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Article ; Online: The Ecology of Unsheltered Homelessness

Mary-Catherine Anderson / Ashley Hazel / Jessica M. Perkins / Zack W. Almquist

International Journal of Environmental Research and Public Health, Vol 18, Iss 7328, p

Environmental and Social-Network Predictors of Well-Being among an Unsheltered Homeless Population

2021 Volume 7328

Abstract: People experiencing homelessness (PEH) face extreme weather exposure and limited social support. However, few studies have empirically assessed biophysical and social drivers of health outcomes among unsheltered PEH. Social network, health, and outdoor ... ...

Abstract	People experiencing homelessness (PEH) face extreme weather exposure and limited social support. However, few studies have empirically assessed biophysical and social drivers of health outcomes among unsheltered PEH. Social network, health, and outdoor exposure data were collected from a convenience sample of unsheltered PEH ( n = 246) in Nashville, TN, from August 2018–June 2019. Using multivariate fixed-effects linear regression models, we examined associations between biophysical and social environments and self-reported general health and emotional well-being. We found that study participants reported the lowest general health scores during winter months—Nashville’s coldest season. We also found a positive association between the number of nights participants spent indoors during the previous week and general health. Participants who spent even one night indoors during the past week had 1.8-point higher general health scores than participants who spent zero nights indoors ( p < 0.01). Additionally, participants who experienced a conflict with a social contact in the past 30 days had lower emotional well-being scores than participants who experienced no conflict. Finally, women had worse general health and emotional well-being than men. Ecologically framed research about health and well-being among PEH is critically needed, especially as climate change threatens to increase the danger of many homeless environments.
Keywords	homelessness ; unsheltered homeless populations ; environmental exposure ; general health ; emotional well-being ; social networks ; Medicine ; R
Language	English
Publishing date	2021-07-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Child anthropometry data quality from Demographic and Health Surveys, Multiple Indicator Cluster Surveys, and National Nutrition Surveys in the West Central Africa region

Daniel J. Corsi / Jessica M. Perkins / S. V. Subramanian

Global Health Action, Vol 11, Iss

are we comparing apples and oranges?

2018 Volume 1

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Antibiotic perceptions, adherence, and disposal practices among parents of pediatric patients.

Keerti L Dantuluri / Kemberlee R Bonnet / David G Schlundt / Rebecca J Schulte / Hannah G Griffith / Alexandria Luu / Cara Charnogursky / Jessica M Perkins / Christine C Whitmore / Ritu Banerjee / Leigh M Howard / Carlos G Grijalva

PLoS ONE, Vol 18, Iss 2, p e

2023 Volume 0281660

Abstract: Antibiotics are frequently prescribed for children in the outpatient setting. Although sometimes necessary, antibiotic use is associated with important downstream effects including the development of antimicrobial resistance among human and environmental ...

Abstract	Antibiotics are frequently prescribed for children in the outpatient setting. Although sometimes necessary, antibiotic use is associated with important downstream effects including the development of antimicrobial resistance among human and environmental microorganisms. Current outpatient stewardship efforts focus on guiding appropriate antibiotic prescribing practices among providers, but little is known about parents' understanding of antibiotics and appropriate disposal of leftover antibiotics. To help bridge this gap, we conducted a qualitative study to assess parental understanding of their children's antibiotics, their adherence to antibiotic instructions, and their disposal practices. We conducted a semi-structured interview with parents of 13 children diagnosed with acute respiratory illnesses and prescribed antibiotics in an urban outpatient clinic. We found that parents had limited understanding of how antibiotics work. Although they received instructions about antibiotic use during the healthcare visit, adherence to the prescription and appropriate disposal of antibiotics was suboptimal. Limited baseline understanding of antibiotics, their prior experiences with antibiotics, perceptions about their social networks' antibiotic use, and information provided to them by healthcare providers may influence these behaviors. Our findings can inform educational efforts of outpatient stewardship programs to help optimize parental understanding of how to use and dispose of their children's antibiotics.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Antibiotic perceptions, adherence, and disposal practices among parents of pediatric patients

