Sharon D Morrison | University of North Carolina at Greensboro (original) (raw)
Papers by Sharon D Morrison
Journal of Exposure Science & Environmental Epidemiology, 2021
In 2015 alone, community water systems serving about 21 million Americans violated the United Sta... more In 2015 alone, community water systems serving about 21 million Americans violated the United States Environmental Protection Agency’s (US-EPA) water quality standards. While water at community treatment and distribution centers is regularly monitored and tested, little is known about pollutants in the water systems at the household level. This pilot study assessed the feasibility of (1) testing for the presence and concentration of 14 contaminants and physicochemical parameters in household tap water in a low-income neighborhood and (2) using community engagement for recruitment and citizen science approaches to data collection. We used a multistage approach that included geo-mapping to delineate testing sites, community engagement for recruitment and citizen science approaches to increase the response rate. We used a 14-in-one dipstick test designed to measure trace amounts of heavy metals, non-metallic elements, and physicochemical water properties in drinking water in a sample of 70 homes. In 50%, 25%, and 7% of water samples tested, the concentration of mercury, lead, and chromium, respectively, were higher than US-EPA drinking water standards. Citizen science approaches were effective for increasing response rates and low-income household participation in water quality testing. The overlap between poverty, older homes, and high concentrations of potentially toxic metals in drinking water presents concerns for community health. Our pilot community engagement and citizen science approaches are likely scalable and would be of benefit to both the scientific community and to municipalities with constrained budgets. Future studies may examine the role of the principles of environmental justice in the distribution and prevalence of toxic elements in drinking water.
Progress in community health partnerships : research, education, and action, 2018
Montagnard refugees, an indigenous multilingual tribal people from Vietnam, experience lifestyle ... more Montagnard refugees, an indigenous multilingual tribal people from Vietnam, experience lifestyle changes and post-resettlement challenges in the United States that contribute to chronic health conditions. Foundational research and health data are lacking. We describe the Montagnard Hypertension Study, a community-based participatory research (CBPR) project documenting chronic disease risk. We developed a Montagnard dictionary of hypertension-specific terminology and conducted two focus group discussions (FGD), 131 biological assessments (blood pressure, height, weight, waist circumference, scalp hair and saliva sample collection), and 127 behavioral surveys. We implemented two health fairs that offered services to the community. This is the first study to examine chronic disease using a CBPR framework for Montagnard health. We highlight lessons learned specific to constituents and their capacities, historical and current conflicts, and the iterative processes in CBPR design. CBPR is...
American Journal of Health Behavior, 2017
Objectives: Studies indicate a higher rate of HIV infection among Latinos in the United States, a... more Objectives: Studies indicate a higher rate of HIV infection among Latinos in the United States, and a pattern of later testing associated with poorer disease management, greater risk of spreading infection, and higher death rates. Thus, it is imperative to generate culturally holistic strategies to improve HIV testing among Latina women. Methods: We surveyed 182 Latina women in the southeastern US. We cross-tabulated demographic, social, and experiential factors of women who have taken a previous HIV test with women who have not yet been tested. We examined key comparisons between these women in terms of socio-demographic characteristics, sources of information about HIV testing, and responses to questions that identify factors enabling women to take an HIV test. Results: Our results indicate that Latina women perceive HIV testing as worthwhile, beneficial, and a priority for them. They demonstrate the importance of family networks, trusted and bilingual service providers, and known test locations associated with higher percentages of women taking the HIV test. Conclusions: The results provide input to community health advocates to identify women who need additional support to take an HIV test.
Pedagogy in Health Promotion, 2016
With the proportions and numbers of older adults increasing rapidly in the United States and worl... more With the proportions and numbers of older adults increasing rapidly in the United States and worldwide, there is acute need for professionals with “gero-competency” and “gero-interest” in the spectrum of health and human service fields. We examine whether adding on gerontology content to an existing international health-focused service learning course would suffice to spark interest in gerontology and gero-focused careers among Master’s in Public Health students in Community Health Education. Currently, comparatively few graduate programs in public health education in the United States offer aging concentrations. We thus explore this alternative strategy. We used case study methodology to guide our assessment, which included content and thematic analyses of “artifacts of learning” and transcripts of in-depth interviews with five graduate students. Despite little prior exposure to gerontology and limited preparation with gerontology content, the students were able to competently anal...
