Nicole Vaughn - Academia.edu (original) (raw)

Papers by Nicole Vaughn

ABSTRACT The pipeline for individuals from underrepresented populations into careers in health di... more ABSTRACT The pipeline for individuals from underrepresented populations into careers in health disparities research needs to be expanded (Rosenstock, et al., 2008). As noted by Riegelman, “it has become evident that undergraduates seek and appreciate public health approaches and public health courses” (2007, p. 237). This appreciation by undergraduates has not increased enrollments in graduate education related to health disparities enough to meet the growing need for health disparities researchers. Therefore, there is a need for the creation of “pipeline programs” (ASPH, 2008, p. 20). The Drexel University School of Public Health’s “Opening the Doors for Diverse Populations to Health Disparities Research” Program is focused on addressing the barriers to health disparities science education that socially, economically, and environmentally disadvantaged groups’ experience. The Opening Doors Program recruits graduate (doctoral and master’s) students in public health programs for 8-months of faculty-mentored research, and undergraduate (juniors and seniors) and medical school students for 10-weeks of faculty-mentored research. All students take part in professional development seminars and ethical/responsible research seminars.Current and ongoing research exploring health disparities among the African-American population has specifically sought to engage faith-based organizations in the implementation of public health interventions. Students work with faith-based organizations to address the disparate impact of pre-diabetes on the African-American population. Using community-based participatory research methods, students work in collaboration with faith leaders to disseminate health promotion and education programs to promote healthy lifestyles, weight loss and reduce risk for chronic disease among African-Americans recruited from Philadelphia’s faith community in two public health interventions.

International Journal of Health Sciences, 2015

Background: Currently, widespread HIV testing is the best preventive action against further sprea... more Background: Currently, widespread HIV testing is the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV and 25% of those with HIV have never been tested. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis. Methods: Qualitative, semi-structured interviews with ten seropositive patients and ten seronegative were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing. Participants were asked about their HIV testing history and attitudes towards optout, incentivized, and mandatory anonymous HIV testing. Results: Major themes were identified using grounded theory data analysis. All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. Conclusion: Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially reduce HIV infection rates.

Type 2 diabetes affects 16 million Americans and disproportionately affects ethnic minorities. Sp... more Type 2 diabetes affects 16 million Americans and disproportionately affects ethnic minorities. Specifically, African American and Hispanics are twice as likely to have Type 2 diabetes compared to their Caucasian counterparts. The impact of this disparity goes beyond the greater prevalence of the disease and includes greater morbidity and mortality. The recent Institute of Medicine (IOM) report documents racial and ethnic disparities in the treatment for many different medical conditions, including diabetes. Understanding and combating health disparities among minority groups is a national priority. Many researchers have focused on socioeconomic status (SES) as the main cause in health disparities. Much of the research over the past two decades has examined the impact of health outcomes among the uninsured and much of this research has found that insured individuals have better health outcomes than those without insurance. In order to begin to unravel the myriad of factors that contr...

Issue: There is a dearth of research on the relationship between shopping habits and the impact i... more Issue: There is a dearth of research on the relationship between shopping habits and the impact it has on weight loss behavior among African Americans, particularly in urban settings. The lack of access to healthy and affordable food options in urban areas has been well studied and continues to be a barrier towards attaining and maintaining a healthy lifestyle. Background: Although many interventions promoting healthy lifestyle change exist, many do not discuss how weight loss may be affected by food accessibility for participants. The Getting People in Sync program (GPS) is a 16-week pre-diabetes prevention program that aims to promote healthy lifestyle change through the use of the Project NOT ME video series. Methods: Participants were administered a brief shopping habits survey assessing barriers (e.g., cost, variety of food retailers, accessibility) facilitators, (e.g., couponing, proximity, public assistance) and the overall impact it has on an individual’s lifestyle change. W...

