Effective applied anthropology needs to move toward the bringing together of researchers and prac... more Effective applied anthropology needs to move toward the bringing together of researchers and practitioners, toward the development of collaborative research models, and toward explicitly outlined approaches to change Any training program in applied These same models have been deanthropology or the applied behavioral • scribed in applied anthropology and adsciences should begin with the following ministration, culturalbrokerage, in health assumptions: and mental health settings, and .. colla-• that the institutionalization of anthro-borative research in community and instipology in tbe university has been central to tutional settings. Effectjve applied anthroits survival as a discipline;
... To do so, it draws on methods and approaches used in network research and sociogeographicmapp... more ... To do so, it draws on methods and approaches used in network research and sociogeographicmapping, as well as essential ethnographic methods ... The second chapter in Book 4 moves readers from social relationships to the location of these relationships in geo-graphic space ...
The AIDS crisis has forced the consideration of controversial prevention strategies, including th... more The AIDS crisis has forced the consideration of controversial prevention strategies, including the public distribution of sterile syringes and needles as a public heath measure. Because this strategy appears to some to condone IV drug use, it has met with considerable opposition. Arguing for the importance of a research approach to evaluating the health costs and benefits of needle exchange, this paper reviews existing studies and reports on needle exchange programs, IV drug user attitudes and behavior relative to needle sharing, and public attitudes on needle access. to draw public health policy recommendations.
This study focuses on the impact of mass media in creating awareness and enhancing efficacy of to... more This study focuses on the impact of mass media in creating awareness and enhancing efficacy of tobacco control interventions by disseminating knowledge to the public about the harmful effects of tobacco. It examines variations in awareness of tobacco's health hazards and anti-tobacco campaigns among 69,296 adults aged 15 and above based on gender and tobacco use (smoked or smokeless) and the role of the media in cessation attempts by tobacco users using data from the Global Adult Tobacco Survey (GATS). The GATS is a household survey which was conducted in India during 2009-10. The study found that a higher proportion of adults was exposed to anti-smoking information across different media compared with anti-smokeless tobacco information. Tobacco users are also less likely to be aware of the health hazards of tobacco compared with non-users. Noticing anti-tobacco messages and knowing the health hazards of smokeless tobacco use are significantly associated with cessation attempts among tobacco users in India. Males are more likely to notice anti-smoking and anti-smokeless tobacco information through any media compared with females.
A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prev... more A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m2 lower than participants who did not drink from well water historically (p = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells (n = 262) indicated 68% had detectable a...
Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income c... more Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income countries are at risk for HIV and other sexually transmitted diseases. This study examines the sex-related risks of young women migrant workers in the IZ in Vietnam.Materials and Methods: This cross-sectional survey was conducted among 1,061 young migrant women working in the IZ park in Hanoi, Vietnam. Multivariate logistic regression analysis was used to identify factors associated with HIV testing and condom use at last sex.Results: A total of 1,061 young women migrant workers completed the survey in which 652 participants consented to take the initial rapid HIV test. All but one participant tested negative indicating a HIV prevalence of 150 (95% CI: 27–860) per 100,000 population among this population. There were no differences in sexual behavior, use of sexual and reproductive health services, HIV knowledge, perceived HIV risk or alcohol use between those who were HIV tested and those...
Background Quality of life outcomes have been used frequently in clinical trials of oral health i... more Background Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention. Methods Participants were recruited from six low-income senior housing residences. Buildings were randomly assigned to receive the individual-based intervention followed by the community-based intervention or to receive the community-based intervention followed by the individual intervention. Participants’ oral hygiene was assessed at baseline (T0), one month after the first intervention (T1) and one month after the second intervention (T2) and six months after the T2 assessment (T3). Oral hygiene was measured by the Gingival Index (GI) and Plaque scores (PS). Surveys collected data on beliefs, attitudes, behaviors and self-reported health status at T0, T1 and T2. Only oral hygiene and quality...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Media campaigns have been shown to affect intention to quit the use of smoked tobacco... more Background: Media campaigns have been shown to affect intention to quit the use of smoked tobacco and quit behaviour among men. However, despite warning messages on tobacco packages and delivered via mass media, such campaigns have had limited reach and effect on women’s use of smokeless tobacco (SLT) and SLT use among Indian women is increasing. This paper explores the association between selected warning messages conveyed through different media mechanisms and intention to quit smokeless tobacco among women of reproductive age in Mumbai.Methods: A cross-sectional community survey was conducted in a representative sample of 409 daily smokeless tobacco (SLT) women users aged 18- 40 years in a low-income community in Mumbai during 2011-2012. The paper utilizes information on socio-demographic characteristics, types of tobacco use, exposure to different types of warning messages and intention to quit collected through a researcher-administered structured questionnaire. Univariate and ...