Keerti L. Dantuluri / Kemberlee R. Bonnet / David G. Schlundt / Rebecca J. Schulte / Hannah G. Griffith / Alexandria Luu / Cara Charnogursky / Jessica M. Perkins / Christine C. Whitmore / Ritu Banerjee / Leigh M. Howard / Carlos G. Grijalva

PLoS ONE, Vol 18, Iss

2023 Volume 2

Abstract	Antibiotics are frequently prescribed for children in the outpatient setting. Although sometimes necessary, antibiotic use is associated with important downstream effects including the development of antimicrobial resistance among human and environmental microorganisms. Current outpatient stewardship efforts focus on guiding appropriate antibiotic prescribing practices among providers, but little is known about parents’ understanding of antibiotics and appropriate disposal of leftover antibiotics. To help bridge this gap, we conducted a qualitative study to assess parental understanding of their children’s antibiotics, their adherence to antibiotic instructions, and their disposal practices. We conducted a semi-structured interview with parents of 13 children diagnosed with acute respiratory illnesses and prescribed antibiotics in an urban outpatient clinic. We found that parents had limited understanding of how antibiotics work. Although they received instructions about antibiotic use during the healthcare visit, adherence to the prescription and appropriate disposal of antibiotics was suboptimal. Limited baseline understanding of antibiotics, their prior experiences with antibiotics, perceptions about their social networks’ antibiotic use, and information provided to them by healthcare providers may influence these behaviors. Our findings can inform educational efforts of outpatient stewardship programs to help optimize parental understanding of how to use and dispose of their children’s antibiotics.
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Social network correlates of free and purchased insecticide-treated bed nets in rural Uganda

Sae Takada / Paul J. Krezanoski / Viola Nyakato / Vincent Bátwala / A. James O’Malley / Jessica M. Perkins / Alexander C. Tsai / David R. Bangsberg / Nicholas A. Christakis / Akihiro Nishi

Malaria Journal, Vol 21, Iss 1, Pp 1-

2022 Volume 10

Abstract: Abstract Background Malaria is a major cause of mortality and morbidity in Uganda. Despite Uganda’s efforts to distribute bed nets, only half of households have achieved the World Health Organization (WHO) Universal Coverage Criteria (one bed net for ... ...

Abstract	Abstract Background Malaria is a major cause of mortality and morbidity in Uganda. Despite Uganda’s efforts to distribute bed nets, only half of households have achieved the World Health Organization (WHO) Universal Coverage Criteria (one bed net for every two household members). The role of peer influence on bed net ownership remains underexplored. Data on the complete social network of households were collected in a rural parish in southwestern Uganda to estimate the association between household bed net ownership and peer household bed net ownership. Methods Data on household sociodemographics, bed net ownership, and social networks were collected from all households across one parish in southwestern Uganda. Bed nets were categorized as either purchased or free. Purchased and free bed net ownership ratios were calculated based on the WHO Universal Coverage Criteria. Using network name generators and complete census of parish residents, the complete social network of households in the parish was generated. Linear regression models that account for network autocorrelation were fitted to estimate the association between households’ bed net ownership ratios and bed net ownership ratios of network peer households, adjusting for sociodemographics and network centrality. Results One thousand seven hundred forty-seven respondents were interviewed, accounting for 716 households. The median number of peer households to which a household was directly connected was 7. Eighty-six percent of households owned at least one bed net, and 41% of households met the WHO Universal Coverage Criterion. The median bed net ownership ratios were 0.67 for all bed nets, 0.33 for free bed nets, and 0.20 for purchased bed nets. In adjusted multivariable models, purchased bed net ownership ratio was associated with average household wealth among peer households (b = 0.06, 95% CI 0.03, 0.10), but not associated with average purchased bed net ownership ratio of peer households. Free bed net ownership ratio was associated with the number of ...
Keywords	Malaria ; Bed net ; Social networks ; Uganda ; Insecticide-treated bed net (ITN) ; Arctic medicine. Tropical medicine ; RC955-962 ; Infectious and parasitic diseases ; RC109-216
Subject code	303
Language	English
Publishing date	2022-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adverse childhood experiences, alcohol consumption, and the modifying role of social participation