PsycEXTRA Dataset

ABSTRACT The importance of eliminating health disparities in the United States has become a top p... more ABSTRACT The importance of eliminating health disparities in the United States has become a top priority in public health efforts. Ethnic minorities have historically different experiences and access to health care services that may influence their current attitudes and health behaviors. The military provides a unique opportunity to address these important questions. Military personnel are a racially diverse sample that has universal access to quality health care thereby removing access as one of the major barriers to utilization and controlling for SES. The purpose of this study was to compare delay in treatment seeking behaviors as related to knowledge of disease among African American, Hispanic American, and Caucasian active duty enlisted personnel. Two hundred ninetyfive enlisted males personnel (X=22.86 years; SD= 4.14) from a command within the continental U.S. completed the Illness Attitudes Scale (IAS; Kellner, 1986) to measure the participant's overall health-related worries and concerns, the Knowledge of Cancer Warning Signs inventory (KCWSI; Berman & Wandersman, 1991), and a number of questions developed to evaluate diabetes knowledge. Health care rules and behaviors were also examined by a series of health care vignettes that described a pattern of symptoms for acute as well as chronic problems and the respondent indicated their typical response. Results indicated that there were no differences in knowledge of cancer (F (2, 258)=.29, p = .29) and diabetes (F (2, 272) = .19, p = .83) symptoms among the racial groups. Also, there were no differences in treatment experience in the medical setting among the racial groups (F (3, 283) = .22, p = .88). However, differences in concern about bodily symptoms were found between minorities and Caucasians, with ethnic minorities showing higher concern about bodily symptoms, worry about illnesses, and concern about dise

Background: In the absence of a successful HIV vaccine, widespread HIV testing remains the best p... more Background: In the absence of a successful HIV vaccine, widespread HIV testing remains the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis.Objective: Qualitative, semi-structured interviews were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing.Methods: Ten HIV-positive patients aged 18-64 were interviewed. Participants were asked about their HIV testing history and attitudes towards opt-out, incentivized, and mandatory anonymous HIV testing. Other ways to improve U.S. HIV testing rates were also explored. Major themes were identified using grounded theory data analysis.Results: All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. Participants still preferred providing counseling either before or after the test as a form of support. Participants were supportive of incentivized testing as a pragmatic measure to entice people to test, but felt that ideally these coercive measures shouldn't be needed to encourage individuals to look after their own health. Participants were supportive of mandatory testing with consideration for confidentiality of test results. Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. Some participants wanted testing to be mandatory but did not feel that it was a feasible testing initiative because it would never be implemented due to overwhelming resistance.Conclusion: A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially red [...]

Cancer causes & control : CCC, 2018

It is critical to accelerate the integration of evidence-based programs, practices, and strategie... more It is critical to accelerate the integration of evidence-based programs, practices, and strategies for cancer prevention and control into clinical, community, and public health settings. While it is clear that effective translation of existing knowledge into practice can reduce cancer burden, it is less clear how best to achieve this. This gap is addressed by the rapidly growing field of implementation science. Given that context influences and is influenced by implementation efforts, engaging stakeholders in the co-production of knowledge and solutions offers an opportunity to increase the likelihood that implementation efforts are useful, scalable, and sustainable in real-world settings. We argue that a participatory implementation science approach is critical, as it supports iterative, ongoing engagement between stakeholders and researchers to improve the pathway between research and practice, create system change, and address health disparities and health equity. This article hi...

Healthcare (Basel, Switzerland), Jan 5, 2018

As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chron... more As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform c...

Background: The access of immigrants to prenatal healthcare has been heavily documented because a... more Background: The access of immigrants to prenatal healthcare has been heavily documented because adequate care is key in the reduction of infant mortality and the improvement of birth outcomes. While most available research centers on the needs of Hispanic American and Asian populations, there is less information on the growing number of West African immigrants. Even though West Africans also face the discrimination, language, and financial barriers that other immigrants face, their prenatal needs have not been adequately addressed. Methods: Two phases of interviews gathered qualitative results on West African women and prenatal care. Phase 1 included interviews with community stakeholders and Phase 2 involved a focus group of West African females. Results were used for recommendations to the Nationalities Service Center of Philadelphia to enhance services to West Africans. Results: Preliminary results suggest that belief in the importance of prenatal care in both country of origin a...

