Browsing by Author "Hites, Lisle"

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    Assessment of Youth-Friendly Health Services and Quality from Users' Perspectives
    (University of Alabama Libraries, 2023) Oyerinde, Ifeoluwa; Payne-Foster, Pamela; Morales-Aleman, Mercedes
    Background:Youth-Friendly Health Services (YFHS) are one of those services recommended by the World Health Organization (WHO) to address adolescent and young people's sexual health needs. YFHS are sexual and reproductive health services that are accessible, acceptable, appropriate, effective, and equitable for young people. Therefore, this study aims to assess the utilization and perceived quality of Youth-Friendly Health Services among the users.Method:The study design was descriptive cross-sectional. A total of 122 respondents from the University of Alabama, Tuscaloosa, were recruited and sampled using a validated semi-structured self-administered questionnaire to collect data. Results: Of the 122 participants recruited, 5 were excluded due to age, and 117 respondents aged 18 - 24 were included for further analysis of this study. The 117 respondents were 59.8% males and 40.2% females; 87.2% were heterosexual, 53.8% were from urban areas, and 65.8% were living with both parents. The majority (72.6%) were from middle-income families, 17.1% from low-income, and 9.4% from high-income families. This study revealed low awareness (17.9%) and low utilization (11.1%) of YFHS among young people. About 15.4% of those who ever visited the school health center (SHC) for YFHS rated the service as good, 53.8% were comfortable going to SHC for YFHS, 30.8% were comfortable discussing their sexuality with the healthcare provider, 38.5% were extremely satisfied with the services received. The quality of service from the users' perspective was low. Factors associated with the utilization of YHFS include gender, family income, accessibility, and appropriateness of the YFHS at a statistically significant value of p<0.001, 0.018, 0.046, and 0.048, respectively.Conclusions:Awareness and utilization of YFHS in this study were relatively low. The quality of YFHS provided at the student health center did not meet all the five components of YFHS. More than half of the users perceived the YFHS at the school health center as inaccessible and unacceptable. Awareness of YFHS should be aired in the university through health promotion, health education programs, and sharing of media materials. Also, campus-wide health interventions, campaigns, and outreach should be organized to increase the health-seeking behavior of young people. Policymakers and health advocate should formulate and strategically implement policies to improve the quality of YFHS provided at the health center. Keywords: Youth-Friendly Health Services, YFHS, Sexual and Reproductive Health, SRH, Utilization,Young people
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    Bringing Community and Academic Scholars Together to Facilitate and Conduct Authentic Community Based Participatory Research: Project UNITED
    (MDPI, 2016) Lewis, Dwight, Jr.; Yerby, Lea; Tucker, Melanie; Foster, Pamela Payne; Hamilton, Kara C.; Fifolt, Matthew M.; Hites, Lisle; Shreves, Mary Katherine; Page, Susan B.; Bissell, Kimberly L.; Lucky, Felecia L.; Higginbotham, John C.; University of Alabama Tuscaloosa; University of Alabama Birmingham
    Cultural competency, trust, and research literacy can affect the planning and implementation of sustainable community-based participatory research (CBPR). The purpose of this manuscript is to highlight: (1) the development of a CBPR pilot grant request for application; and (2) a comprehensive program supporting CBPR obesity-related grant proposals facilitated by activities designed to promote scholarly collaborations between academic researchers and the community. After a competitive application process, academic researchers and non-academic community leaders were selected to participate in activities where the final culminating project was the submission of a collaborative obesity-related CBPR grant application. Teams were comprised of a mix of academic researchers and non-academic community leaders, and each team submitted an application addressing obesity-disparities among rural predominantly African American communities in the US Deep South. Among four collaborative teams, three (75%) successfully submitted a grant application to fund an intervention addressing rural and minority obesity disparities. Among the three submitted grant applications, one was successfully funded by an internal CBPR grant, and another was funded by an institutional seed funding grant. Preliminary findings suggest that the collaborative activities were successful in developing productive scholarly relationships between researchers and community leaders. Future research will seek to understand the full-context of our findings.
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    The Mississippi Delta Health Collaborative Medication Therapy Management Model: Public Health and Pharmacy Working Together to Improve Population Health in the Mississippi Delta
    (Centers for Disease Control and Prevention, 2020) Ross, Leigh Ann; Bloodworth, Lauren S.; Brown, Meagan A.; Malinowski, Scott S.; Crane, Rebecca; Sutton, Victor; Karimi, Masoumeh; Brown, Cassandra Dove; Dobbs, Thomas; Hites, Lisle; University of Mississippi; University of Alabama Tuscaloosa
    Introduction The Mississippi Delta has high rates of chronic disease and is known for its poor health outcomes and health disparities. The University of Mississippi School of Pharmacy (UMSOP) and the Mississippi State Department of Health partnered in 2009 through the Mississippi Delta Health Collaborative to reduce health disparities and improve clinical outcomes by expanding the UMSOP's evidence-based medication therapy management (MTM) initiative, focused in Mississippi's 18-county Delta region, to federally qualified health centers (FQHCs) in 4 of those counties. Methods Between January 2009 and August 2018, the MTM initiative targeted FQHC patients aged 18 years or older with a diagnosis of diabetes, hypertension, and/or dyslipidemia. Pharmacists initially met face-to-face with patients to review all medications, provide education about chronic diseases, identify and resolve drug therapy problems, and take appropriate actions to help improve the effectiveness of medication therapies. Clinical parameters evaluated were systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and hemoglobin A(1c) (HbA(1c)). Results The analysis included 335 patients with hypertension (n = 287), dyslipidemia (n = 131), and/or diabetes (n = 331). Significant mean reductions occurred in the following metrics: SBP (7.1 mm Hg), DBP (6.3 mm Hg), LDL cholesterol (24.9 mg/dL), triglycerides (45.5 mg/dL), total cholesterol (37.7 mg/dL), and HbA(1c) (1.6% [baseline >= 6%] and 1.9% [baseline >= 9%]). Conclusion Despite the cultural and environmental disadvantages present in the Mississippi Delta, the integrated MTM treatment program demonstrated significant health improvements across 3 chronic diseases: hypertension, dyslipidemia, and diabetes. This model demonstrates that a partnership between public health and pharmacy is a successful and innovative approach to care.
