Papers by Debarchana Ghosh
Cancer Epidemiology, Biomarkers & Prevention, Jan 2, 2024
Landscape and Urban Planning, Sep 1, 2023
BACKGROUND Antiretroviral therapy (ART) is effective in reducing HIV-related morbidity and mortal... more BACKGROUND Antiretroviral therapy (ART) is effective in reducing HIV-related morbidity and mortality, and transmission among people with HIV (PWH). Adherence and persistence to ART, however, is crucial for successful HIV treatment outcomes. PWH who are cocaine users have poor access to HIV services and lower retention in care. OBJECTIVE The goal of this study was to examine the feasibility and acceptability of an mHealth intervention on ART adherence among cocaine using PWH. METHODS This project, titled Project SMART, used a wireless technology-based intervention, including cellular-enabled electronic pillboxes called TowerView Health® and smartphones to provide reminders and feedback on adherence behavior. This 12-week pilot (randomized control trial) with four arms provided three types of feedback: automated feedback, automated + clinician feedback, and automated feedback + social network feedback. RESULTS Between June 2017 to January 2020, this study screened 182 participants, ou...
Springer eBooks, 2011
ABSTRACT West Nile virus (WNV) infected dead bird sites and human cases are frequently located in... more ABSTRACT West Nile virus (WNV) infected dead bird sites and human cases are frequently located in the densely populated, urban areas primarily because they are reported by people. However, the spatial pattern (i.e. morphology) of the urban landscape features could also contribute to the location of WNV incidences. This study has two objectives: (1) analyzing the association of urban environmental features that facilitated the viral activities of WNV infection in the TCMA from 2002 to 2007 and (2) comparing the spatial association between WNV infected mosquito pools and human cases with heterogeneous urban characteristics. It also addresses the question of how urban morphology affects human health. Using a combination of factorial ecology, geospatial techniques, and hierarchical cluster analysis, urban landscape classes are derived from the environmental and built environment risk-factors hypothesized to be associated with WNV transmission. The infection rate among, birds, mosquitoes, and human cases are then compared to these urban classes. Results indicate that the WNV infection rate is considerably higher in the urban class located just outside the cities of Minneapolis and Saint Paul. The dominant features of this class are close proximity to bogs and swamps, parks, sewerage system, waste water discharge sites, trails, high density of catch basins, moderate density of single family houses, and medium vegetation cover with stagnant waters. In general, the rate of infection decreases with increasing distance from the urban core. This is critical, in terms of vector control policies, because two out of four WNV carrying vectors, Culex restuans and Culex pipiens are predominantly urban mosquitoes. KeywordsWest Nile virus-Urban environment-Factor analysis-Geographic Information Science-Cluster analysis
Cartography and Geographic Information Science, 2010
Various approaches are used to identify West Nile virus (WNV) exposure areas, including unusual s... more Various approaches are used to identify West Nile virus (WNV) exposure areas, including unusual sightings of infected dead birds, mosquito pools or human cases both prospectively and retrospectively. A significant and largely unmet need in WNV research is to incorporate the temporal characterization of virus spread and locational information of the three components of transmission cycle-i.e., birds (reservoir), mosquitoes (vector), and humans (host)-on a localized scale. Exposure areas containing all three components of the WNV cycle in close proximity have higher potential to amplify an outbreak as compared to exposure areas delineated by a single component. In this paper, we introduce a novel approach, termed 'Nearest Neighbor Distance Time' or NNDT, to identify and retrospectively monitor WNV transmission cycles on various scales in the Twin Cities Metropolitan area of Minnesota. The NNDT model was implemented in a geographic information system using data from the period 2002 to 2006. The results indicated that 2002 and 2003 had three such WNV cycles, followed by one, two, and four respectively in 2004, 2005, and 2006. The NNDT method can be useful in locating chronically exposed areas and generating hypotheses about the transmission of WNV.