Progress in Community Health Partnerships: Research, Education, and Action, 2013

One of the key principles in community-based participatory research is that it is an endeavor tha... more One of the key principles in community-based participatory research is that it is an endeavor that fully engages community members and researchers in a joint process with mutual exchange of ideas and shared work and responsibilities (Israel et al., 1998). In this dynamic interchange, there can be many challenges if both groups do not actively listen, hear, understand and respect all aspect of the work. This presentation will describe a partnership between the community and academic researchers in Philadelphia, working together on a youth violence prevention project. By achieving a balance between research and action for the community, the partnership was able to successfully offer a community-wide symposium as well as 2 youth workshops and extend its dissemination activities to over 10,000 households within 6 months, all while including research and evaluation as well as community involvement, voice, and action.

American Journal of Health Education, 2006

Ethnicity & disease

This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment p... more This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment program that promotes weight loss and exercise, among 22 Caucasian-American and 10 African-American overweight women in a university setting to 10 African-American overweight women in a church setting. Behavioral Choice Treatment (BCT) promotes moderate behavior change that can be comfortably and therefore permanently maintained. Participants obtained feedback from computerized eating diaries and kept exercise logs. Results indicated that both university groups exhibited comparable eating pathology at pre- and post-treatment and comparable weight loss, despite the African-American sample attending fewer sessions. The African-American church group exhibited less disordered eating attitudes, less interpersonal distrust (eg, reluctance to form close relationships or sense of alienation) at pre-treatment, and experienced significantly greater weight loss than either university group. All grou...

Community-based participatory research (CBPR) as an approach to empower communities and engage ac... more Community-based participatory research (CBPR) as an approach to empower communities and engage academics in meaningful collaborative work has increased in the past decade. CBPR public health projects have varied from focusing on specific diseases to intervention strategies for prevention. Two key principles of CBPR involve ensuring that co-learning is promoted and capacity is built among all partners, and that strengths and resources from the community are capitalized. Through our work with the CDC-funded Philadelphia Collaborative Violence Prevention Center (PCVPC), a community mobilization team (CMT) was developed as a fundamental component of the intervention study. Based on feedback from our community partners, team construction would be vital to the research project being received and sustained in the community. Traditional community outreach workers typically recruit research participants and disseminate information to communities. By distinction, our CMT is held to a higher l...

Background Whether or not they allow smoking in their own homes, residents of multi-unit housing ... more Background Whether or not they allow smoking in their own homes, residents of multi-unit housing are exposed to significant second hand smoke (SHS). Exposure may be greater for families living in public housing, due to higher rates of tobacco use in these communities. Since 2009, HUD has supported local public housing authorities to enact policies to reduce SHS exposure, and many PHAs are working to develop and implement smoke-free policies. In Philadelphia, formative work was conducted in partnership with the Philadelphia Housing Authority (PHA) and the Philadelphia Department of Public Health, to better understand stakeholder readiness for smoke-free public housing. Methods During 2012, we conducted in-depth interviews (n=6) with PHA staff, resident leaders and other tobacco control stakeholders and focus groups (n=2) with public housing residents, both smokers and non-smokers. Data were transcribed and analyzed to identify themes related to current tobacco use in public housing c...

The pipeline for individuals from underrepresented populations into careers in health disparities... more The pipeline for individuals from underrepresented populations into careers in health disparities research needs to be expanded (Rosenstock, et al., 2008). As noted by Riegelman, “it has become evident that undergraduates seek and appreciate public health approaches and public health courses” (2007, p. 237). This appreciation by undergraduates has not increased enrollments in graduate education related to health disparities enough to meet the growing need for health disparities researchers. Therefore, there is a need for the creation of “pipeline programs” (ASPH, 2008, p. 20). The Drexel University School of Public Health’s “Opening the Doors for Diverse Populations to Health Disparities Research” Program is focused on addressing the barriers to health disparities science education that socially, economically, and environmentally disadvantaged groups’ experience. The Opening Doors Program recruits graduate (doctoral and master’s) students in public health programs for 8-months of fa...