AIDS education and prevention : official publication of the International Society for AIDS Education, Aug 1, 2016
This study aims to identify enablers or facilitators of HIV testing among Latina immigrant women ... more This study aims to identify enablers or facilitators of HIV testing among Latina immigrant women through qualitative interviews with five community health advocates (CHAs). CHAs act as cultural bridges between Latinos and service providers. We employed a single case-study design using the PEN-3 model as a conceptual framework for situating HIV testing behaviors within cultural and structural contexts of Latina immigrant women's lives. A cross-case analysis of themes revealed that intrinsic enablers of HIV testing included individual trust, confidentiality, intergenerational family participation, and peers. The extrinsic enablers were local community outreach, bicultural/bilingual testing staff, service location and mass media outlets. These results have implications for the cultural competency of health and social service providers, instituting and revising HIV testing outreach interventions, and the earlier identification of women who may have been infected. They offer importan...
Journal of Health Care for the Poor and Underserved, 2016
The goals of the United States' National HIV/ AIDS Strategy are reducing HIV infections, increasi... more The goals of the United States' National HIV/ AIDS Strategy are reducing HIV infections, increasing linkage to care, and reducing health disparities. To accomplish these, it is imperative to have accurate data about HIV prevalence, especially in high-burden populations, including immigrants, ethnic/ racial minorities and other minority populations. However, recent increases in HIV prevalence among Black migrants from sub-Saharan Africa has drawn attention to the need to examine the epidemiological diversity of the Black population, and accurately account for HIV prevalence within it. In most HIV surveillance data, a single category, Black/ African American, is used to combine data for U.S.-born and foreign-born Blacks, including migrants from sub-Saharan Africa. Such categorizations result in underestimation of HIV prevalence in the African immigrant population, making it difficult to allocate resources appropriately for HIV prevention and treatment. This paper highlights and provides recommendations regarding the importance of disaggregating HIV surveillance data on Blacks by country of birth.
Hispanic health care international : the official journal of the National Association of Hispanic Nurses, 2015
This article describes the procedures used to determine the conceptual adequacy and cultural appr... more This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, comfort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population.
apha.confex.com
Trends in early childcare and development indicate that young children of immigrant households ar... more Trends in early childcare and development indicate that young children of immigrant households are less likely to be represented in quality programs designed to enhance child health and well-being. This puts these immigrant children at risk for poor educational and ...
Journal of Nutrition Education and Behavior, 2012
Intervention: The Collaboration for Health, Activity, and Nutrition in Children's Environments (C... more Intervention: The Collaboration for Health, Activity, and Nutrition in Children's Environments (CHANCE) called on NEs and supervisors to engage with local partners to influence children's environments, shifting the direct education paradigm to include socioecological. Outcome Measures and Analysis: Process evaluation documented activities, relationships, successes, and challenges. Thematic qualitative analysis of structured reports, observations, minutes, and evaluations of meetings complemented assessment of staff self-efficacy. Results: CHANCE staff expanded their roles effectively. Small, achievable steps facilitated individual and organizational success. Dedicated staff time increased buy-in and development of collaborative partnerships. Agency-level changes included increased healthy food availability, time and equipment for physical activity, and social support for healthy changes in microenvironments. Community results included promoting increased access to low-fat milk and active play opportunities, provision of small scholarships for agency changes, and training for partners engaged in making healthy choices easier in communities. NEs reported increased professionalism; supervisors reported expanded skills in partnership development. Conclusions and Implications: With skill development, dedicated time, and small amounts of unrestricted funds, staff can develop strong partnerships and make multiple, sustainable changes to community environments. Funding: Expanded Food and Nutrition Education Program.
Journal of Immigrant and Minority Health, 2014
Objectives of this study: (1) Examine food insecurity (FI) prevalence and its relationship with s... more Objectives of this study: (1) Examine food insecurity (FI) prevalence and its relationship with sociodemographic and pre-resettlement characteristics; (2) Investigate differences in amount of money spent on food/month by food security status and socio-demographic characteristics. A pilot study with semi-structured in-home interviews was conducted with Liberian caregivers (n = 33). FI was indicated in 61 % of households. FI was higher among women >40, had ≤ high school education and those making ≤$1,000/month. Women arriving in US >15 years of age were more likely to be food insecure. Participants spent an average $109/month on groceries/member. Food insecure women, and those without a car spent more money on food (P < .10). Liberian women in this sample experience high levels of FI upon resettlement. Besides poor economic conditions, pre-resettlement characteristics were associated with food security status. These findings call for future research to understand how preresettlement conditions affect food choices, budgeting and thereby food security status.