Depression as well as other psychosocial factors remain largely unaddressed among people living w... more Depression as well as other psychosocial factors remain largely unaddressed among people living with HIV (PLHIV) in low and middle-income countries (LMIC). Depression is a common occurrence among PLHIV and is elevated in those who consume alcohol. This paper will document the presence of depressive symptoms in alcohol-consuming male PLHIV receiving antiretroviral treatment (ART) in India. It examines the correlates of depressive symptoms and uses the data from in-depth interviews to explain the nature of the statistical relationships obtained from an NIH-funded a multilevel, multicentric intervention study. A cross-sectional, baseline survey was administered to 940 alcohol consuming, male PLHIV in five hospital-based ART Centers in urban Maharashtra, India via face to face interviews from October 2015 to April 2016. An additional 55 men were recruited independently to engage in in-depth interviews on alcohol use and other factors related to adherence. The results of the survey showed that approximately 38% of PLHIV reported having moderate to severe depressive symptoms. Depressive symptoms were positively associated with higher levels of family-related concerns (OR=1.18; 95%CI=1.12-1.23), work difficulties (OR=2.04; 95%CI=1.69-2.69) and HIV-related self-stigma (OR=1.05; 95%CI=1.03-1.07) and a lower level of ART service satisfaction (OR=0.58 95% CI:0.44-0.77).
Over the last two decades, a global epidemic of chronic kidney disease of unknown etiology (CKDu)... more Over the last two decades, a global epidemic of chronic kidney disease of unknown etiology (CKDu) has emerged in rural, arid, agricultural, lowland areas. Endemic regions have reported 15 to 20% prevalence among residents aged 30-60 years. CKDu is a progressive and irreversible disease resulting in renal failure and death in the absence of dialysis or a kidney transplant. While much of the research has focused on identifying etiology, this project seeks to ascertain factors associated with the rapidity of kidney disease progression in one of Sri Lanka's CKDu endemic areas. A sample of 296 male and female residents aged 21 to 65 with moderate CKD, as measured by their serum creatinine level, and a clinical diagnosis of CKDu are followed using quarterly serum testing to track the rate of progression. A baseline survey administered to the entire sample addresses potential risk factors, supplemented by a short survey focusing on changes through time. Concurrently water, soil and air...
Asian Pacific journal of cancer prevention : APJCP, Jan 25, 2018
Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users ... more Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users who want to quit. This paper uses Fishbein’s IM model to identify women SLT users’ challenges to quitting and multilevel correlates of “readiness to quit”. Methods: A survey of SLT use among women of reproductive age was conducted in 2010-13 in an urban slum community of Mumbai with a representative sample of 409 married women aged 18 to 40 years using at least one type of SLT daily. Data were analyzed using frequencies, bivariate statistics and logistic regression. Results: Social influences to continue SLT use included husband’s use (71%), family influence and positive beliefs and norms about use. Pressure to quit from significant others influenced past quit attempts but media had no effect on reported behavior. Four groups represented different readiness to quit statues based on intention to quit and past quit/reduce attempts. Seventeen percent had no intention of quitting or reducing...
Great idea to focus more on the 'outside of academia' anthropology. As a PPA myself I have a ton ... more Great idea to focus more on the 'outside of academia' anthropology. As a PPA myself I have a ton of wishes about dialogue and support, that I thought I could find through a membership of AAA. I haven't been successful in finding groups of people within applied anthropology, or journals that are updated about issues like 'how to increase sales by using anthropological methods'. EASA has a 'why does the world need anthropologist' seminar in Nov. which sounds awesome, but that's sort of all I could find. Everybody talks about anthropology in business, but we're generally silent. Why? And anyone want to get together and put something out there? Reply
Journal of urban health : bulletin of the New York Academy of Medicine, Jan 6, 2017
Neighborhood-level structural interventions are needed to address HIV/AIDS in highly affected are... more Neighborhood-level structural interventions are needed to address HIV/AIDS in highly affected areas. To develop these interventions, we need a better understanding of contextual factors that drive the pandemic. We used multinomial logistic regression models to examine the relationship between census tract of current residence and mode of HIV transmission among HIV-positive cases. Compared to the predominantly white high HIV prevalence tract, both the predominantly black high and low HIV prevalence tracts had greater odds of transmission via injection drug use and heterosexual contact than male-to-male sexual contact. After adjusting for current age, gender, race/ethnicity, insurance status, and most recently recorded CD4 count, there was no statistically significant difference in mode of HIV transmission by census tract. However, heterosexual transmission and injection drug use remain key concerns for underserved populations. Blacks were seven times more likely than whites to have h...