Issues: Although research provides a basis of information about issues and problems affecting our... more Issues: Although research provides a basis of information about issues and problems affecting our society, the knowledge and results obtained from research are not always readily available to underprivileged communities and/or translated in manners that are conducive to the community's understanding. Thus, communities are given limited opportunity to implement recommended practices derived from research studies that aim to improve the health and lifestyles of communities. Description: An examination of internal and external communications facilitated by the Communication and Dissemination (C&D) Core of the CDC-funded Philadelphia Collaborative Violence Prevention Center (PCVPC) was conducted to gain an understanding of previous and current research dissemination efforts. The analysis assisted in the development of communication strategies and tools for improving PCVPC's communication efforts and presence within the targeted communities of West and Southwest Philadelphia. Les...

The study compared the nation as a whole and fourteen regions selected for participation in the R... more The study compared the nation as a whole and fourteen regions selected for participation in the RWJF Aligning Forces for Quality initiative (Cincinnati, Cleveland, Detroit, Humboldt County, Kansas City, Maine, Memphis, Minnesota, Seattle, Willamette Valley, Western Michigan, Western New York, Wisconsin, and York County, PA). We compiled regional statistical profiles from a systematic review of all major public data sources (AHRQ, CMS, AHA, AHRQ, NCHS, HRSA, JCAHO and US Census Bureau). The CMS MEDPAR was used to develop racial comparisons of hospital outcomes (medical and surgical death rates, incidents rates of safety problems).We used the CMS/JCHO HospitalCompare consensus process indicators (AMI, Heart Failure, Pneumonia, and Surgical Infection Prevention) and computed structural disparity indicators by region weighting a summary process indicator for each hospital in a region by the proportion of white and black discharges in the region as identified in the MEDPAR. The principal...

Prolonged exposure to community violence coupled with the demands of being a community leader may... more Prolonged exposure to community violence coupled with the demands of being a community leader may increase stress and negatively impact physical and mental health. Community leaders living in high-crime, high-poverty neighborhoods often support individuals who have faced significant traumas (i.e., abuse, violence, mental illness, death), and may experience vicarious trauma. The purpose of our research was to understand how to support and build resilience in community leaders working and living in these environments, as doing so is vital for their physical and mental health, and for overall community well-being. Using a series of focus groups and pre/post survey assessments with a group of 13 community leaders from a community networking organization in Philadelphia, we identified types of stressors and coping strategies. We delivered an introductory Sanctuary Model training and worked with the leaders to develop a trauma-informed training plan for the community. Key findings of this...

Issues: Seventy-nine million adults in the United States have prediabetes. To prevent the onset o... more Issues: Seventy-nine million adults in the United States have prediabetes. To prevent the onset of type II diabetes, individuals with prediabetes are recommended to lose 5-7% of their body weight. Studies have provided evidence that dietary self-monitoring significantly improves weight loss. Current literature lacks adequate research on weight loss and dietary self-monitoring among African Americans with prediabetes. Description: The Getting People in Sync (GPS) Prediabetes Program is a 16-week a faith-placed community-based participatory research study which focuses on lifestyle behavior change. GPS aims to determine the effectiveness of social support on weight loss, while this study seeks to identify best practices for increasing dietary self-monitoring among program participants. Participants (n=86) were recruited from African Americans churches in Philadelphia across two phases. Seven-day food trackers were distributed each week and collected at weeks 2, 8, 15 and 16. Perspecti...