Journal of Hunger & Environmental Nutrition, 2013
Ecology of Food and Nutrition, 2009
This study aimed to explore Mexican dietary acculturation patterns among immigrants using a uniqu... more This study aimed to explore Mexican dietary acculturation patterns among immigrants using a unique transnational photographic assessment. Participants (N = 10) were Latino mother and child pairs living in Mexico (1 pair) and in the United States (4 pairs). Data were collected in 2 phases: 1) participant observation and photography in Mexico, and 2) in-depth interviewing using photographic guides in North Carolina. Environment, daily activity patterns, shopping, and dietary patterns in Mexico were all documented. Acculturation resulted in poor dietary intake due to decreased availability, food displacement, and cost. Decreases in physical activity due to environmental and social barriers were also reported.
Using the PEN-3 model as a conceptual framework this study described and determined relationships... more Using the PEN-3 model as a conceptual framework this study described and determined relationships among AIDS-related knowledge beliefs and sex behavior of young adults in rural Jamaica and explored AIDS-related community perceptions and selected community enablers. Data were gathered from a survey of 58 youth aged 18-24 and from an ethnographic study that sampled 10 survey respondents and seven community leaders. Participant observation was conducted at points of condom acquisition and youth group sessions. Statistical analysis revealed that 1) the youth were knowledgeable about HIV transmission AIDS and self-protective actions; 2) they predominantly participated in vaginal sex; 3) there was no significant relationship among knowledge beliefs and the practice of safe sex; 4) neither gender nor prior STD experience was significantly related to the practice of safe sex; 5) knowledge about HIV transmission was weakly but positively related to knowledge about AIDS; 6) reasons for unsafe sex included misconceptions about disease etiology conflicting cultural values risk denial and partner pressures trust and partner significance accusations of promiscuity lack of community endorsement of protective measures and barriers to condom access. In addition socioeconomic pressures psychosocial issues poor community participation and attitudes and low educational levels limited the effectiveness of existing HIV/AIDS prevention education. While high levels of AIDS knowledge and the wide availability of condoms in the community were positive factors the lack of condom use and poor community participation threatened the success of HIV/AIDS prevention initiatives. (full text modified)
This article describes the procedures used to determine the conceptual adequacy and cultural appr... more This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, com-fort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population
The University of North Carolina at Greensboro, 2021
This report documents needs of refugee older adults in the Greensboro metropolitan area of North ... more This report documents needs of refugee older adults in the Greensboro metropolitan area of North Carolina, as exemplified by two communities: Nepali-speaking Bhutanese and Congolese. We describe the demographics of refugee populations in North Carolina and Greensboro. We draw attention to the fact that although refugee streams are in general younger in age, older refugees do exist in appreciable numbers, and their specific needs must be recognized and provided for. This is the first such report for the state of North Carolina.
Health Equity, 2021
Purpose: Community health workers (CHWs) are trusted community leaders and public health workers ... more Purpose: Community health workers (CHWs) are trusted community leaders and public health workers dedicated to promoting the health and well-being of community members. CHWs, who share similar language and culture, work with refugee communities that are often missed in traditional U.S. health systems. CHWs help refugees gain access to health care through culturally appropriate strategies. However, the scope of their study as cultural brokers with regard to refugee health access is largely unknown in the peer-reviewed literature. This qualitative research study used a constructivist grounded approach to examine the extent to which CHWs helped refugee clients gain access to the health care system. Methods: Data were collected through interviews with a purposeful sample of 10 CHW participants affiliated with a primary care access program in Greensboro, North Carolina. Results: The diagram derived from this study provided a schema that allowed for an improved understanding of CHW perspectives and experiences when connecting refugee clients to the health care system. Conclusions: Further research incorporating CHW voices is recommended because CHWs are instrumental in improving the health and well-being of refugees.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2021
The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, a... more The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, as far as getting treatment facilities are concerned. The crisis is more intense in developing countries where the health system is more vulnerable due to poor infrastructures and insufficient health professionals. Bangladesh, being a developing nation, is also facing similar challenges to provide sufficient services to patients with chronic kidney disease. In this short report, we have discussed the challenges and barriers non-COVID chronic kidney disease patients are facing in terms of healthcare access along with getting proper medical interventions and suggested probable strategies to minimize the suffering.
