Publications by authors named "Sarojini Kanotra"

6 Publications

  • Page 1 of 1

A population-based estimate of the health care burden of obstructive sleep apnea using a STOP-BAG questionnaire in South Carolina.

J Clin Sleep Med 2021 03;17(3):367-374

Division of Pulmonary Diseases and Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Study Objectives: Population based estimates of obstructive sleep apnea (OSA) frequency and health impact are incomplete. The aim of this study was to determine the prevalence of risk factors for physician and sleep study diagnosed OSA among individuals in a state-based surveillance program.

Methods: Using questions inserted into the 2016 (n = 5,564) and 2017 (n = 10,884) South Carolina Behavioral Risk Factor Surveillance System of the Centers for Disease Control and Prevention, we analyzed the prevalence of physician diagnosed OSA and associated comorbidities. The validated STOP-BANG questionnaire without neck circumference (STOP-BAG) defined populations at moderate risk (score 3-4) and high risk (score 5-7). Statistical analysis using weighted prevalence and means and their 95% confidence intervals (CI) thus reflect population estimates of disease burden.

Results: The population-based prevalence of physician diagnosed OSA in South Carolina was 9.7% (95% CI: 9.0-10.4). However, the populations with moderate risk (18.5%, 95% CI: 17.3-19.8) and high risk (25.5%, 95% CI: 23.9-27.1) for OSA, as determined by the STOP-BAG questionnaire, were much higher. Compared to those at low risk for OSA, those at high risk were more often diagnosed with coronary heart disease, stroke, asthma, skin cancer, other cancers, chronic obstructive pulmonary disease, arthritis, depression, kidney disease, and diabetes (all P < .001).

Conclusions: OSA is common and strongly associated with major comorbidities. As such, this public health crisis warrants more diagnostic and therapeutic attention. The STOP-BAG questionnaire provides a public health platform to monitor this disease.
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March 2021

Prevalence and Comorbidities of Chronic Obstructive Pulmonary Disease Among Adults in Kentucky Across Gender and Area Development Districts, 2011.

Chronic Obstr Pulm Dis 2015 Oct 15;2(4):296-312. Epub 2015 Oct 15.

Kentucky Department for Public Health, Frankfort.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in Kentucky, and precise estimates of the prevalence of this disease and its comorbidities are needed. This study aimed to determine the prevalence of both COPD and its comorbidities and risk differences of COPD comorbidities across Area Development Districts (ADDs) and gender. The demographic characteristics, prevalence of self- reported COPD and its comorbidities were determined by using data from the 2011 Kentucky Behavioral Risk Factor Survey (KyBRFS). Logistic regression was used to estimate adjusted odds ratios (ORs) for COPD and comorbidities. The overall prevalence of age adjusted COPD was 10.09% (95% confidence interval [CI] 9.99, 10.19), 8.85% for men (95% CI 8.76, 8.93), and 10.78% for women (95% CI 10.67, 10.88). Odds ratios for risk of angina or coronary heart disease (CHD), and arthritis among patients with COPD, by sex and ADDs varied significantly (pooled overall OR=3.43, 95% CI 2.70-4.34, heterogeneity =0.0001) and (pooled overall OR=2.16, 95% CI 1.75-2.67, heterogeneity =0.0001), respectively. ORs for risk of depression (pooled OR=2.61, 95% CI 1.78-3.70, heterogeneity =0.028) and hypertension (pooled OR=1.67, 95% CI 1.16-2.42, heterogeneity =0. 006) only varied significantly in men. Odds ratios for risk of diabetes was not significant across ADDs and gender (pooled overall OR=2.02, 95% CI 1.61-2.53, heterogeneity =0.709). Gender differences account for the discrepancy in the risk of comorbidities in patients with COPD across Kentucky's Area Development Districts. This should guide public health officials and physicians to create gender-based prevention interventions.
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October 2015

Understanding Barriers to Colorectal Cancer Screening in Kentucky.

Prev Chronic Dis 2015 Jun 18;12:E95. Epub 2015 Jun 18.

Kentucky Department for Public Health, Frankfort, Kentucky.

Introduction: Colorectal cancer screening rates have increased significantly in Kentucky, from 35% in 1999 to 66% in 2012. A continued improvement in screening requires identification of existing barriers and implementation of interventions to address barriers.

Methods: The state of Kentucky added a question to the 2012 Kentucky Behavioral Risk Factor Surveillance System survey for respondents aged 50 years or older who answered no to ever having been screened for colorectal cancer by colonoscopy or sigmoidoscopy to assess the reasons why respondents had not been screened. Combined responses constituted 4 categories: attitudes and beliefs, health care provider and health care systems barriers, cost, and other. Prevalence estimates for barriers were calculated by using raking weights and were stratified by race/ethnicity, sex, education, income, and health insurance coverage. Logistic regression estimated odds ratios for barriers to screening.

