Mariano Kanamori

Background. In 2007, there were 898,000 orphans because of AIDS in Ethiopia. There is a need to increase access to, and availability of, compassionate, effective, and culturally appropriate services for the care of these orphans and vulnerable children (OVC) and their families. To that end, the Salesian Missions has configured a social network composed by USAID-Ethiopia, federal and local HIV/AIDS Planning and Coordinating Offices, the Ethiopian government, local and regional non-governmental organizations, and the Project Concern International to implement and evaluate the Caring for our youth project (Caring) in Addis Ababa, Makele, Adigrat, Zway, and Debre Zeit, Ethiopia. Methods. This study presents Caring's multilevel strategy aimed at increasing the number of OVC with: 1) essential needs for shelter and care met; 2) formal and non-formal educational opportunities; 3) households with improved economic status; 4) access to health care, nutritional, legal, and psychosocial su...

Smoking is the leading cause of disease and death in Maryland. To better understand the quitting process in Maryland we examined data from the 2006 Maryland Adult Tobacco Survey (MATS), one of the largest tobacco surveys in the U.S. (n=21,799). Ex-smokers and smokers were given a list of 14 reasons why people quit smoking. The top reason among both ex-smokers (34.5%) and smokers (40.7%) was physical fitness. In examining ethnic minorities, the MATS found that Latino ex-smokers (22.3%) and smokers (23.0%) were significantly less likely than White ex-smokers (36.6%) and smokers (41.7%) to state that physical fitness was a reason. The second most reported reason for ex-smokers (33.3%) was concern about health hazards, with Latinos (22.8%) less likely to report health hazards than Whites (35.5%). The second most reported reason to quit for smokers was personal health problems (38.5%) with Latinos (32.4%) being the least likely to report this reason compared to other ethnic groups (nonsi...

Background Little is known regarding social and environmental factors that may be associated with smoking onset. Further understanding may aid in prevention efforts consistent with HP 2010 objectives. Methods This study investigates multiple factors associated with adolescent initiation in the Maryland Youth Tobacco Survey, one of the largest and most diverse school-based surveys in the U.S.(308 middle and high schools; n=82,500) including 1,969 American Indians, 3,226 Asians, 20,739 Blacks, 3,898 Hispanics, and 1,015 Native Hawaiian/Pacific Islanders. The questionnaire was administered in paper-and-pencil format either in individual classrooms or in alternative locations using CDC protocols. Results Black youth were less likely to initiate smoking during the past year compared to White or Hispanic youth. Bivariate analyses show that youth living with current smokers were significantly more likely to initiate smoking as were youth reporting second hand smoke exposure in rooms or car...

Background. Ethiopia is struggling to provide needed services to approximately 898,000 orphaned and vulnerable children (OVC) due to AIDS. Education provides OVC hope to improve quality of life and community development. This socio-ecological study addresses the need for understanding how health, nutritional and societal factors at the inter-personal, intra-personal, community and societal levels are associated with OVC's adequate school performance. Methods. This cross-sectional study used data from the Caring Program for 816 Ethiopian OVC 7-18 year old from Oromiya, Tigray and Addis Ababa. Child Status Index measures were analyzed using univariate, bivariate and logistic regression statistics. Adequate school performance was defined as enrollment and attendance (regularly or irregularly) at school or a skills training program, or engagement in age-appropriate play, learning activity or job. Results. 62.8% of OVC had adequate school performance. Compared to those residing in Ad...

Introduction: Ethiopia's current challenges include the health and migration of millions of HIV/AIDS impacted orphan/vulnerable children (OVC). Many OVCs' families migrate. This study aims to understand associations between climate changes and migration on OVC families' health and food access. Methods: In November 2011, 8 focus groups (n=149) were conducted in Amharic, Trigregna and English with professionals working with OVC, community leaders from high prevalent OVC communities and OVC's caregivers in 6 Ethiopian towns: Addis Ababa, Adigrat, Adwa, DebreZeit, Mekelle and Zeway. Semi-structured, open-ended questions collected data on societal changes, climate change and internal migration. A research panel developed coding schemes and analyzed the data using ATLAS.ti: Qualitative Software. Results: Factors influencing migration include: proliferation of flower farms, expensive rent, governmental resettlement plans, seasonal jobs (e.g., cobblestone), shortage of farmi...

Around 10% of adolescent students under 18 years have current asthma. Asthmatic adolescents smoke as much or more than non-asthmatic adolescents. We explored the association between exposure to mass media and social networks' influence with asthmatic student smoking, and variations of these exposures by sex. This study included 9755 asthmatic and 38,487 non-asthmatic middle and high school students. Secondary data analysis incorporated the complex sample design; and univariate, bivariate, and logistic regression statistics. Asthmatic students had greater odds of smoking than non-asthmatic students. Asthmatic female students were more likely than asthmatic male students to have been exposed to secondhand smoke in rooms or cars and to smoking actors, but less likely to associate smoking with intent to wear tobacco-marketing products, or with looking cool/fitting in. Asthmatic male and female students, who have smoking friends, were exposed to secondhand smoke in rooms (only girls)...