ABSTRACT The pipeline for individuals from underrepresented populations into careers in health di... more ABSTRACT The pipeline for individuals from underrepresented populations into careers in health disparities research needs to be expanded (Rosenstock, et al., 2008). As noted by Riegelman, “it has become evident that undergraduates seek and appreciate public health approaches and public health courses” (2007, p. 237). This appreciation by undergraduates has not increased enrollments in graduate education related to health disparities enough to meet the growing need for health disparities researchers. Therefore, there is a need for the creation of “pipeline programs” (ASPH, 2008, p. 20). The Drexel University School of Public Health’s “Opening the Doors for Diverse Populations to Health Disparities Research” Program is focused on addressing the barriers to health disparities science education that socially, economically, and environmentally disadvantaged groups’ experience. The Opening Doors Program recruits graduate (doctoral and master’s) students in public health programs for 8-months of faculty-mentored research, and undergraduate (juniors and seniors) and medical school students for 10-weeks of faculty-mentored research. All students take part in professional development seminars and ethical/responsible research seminars.Current and ongoing research exploring health disparities among the African-American population has specifically sought to engage faith-based organizations in the implementation of public health interventions. Students work with faith-based organizations to address the disparate impact of pre-diabetes on the African-American population. Using community-based participatory research methods, students work in collaboration with faith leaders to disseminate health promotion and education programs to promote healthy lifestyles, weight loss and reduce risk for chronic disease among African-Americans recruited from Philadelphia’s faith community in two public health interventions.

International Journal of Health Sciences, 2015

Background: Currently, widespread HIV testing is the best preventive action against further sprea... more Background: Currently, widespread HIV testing is the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV and 25% of those with HIV have never been tested. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis. Methods: Qualitative, semi-structured interviews with ten seropositive patients and ten seronegative were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing. Participants were asked about their HIV testing history and attitudes towards optout, incentivized, and mandatory anonymous HIV testing. Results: Major themes were identified using grounded theory data analysis. All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. Conclusion: Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially reduce HIV infection rates.

Type 2 diabetes affects 16 million Americans and disproportionately affects ethnic minorities. Sp... more Type 2 diabetes affects 16 million Americans and disproportionately affects ethnic minorities. Specifically, African American and Hispanics are twice as likely to have Type 2 diabetes compared to their Caucasian counterparts. The impact of this disparity goes beyond the greater prevalence of the disease and includes greater morbidity and mortality. The recent Institute of Medicine (IOM) report documents racial and ethnic disparities in the treatment for many different medical conditions, including diabetes. Understanding and combating health disparities among minority groups is a national priority. Many researchers have focused on socioeconomic status (SES) as the main cause in health disparities. Much of the research over the past two decades has examined the impact of health outcomes among the uninsured and much of this research has found that insured individuals have better health outcomes than those without insurance. In order to begin to unravel the myriad of factors that contr...

Issue: There is a dearth of research on the relationship between shopping habits and the impact i... more Issue: There is a dearth of research on the relationship between shopping habits and the impact it has on weight loss behavior among African Americans, particularly in urban settings. The lack of access to healthy and affordable food options in urban areas has been well studied and continues to be a barrier towards attaining and maintaining a healthy lifestyle. Background: Although many interventions promoting healthy lifestyle change exist, many do not discuss how weight loss may be affected by food accessibility for participants. The Getting People in Sync program (GPS) is a 16-week pre-diabetes prevention program that aims to promote healthy lifestyle change through the use of the Project NOT ME video series. Methods: Participants were administered a brief shopping habits survey assessing barriers (e.g., cost, variety of food retailers, accessibility) facilitators, (e.g., couponing, proximity, public assistance) and the overall impact it has on an individual’s lifestyle change. W...

