Louisiana Public Health Institute

Poydras, LA, United States

Louisiana Public Health Institute

Poydras, LA, United States
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Parker K.M.,Prevention Research Center | Ruley J.,Louisiana Public Health Institute | Spriggs A.,Tulane University | Johnson C.,Tulane University
Annals of Behavioral Medicine | Year: 2013

Background: Incorporating cycling into daily life is one way to increase physical activity. Purpose: This study examined the impact of building new bike lanes in New Orleans to determine whether more people were cycling on the street and with the flow of traffic after bike lanes were built. Methods: Through direct observation of one intervention and two adjacent streets, observers counted cyclists riding on the street and sidewalk, with and against traffic, before and after installation of the lanes. Data were tallied separately for adults, children, males, females, and by race for each location. Results: There was an increase in cyclists on all three streets after the installation of the bike lanes, with the largest increase on the street with the new lane. Additionally, the proportion of riders cycling with traffic increased after the lanes were striped. Conclusions: Bike lanes can have a positive impact in creating a healthy neighborhood. © The Society of Behavioral Medicine 2012.

Clum G.A.,Tulane University | Czaplicki L.,Louisiana Public Health Institute | Andrinopoulos K.,Tulane University | Hamvas L.,Washington University in St. Louis
AIDS Patient Care and STDs | Year: 2013

Young women with HIV and histories of physical and/or sexual abuse in childhood may be vulnerable to difficulties with disclosure to sexual partners. Abuse in childhood is highly prevalent in HIV-positive women, and has been associated with poorer communication, low assertiveness, low self worth, and increased risk for sexual and other risk behaviors that increase the risk of secondary transmission of HIV. HIV disclosure may be an important link between abuse and sexual risk behaviors. Qualitative interviews with 40 HIV-positive young women with childhood physical and/or sexual abuse were conducted; some women had also experienced adult victimization. Results suggest that HIV-positive women with abuse histories use a host of strategies to deal with disclosure of HIV status, including delaying disclosure, assessing hypothetical responses of partners, and determining appropriate stages in a relationship to disclose. Stigma was an important theme related to disclosure. We discuss how these disclosure processes impact sexual behavior and relationships and discuss intervention opportunities based on our findings. © Mary Ann Liebert, Inc.

Khurshid A.,Louisiana Public Health Institute | Nauman E.,Louisiana Public Health Institute | Carton T.,Louisiana Public Health Institute | Horswell R.,Pennington Biomedical Research Center
Journal of the American Medical Informatics Association | Year: 2014

The state of Louisiana, like the nation as a whole, is facing the salient challenge of improving population health and efficiency of healthcare delivery. Research to inform innovations in healthcare will best enhance this effort if it is timely, efficient, and patient-centered. The Louisiana Clinical Data Research Network (LACDRN) will increase the capacity to conduct robust comparative effectiveness research by building a health information technology infrastructure that provides access to comprehensive clinical data for more than 1 million patients statewide. To ensure that network-based research best serves its end-users, the project will actively engage patients and providers as key informants and decision-makers in the implementation of LACDRN. The network's patient-centered research agenda will prioritize patients' and clinicians' needs and aim to support evidence-based decisions on the healthcare they receive and provide, to optimize patient outcomes and quality of life.

Demby H.,Policy and Research Group | Gregory A.,Policy and Research Group | Broussard M.,Louisiana Public Health Institute | Dickherber J.,Louisiana Public Health Institute | And 2 more authors.
Journal of Adolescent Health | Year: 2014