Medical Research Archives, 2020
Comprising 18% of the total population in the United States, Latinos are one of the fastest growi... more Comprising 18% of the total population in the United States, Latinos are one of the fastest growing minority groups in the country and an important demographic group for our public health efforts. In the current socioeconomic and political climate, the development of resources and health education materials tailored to specific cultural groups is urgently needed. To be effective, these materials must acknowledge the role of history, social and physical environment, cultural and economic conditions, migration history, and politics as key determinants of health and well-being. This article describes the development of Nuestros Cuerpos, Nuestras Vidas, the Spanish-language translation and cultural adaptation of the classic women's health book Our Bodies, Ourselves, and the companion Spanish-language training guide for community health workers (Guía de Capacitación para Promotoras de Salud). Further, it examines the relevance of these health education materials to our current sociopolitical and historical moment. The Spanishlanguage and cultural adaptation process of Our Bodies, Ourselves is predicated on the social determinants and the cultural models of health. Both represent strong approaches that promote health and well-being in the midst of the current dramatic social change that adversely and disproportionately impacts the health of US minority groups.
Reflective Practice, 2020
Reflexivity, an important component of qualitative inquiry generally, gains additional significan... more Reflexivity, an important component of qualitative inquiry generally, gains additional significance in community-based participatory research (CBPR). The varying partnerships among researchers, community partners, and community members are strengthened when a colearning, reflective model is applied. The use of reflective field notes can be a powerful tool to help achieve this end. In this article, we describe the dynamics of community-engaged research team where members applied a co-learning model to reflect upon their positionality in the community and in research. Using reflective field notes examined through a narrative approach to the PI's time in the field, we assess these positionalities through the relationships between CBPR work and power relations. The reflective practice embedded in the CBPR process brought these power relations to our attention. We then turned to the literature on power relations to better understand what was occurring in the study. The current case details the additional complexity that occurs when issues of language, translation, gender, and culture are introduced. Thus, this paper is a reflective analysis of a bilingual researcher's experience in the field specific to cross-cultural CBPR work.
North Carolina Medical Journal, 2019
Journal of Exposure Science & Environmental Epidemiology, 2021
In 2015 alone, community water systems serving about 21 million Americans violated the United Sta... more In 2015 alone, community water systems serving about 21 million Americans violated the United States Environmental Protection Agency’s (US-EPA) water quality standards. While water at community treatment and distribution centers is regularly monitored and tested, little is known about pollutants in the water systems at the household level. This pilot study assessed the feasibility of (1) testing for the presence and concentration of 14 contaminants and physicochemical parameters in household tap water in a low-income neighborhood and (2) using community engagement for recruitment and citizen science approaches to data collection. We used a multistage approach that included geo-mapping to delineate testing sites, community engagement for recruitment and citizen science approaches to increase the response rate. We used a 14-in-one dipstick test designed to measure trace amounts of heavy metals, non-metallic elements, and physicochemical water properties in drinking water in a sample of 70 homes. In 50%, 25%, and 7% of water samples tested, the concentration of mercury, lead, and chromium, respectively, were higher than US-EPA drinking water standards. Citizen science approaches were effective for increasing response rates and low-income household participation in water quality testing. The overlap between poverty, older homes, and high concentrations of potentially toxic metals in drinking water presents concerns for community health. Our pilot community engagement and citizen science approaches are likely scalable and would be of benefit to both the scientific community and to municipalities with constrained budgets. Future studies may examine the role of the principles of environmental justice in the distribution and prevalence of toxic elements in drinking water.
Progress in community health partnerships : research, education, and action, 2018
Montagnard refugees, an indigenous multilingual tribal people from Vietnam, experience lifestyle ... more Montagnard refugees, an indigenous multilingual tribal people from Vietnam, experience lifestyle changes and post-resettlement challenges in the United States that contribute to chronic health conditions. Foundational research and health data are lacking. We describe the Montagnard Hypertension Study, a community-based participatory research (CBPR) project documenting chronic disease risk. We developed a Montagnard dictionary of hypertension-specific terminology and conducted two focus group discussions (FGD), 131 biological assessments (blood pressure, height, weight, waist circumference, scalp hair and saliva sample collection), and 127 behavioral surveys. We implemented two health fairs that offered services to the community. This is the first study to examine chronic disease using a CBPR framework for Montagnard health. We highlight lessons learned specific to constituents and their capacities, historical and current conflicts, and the iterative processes in CBPR design. CBPR is...