PsycEXTRA Dataset

ABSTRACT The importance of eliminating health disparities in the United States has become a top p... more ABSTRACT The importance of eliminating health disparities in the United States has become a top priority in public health efforts. Ethnic minorities have historically different experiences and access to health care services that may influence their current attitudes and health behaviors. The military provides a unique opportunity to address these important questions. Military personnel are a racially diverse sample that has universal access to quality health care thereby removing access as one of the major barriers to utilization and controlling for SES. The purpose of this study was to compare delay in treatment seeking behaviors as related to knowledge of disease among African American, Hispanic American, and Caucasian active duty enlisted personnel. Two hundred ninetyfive enlisted males personnel (X=22.86 years; SD= 4.14) from a command within the continental U.S. completed the Illness Attitudes Scale (IAS; Kellner, 1986) to measure the participant's overall health-related worries and concerns, the Knowledge of Cancer Warning Signs inventory (KCWSI; Berman & Wandersman, 1991), and a number of questions developed to evaluate diabetes knowledge. Health care rules and behaviors were also examined by a series of health care vignettes that described a pattern of symptoms for acute as well as chronic problems and the respondent indicated their typical response. Results indicated that there were no differences in knowledge of cancer (F (2, 258)=.29, p = .29) and diabetes (F (2, 272) = .19, p = .83) symptoms among the racial groups. Also, there were no differences in treatment experience in the medical setting among the racial groups (F (3, 283) = .22, p = .88). However, differences in concern about bodily symptoms were found between minorities and Caucasians, with ethnic minorities showing higher concern about bodily symptoms, worry about illnesses, and concern about dise

Background: In the absence of a successful HIV vaccine, widespread HIV testing remains the best p... more Background: In the absence of a successful HIV vaccine, widespread HIV testing remains the best preventive action against further spread of the HIV epidemic. However, over 40% of the U.S. population has never been tested for HIV. To increase testing rates, in 2006 the CDC advised healthcare settings to conduct testing on an opt-out basis.Objective: Qualitative, semi-structured interviews were conducted to address the lack of studies investigating patients' acceptance of and attitude towards this and more novel testing models, e.g. incentivized or anonymous mandatory testing.Methods: Ten HIV-positive patients aged 18-64 were interviewed. Participants were asked about their HIV testing history and attitudes towards opt-out, incentivized, and mandatory anonymous HIV testing. Other ways to improve U.S. HIV testing rates were also explored. Major themes were identified using grounded theory data analysis.Results: All participants were receptive to opt-out testing, and saw the removal of separate written consent as beneficial as long as patients were given the opportunity to consent in some form. Participants still preferred providing counseling either before or after the test as a form of support. Participants were supportive of incentivized testing as a pragmatic measure to entice people to test, but felt that ideally these coercive measures shouldn't be needed to encourage individuals to look after their own health. Participants were supportive of mandatory testing with consideration for confidentiality of test results. Ultimately, both mandatory and opt-out testing were equally indicated by participants as being the most effective testing model at increasing testing rates. Some participants wanted testing to be mandatory but did not feel that it was a feasible testing initiative because it would never be implemented due to overwhelming resistance.Conclusion: A firm understanding of patients' perspectives allows for development of effective HIV testing initiatives that are patient-sensitive and can substantially red [...]

Cancer causes & control : CCC, 2018

It is critical to accelerate the integration of evidence-based programs, practices, and strategie... more It is critical to accelerate the integration of evidence-based programs, practices, and strategies for cancer prevention and control into clinical, community, and public health settings. While it is clear that effective translation of existing knowledge into practice can reduce cancer burden, it is less clear how best to achieve this. This gap is addressed by the rapidly growing field of implementation science. Given that context influences and is influenced by implementation efforts, engaging stakeholders in the co-production of knowledge and solutions offers an opportunity to increase the likelihood that implementation efforts are useful, scalable, and sustainable in real-world settings. We argue that a participatory implementation science approach is critical, as it supports iterative, ongoing engagement between stakeholders and researchers to improve the pathway between research and practice, create system change, and address health disparities and health equity. This article hi...

Healthcare (Basel, Switzerland), Jan 5, 2018

As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chron... more As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform c...