HIV has reached epidemic proportions among African Americans in the USA but certain urban context... more HIV has reached epidemic proportions among African Americans in the USA but certain urban contexts appear to experience a disproportionate disease burden. Geographic information systems mapping in Philadelphia indicates increased HIV incidence and prevalence in predominantly Black census tracts, with major differences across adjacent communities. What factors shape these geographic HIV disparities among Black Philadelphians? This descriptive study was designed to refine and validate a conceptual model developed to better understand multi-level determinants of HIV-related risk among Black Philadelphians. We used an expanded ecological approach to elicit reflective perceptions from administrators, direct service providers and community members about individual, social and structural factors that interact to protect against or increase the risk for acquiring HIV within their community. Gender equity, social capital and positive cultural mores (e.g., monogamy, abstinence) were seen as t...
Community-based Participatory Research (CBPR) provides a methodology that creates mutually benefi... more Community-based Participatory Research (CBPR) provides a methodology that creates mutually beneficial and equitable partnerships between researchers and community people involved in positive change. Participatory Action Research (PAR) is rooted in trust, connectivity, and reciprocity to address issues and actions that remedy inequitable social, economic, and environmental problems arising from racism rooted in structural/political imbalances. In this paper, we discuss the Health Equity Alliance of Tallahassee (HEAT) and its affiliated six week Ethnographic Field School that trains graduate students in CBPR methodology by bringing faculty, local community activists and stakeholders, and students together for mutual learning in dynamic classroom, community, and social settings. The paper offers reflections on the experience by a student, HEAT activist, local and visiting faculty, and demonstrate how a model field school based on PAR offers an empirical approach to building capacity to...
Abstract: This paper compares older drug users' exposure to HIV infection or to infectin... more Abstract: This paper compares older drug users' exposure to HIV infection or to infecting others with the HIV virus to that of their younger counterparts and addresses the extent to which their personal networks, and the macro-networks within which they use drugs, play ...
Effective applied anthropology needs to move toward the bringing together of researchers and prac... more Effective applied anthropology needs to move toward the bringing together of researchers and practitioners, toward the development of collaborative research models, and toward explicitly outlined approaches to change Any training program in applied These same models have been deanthropology or the applied behavioral • scribed in applied anthropology and adsciences should begin with the following ministration, culturalbrokerage, in health assumptions: and mental health settings, and .. colla-• that the institutionalization of anthro-borative research in community and instipology in tbe university has been central to tutional settings. Effectjve applied anthroits survival as a discipline;
... To do so, it draws on methods and approaches used in network research and sociogeographicmapp... more ... To do so, it draws on methods and approaches used in network research and sociogeographicmapping, as well as essential ethnographic methods ... The second chapter in Book 4 moves readers from social relationships to the location of these relationships in geo-graphic space ...
The AIDS crisis has forced the consideration of controversial prevention strategies, including th... more The AIDS crisis has forced the consideration of controversial prevention strategies, including the public distribution of sterile syringes and needles as a public heath measure. Because this strategy appears to some to condone IV drug use, it has met with considerable opposition. Arguing for the importance of a research approach to evaluating the health costs and benefits of needle exchange, this paper reviews existing studies and reports on needle exchange programs, IV drug user attitudes and behavior relative to needle sharing, and public attitudes on needle access. to draw public health policy recommendations.
This study focuses on the impact of mass media in creating awareness and enhancing efficacy of to... more This study focuses on the impact of mass media in creating awareness and enhancing efficacy of tobacco control interventions by disseminating knowledge to the public about the harmful effects of tobacco. It examines variations in awareness of tobacco's health hazards and anti-tobacco campaigns among 69,296 adults aged 15 and above based on gender and tobacco use (smoked or smokeless) and the role of the media in cessation attempts by tobacco users using data from the Global Adult Tobacco Survey (GATS). The GATS is a household survey which was conducted in India during 2009-10. The study found that a higher proportion of adults was exposed to anti-smoking information across different media compared with anti-smokeless tobacco information. Tobacco users are also less likely to be aware of the health hazards of tobacco compared with non-users. Noticing anti-tobacco messages and knowing the health hazards of smokeless tobacco use are significantly associated with cessation attempts among tobacco users in India. Males are more likely to notice anti-smoking and anti-smokeless tobacco information through any media compared with females.
A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prev... more A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m2 lower than participants who did not drink from well water historically (p = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells (n = 262) indicated 68% had detectable a...
Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income c... more Background: Young migrant workers working in the industrial zones (IZ) in low and middle-income countries are at risk for HIV and other sexually transmitted diseases. This study examines the sex-related risks of young women migrant workers in the IZ in Vietnam.Materials and Methods: This cross-sectional survey was conducted among 1,061 young migrant women working in the IZ park in Hanoi, Vietnam. Multivariate logistic regression analysis was used to identify factors associated with HIV testing and condom use at last sex.Results: A total of 1,061 young women migrant workers completed the survey in which 652 participants consented to take the initial rapid HIV test. All but one participant tested negative indicating a HIV prevalence of 150 (95% CI: 27–860) per 100,000 population among this population. There were no differences in sexual behavior, use of sexual and reproductive health services, HIV knowledge, perceived HIV risk or alcohol use between those who were HIV tested and those...
Background Quality of life outcomes have been used frequently in clinical trials of oral health i... more Background Quality of life outcomes have been used frequently in clinical trials of oral health interventions. This study assessed the effects of a randomized trial on oral health related quality of life comparing an individual-based oral hygiene intervention to a community-based intervention. Methods Participants were recruited from six low-income senior housing residences. Buildings were randomly assigned to receive the individual-based intervention followed by the community-based intervention or to receive the community-based intervention followed by the individual intervention. Participants’ oral hygiene was assessed at baseline (T0), one month after the first intervention (T1) and one month after the second intervention (T2) and six months after the T2 assessment (T3). Oral hygiene was measured by the Gingival Index (GI) and Plaque scores (PS). Surveys collected data on beliefs, attitudes, behaviors and self-reported health status at T0, T1 and T2. Only oral hygiene and quality...
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: Media campaigns have been shown to affect intention to quit the use of smoked tobacco... more Background: Media campaigns have been shown to affect intention to quit the use of smoked tobacco and quit behaviour among men. However, despite warning messages on tobacco packages and delivered via mass media, such campaigns have had limited reach and effect on women’s use of smokeless tobacco (SLT) and SLT use among Indian women is increasing. This paper explores the association between selected warning messages conveyed through different media mechanisms and intention to quit smokeless tobacco among women of reproductive age in Mumbai.Methods: A cross-sectional community survey was conducted in a representative sample of 409 daily smokeless tobacco (SLT) women users aged 18- 40 years in a low-income community in Mumbai during 2011-2012. The paper utilizes information on socio-demographic characteristics, types of tobacco use, exposure to different types of warning messages and intention to quit collected through a researcher-administered structured questionnaire. Univariate and ...
Depression as well as other psychosocial factors remain largely unaddressed among people living w... more Depression as well as other psychosocial factors remain largely unaddressed among people living with HIV (PLHIV) in low and middle-income countries (LMIC). Depression is a common occurrence among PLHIV and is elevated in those who consume alcohol. This paper will document the presence of depressive symptoms in alcohol-consuming male PLHIV receiving antiretroviral treatment (ART) in India. It examines the correlates of depressive symptoms and uses the data from in-depth interviews to explain the nature of the statistical relationships obtained from an NIH-funded a multilevel, multicentric intervention study. A cross-sectional, baseline survey was administered to 940 alcohol consuming, male PLHIV in five hospital-based ART Centers in urban Maharashtra, India via face to face interviews from October 2015 to April 2016. An additional 55 men were recruited independently to engage in in-depth interviews on alcohol use and other factors related to adherence. The results of the survey showed that approximately 38% of PLHIV reported having moderate to severe depressive symptoms. Depressive symptoms were positively associated with higher levels of family-related concerns (OR=1.18; 95%CI=1.12-1.23), work difficulties (OR=2.04; 95%CI=1.69-2.69) and HIV-related self-stigma (OR=1.05; 95%CI=1.03-1.07) and a lower level of ART service satisfaction (OR=0.58 95% CI:0.44-0.77).
Over the last two decades, a global epidemic of chronic kidney disease of unknown etiology (CKDu)... more Over the last two decades, a global epidemic of chronic kidney disease of unknown etiology (CKDu) has emerged in rural, arid, agricultural, lowland areas. Endemic regions have reported 15 to 20% prevalence among residents aged 30-60 years. CKDu is a progressive and irreversible disease resulting in renal failure and death in the absence of dialysis or a kidney transplant. While much of the research has focused on identifying etiology, this project seeks to ascertain factors associated with the rapidity of kidney disease progression in one of Sri Lanka's CKDu endemic areas. A sample of 296 male and female residents aged 21 to 65 with moderate CKD, as measured by their serum creatinine level, and a clinical diagnosis of CKDu are followed using quarterly serum testing to track the rate of progression. A baseline survey administered to the entire sample addresses potential risk factors, supplemented by a short survey focusing on changes through time. Concurrently water, soil and air...