Enhancement of women's autonomy is a key factor for improving women's health and nutrition. With nearly 12 million orphan and vulnerable children (OVC) in Africa due to HIV/AIDS, the study of OVC primary caregivers' nutrition is fundamental. We investigated the association between married women's autonomy and their nutritional status; explored whether this relationship was modified by OVC primary caregiving; and analyzed whether decision-making autonomy mediated the association between household wealth and body mass index (BMI). This cross-sectional study used the data from Demographic Health Surveys collected during 2006-2007 from 20- to 49-year-old women in Namibia (n = 2633), Swaziland (n = 1395), and Zambia (n = 2920). Analyses included logistic regression, Sobel, and Goodman tests. Our results indicated that women's educational attainment increased the odds for being overweight (Swaziland and Zambia) and decreased the odds for being underweight (Namibia). In...

Enhancement of women's autonomy is a key factor for improving women's health and nutrition. With nearly 12 million orphan and vulnerable children (OVC) in Africa due to HIV/AIDS, the study of OVC primary caregivers' nutrition is fundamental. We investigated the association between married women's autonomy and their nutritional status; explored whether this relationship was modified by OVC primary caregiving; and analyzed whether decision-making autonomy mediated the association between household wealth and body mass index (BMI). This cross-sectional study used the data from Demographic Health Surveys collected during 2006-2007 from 20- to 49-year-old women in Namibia (n = 2633), Swaziland (n = 1395), and Zambia (n = 2920). Analyses included logistic regression, Sobel, and Goodman tests. Our results indicated that women's educational attainment increased the odds for being overweight (Swaziland and Zambia) and decreased the odds for being underweight (Namibia). In...

ABSTRACT Background. Africa is facing a nutritional transition where underweight and overweight coexist.The association between being an orphan and vulnerable child (OVC) caregiver in Africa on the caregivers' overweight status is inadequately understood. OVC caregivers should be in the spotlight due to the crisis that 12 million OVC represents in Africa. This cross-sectional study investigated the association between African OVC caregiving and women's overweight status, and the modifying role of socio-demographic characteristics on this relationship. Methods. Demographic Health Surveys data collected during 2006-2007 from 20-49 year old women in Namibia (n=6,638), Swaziland (n=3,285), and Zambia (n=4,497) were analyzed using weighted marginal means and logistic regressions. Results. The overweight prevalence for 20-49 year old women was 34.2% in Namibia, 59.5% in Swaziland and 22.1% in Zambia.In Namibia, non-OVC caregivers (OR=1.70; 95% CI=1.08-2.68) and non-primary caregivers not living with an OVC (OR=2.59; 95% CI=1.57-4.27) were more likely to be overweight than OVC primary caregivers. In Zambia, non-OVC caregivers were less likely to be overweight than OVC caregivers (OR=0.54; 95% CI=0.41-0.71). In Swaziland and Zambia, OVC caregivers were more likely to be overweight than non-child caregivers. Women's age (Namibia) and parity (Zambia) were effect modifiers. Conclusions. Overweight problems among African OVC caregivers have emerged and should be addressed. Given the chronic nature of most diseases associated with overweight and by extension the huge cost of treatment, African public health systems and programs targeting OVC families should be prepared to face a new overweight epidemic alongside existing ones such as HIV/AIDS, tuberculosis, and malaria.

Purpose. Identify demographic, social, and environmental factors associated with smoking initiation in a large, racially and ethnically diverse sample of underage youth participating in the 2006 Maryland Youth Tobacco Survey. Design. Cross-sectional, multistage, probability sample survey. Setting. Schools (308 middle and high schools) in Maryland. Subjects. Subjects were 12- to 17-year-old adolescents participating in a school-based survey. New smokers and nonsmokers were included in the analysis (n = 57,072). Measures. Social and media influence, secondhand smoke exposure, tobacco product use, and demographic information including age, race/ethnicity, and geographic region. Analysis. Chi-square and multiple logistic regression analyses controlling for clustering. Results. Hispanic and Hawaiian/Pacific Islander youth were most likely and Asian and Black youth were least likely to be new smokers. Smoking initiation was positively associated with higher age, living with a current smok...

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.

American Indians have the highest prevalence of cigarette use in the United States, but there is a shortage of knowledge about American Indians' own perspectives on smoking and cessation. The purpose of this exploratory qualitative study was to obtain information on American Indians' views that would be useful for subsequent intervention planning and development. Four focus groups were conducted with urban American Indians living in Maryland to explore the sociocultural contexts of tobacco use and their perspectives on various mainstream and culturally-specific smoking cessation strategies and service delivery models. Tobacco interventions targeting American Indians should increase service access, address negative experiences with medications, emphasize empowerment for behavior change, explicitly distinguish ceremonial tobacco from cigarette use, and send culturally-relevant messages. Smoking cessation programs and health promotion efforts may be perceived as more relevant by the target population if they incorporate an understanding of the social and cultural facets of smoking behavior.