In recent years, the demand for evidence-based teen pregnancy prevention programs has increased, but practitioners often struggle to replicate and implement them as designed in real-world community settings. The purpose of this article is to describe the barriers and facilitators encountered during pilot year attempts to implement an evidence-based teen pregnancy prevention program within three types of organizations: (1) small community-based organizations; (2) a school-based organization; and (3) a large decentralized city-sponsored summer youth program. We frame our discussion of these experiences within the context of a systemic, multilevel framework for implementation consisting of (1) core implementation components; (2) organizational components; and (3) external factors. This article explores the organizational and external implementation factors we experienced during the implementation process, describes our lessons learned throughout this process, and offers strategies for other practitioners to proactively address these factors from the start of program planning. These findings may provide useful insight for other organizations looking to implement multi-session, group-level interventions with fidelity. © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Brewer R.A.,Louisiana Public Health Institute | Magnus M.,George Washington University | Kuo I.,George Washington University | Wang L.,Fred Hutchinson Cancer Research Center | And 2 more authors.
American Journal of Public Health | Year: 2014

Objectives. We examined lifetime incarceration history and its association with key characteristics among 1553 Black men who have sex with men (BMSM) recruited in 6 US cities. Methods. We conducted bivariate analyses of data collected from the HIV Prevention Trials Network 061 study from July 2009 through December 2011 to examine the relationship between incarceration history and demographic and psychosocial variables predating incarceration and multivariate logistic regression analyses to explore the associations between incarceration history and demographic and psychosocial variables found to be significant. We then used multivariate logistic regression models to explore the independent association between incarceration history and 6 outcome variables. Results. After adjusting for confounders, we found that increasing age, transgender identity, heterosexual or straight identity, history of childhood violence, and childhood sexual experience were significantly associated with incarceration history. A history of incarceration was also independently associated with any alcohol and drug use in the past 6 months. Conclusions. The findings highlight an elevated lifetime incarceration history among a geographically diverse sample of BMSM and the need to adequately assess the impact of incarceration among BMSM in the United States.

Brewer R.A.,Louisiana Public Health Institute | Magnus M.,George Washington University | Kuo I.,George Washington University | Wang L.,Fred Hutchinson Cancer Research Center | And 4 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2014

This study examined the predictors of new incarceration and their association with HIV infection among 1278 black men who have sex with men enrolled and followed up in the HIV Prevention Trials Network 061 study. HIV Prevention Trials Network 061 was conducted to determine the feasibility and acceptability of a multicomponent intervention to reduce HIV infection among BMSM in 6 US cities. In this study, multivariable logistic regression models were used to explore the association between incarceration during study follow-up and several demographic, behavioral, and psychosocial variables at baseline found to be significant in bivariate analyses. In addition, Cox proportional hazard regression was used to explore the association between incarceration during study follow-up and incident HIV infection. Among the 1278 BMSM with follow-up data, 305 (24%) reported a new incarceration within 1 year of entering the study with an estimated incarceration incidence of 35% (95% confidence interval: 31% to 38%). After adjusting for confounders, lower education, lower annual income, previous incarceration frequency, and higher levels of perceived racism were significantly associated with new incarcerations during study followup. There was no observed association between incarceration during study follow-up and incident HIV infection. The very high level of new incarcerations highlights the importance of structural-level interventions to prevent incarceration among economically disenfranchised black men who have sex with men in the United States. Copyright © 2013 by Lippincott Williams and Wilkins.

Abebe N.A.,Louisiana Public Health Institute | Capozza K.L.,HealthInsight | Des Jardins T.R.,Southeast Michigan Beacon Community | Kulick D.A.,Louisiana Public Health Institute | And 3 more authors.
Journal of Medical Internet Research | Year: 2013

Mobile health (mHealth) is gaining widespread attention for its potential to engage patients in their health and health care in their daily lives. Emerging evidence suggests that mHealth interventions can be used effectively to support behavior change, but numerous challenges remain when implementing these programs at the community level. This paper provides an overview of considerations when implementing community-based mHealth initiatives, based on the experiences of three Beacon Communities across the United States that have launched text messaging (short message service, SMS) pilot programs aimed at diabetes risk reduction and disease management. The paper addresses lessons learned and suggests strategies to overcome challenges related to developing text message content, conducting marketing and outreach, enrolling participants, engaging providers, evaluating program effectiveness, and sustaining and scaling the programs. © Nebeyou A Abebe, Korey L Capozza, Terrisca R Des Jardins, David A Kulick, Alison L Rein, Abigail A Schachter, Scott A Turske.