Results: The most common barriers in all areas were related to attitudes and beliefs, followed by health care provider and systems, and cost. Non-Hispanic whites and respondents with more than a high school education were more likely to choose attitudes and beliefs as a barrier than were non-Hispanic blacks and those with less than a high school education. Respondents with low incomes and with no insurance were significantly more likely to select cost as a barrier. No significant associations were observed between demographic variables and the selection of a health care provider and a health care system.

Conclusion: Barriers related to education, race/ethnicity, income, and insurance coverage should be considered when designing interventions. Expansion of Medicaid and implementation of the Affordable Care Act in Kentucky could have an impact on reducing these barriers.
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June 2015

Proportion of dermatitis attributed to work exposures in the working population, United States, 2011 behavioral risk factor surveillance system.

Am J Ind Med 2014 Jun 11;57(6):653-9. Epub 2014 Mar 11.

Connecticut Department of Public Health, Occupational Health Unit, Hartford, Connecticut.

Background: The US employer-based surveillance system for work-related health conditions underestimates the prevalence of work-related dermatitis.

Objective: The authors sought to utilize information from workers to improve the accuracy of prevalence estimates for work-related dermatitis.

Methods: Three state health departments included questions in the 2011 Behavioral Risk Factor Surveillance System survey designed to ascertain the prevalence of dermatitis in the working population, as well as healthcare experiences, personal perceptions of work-relatedness, and job changes associated with dermatitis.

Results: The percentage of working respondents who reported receiving a clinician's opinion that their dermatitis was work-related was between 3.8% and 10.2%. When patients' perceptions were considered, the work-related dermatitis prevalence estimate increased to between 12.9% and 17.6%.

Conclusions: Including patients' perceptions of work-relatedness produced a larger prevalence estimate for work-related dermatitis than the previously published estimate of 5.6%, which included only those cases of dermatitis attributed to work by healthcare professionals.
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June 2014

The effect of parental involvement on problematic social behaviors among school-age children in Kentucky.

Matern Child Health J 2012 Dec;16 Suppl 2:287-97

Division of Maternal and Child Health, Kentucky Department for Public Health, 275 East Main Street, Frankfort, KY 40601, USA.

This study examines the associations among parental active involvement and healthy role modeling behavior with social behavior among children in Kentucky and the nation. Data from the 2007 National Survey of Children's Health was used, limited to children 6-17 years old. The dependent variable was a composite measure of problematic social behavior. Independent variables included parental involvement, parental healthy role modeling, and demographic variables. Chi square tests of independence were completed for bivariate analyses and multivariable logistic regression models were developed for Kentucky and the nation. The prevalence of problematic social behaviors in children was 10.4 % in Kentucky and 8.8 % in the nation. The parents of children in Kentucky who often exhibited problematic social behavior reported poor parent-child communication (50.4 %), not coping well with parenthood (56.5 %), parental aggravation (48.3 %), and less emotional help with parenting (9.1 %). The factor with the largest magnitude of association in Kentucky (adjusted odds ratio [AOR] = 6.2; 95 % confidence interval [CI]: 1.6, 24.5) and the nation (AOR = 4.8; 95 % CI: 3.3, 7.0) was observed for whether or not the parent communicated well with the child. Additional factors associated with problematic social behavior among children in Kentucky were living in a single parent, mother-led household, and having a parent with fair or poor mental health. Public health programs that target factors addressing the parent-child dyad, parent-child communication, and model healthy relationships may reduce the occurrence of problematic social behavior in 6-17-year-old children in Kentucky.
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December 2012

Challenges faced by new mothers in the early postpartum period: an analysis of comment data from the 2000 Pregnancy Risk Assessment Monitoring System (PRAMS) survey.

Matern Child Health J 2007 Nov 12;11(6):549-58. Epub 2007 Jun 12.

Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA.

Objective: To identify challenges that women face 2-9 months postpartum using qualitative data gathered by the Pregnancy Risk Assessment Monitoring System (PRAMS).

Methods: PRAMS is an on-going population-based surveillance system that collects self-reported information on maternal behaviors and experiences before, during, and after the birth of a live infant. We analyzed free text comment data from women in 10 states who answered the PRAMS survey in 2000. Preliminary analysis included a review of the comment data to identify major themes and a demographic comparison of women who commented (n = 3,417) versus women who did not (n = 12,497). Subsequent analysis included systematic coding of the data from 324 women that commented about postpartum concerns and evaluation to ensure acceptable levels of reliability among coders.

Results: We identified the following major themes, listed in order of frequency: (1) need for social support, (2) breastfeeding issues, (3) lack of education about newborn care after discharge, (4) need for help with postpartum depression, (5) perceived need for extended postpartum hospital stay, and (6) need for maternal insurance coverage beyond delivery.

Conclusion: The themes identified indicate that new mothers want more social support and education and that some of their concerns relate to policies regarding breastfeeding and medical care. These results can be used to inform programs and policies designed to address education and continuity of postpartum care for new mothers.
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November 2007