Scholastic Ashaba / Bernard Kakuhikire / Charles Baguma / Emily N. Satinsky / Jessica M. Perkins / Justin D. Rasmussen / Christine E. Cooper-Vince / Phionah Ahereza / Patrick Gumisiriza / Justus Kananura / David R. Bangsberg / Alexander C. Tsai

SSM - Mental Health, Vol 2, Iss , Pp 100062- (2022)

population-based study of adults in southwestern Uganda

2022

Abstract: Background: Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as ... ...

Abstract	Background: Adverse childhood experiences (ACEs) include multiple forms of child maltreatment, including abuse and neglect, as well as other forms of household dysfunction. Studies from Uganda have revealed a high prevalence of child abuse, as well as one of the highest levels of alcohol consumption in Africa. Few population-based studies from Africa have estimated associations between ACEs and adult alcohol use, or assessed the potential buffering effects of social participation. Methods: This cross-sectional, population-based study was conducted in a rural parish in southwestern Uganda between 2016 and 2018. We assessed self-reported ACEs using a modified version of the Adverse Childhood Experiences – International Questionnaire (ACE-IQ) scale. We measured heavy alcohol consumption using a 3-item scale previously validated in this population. We measured social participation using a 10-item scale eliciting participants’ membership and participation in different community groups over the past two months. We fitted multivariable Poisson regression models to estimate the associations between ACEs and heavy alcohol consumption, and to assess for the potential buffering effects of social participation. Results: We estimated statistically significant associations between the total ACE score and heavy alcohol consumption (adjusted relative risk [ARR] per ACE = 1.17; 95% CI, 1.09–1.25; P ≤ 0.001). Social participation had a statistically significant moderating effect on the association between total ACE score and heavy alcohol consumption (P = 0.047 for interaction): the estimated association between total ACE score and heavy alcohol consumption among study participants who did not participate in a community group was larger, with a narrower confidence interval (ARR = 1.21 per ACE; 95% CI, 1.11–1.33; P < 0.001), while the estimated association among study participants who did participate in a community group was smaller and less precisely estimated (ARR = 1.12 per ACE; 95% CI, 1.02–1.24; P = 0.02). Conclusions: Our findings demonstrate an association between ACEs and heavy alcohol consumption behavior among adults in rural Uganda. The adverse effects of ACEs were buffered in part by social participation. To prevent or reduce harmful alcohol use behaviors among adults, it is important to address the chronic stress caused by ACEs.
Keywords	Adverse childhood experiences ; Buffering hypothesis ; Heavy alcohol consumption ; Social integration ; Social participation ; Stress buffering ; Mental healing ; RZ400-408 ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Social norms, misperceptions, and mosquito net use

Jessica M. Perkins / Paul Krezanoski / Sae Takada / Bernard Kakuhikire / Vincent Batwala / Alexander C. Tsai / Nicholas A. Christakis / David R. Bangsberg

Malaria Journal, Vol 18, Iss 1, Pp 1-

a population-based, cross-sectional study in rural Uganda

2019 Volume 13

Abstract: Abstract Background Mosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under ...