Background: The access of immigrants to prenatal healthcare has been heavily documented because a... more Background: The access of immigrants to prenatal healthcare has been heavily documented because adequate care is key in the reduction of infant mortality and the improvement of birth outcomes. While most available research centers on the needs of Hispanic American and Asian populations, there is less information on the growing number of West African immigrants. Even though West Africans also face the discrimination, language, and financial barriers that other immigrants face, their prenatal needs have not been adequately addressed. Methods: Two phases of interviews gathered qualitative results on West African women and prenatal care. Phase 1 included interviews with community stakeholders and Phase 2 involved a focus group of West African females. Results were used for recommendations to the Nationalities Service Center of Philadelphia to enhance services to West Africans. Results: Preliminary results suggest that belief in the importance of prenatal care in both country of origin a...

Progress in Community Health Partnerships: Research, Education, and Action, 2013

One of the key principles in community-based participatory research is that it is an endeavor tha... more One of the key principles in community-based participatory research is that it is an endeavor that fully engages community members and researchers in a joint process with mutual exchange of ideas and shared work and responsibilities (Israel et al., 1998). In this dynamic interchange, there can be many challenges if both groups do not actively listen, hear, understand and respect all aspect of the work. This presentation will describe a partnership between the community and academic researchers in Philadelphia, working together on a youth violence prevention project. By achieving a balance between research and action for the community, the partnership was able to successfully offer a community-wide symposium as well as 2 youth workshops and extend its dissemination activities to over 10,000 households within 6 months, all while including research and evaluation as well as community involvement, voice, and action.

American Journal of Health Education, 2006

Ethnicity & disease

This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment p... more This study compared adherence to Behavioral Choice Treatment (BCT), a 12-week obesity treatment program that promotes weight loss and exercise, among 22 Caucasian-American and 10 African-American overweight women in a university setting to 10 African-American overweight women in a church setting. Behavioral Choice Treatment (BCT) promotes moderate behavior change that can be comfortably and therefore permanently maintained. Participants obtained feedback from computerized eating diaries and kept exercise logs. Results indicated that both university groups exhibited comparable eating pathology at pre- and post-treatment and comparable weight loss, despite the African-American sample attending fewer sessions. The African-American church group exhibited less disordered eating attitudes, less interpersonal distrust (eg, reluctance to form close relationships or sense of alienation) at pre-treatment, and experienced significantly greater weight loss than either university group. All grou...

Community-based participatory research (CBPR) as an approach to empower communities and engage ac... more Community-based participatory research (CBPR) as an approach to empower communities and engage academics in meaningful collaborative work has increased in the past decade. CBPR public health projects have varied from focusing on specific diseases to intervention strategies for prevention. Two key principles of CBPR involve ensuring that co-learning is promoted and capacity is built among all partners, and that strengths and resources from the community are capitalized. Through our work with the CDC-funded Philadelphia Collaborative Violence Prevention Center (PCVPC), a community mobilization team (CMT) was developed as a fundamental component of the intervention study. Based on feedback from our community partners, team construction would be vital to the research project being received and sustained in the community. Traditional community outreach workers typically recruit research participants and disseminate information to communities. By distinction, our CMT is held to a higher l...

Background Whether or not they allow smoking in their own homes, residents of multi-unit housing ... more Background Whether or not they allow smoking in their own homes, residents of multi-unit housing are exposed to significant second hand smoke (SHS). Exposure may be greater for families living in public housing, due to higher rates of tobacco use in these communities. Since 2009, HUD has supported local public housing authorities to enact policies to reduce SHS exposure, and many PHAs are working to develop and implement smoke-free policies. In Philadelphia, formative work was conducted in partnership with the Philadelphia Housing Authority (PHA) and the Philadelphia Department of Public Health, to better understand stakeholder readiness for smoke-free public housing. Methods During 2012, we conducted in-depth interviews (n=6) with PHA staff, resident leaders and other tobacco control stakeholders and focus groups (n=2) with public housing residents, both smokers and non-smokers. Data were transcribed and analyzed to identify themes related to current tobacco use in public housing c...