Clum G.A.,Tulane University | Rice J.C.,Tulane University | Broussard M.,Louisiana Public Health Institute | Johnson C.C.,Tulane University | Webber L.S.,Tulane University
Journal of Behavioral Medicine | Year: 2014

This article explores cross-sectional associations between depressive symptoms and body mass index (BMI) in women working in schools in the Greater New Orleans area. Self-efficacy for eating and exercise, eating styles, and exercise are examined as potential pathways. This is a secondary data analysis of 743 women who were participating in a workplace wellness randomized controlled trial to address environmental factors influencing eating and exercise behaviors using baseline data prior to the intervention. BMI was the primary outcome examined. Path analysis suggested that increased depressive symptoms were associated with increased BMI in women. Indirect effects of depressive symptoms on BMI were found for increased healthy eating self-efficacy, increased emotional eating, and decreased exercise self-efficacy. The association between greater healthy eating self efficacy and BMI was unexpected, and may indicate a suppressor effect of eating self-efficacy in the relationship between depressive symptoms and BMI in women. The findings suggest the importance of depressive symptoms to BMI in women. Targets for interventions to reduce BMI include targeting depressive symptoms and related sequelae including self-efficacy for exercise, and emotional eating. Further investigation of eating self-efficacy and BMI are recommended with particular attention to both efficacy for health eating and avoidance of unhealthy foods. © 2013 Springer Science+Business Media New York.

Levy M.E.,George Washington University | Wilton L.,Binghamton University State University of New York | Phillips II G.,George Washington University | Glick S.N.,George Washington University | And 5 more authors.
AIDS and Behavior | Year: 2014

Structural-level factors have contributed to the substantial disproportionate rates of HIV among Black men who have sex with men (BMSM) in the United States. Despite insufficient HIV testing patterns, however, there is a void in research investigating the relationship between structural factors and access to HIV testing and prevention services among BMSM. Building on previous scholarly work and incorporating a dynamic social systems conceptual framework, we conducted a comprehensive review of the literature on structural barriers to HIV testing and prevention services among BMSM across four domains: healthcare, stigma and discrimination, incarceration, and poverty. We found that BMSM experience inadequate access to culturally competent services, stigma and discrimination that impede access to services, a deficiency of services in correctional institutions, and limited services in areas where BMSM live. Structural interventions that eliminate barriers to HIV testing and prevention services and provide BMSM with core skills to navigate complex systems are needed. © 2014 Springer Science+Business Media New York.

Herwehe J.,Louisiana State University | Wilbright W.,Louisiana State University | Abrams A.,Louisiana State University | Bergson S.,Louisiana Public Health Institute | And 6 more authors.
Journal of the American Medical Informatics Association | Year: 2012

Louisiana is severely affected by HIV/AIDS, ranking fifth in AIDS rates in the USA. The Louisiana Public Health Information Exchange (LaPHIE) is a novel, secure bidirectional public health information exchange, linking statewide public health surveillance data with electronic medical record data. LaPHIE alerts medical providers when individuals with HIV/AIDS who have not received HIV care for >12 months are seen at any ambulatory or inpatient facility in an integrated delivery network. Between 2/1/ 2009 and 1/31/2011, 488 alerts identified 345 HIV positive patients. Of those identified, 82% had at least one CD4 or HIV viral load test over the study follow-up period. LaPHIE is an innovative use of health information exchange based on surveillance data and real time clinical messaging, facilitating rapid provider notification of those in need of treatment. LaPHIE successfully reduces critical missed opportunities to intervene with individuals not in care, leveraging information historically collected solely for public health purposes, not health care delivery, to improve public health.

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