Abstract	Abstract Background Mosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Furthermore, perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours. Methods Population-based data were collected from 1669 adults across eight villages in one rural parish in southwestern Uganda. Individuals’ perception about whether most adults in their community sleep under a mosquito net every night was compared with whether daily mosquito net use was the actual norm in their community to identify the extent of norm misperception. The association between whether an individual perceived daily mosquito net use to be the norm and personal mosquito net use was assessed while adjusting for the ratio of nets:people in the household and other factors. Results Although the majority (65%) of participants reported sleeping under a mosquito net every night (and 75% did so among the 86% of people with at least one net), one-quarter of participants thought that most adults in their community did not sleep under a mosquito net every night. Another 8% were unsure how many nights per week most adults in their community sleep under a mosquito net. Participants who perceived that daily mosquito net use was the norm were 2.94 times more likely to report personally sleeping under a mosquito net every night (95% CI 2.09–4.14, p < 0.001) compared to participants who thought doing so was not normative, adjusting for other factors. Conclusions Results suggest an opportunity for anti-malarial interventions to reduce misperceptions about mosquito net use norms and emphasize the commonness of daily mosquito net use in malaria-endemic regions. If people correctly perceive most others to sleep under a net ...
Keywords	Malaria ; Bed net ; ITN ; Perceived norm ; Descriptive norm ; Social norms ; Arctic medicine. Tropical medicine ; RC955-962 ; Infectious and parasitic diseases ; RC109-216
Subject code	150
Language	English
Publishing date	2019-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The association between men’s family planning networks and contraceptive use among their female partners

Alison B. Comfort / Cynthia C. Harper / Alexander C. Tsai / Jessica M. Perkins / James Moody / Justin Ranjalahy Rasolofomana / Cora Alperin / Margaret Schultz / Anja Noeliarivelo Ranjalahy / Ravo Heriniaina / Paul J. Krezanoski

BMC Public Health, Vol 21, Iss 1, Pp 1-

an egocentric network study in Madagascar

2021 Volume 14

Abstract: Abstract Background Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research ... ...

Abstract	Abstract Background Ensuring women have information, support and access to family planning (FP) services will allow women to exercise their reproductive autonomy and reduce maternal mortality, which remains high in countries such as Madagascar. Research shows that women’s social networks - their ties with partners, family members, friends, and providers - affect their contraceptive use. Few studies have considered the role of men’s social networks on women’s contraceptive use. Insofar as women’s contraceptive use may be influenced by their male partners, women’s contraceptive use may also be affected by their partner’s social networks. Men may differ by the types of ties they rely on for information and advice about FP. It is unknown whether differences in the composition of men’s FP networks matter for couples’ contraceptive use. This study assessed the association between men’s FP networks and couples’ contraceptive use. Methods This egocentric network study was conducted among married/partnered men (n = 178) in rural Madagascar. Study participants listed who they relied on for FP information and advice, including health providers and social ties. They provided ties’ gender, age, relationship, and perceived support of contraceptive use. The primary outcome was couples’ contraceptive use, and explanatory variables included FP networks and their composition (no FP network, social-only network, provider-only network, and mixed network of social and provider ties). Analyses used generalized linear models specifying a Poisson distribution, with covariate adjustment and cluster robust standard errors. Results Men who had FP networks were 1.9 times more likely to use modern contraception as a couple compared to men with no FP network (95% confidence interval [CI] 1.64–2.52; p ≤ 0.001). Compared to men with no FP network, men were more likely to use modern contraception if they had a social-only network, relative risk (RR) = 2.10 (95% CI, 1.65–2.68; p ≤ 0.001); a provider-only network, RR = 1.80 (95% CI, 1.54–2.11; p ...
Keywords	Social networks ; Contraceptives ; Family planning ; Male partner ; Influencers ; Health providers ; Public aspects of medicine ; RA1-1270
Subject code	360
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Adverse childhood experiences, adult depression, and suicidal ideation in rural Uganda

Emily N Satinsky / Bernard Kakuhikire / Charles Baguma / Justin D Rasmussen / Scholastic Ashaba / Christine E Cooper-Vince / Jessica M Perkins / Allen Kiconco / Elizabeth B Namara / David R Bangsberg / Alexander C Tsai

PLoS Medicine, Vol 18, Iss 5, p e

A cross-sectional, population-based study.

