diverse refugee populations participated in this project, of which 12 participated in 4 focus groups. Results: Desires to “stay healthy” and “to be there for family” appeared to be key facilitators for healthy lifestyle. Key barriers to healthy lifestyle include “busy schedule,” and “not able to afford healthy food.” Participants described their struggles to access affordable fresh food and believed having adopted the American diet caused adverse health outcomes. Throughout the project, participants showed interests in utilizing local parks but lacked information on access and use. Conclusion: Future health promotion interventions should focus on familiarizing refugee families with local produce whilst being culturally sensitive on different cooking methods and diet preferences. More health classes and opportunities for free to low-cost exercise are needed.

Knowledge and Perceptions of Influenza Vaccinations Among College Students in Vietnam and the United States

Objectives Influenza is a significant worldwide public health issue. Knowledge and perceptions regarding the flu vaccination are associated with whether individuals obtain the vaccination. The purpose of this study was to examine how such perceptions were related to knowledge and self-efficacy regarding influenza and the flu vaccination in Vietnam and the US. Methods College students (n=932) in Vietnam (n=495) and the US (n=437) completed a self-administered survey regarding knowledge and perceptions of influenza vaccinations in September and October 2016. Results Vietnamese participants reported significantly lower levels of awareness about flu risk, higher levels of negative attitudes toward flu vaccination, lower levels of knowledge about the flu and vaccination, and lower levels of self-efficacy than US participants. Higher levels of flu and flu vaccination knowledge and self-efficacy regarding general responsible health practices were associated with lower levels of negative perceptions of flu risk and attitudes toward vaccination. At the same time, self-efficacy regarding responsible health practices was associated with higher levels of awareness of flu risk and lower levels of negative attitudes toward vaccination. Self-efficacy regarding exercise was associated with lower levels of perceptions of flu risk and higher levels of negative attitudes toward vaccination. Conclusions Vietnam could benefit from influenza education based on this comparison with the US. In both countries, knowledge and self-efficacy were found to be important factors influencing perceptions of influenza risk and vaccination.

Factors Associated with Perpetration of Physical Intimate Partner Violence among College Students: Russia and Lithuania

ABSTRACT This study examined factors associated with physical IPV perpetration in Russia and Lithuania. The data from the International Dating Violence Study 2001–2006 were analyzed (N= 818). Male and female perpetrators as compared to non-perpetrators of physical IPV have a higher prevalence of being perpetrators of other forms of IPV. Perpetrators of physical IPV as compared to non-perpetrators are more likely to have been victims of IPV. Male and female ‘intimate terrorist’ perpetrators exhibit different characteristics. Factors associated with IPV are different between male and female perpetrators. Interventions should focus on victimization and perpetration.