Social Science & Medicine, Feb 1, 2011
The West Nile Virus (WNV) is an infectious disease spreading rapidly throughout the United States... more The West Nile Virus (WNV) is an infectious disease spreading rapidly throughout the United States, causing illness among thousands of birds, animals, and humans. Yet, we only have a rudimentary understanding of how the mosquito-borne virus operates in complex avian-human environmental systems. The four broad categories of risk factors underlying WNV incidences are: environmental (temperature, precipitation, wetlands), socioeconomic (housing age), built-environment (catch basins, ditches), and existing mosquito abatement policies. This research first built a model incorporating the non-linear relationship between WNV incidences and hypothesized risk factors and second, identified important factor(s) whose management would result in effective disease prevention and containment. The research was conducted in the Metropolitan area of Minnesota, which had experienced significant WNV outbreaks from 2002. Computational neural network (CNN) modeling was used to understand the occurrence of WNV infected dead birds because of their ability to capture complex relationships with higher accuracy than linear models. Further a detailed interpretation technique, based on weights and biases of the network, provided a means for extracting relationships between risk factors and disease occurrence. Five risk factors: proximity to bogs, lakes, temperature, housing age, and developed medium density land cover class, were selected by the model. The detailed interpretation indicated that temperature, age of houses, and developed medium density land cover were positively related, and distance to bogs and lakes were negatively related to the incidence of WNV. This paper provides both applied and methodological contributions to the field of health geography. The relationships between the risk factors and disease occurrence could contribute to vector control strategies such as targeted insecticide spraying near bogs and lakes, mosquito control treatments for older houses, and extensive mapping, inspection, and treatments of catch basins. The proposed interpretation technique expanded the role of CNN models in health sciences as both predictive and explanatory tools.
Computers, Environment and Urban Systems, May 1, 2010
The West Nile virus (WNV) is an infectious disease spreading rapidly throughout the United States... more The West Nile virus (WNV) is an infectious disease spreading rapidly throughout the United States, causing illness among thousands of birds, animals, and humans. Yet, we only have a rudimentary understanding of how the mosquito-borne virus operates in complex avian-human environmental systems coupled with risk factors. The large array of multidimensional risk factors underlying WNV incidences is environmental, built-environment, socioeconomic, and existing mosquito abatement policies. Therefore it is essential to identify an optimal number of risk factors whose management would result in effective disease prevention and containment. Previous models built to select important risk factors assumed a priori that there is a linear relationship between these risk factors and disease incidences. However, it is difficult for linear models to incorporate the complexity of the WNV transmission network and hence identify an optimal number of risk factors objectively. There are two objectives of this paper, first, use combination of genetic algorithm (GA) and computational neural network (CNN) approaches to build a model incorporating the non-linearity between incidences and hypothesized risk factors. Here GA is used for risk factor (variable) selection and CNN for model building mainly because of their ability to capture complex relationships with higher accuracy than linear models. The second objective is to propose a method to measure the relative importance of the selected risk factors included in the model. The study is situated in the metropolitan area of Minnesota, which had experienced significant outbreaks from 2002 till present.
PLOS ONE, Apr 9, 2014
Introduction: Research on urban food environments emphasizes limited access to healthy food, with... more Introduction: Research on urban food environments emphasizes limited access to healthy food, with fewer large supermarkets and higher food prices. Many residents of Hartford, Connecticut, which is often considered a food desert, buy most of their food from small and medium-sized grocery stores. We examined the food environment in greater Hartford, comparing stores in Hartford to those in the surrounding suburbs, and by store size (small, medium, and large). Methods: We surveyed all small (over 1,000 ft 2), medium, and large-sized supermarkets within a 2-mile radius of Hartford (36 total stores). We measured the distance to stores, availability, price and quality of a market basket of 25 items, and rated each store on internal and external appearance. Geographic Information System (GIS) was used for mapping distance to the stores and variation of food availability, quality, and appearance. Results: Contrary to common literature, no significant differences were found in food availability and price between Hartford and suburban stores. However, produce quality, internal, and external store appearance were significantly lower in Hartford compared to suburban stores (all p,0.05). Medium-sized stores had significantly lower prices than small or large supermarkets (p,0.05). Large stores had better scores for internal (p,0.05), external, and produce quality (p,0.01). Most Hartford residents live within 0.5 to 1 mile distance to a grocery store. Discussion: Classifying urban areas with few large supermarkets as 'food deserts' may overlook the availability of healthy foods and low prices that exist within small and medium-sized groceries common in inner cities. Improving produce quality and store appearance can potentially impact the food purchasing decisions of low-income residents in Hartford.
Environment and Planning B: Planning and Design, 2010
Spatial distance is a critical component of theories across the social, natural, and information ... more Spatial distance is a critical component of theories across the social, natural, and information sciences, but too often the methods and metrics used to describe spatial distance are implicit or underspecified. How distance is measured may influence model results in unanticipated ways. We examined the differences among distances calculated in three ways: Euclidean distances, vector-based road-network distances, and raster-based cost-weighted distances. We applied these different measures to the case of the economic value of open space, which is frequently derived using hedonic pricing (HP) models. In HP models, distance to open space is used to quantify access for residential properties. Under the assumption that vector-based road distances better match actual travel distance between homes and open spaces, we compared these distances with Euclidean and raster-based costweighted distances, finding that the distance values themselves differed significantly. Open-space values estimated using these distances in hedonic models differed greatly and values for Euclidean and cost-weighted distances to open space were much lower than those for road-network distances. We also highlight computational issues that can lead to counterintuitive effects in distance calculations. We recommend the use of road-network distances in valuing open space using HP models and caution against the use of Euclidean and cost-weighted distances unless there are compelling theoretical reasons to do so.