American Journal of Health Behavior, 2017
Objectives: Studies indicate a higher rate of HIV infection among Latinos in the United States, a... more Objectives: Studies indicate a higher rate of HIV infection among Latinos in the United States, and a pattern of later testing associated with poorer disease management, greater risk of spreading infection, and higher death rates. Thus, it is imperative to generate culturally holistic strategies to improve HIV testing among Latina women. Methods: We surveyed 182 Latina women in the southeastern US. We cross-tabulated demographic, social, and experiential factors of women who have taken a previous HIV test with women who have not yet been tested. We examined key comparisons between these women in terms of socio-demographic characteristics, sources of information about HIV testing, and responses to questions that identify factors enabling women to take an HIV test. Results: Our results indicate that Latina women perceive HIV testing as worthwhile, beneficial, and a priority for them. They demonstrate the importance of family networks, trusted and bilingual service providers, and known test locations associated with higher percentages of women taking the HIV test. Conclusions: The results provide input to community health advocates to identify women who need additional support to take an HIV test.
Pedagogy in Health Promotion, 2016
With the proportions and numbers of older adults increasing rapidly in the United States and worl... more With the proportions and numbers of older adults increasing rapidly in the United States and worldwide, there is acute need for professionals with “gero-competency” and “gero-interest” in the spectrum of health and human service fields. We examine whether adding on gerontology content to an existing international health-focused service learning course would suffice to spark interest in gerontology and gero-focused careers among Master’s in Public Health students in Community Health Education. Currently, comparatively few graduate programs in public health education in the United States offer aging concentrations. We thus explore this alternative strategy. We used case study methodology to guide our assessment, which included content and thematic analyses of “artifacts of learning” and transcripts of in-depth interviews with five graduate students. Despite little prior exposure to gerontology and limited preparation with gerontology content, the students were able to competently anal...
AIDS education and prevention : official publication of the International Society for AIDS Education, Aug 1, 2016
This study aims to identify enablers or facilitators of HIV testing among Latina immigrant women ... more This study aims to identify enablers or facilitators of HIV testing among Latina immigrant women through qualitative interviews with five community health advocates (CHAs). CHAs act as cultural bridges between Latinos and service providers. We employed a single case-study design using the PEN-3 model as a conceptual framework for situating HIV testing behaviors within cultural and structural contexts of Latina immigrant women's lives. A cross-case analysis of themes revealed that intrinsic enablers of HIV testing included individual trust, confidentiality, intergenerational family participation, and peers. The extrinsic enablers were local community outreach, bicultural/bilingual testing staff, service location and mass media outlets. These results have implications for the cultural competency of health and social service providers, instituting and revising HIV testing outreach interventions, and the earlier identification of women who may have been infected. They offer importan...
Journal of Health Care for the Poor and Underserved, 2016
The goals of the United States' National HIV/ AIDS Strategy are reducing HIV infections, increasi... more The goals of the United States' National HIV/ AIDS Strategy are reducing HIV infections, increasing linkage to care, and reducing health disparities. To accomplish these, it is imperative to have accurate data about HIV prevalence, especially in high-burden populations, including immigrants, ethnic/ racial minorities and other minority populations. However, recent increases in HIV prevalence among Black migrants from sub-Saharan Africa has drawn attention to the need to examine the epidemiological diversity of the Black population, and accurately account for HIV prevalence within it. In most HIV surveillance data, a single category, Black/ African American, is used to combine data for U.S.-born and foreign-born Blacks, including migrants from sub-Saharan Africa. Such categorizations result in underestimation of HIV prevalence in the African immigrant population, making it difficult to allocate resources appropriately for HIV prevention and treatment. This paper highlights and provides recommendations regarding the importance of disaggregating HIV surveillance data on Blacks by country of birth.
Hispanic health care international : the official journal of the National Association of Hispanic Nurses, 2015
This article describes the procedures used to determine the conceptual adequacy and cultural appr... more This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, comfort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population.
apha.confex.com
Trends in early childcare and development indicate that young children of immigrant households ar... more Trends in early childcare and development indicate that young children of immigrant households are less likely to be represented in quality programs designed to enhance child health and well-being. This puts these immigrant children at risk for poor educational and ...