Asian Pacific journal of cancer prevention : APJCP, Jan 25, 2018
Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users ... more Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users who want to quit. This paper uses Fishbein’s IM model to identify women SLT users’ challenges to quitting and multilevel correlates of “readiness to quit”. Methods: A survey of SLT use among women of reproductive age was conducted in 2010-13 in an urban slum community of Mumbai with a representative sample of 409 married women aged 18 to 40 years using at least one type of SLT daily. Data were analyzed using frequencies, bivariate statistics and logistic regression. Results: Social influences to continue SLT use included husband’s use (71%), family influence and positive beliefs and norms about use. Pressure to quit from significant others influenced past quit attempts but media had no effect on reported behavior. Four groups represented different readiness to quit statues based on intention to quit and past quit/reduce attempts. Seventeen percent had no intention of quitting or reducing...
Great idea to focus more on the 'outside of academia' anthropology. As a PPA myself I have a ton ... more Great idea to focus more on the 'outside of academia' anthropology. As a PPA myself I have a ton of wishes about dialogue and support, that I thought I could find through a membership of AAA. I haven't been successful in finding groups of people within applied anthropology, or journals that are updated about issues like 'how to increase sales by using anthropological methods'. EASA has a 'why does the world need anthropologist' seminar in Nov. which sounds awesome, but that's sort of all I could find. Everybody talks about anthropology in business, but we're generally silent. Why? And anyone want to get together and put something out there? Reply
Journal of urban health : bulletin of the New York Academy of Medicine, Jan 6, 2017
Neighborhood-level structural interventions are needed to address HIV/AIDS in highly affected are... more Neighborhood-level structural interventions are needed to address HIV/AIDS in highly affected areas. To develop these interventions, we need a better understanding of contextual factors that drive the pandemic. We used multinomial logistic regression models to examine the relationship between census tract of current residence and mode of HIV transmission among HIV-positive cases. Compared to the predominantly white high HIV prevalence tract, both the predominantly black high and low HIV prevalence tracts had greater odds of transmission via injection drug use and heterosexual contact than male-to-male sexual contact. After adjusting for current age, gender, race/ethnicity, insurance status, and most recently recorded CD4 count, there was no statistically significant difference in mode of HIV transmission by census tract. However, heterosexual transmission and injection drug use remain key concerns for underserved populations. Blacks were seven times more likely than whites to have h...
HIV has reached epidemic proportions among African Americans in the USA but certain urban context... more HIV has reached epidemic proportions among African Americans in the USA but certain urban contexts appear to experience a disproportionate disease burden. Geographic information systems mapping in Philadelphia indicates increased HIV incidence and prevalence in predominantly Black census tracts, with major differences across adjacent communities. What factors shape these geographic HIV disparities among Black Philadelphians? This descriptive study was designed to refine and validate a conceptual model developed to better understand multi-level determinants of HIV-related risk among Black Philadelphians. We used an expanded ecological approach to elicit reflective perceptions from administrators, direct service providers and community members about individual, social and structural factors that interact to protect against or increase the risk for acquiring HIV within their community. Gender equity, social capital and positive cultural mores (e.g., monogamy, abstinence) were seen as t...
Community-based Participatory Research (CBPR) provides a methodology that creates mutually benefi... more Community-based Participatory Research (CBPR) provides a methodology that creates mutually beneficial and equitable partnerships between researchers and community people involved in positive change. Participatory Action Research (PAR) is rooted in trust, connectivity, and reciprocity to address issues and actions that remedy inequitable social, economic, and environmental problems arising from racism rooted in structural/political imbalances. In this paper, we discuss the Health Equity Alliance of Tallahassee (HEAT) and its affiliated six week Ethnographic Field School that trains graduate students in CBPR methodology by bringing faculty, local community activists and stakeholders, and students together for mutual learning in dynamic classroom, community, and social settings. The paper offers reflections on the experience by a student, HEAT activist, local and visiting faculty, and demonstrate how a model field school based on PAR offers an empirical approach to building capacity to...
Abstract: This paper compares older drug users' exposure to HIV infection or to infectin... more Abstract: This paper compares older drug users' exposure to HIV infection or to infecting others with the HIV virus to that of their younger counterparts and addresses the extent to which their personal networks, and the macro-networks within which they use drugs, play ...
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Papers by Jean Schensul