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    The Narratives of Natural Helpers: a Qualitative Exploration of the Lived Experiences of Community Health Workers in Alabama
    (University of Alabama Libraries, 2024) Agomo, Carol; Nickelson, Jen
    Alabamian access to healthcare is declining in rural areas and rural hospitals are experiencing monetary loss in services due to the high cost in service delivery and low insurance reimbursements. CHWs may complement an under-resourced and over-stretched health workforce, increasing the availability and access to health services. This study aimed to explore the lived experiences and personal knowledge of CHWs in Alabama, share their stories of community impact, and inform CHW employers and decision-makers to guide policy development and training. The research questions that guided this study include: How do lived experiences and personal knowledge of CHWs in Alabama (a) influence their decision to join the CHW workforce, (b) contribute to their ability to work successfully in the field, and (c) influence their motivation to continue in the field? What professional and community-focused aspirations do CHWs in Alabama have for themselves? In what ways do CHWs in Alabama understand their professional identity? How do CHWs in Alabama understand and respond to the contextual messages they receive about their professional role? What challenges and successes do CHWs in Alabama experience as they understand their professional role? Seven CHWs were recruited using purposive sampling and shared their stories in individual online interviews. The findings illuminate the caring nature of CHWs, curiosity as a motivator, and the value CHWs place in having a network of support. Analysis revealed four themes and 12 sub-themes. This study provides insights into the meaning of the CHW role to CHWs in Alabama through their lived experiences.
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    Understanding the Drivers of Vaccine Hesitancy During COVID-19 in Mississippi, United States
    (University of Alabama Libraries, 2025) Naher, Shabnam; Hites, Lisle
    This dissertation examines vaccine hesitancy in Mississippi, a state with low vaccination rates and healthcare disparities. Using a quantitative approach with secondary data, guided by the Health Belief Model and Social Ecological Model, this study explores vaccine acceptance through three interconnected papers. The first two analyze data from the “Mississippi State Department of Health Vaccine Confidence Survey”, while the third uses the “Mississippi Medical Professional Vaccine Confidence Survey”. In the first study, I explored how physician-participant demographic concordance affects vaccine intentions. Race-concordant physician trust consistently associated with lower vaccine intentions, potentially reflecting deep-rooted historical (mis)trust. Gender- and age-concordant trust initially showed negative associations but shifted after adjusting for demographic and socioeconomic factors. Subgroup analyses revealed that race-concordant trust increased intentions among both White and Black participants, while gender-concordance was linked to lower intentions for both men and women. Age-concordance negatively influenced older adults’ intentions. Education, income, and widowhood increased vaccine confidence; however, private/no insurance and Republican affiliation lowered it. Physician diversity is likely to improve trust; however, Mississippi’s provider shortage necessitates practical strategies to increase representation where feasible.In the second study, I examined demographic predictors of two domains of vaccine concerns: health risk and trust, and efficacy and timing. Older age and higher education correlated with reduced health risk and trust concerns, while Black participants reported more skepticism. Education also corresponded with slightly greater concerns about efficacy and timing, particularly among women. Higher income decreased overall concerns, whereas Republican affiliation was linked to lower perceived safety and effectiveness. In my third paper, I examined how demographic and decision-making factors influence HCWs' vaccine advocacy. Conspiracy-related concerns reduced vaccine promotion, while risk and safety concerns were not predictive. Political affiliation was non-significant, though Independents trended toward greater encouragement than Republicans. Gender had no significant effect. Interaction analysis revealed no moderating effects of gender or political affiliation, reinforcing that attitudinal rather than demographic factors drive hesitancy. Given the small sample and exclusion of pediatric providers, results should be interpreted cautiously. Findings highlight the need for HCW training, peer influence, and (mis)information correction to strengthen vaccine promotion in MS.
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    The Urgent Need for Public Health Preparedness Funding and Support
    (American Public Health Association, 2021) Degutis, Linda C.; Shoaf, Kimberley; Aragon, Tomas J.; Atchison, Christopher; Dyjack, David; Hites, Lisle; Links, Jonathan; Olson, Debra; Potter, Margaret; Thompson, Jack; Turnock, Bernard; Yale University; University of Utah; San Francisco Department of Public Health; University of Iowa; University of Alabama Tuscaloosa; Johns Hopkins University; Johns Hopkins Bloomberg School of Public Health; University of Minnesota Twin Cities; University of Pittsburgh; University of Washington; University of Washington Seattle; University of Illinois Chicago; University of Illinois Chicago Hospital