IEEE Engineering Management Review, Sep 1, 2020
The grocery retail industry is encountering unique challenges and opportunities during the 2019 N... more The grocery retail industry is encountering unique challenges and opportunities during the 2019 Novel Coronavirus (COVID-19). The pandemic led to various transformations in the food retail industry, including changes in consumer perception and behavior. Although the pandemic has a situational nature, these transformations could have both temporary and long-lasting effects on reforms of the grocery retail industry. We examined consumer retail grocery shopping behavior change during the pandemic using a national survey among 2500 U.S. adults. Survey results show that consumers now have higher expectations for in-store safety; they have reduced the frequency of store patronage, travel time, and in-store duration; they have shifted from regular shopping schedule and shopping destinations; and they have spent more per shopping trip. The increased spending at brick-and-mortar stores also paralleled with the expanded transactions across various types of online grocery shopping platforms. We further arrived at practical managerial implications in both the short term and long term for brick-and-mortar stores as well as online grocery vendors.
JMIR Research Protocols, Apr 7, 2022
, together with the publication of this correction notice. Because this was made after submission... more , together with the publication of this correction notice. Because this was made after submission to PubMed, PubMed Central, and other full-text repositories, the corrected article has also been resubmitted to those repositories.
JMIR Research Protocols, Mar 1, 2021
Psychiatric Services, Mar 1, 2012
Addiction Science & Clinical Practice, Feb 20, 2015
Springer eBooks, 2010
The West Nile Virus (WNV) is an infectious disease spreading rapidly throughout the United States... more The West Nile Virus (WNV) is an infectious disease spreading rapidly throughout the United States, causing illness among thousands of birds, animals, and humans. The broad categories of risk factors underlying WNV incidences are: environmental, socioeconomic, built-environment, and existing mosquito abatement policies. Computational neural network (CNN) model was developed to understand the occurrence of WNV infected dead birds because of their ability to capture complex relationships with higher accuracy than linear models. In this paper, we describe a method to interpret a CNN model by considering the final optimized weights. The research was conducted in the Metropolitan area of Minnesota, which had experienced significant outbreaks from 2002 till present.
Social Science & Medicine, Nov 1, 2020
Individuals with diverse sexual orientations and gender identities have historically experienced ... more Individuals with diverse sexual orientations and gender identities have historically experienced the major share of stigma, discrimination, and marginalization among all the LGTBIQ+ communities in India. Transgender, intersex, or queer individuals are deprived of their basic rights, self-dignity, bodily autonomy, and healthcare leading to significant negative health status. Recent legal reforms such as the decriminalization of Section 377 of the Indian Penal Code (prohibited same-sex activity) and amendments to the Transgender Persons (Protection of Rights) Bill may improve their health. In this context, the study has the following objectives: 1) to measure the physical and the mental health status of hijra, kothi, and transgender (HKT) individuals using the Short Form 12 (SF-12) questionnaire; 2) understand the variation in their health status by social determinants; and 3) identify spatial patterns of HKTs general, physical, and mental health. Data was collected using a Bengali version of SF-12 (N=98). We calculated physical (PCS) and mental (MCS) health composite scores and conducted the relevant statistical and spatial analysis. Findings revealed that HKT individuals had poor mental health (mean MCS = 42.3) compared to their physical health (mean PCS = 49.0). ANOVA tests showed statistically significant variation of PCS and MCS among HKTs by their age and income. Participants with both poor and good health conditions were evenly distributed in the study area, with no significant spatial clustering. This study was the first attempt to assess the health-related quality of life among the HKT individuals using SF-12, not previously adapted to gender-diverse communities in India. Results clearly indicate that there is a pressing need to address both physical and mental health among gender-diverse communities by not only improving awareness of their healthcare rights but by also removing social and structural barriers to health programs, increasing targeted health interventions, grassroots level activism, and government advocacy.