The pipeline for individuals from underrepresented populations into careers in health disparities... more The pipeline for individuals from underrepresented populations into careers in health disparities research needs to be expanded (Rosenstock, et al., 2008). As noted by Riegelman, “it has become evident that undergraduates seek and appreciate public health approaches and public health courses” (2007, p. 237). This appreciation by undergraduates has not increased enrollments in graduate education related to health disparities enough to meet the growing need for health disparities researchers. Therefore, there is a need for the creation of “pipeline programs” (ASPH, 2008, p. 20). The Drexel University School of Public Health’s “Opening the Doors for Diverse Populations to Health Disparities Research” Program is focused on addressing the barriers to health disparities science education that socially, economically, and environmentally disadvantaged groups’ experience. The Opening Doors Program recruits graduate (doctoral and master’s) students in public health programs for 8-months of fa...

Issues: Although research provides a basis of information about issues and problems affecting our... more Issues: Although research provides a basis of information about issues and problems affecting our society, the knowledge and results obtained from research are not always readily available to underprivileged communities and/or translated in manners that are conducive to the community's understanding. Thus, communities are given limited opportunity to implement recommended practices derived from research studies that aim to improve the health and lifestyles of communities. Description: An examination of internal and external communications facilitated by the Communication and Dissemination (C&D) Core of the CDC-funded Philadelphia Collaborative Violence Prevention Center (PCVPC) was conducted to gain an understanding of previous and current research dissemination efforts. The analysis assisted in the development of communication strategies and tools for improving PCVPC's communication efforts and presence within the targeted communities of West and Southwest Philadelphia. Les...

The study compared the nation as a whole and fourteen regions selected for participation in the R... more The study compared the nation as a whole and fourteen regions selected for participation in the RWJF Aligning Forces for Quality initiative (Cincinnati, Cleveland, Detroit, Humboldt County, Kansas City, Maine, Memphis, Minnesota, Seattle, Willamette Valley, Western Michigan, Western New York, Wisconsin, and York County, PA). We compiled regional statistical profiles from a systematic review of all major public data sources (AHRQ, CMS, AHA, AHRQ, NCHS, HRSA, JCAHO and US Census Bureau). The CMS MEDPAR was used to develop racial comparisons of hospital outcomes (medical and surgical death rates, incidents rates of safety problems).We used the CMS/JCHO HospitalCompare consensus process indicators (AMI, Heart Failure, Pneumonia, and Surgical Infection Prevention) and computed structural disparity indicators by region weighting a summary process indicator for each hospital in a region by the proportion of white and black discharges in the region as identified in the MEDPAR. The principal...

Prolonged exposure to community violence coupled with the demands of being a community leader may... more Prolonged exposure to community violence coupled with the demands of being a community leader may increase stress and negatively impact physical and mental health. Community leaders living in high-crime, high-poverty neighborhoods often support individuals who have faced significant traumas (i.e., abuse, violence, mental illness, death), and may experience vicarious trauma. The purpose of our research was to understand how to support and build resilience in community leaders working and living in these environments, as doing so is vital for their physical and mental health, and for overall community well-being. Using a series of focus groups and pre/post survey assessments with a group of 13 community leaders from a community networking organization in Philadelphia, we identified types of stressors and coping strategies. We delivered an introductory Sanctuary Model training and worked with the leaders to develop a trauma-informed training plan for the community. Key findings of this...

Issues: Seventy-nine million adults in the United States have prediabetes. To prevent the onset o... more Issues: Seventy-nine million adults in the United States have prediabetes. To prevent the onset of type II diabetes, individuals with prediabetes are recommended to lose 5-7% of their body weight. Studies have provided evidence that dietary self-monitoring significantly improves weight loss. Current literature lacks adequate research on weight loss and dietary self-monitoring among African Americans with prediabetes. Description: The Getting People in Sync (GPS) Prediabetes Program is a 16-week a faith-placed community-based participatory research study which focuses on lifestyle behavior change. GPS aims to determine the effectiveness of social support on weight loss, while this study seeks to identify best practices for increasing dietary self-monitoring among program participants. Participants (n=86) were recruited from African Americans churches in Philadelphia across two phases. Seven-day food trackers were distributed each week and collected at weeks 2, 8, 15 and 16. Perspecti...