2021 Volume 1003642

Abstract: Background Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby ... ...

Abstract	Background Depression is recognized globally as a leading cause of disability. Early-life adverse childhood experiences (ACEs) have been shown to have robust associations with poor mental health during adulthood. These effects may be cumulative, whereby a greater number of ACEs are progressively associated with worse outcomes. This study aimed to estimate the associations between ACEs and adult depression and suicidal ideation in a cross-sectional, population-based study of adults in Uganda. Methods and findings Between 2016 and 2018, research assistants visited the homes of 1,626 adult residents of Nyakabare Parish, a rural area in southwestern Uganda. ACEs were assessed using a modified version of the Adverse Childhood Experiences-International Questionnaire, and depression symptom severity and suicidal ideation were assessed using the Hopkins Symptom Checklist for Depression (HSCL-D). We applied a validated algorithm to determine major depressive disorder diagnoses. Overall, 1,458 participants (90%) had experienced at least one ACE, 159 participants (10%) met criteria for major depressive disorder, and 28 participants (1.7%) reported suicidal ideation. We fitted regression models to estimate the associations between cumulative number of ACEs and depression symptom severity (linear regression model) and major depressive disorder and suicidal ideation (Poisson regression models). In multivariable regression models adjusted for age, sex, primary school completion, marital status, self-reported HIV status, and household asset wealth, the cumulative number of ACEs was associated with greater depression symptom severity (b = 0.050; 95% confidence interval [CI], 0.039-0.061, p < 0.001) and increased risk for major depressive disorder (adjusted relative risk [ARR] = 1.190; 95% CI, 1.109-1.276; p < 0.001) and suicidal ideation (ARR = 1.146; 95% CI, 1.001-1.311; p = 0.048). We assessed the robustness of our findings by probing for nonlinearities and conducting analyses stratified by age. The limitations of the ...
Keywords	Medicine ; R
Subject code	360
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Social network correlates of IPV acceptance in rural Honduras and rural Uganda

Holly B. Shakya / Jessica M. Perkins / Margaret Traeger / Alexander C. Tsai / David R. Bangsberg / Bernard Kakuhikire / Nicholas A. Christakis

SSM: Population Health, Vol 4, Iss , Pp 236-

2018 Volume 243

Abstract: We investigated the household-level social network correlates of acceptance of intimate partner violence (IPV) in rural, agrarian settings of Honduras and Uganda, two low-income countries with unequal access to resources based upon gender. We collected ... ...

Abstract	We investigated the household-level social network correlates of acceptance of intimate partner violence (IPV) in rural, agrarian settings of Honduras and Uganda, two low-income countries with unequal access to resources based upon gender. We collected complete social network data in each location (Honduras in 2014 and Uganda in 2012), across a diverse range of relationships, and then created a measure of household cohesion by calculating the degree to which members of a household nominated each other as important social connections. Our measure of IPV acceptance was based on 4 questions from the Demographic Health Survey to assess the conditions under which a person believes that it is acceptable for a man to perpetrate physical violence against his wife or partner and we coded a person as positive on IPV acceptance if they answered positively to any of the four questions. We used logistic regression to calculate the odds that an individual accepted IPV given (1) household level cohesion and (2) the proportion of the household that accepts IPV. We found individuals from more cohesive households were less likely to accept IPV controlling for the overall level of IPV acceptance in the household. Nevertheless, those in households more accepting of IPV were more likely to personally accept IPV. In stratified analyses, when household IPV acceptance was especially high, the benefit of household cohesion with respect to IPV was attenuated. The design and implementation of interventions to prevent IPV should consider household structure and norms rather than focusing only on individuals or couples. Keywords: Honduras, Uganda, Social networks, Social norms, Intimate partner violence, Social cohesion
Keywords	Public aspects of medicine ; RA1-1270 ; Social sciences (General) ; H1-99
Subject code	338
Language	English
Publishing date	2018-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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