Urban Forestry & Urban Greening, Aug 1, 2017
Urban greenspace benefits urbanites in numerous ways ranging from regulating flooding, air qualit... more Urban greenspace benefits urbanites in numerous ways ranging from regulating flooding, air quality, and local climate to providing opportunities for exercise and relaxation. These benefits may influence human health. Greenspace, for example, may facilitate exercise, thereby helping to reduce body mass index (BMI) and combat obesity, a current epidemic of great public health concern. Little evidence exists to support this assertion, however, and we lack a full understanding of the mechanisms whereby this relationship operates, the populations for whom greenspace is linked to weight status, and the aspects of urban greenspace that are linked to weight status. This study seeks to identify relationships among the composition and arrangement of greenspace and BMI for different populations using regression models for eight age and gender groups in Cleveland, Ohio, US. We find that several greenspace variables are related to BMI for women under 65 years and males under 51 years, but not for older groups, and that the aspects and types of greenspace that are significantly related to BMI vary among groups. Relationships between greenspace attributes and BMI are generally stronger for female groups and for younger groups. Providing access to greenspace with particular attributes such as greenspaces with water, canopy cover, or connected greenspaces could support a healthy weight status for some populations, but these attributes are not consistent across age and gender groups. These results could help to inform policy aimed at designing urban greenspace to benefit the health of different population subgroups.
, together with the publication of this correction notice. Because this was made after submission... more , together with the publication of this correction notice. Because this was made after submission to PubMed, PubMed Central, and other full-text repositories, the corrected article has also been resubmitted to those repositories.
Psychiatric Services, Dec 1, 2011
The objectives of this study were to identify geographic regions with shortages of psychiatric me... more The objectives of this study were to identify geographic regions with shortages of psychiatric mental health-advanced practice registered nurses (PMH-APRNs), describe rural-urban differences in the distribution of PMH-APRNs, and discuss implications of the uneven geographic distribution. The data source was a complete listing, provided by the American Nurses Credentialing Center, of the employment zip codes of certified PMH-APRNs during 2007 (N=10,452). Geographic information science techniques and spatial statistics were used to conduct a cluster analysis of the spatial distribution of PMH-APRNs. After adjustment for population on the basis of U.S. census reports, statistically significant clusters of counties with high and low density of PMH-APRNs, an indicator of uneven accessibility, were identified. Rural-urban differences in the distribution were also illustrated. The interdisciplinary approach, including both mapping and statistical analyses, identified shortage areas and provided the groundwork for directing future education, clinical practice, and public policy initiatives.
Public Health Nutrition, Jun 16, 2023
Objective: This paper assesses trends in food environment and market concentration and racial and... more Objective: This paper assesses trends in food environment and market concentration and racial and ethnic inequities in food environment exposure and food retail market concentration at the US census tract level from 2000 to 2019. Design: Establishment-level data from the National Establishment Time Series were used to measure food environment exposure and food retail market concentration. We linked that dataset to race, ethnicity and social vulnerability information from the American Community Survey and the Agency for Toxic Substances and Disease Registry. A geospatial hot-spot analysis was conducted to identify relatively low and high healthy food access clusters based on the modified Retail Food Environment Index (mRFEI). The associations were assessed using two-way fixed effects regression models. Setting: Census tracts spanning all US states. Participants: 69 904 US census tracts. Results: The geospatial analysis revealed clear patterns of areas with high and low mRFEI values. Our empirical findings point to disparities in food environment exposure and market concentration by race. The analysis shows that Asian Americans are likelier to live in neighbourhoods with a low food environment exposure and low retail market concentration. These adverse effects are more pronounced in metro areas. The robustness analysis for the social vulnerability index confirms these results. Conclusion: US food policies must address disparities in neighbourhood food environments and foster a healthy, profitable, equitable and sustainable food system. Our findings may inform equity-oriented neighbourhood, land use and food systems planning. Identifying priority areas for investment and policy interventions is essential for equity-oriented neighbourhood planning. Keywords Racial and ethnic inequities Food environment exposure Food retail market concentration Longitudinal analysis Neighbourhood disparities in access to food outlets are a significant concern for the US food system (1). Differences in food access can affect dietary intake and increase the risk of several diet-related negative health outcomes (2). Racial and ethnic minority populations mostly living in neighbourhoods with limited access to grocery stores and other services such as healthcare and social support experience disproportionately poor health outcomes (e.g. healthy diet and physical and mental health) than their White counterparts due to systemic socioeconomic inequities (2). Neighbourhoods with higher concentrations of racial and ethnic minority populations likely have food deserts and food swamps (3,4). Among the several definitions of food deserts, the United States Department of Agriculture's (5) description of a food desert is the most commonly used, where US census tracts are identified as food deserts if they satisfy the following two conditions of (1) 'low-income communities', based on having a poverty rate of 20 % or greater or a median family income at or below 80 % of the area median family income and (2) 'lowaccess communities', based on the determination that at
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Papers by Debarchana Ghosh