John E Ehiri

Interests

Teaching

Global Health; Global Reproductive, Maternal, Newborn, and Child health; Program Planning and Evaluation; Evidence-Based Methods; Policy Analysis

Research

HIV/AIDS; Global Infectious Disease Control; Behavioral Interventions

Courses

Scholarly Contributions

Journals/Publications

• Asaolu, I. O., Alaofè, H., Gunn, J. K., Adu, A. K., Monroy, A. J., Ehiri, J. E., Hayden, M. H., & Ernst, K. C. (2018). Measuring Women's Empowerment in Sub-Saharan Africa: Exploratory and Confirmatory Factor Analyses of the Demographic and Health Surveys. Frontiers in psychology, 9, 994.
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  Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA. Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize women's empowerment. Pooled data from all countries were randomly divided into two datasets-one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)-to verify the factor structure hypothesized during EFA. Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define women's empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of women's empowerment. This foremost study advances scholarship on women's empowerment by providing a validated measure of women's empowerment for researchers and other stakeholders in health and development.
• Ehiri, J., Alaofè, H., Asaolu, I., Chebet, J., Esu, E., & Meremikwu, M. (2018). Emergency transportation interventions for reducing adverse pregnancy outcomes in low- and middle-income countries: a systematic review protocol. Systematic reviews, 7(1), 65.
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  Transportation interventions seek to decrease delay in reaching a health facility for emergency obstetric care and are, thus, believed to contribute to reductions in such adverse pregnancy and childbirth outcomes as maternal deaths, stillbirths, and neonatal mortality in low- and middle-income countries (LMICs). However, there is limited empirical evidence to support this hypothesis. The objective of the proposed review is to summarize and critically appraise evidence regarding the effect of emergency transportation interventions on outcomes of labor and delivery in LMICs.
• Ezeanolue, E. E., Pharr, J. R., Patel, D. V., Ezeanolue, C. O., Obiefune, M. C., Ogidi, A. G., & Ehiri, J. E. (2018). Developing a theoretical framework for a complex maternal-child health intervention: Health beginning initiative. Health promotion practice, 1524839918782929.
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  A theoretical framework serves as a roadmap for the implementation and application of a complex, health promotion intervention; is used to test hypotheses; and guides analysis and evaluation of the intervention. The purpose of this article is to demonstrate how a theoretical framework was developed and used to guide the implementation of Healthy Beginning Initiative (HBI) to promote uptake of HIV services in a low-income country. We used the guide for developing a theoretical framework published in Health Promotion Practice. Developing the theoretical framework included seven steps: (1) identifying the essential elements of the intervention; (2) identifying the variables and the context; (3) listing the postulated mechanisms, mediating variables, and postulated outcomes; (4) identifying existing theoretical models supporting the theoretical framework underdevelopment; (5) scripting the theoretical framework into either a figure or sets of statements; (6) conducting content and face validation of the theoretical framework; and (7) revising the theoretical framework. The theoretical framework was developed and used to evaluate HBI's impact on HIV testing, linkage to care and retention in care for pregnant women, their male partners, and newborns. The theoretical framework will also be adapted for other screenings and other settings while remaining true to the essential elements of HBI.
• Iwelunmor, J., Blackstone, S., Jennings, L., Converse, D., Ehiri, J., & Curley, J. (2018). Determinants of HIV testing and receipt of test results among adolescent girls in Nigeria: the role of assets and decision-making. International journal of adolescent medicine and health.
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  Purpose Many adolescent girls in Nigeria do not test for HIV despite being at high risk. While the influence of psychosocial factors on HIV testing has been examined, there is less evidence regarding the impact of assets and control of assets on HIV testing. This study investigated the protective effects of specific adolescent girls' assets on decision-making regarding HIV testing. Methods Cross-sectional data from the 2013 Nigeria Demographic and Health Survey was analyzed. The main outcome variables were self-reports of having been tested for HIV and knowledge of a place that offers HIV testing. Binary logistic regression was used with employment, education, wealth index, home ownership, land ownership and decision making as potential predictors. Demographic characteristics were controlled in the analysis. Results Age [odds ratio (OR = 1.49)], employment (OR = 3.38), education (OR = 3.16), wealth index (OR = 1.33) and decision making (OR = 3.16) were positively associated with HIV testing. Age (OR = 1.20), employment (OR = 1.33), education (OR = 1.38), wealth (OR = 1.64), land ownership (OR = 1.42), and decision making (OR = 1.26) were positively associated with knowledge of an HIV testing location. Conclusion Our findings suggest that assets play an important role with HIV testing decisions for adolescent girls. Further research to elucidate the specific asset-based needs of adolescent girls will be needed to enhance decisions surrounding uptake of HIV testing and receipt of test results in Nigeria.

Presentations

• Asaolu, I., Frisch, A., Kato-Lagumbay, K., Valencia, C., Nunez, A., Ehiri, J. E., & Rosales, C. (2018, November). Medical Marijuana as a substitution for Opioids: A Systematic Review. Annual Meeting of the American Public Health Association. San Diego: American Public Health Association.
• Chebet, J., Thomson, C., Ehiri, J. E., & Bell, M. (2018, November). Antecedent Health Behavior and Obesity-Related Cancer Risk in Non-Hispanic Black Women: Results from the Women Health Initiative. Annual Meeting of the American Public Health Association. San Diego: American Public Health Association.
• Peterson, R., Fain, M., Butler, E., Ehiri, J. E., & Carvajal, S. (2018, Nov. 10 - Nov. 14). Mechanisms for race and gender disparities in cognitive decline: A systematic review. Annual Meeting of the American Public Health Association (APHA). San Diego, CA.: American Public Health Association (APHA).

Poster Presentations

• Chebet, J., Thomson, C. A., Ehiri, J. E., & Bell, M. L. (2018, Fall). Abstract: Antecedent Health Behavior and Obesity-Related cancer risk in Non-Hispanic Black Women: Results from the Women Health Initiative. APHA. San Diego, CA.
• Thomson, C. A., Dickeson, K., Kohler, L. N., Garcia, D. O., Harris, R. B., & Ehiri, J. E. (2018, Fall). Abstract: STEP-Up for Cancer Prevention. UACC Scientific Retreat.