Journal of Nutrition Education and Behavior, 2012
Intervention: The Collaboration for Health, Activity, and Nutrition in Children's Environments (C... more Intervention: The Collaboration for Health, Activity, and Nutrition in Children's Environments (CHANCE) called on NEs and supervisors to engage with local partners to influence children's environments, shifting the direct education paradigm to include socioecological. Outcome Measures and Analysis: Process evaluation documented activities, relationships, successes, and challenges. Thematic qualitative analysis of structured reports, observations, minutes, and evaluations of meetings complemented assessment of staff self-efficacy. Results: CHANCE staff expanded their roles effectively. Small, achievable steps facilitated individual and organizational success. Dedicated staff time increased buy-in and development of collaborative partnerships. Agency-level changes included increased healthy food availability, time and equipment for physical activity, and social support for healthy changes in microenvironments. Community results included promoting increased access to low-fat milk and active play opportunities, provision of small scholarships for agency changes, and training for partners engaged in making healthy choices easier in communities. NEs reported increased professionalism; supervisors reported expanded skills in partnership development. Conclusions and Implications: With skill development, dedicated time, and small amounts of unrestricted funds, staff can develop strong partnerships and make multiple, sustainable changes to community environments. Funding: Expanded Food and Nutrition Education Program.
Journal of Immigrant and Minority Health, 2014
Objectives of this study: (1) Examine food insecurity (FI) prevalence and its relationship with s... more Objectives of this study: (1) Examine food insecurity (FI) prevalence and its relationship with sociodemographic and pre-resettlement characteristics; (2) Investigate differences in amount of money spent on food/month by food security status and socio-demographic characteristics. A pilot study with semi-structured in-home interviews was conducted with Liberian caregivers (n = 33). FI was indicated in 61 % of households. FI was higher among women >40, had ≤ high school education and those making ≤$1,000/month. Women arriving in US >15 years of age were more likely to be food insecure. Participants spent an average $109/month on groceries/member. Food insecure women, and those without a car spent more money on food (P < .10). Liberian women in this sample experience high levels of FI upon resettlement. Besides poor economic conditions, pre-resettlement characteristics were associated with food security status. These findings call for future research to understand how preresettlement conditions affect food choices, budgeting and thereby food security status.
Journal of Hunger & Environmental Nutrition, 2013
Ecology of Food and Nutrition, 2009
This study aimed to explore Mexican dietary acculturation patterns among immigrants using a uniqu... more This study aimed to explore Mexican dietary acculturation patterns among immigrants using a unique transnational photographic assessment. Participants (N = 10) were Latino mother and child pairs living in Mexico (1 pair) and in the United States (4 pairs). Data were collected in 2 phases: 1) participant observation and photography in Mexico, and 2) in-depth interviewing using photographic guides in North Carolina. Environment, daily activity patterns, shopping, and dietary patterns in Mexico were all documented. Acculturation resulted in poor dietary intake due to decreased availability, food displacement, and cost. Decreases in physical activity due to environmental and social barriers were also reported.
Using the PEN-3 model as a conceptual framework this study described and determined relationships... more Using the PEN-3 model as a conceptual framework this study described and determined relationships among AIDS-related knowledge beliefs and sex behavior of young adults in rural Jamaica and explored AIDS-related community perceptions and selected community enablers. Data were gathered from a survey of 58 youth aged 18-24 and from an ethnographic study that sampled 10 survey respondents and seven community leaders. Participant observation was conducted at points of condom acquisition and youth group sessions. Statistical analysis revealed that 1) the youth were knowledgeable about HIV transmission AIDS and self-protective actions; 2) they predominantly participated in vaginal sex; 3) there was no significant relationship among knowledge beliefs and the practice of safe sex; 4) neither gender nor prior STD experience was significantly related to the practice of safe sex; 5) knowledge about HIV transmission was weakly but positively related to knowledge about AIDS; 6) reasons for unsafe sex included misconceptions about disease etiology conflicting cultural values risk denial and partner pressures trust and partner significance accusations of promiscuity lack of community endorsement of protective measures and barriers to condom access. In addition socioeconomic pressures psychosocial issues poor community participation and attitudes and low educational levels limited the effectiveness of existing HIV/AIDS prevention education. While high levels of AIDS knowledge and the wide availability of condoms in the community were positive factors the lack of condom use and poor community participation threatened the success of HIV/AIDS prevention initiatives. (full text modified)
This article describes the procedures used to determine the conceptual adequacy and cultural appr... more This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, com-fort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population
The University of North Carolina at Greensboro, 2021
This report documents needs of refugee older adults in the Greensboro metropolitan area of North ... more This report documents needs of refugee older adults in the Greensboro metropolitan area of North Carolina, as exemplified by two communities: Nepali-speaking Bhutanese and Congolese. We describe the demographics of refugee populations in North Carolina and Greensboro. We draw attention to the fact that although refugee streams are in general younger in age, older refugees do exist in appreciable numbers, and their specific needs must be recognized and provided for. This is the first such report for the state of North Carolina.
