Wednesday, November 8th, from 12:30PM-1:30PM Dr. Barbara Entwisle (Kenan Distinguished Professor of Sociology & Fellow of Carolina Pop Center, UNC) will be giving the CSSS Seminar with a talk titled “Numerators and Denominators in Health Disparities Research: What linked Electronic Health Record and American Community Survey Data Reveal.” Barbara Entwisle’s current research examines migration processes in relation to the life course, household dynamics, and community contexts in a variety of contexts. She is also leveraging linkages between electronic health records and data from the Census Bureau to study population health. The seminar will take place in 409 Savery Hall and on Zoom (register here).
We are excited to invite CSDE Trainees & Fellows to meet with Dr. Entwisle in a group from 11:00AM-12:00PM prior to the talk. This is a great opportunity to meet a senior researcher in demography and hear more about her research and career trajectory. The meeting will take place in Miller Hall Room 423A. Please email Jill Fulmore (fulmore@uw.edu) and Jessica Godwin (jlg0003@uw.edu) if you plan to attend!
The New Yorker recently quoted Dan Goldhaber (Social Work) in an article on New York’s lawsuit regarding racial disparities in their teacher licensure tests. Goldhaber commented on the tests, saying “There is inequality in society. And one of the ways that manifests is with different educational outcomes.” Goldhaber also pointed out “there’s a lot of options besides have exams or don’t have exams” and weighed in New York’s new approach, to make preparation programs responsible for evaluating whether they’re ready to be in a classroom. Goldhaber was skeptical of this alternative. Teachers’ colleges have “pretty strong financial incentives not to tell somebody who is pursuing a teaching career, ‘Sorry, we don’t think you’re going to make it,’ ” he said. “Those kinds of institutional incentives make me think that very few people would be ruled out.” Read the full story here.
CSDE Affiliate Dr. Katarina Guttmannova (Psychiatry and Behavioral Science) and colleagues recently published their study in the Journal of Studies on Alcohol and Drug Use, titled “Cross-substance associations with transitions in cannabis and nicotine use in a statewide sample of young adults in Washington State“. Understanding transitions in nicotine and cannabis use has implications for prevention and efforts to reduce harmful use. Focusing on cross-substance associations, authors examined how use of one substance was associated with year-to-year transitions in frequency of use of the other among young adults in the context of legalized nonmedical cannabis.
A statewide sample from Washington (N = 4,039; ages 18–25 at baseline) provided up to three years of annual data on past-month cannabis use and nicotine use (tobacco cigarettes and e-cigarettes/vaping). Manifest Markov models examined how use of each substance was associated with transitions in the other across categories of past-month no use, occasional use (1–19 days), and frequent use (20+ days).
Occasional and frequent nicotine use (vs. no use) predicted higher probability of transitioning from no cannabis use to occasional or frequent cannabis use and from occasional use to frequent use, while associations with cessation and de-escalation were inconsistent in direction, small in magnitude, and not statistically significant. Cannabis use positively predicted onset of nicotine use, and associations of cannabis use with escalation from occasional to frequent nicotine use, de-escalation in use, and cessation in use were small and inconsistent in direction. The findings corroborate prior research on cannabis and nicotine use as risk factors to address in prevention efforts. The findings do not provide strong support for prioritization of dual abstinence in efforts to encourage reductions in or cessation of cannabis or nicotine use among young adults.
Jerusha Mogaka (PhD candidate, Nursing), Dr. Jillian Pintye (Associate Professor, Nursing) and CSDE Affiliates Dr. Alison Drake (Associate Professor, Global Health), and Dr. Grace John-Stewart (Professor, Global Health, Epidemiology, Medicine, and Pediatrics) recently published their research with co-authors, “Prevalence and predictors of Chlamydia trachomatis and Neisseria gonorrhoeae among HIV-negative pregnant women in Kenya” in Sexually Transmitted Diseases. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in pregnancy contribute to adverse perinatal outcomes. Authors identified predictors of CT and/or NG infection among pregnant Kenyan women. For their research design, women without HIV were enrolled at two antenatal clinics in Western Kenya. CT and NG were assessed using endocervical samples for nucleic acid amplification tests (NAAT). Poisson regression models were used to evaluate potential CT/NG risk factors. Classification and regression trees (CART) were generated to evaluate the joint effects of predictors.
Overall, 1276 women had both CT and NG assessments. Women enrolled at a median of 26 weeks gestation (IQR 22-31), median age was 22 years (IQR 19-27), and 78% were married. In total, 98 (7.7%) tested positive for CT/NG: 70 (5.5%) for CT, 32 (2.5%) for NG, 4 of whom (0.3%) had co-infections. Two-thirds (66%) of CT/NG cases were asymptomatic and would have been missed with only syndromic management. Risk factors of CT/NG included age < 22 years, crowded living conditions, being unmarried, being in partnerships for <1-year, abnormal vaginal discharge, previous STI history, and T. vaginalis diagnosis(p < 0.05). CART analyses identified unmarried women <22 years in relationships for <1 year as 6.1 times more likely to have CT/NG compared to women without these characteristics (26% vs. 6%, adjusted prevalence ratio = 6.1, 95% CI: 3.55–10.39, p < 0.001).
CT/NG was frequently asymptomatic and common among young unmarried women in newer partnerships in this cohort. Integrating CT/NG testing into routine antenatal care may be beneficial, especially for young women in Kenya.
CSDE Affiliate Bradley H. Wagenaar (Associate Professor, Global Health) and co-authors published their systematic review in Implementation Science, called “Application of the Expert Recommendations for Implementing Change (ERIC) compilation of strategies to health intervention implementation in low- and middle-income countries: a systematic review“. The Expert Recommendations for Implementing Change (ERIC) project developed a compilation of implementation strategies that are intended to standardize reporting and evaluation. Little is known about the application of ERIC in low- and middle-income countries (LMICs). Authors systematically reviewed the literature on the use and specification of ERIC strategies for health intervention implementation in LMICs to identify gaps and inform future research.
Authors searched peer-reviewed articles published through March 2023 in any language that (1) were conducted in an LMIC and (2) cited seminal ERIC articles or (3) mentioned ERIC in the title or abstract. Two co-authors independently screened all titles, abstracts, and full-text articles, then abstracted study, intervention, and implementation strategy characteristics of included studies.
The final sample included 60 studies describing research from all world regions, with over 30% published in the final year of their review period. Most studies took place in healthcare settings (n = 52, 86.7%), while 11 (18.2%) took place in community settings and four (6.7%) at the policy level. Across studies, 548 distinct implementation strategies were identified with a median of six strategies (range 1–46 strategies) included in each study. Most studies (n = 32, 53.3%) explicitly matched implementation strategies used for the ERIC compilation. Among those that did, 64 (87.3%) of the 73 ERIC strategies were represented. Many of the strategies not cited included those that target systems- or policy-level barriers. Nearly 85% of strategies included some component of strategy specification, though most only included specification of their action (75.2%), actor (57.3%), and action target (60.8%). A minority of studies employed randomized trials or high-quality quasi-experimental designs; only one study evaluated implementation strategy effectiveness.
While ERIC use in LMICs is rapidly growing, its application has not been consistent nor commonly used to test strategy effectiveness. Research in LMICs must better specify strategies and evaluate their impact on outcomes. Moreover, strategies that are tested need to be better specified, so they may be compared across contexts. Finally, strategies targeting policy-, systems-, and community-level determinants should be further explored.