Health Equity, 2021
Purpose: Community health workers (CHWs) are trusted community leaders and public health workers ... more Purpose: Community health workers (CHWs) are trusted community leaders and public health workers dedicated to promoting the health and well-being of community members. CHWs, who share similar language and culture, work with refugee communities that are often missed in traditional U.S. health systems. CHWs help refugees gain access to health care through culturally appropriate strategies. However, the scope of their study as cultural brokers with regard to refugee health access is largely unknown in the peer-reviewed literature. This qualitative research study used a constructivist grounded approach to examine the extent to which CHWs helped refugee clients gain access to the health care system. Methods: Data were collected through interviews with a purposeful sample of 10 CHW participants affiliated with a primary care access program in Greensboro, North Carolina. Results: The diagram derived from this study provided a schema that allowed for an improved understanding of CHW perspectives and experiences when connecting refugee clients to the health care system. Conclusions: Further research incorporating CHW voices is recommended because CHWs are instrumental in improving the health and well-being of refugees.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2021
The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, a... more The coronavirus disease pandemic has created a crisis for patients with chronic kidney disease, as far as getting treatment facilities are concerned. The crisis is more intense in developing countries where the health system is more vulnerable due to poor infrastructures and insufficient health professionals. Bangladesh, being a developing nation, is also facing similar challenges to provide sufficient services to patients with chronic kidney disease. In this short report, we have discussed the challenges and barriers non-COVID chronic kidney disease patients are facing in terms of healthcare access along with getting proper medical interventions and suggested probable strategies to minimize the suffering.
Medical Research Archives, 2020
Comprising 18% of the total population in the United States, Latinos are one of the fastest growi... more Comprising 18% of the total population in the United States, Latinos are one of the fastest growing minority groups in the country and an important demographic group for our public health efforts. In the current socioeconomic and political climate, the development of resources and health education materials tailored to specific cultural groups is urgently needed. To be effective, these materials must acknowledge the role of history, social and physical environment, cultural and economic conditions, migration history, and politics as key determinants of health and well-being. This article describes the development of Nuestros Cuerpos, Nuestras Vidas, the Spanish-language translation and cultural adaptation of the classic women's health book Our Bodies, Ourselves, and the companion Spanish-language training guide for community health workers (Guía de Capacitación para Promotoras de Salud). Further, it examines the relevance of these health education materials to our current sociopolitical and historical moment. The Spanishlanguage and cultural adaptation process of Our Bodies, Ourselves is predicated on the social determinants and the cultural models of health. Both represent strong approaches that promote health and well-being in the midst of the current dramatic social change that adversely and disproportionately impacts the health of US minority groups.
Reflective Practice, 2020
Reflexivity, an important component of qualitative inquiry generally, gains additional significan... more Reflexivity, an important component of qualitative inquiry generally, gains additional significance in community-based participatory research (CBPR). The varying partnerships among researchers, community partners, and community members are strengthened when a colearning, reflective model is applied. The use of reflective field notes can be a powerful tool to help achieve this end. In this article, we describe the dynamics of community-engaged research team where members applied a co-learning model to reflect upon their positionality in the community and in research. Using reflective field notes examined through a narrative approach to the PI's time in the field, we assess these positionalities through the relationships between CBPR work and power relations. The reflective practice embedded in the CBPR process brought these power relations to our attention. We then turned to the literature on power relations to better understand what was occurring in the study. The current case details the additional complexity that occurs when issues of language, translation, gender, and culture are introduced. Thus, this paper is a reflective analysis of a bilingual researcher's experience in the field specific to cross-cultural CBPR work.
North Carolina Medical Journal, 2019