Digital Commons Network^™

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Developing A Blueprint For Health Equity Programs And Investigating Interventions And Metrics, Belita Strudwick

MUSC Theses and Dissertations

Racial and ethnic minority groups and rural and low-income populations are examples of populations who continue to experience health disparities despite policy mandates to eliminate them. This doctoral project will provide a foundational blueprint to aid health plans in addressing and improving health equity internally and with external stakeholders. The blueprint will be based on research comparing the robust health equity initiatives of four states to the NCQA national guidelines. The barriers to achieving and recommendations for advancing the field of health equity by implementing and analyzing policies and data that target health disparities through improved access to quality care …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

Early Stage Or Curable Cancer Diagnoses In Minorities: A Journey Of Survivors, Lora Asberry

Master of Science in Integrative Biology Theses

Patients diagnosed with early-staged or curable forms of cancer experience physical, as well as, mental challenges associated with disease progression and treatment. Previous studies have demonstrated that minorities and underrepresented communities did not receive the same level of care in comparison to their non-minority counterparts. Previous studies have also demonstrated that health disparities among minorities affected their cancer journey. This study addressed: how medical disparities varied between minorities and non-minorities, the overall effects of the cancer diagnoses in minorities compared to non-minorities, whether these perspectives differed in male vs. female participants, and whether there were any possible communication barriers between …

Exploring The Perceptions Of English-Speaking West African Born Registered Nurse Graduates From United States Entry Level Nursing Programs Regarding Academic Factors That Contribute To Retention And Success In United States Nursing Programs, Afua Ampiaw

Seton Hall University Dissertations and Theses (ETDs)

Background: The United States (U. S.) population is becoming more racially and ethnically diverse. To ensure equity in healthcare access and outcomes between majority and majority populations, there is need for minority representation in the health professions including nursing to reflect their representation in the general population. Nevertheless, ethnic minorities are underrepresented in the nursing profession. One of the many issues identified to compound this problem is the lack of retention and success of ethnic minority people in U.S. nursing programs. While the English-Speaking West African (ESWA) population in the U.S. forms about 5% of the 45 million immigrant population …

The Need For Racial And Ethnic Health Disparity Curriculum In Genetic Counseling Programs, Yusra Aziz

Dissertations & Theses (Open Access)

Racial and ethnic health disparities (REHD) exist across all organized medicine, including the spectrum of genetic counseling, particularly in genomic testing and access to care. While cultural competency and health disparities have been included as a part of the Standards of Accreditation for Genetic Counseling, there have not been previous efforts to define what topics related to REHD are most important to include in graduate program curriculum. Therefore, this study aimed to determine what topics related to REHD should be taught in genetic counseling program curriculum by assessing what topics genetic counselors (GCs) learned about and in what settings, …

The Impact Of Race On Quality Of Life Of The Aged After Heart Transplant Or Long-Term Mechanical Circulatory Support, Jerian Dixon-Evans

Graduate Research Theses & Dissertations

The prevalence of heart failure is on the rise, with projections indicating that nearly 3% of the American population will be affected by 2030. This condition is particularly prevalent in adults, with a disproportionate impact on minority communities. The US population is aging, and the lifetime risk of heart failure increases with age. Patients with Stage D heart failure may need advanced surgical therapies, such as a heart transplantation (HT) or long-term mechanical circulatory support (MCS), if ineligible for HT. Health-related quality of life (HRQOL) may differ by race in patients who undergo these advanced surgical therapies. While there have …

Black Maternal And Infant Mortality Rates And Food Apartheid In Louisville, Maame Dei

Undergraduate Theses

The purpose of this thesis is to determine whether there is a correlation between the Black maternal and infant mortality rates and food apartheid or food deserts. This thesis will highlight that further research is needed in understanding how food insecurity may influence maternal and infant mortality. This thesis collected data from several midsize cities to assess accessibility to healthy food options and maternal and infant mortality rates. The cities were selected based on similarities in demographic and geographic makeup and having experienced a similar pattern of redlining. St. Louis, Memphis, Knoxville, and Pittsburgh were cities that were chosen for …

Racial And Ethnic Differences In The Receipt Of Metabolic Syndrome Risk Factor Screening And Treatment Among Prostate Cancer Patients Treated With Androgen Deprivation Therapy., Yazan K. Barqawi

Pharmaceutical Sciences ETDs

Background: Racial and ethnic health disparities in prostate cancer prevalence, incidence, mortality, quality of life, screening, and treatment constitute the largest of all cancer disparities. These health disparities are associated with higher morbidity and mortality rates in minority populations. Treatment with androgen deprivation therapy (ADT) has been the most widely used therapeutic modality to reduce the progression of prostate cancer to a worse disease stage and relieve potential obstructive symptoms. However, ADT is associated with possible toxic metabolic and cardiovascular (CVS) adverse events that may occur within six months of ADT initiation. These adverse events include metabolic syndrome, type II …

Therapists’ Demonstrated Multicultural Competence In Treating Latinx Immigrants, Dulce Diaz Benitez

Graduate Theses and Dissertations

Studies suggest that health disparities occur when people from marginalized communities receive care that is inadequate based on their cultural needs (USDHHS, 2011). Multicultural competence (MCC) models have been proposed to provide a framework of the competencies that therapists should develop to work with multicultural populations (Sue et al., 1992). Researchers have questioned the validity of measures, which are mostly based on therapist self-report (Cartwright, 2008). The multicultural case conceptualization ability task has been used in previous studies as a measure of demonstrated cultural competence using a vignette to assess case conceptualization abilities (Ladany et al., 1997). However, it has …

Two Essays In Applied Microeconomics: Retirement, Income Inequalities, And Other Economic Indicators Of Health And Life Satisfaction, Zahra Akbari

USF Tampa Graduate Theses and Dissertations

The following proposal includes two essays in applied microeconomics. The first essay studied the relationship between income differences among siblings and the health outcomes of the individuals. Health inequalities and the factors associated with them have been a significant interest of health economists. Among those factors that can lead to health differences in adulthood, many studies have studied financial status. There are still many questions about these factors which should be answered in this area, especially about the adulthood income relative to a reference group and how it can be related to differences in adulthood health. The main goal of …

America’S History Of Health Disparities: How Does This Affect The Future Of Healthcare In Mississippi?, Zuri O. Dixon Omere, Jazmin King

Honors Theses

America’s healthcare system runs rampant with healthcare inequalities that have an alarming effect on minorities and people of color. In order for people of color and marginalized groups to receive proper care and treatment, more attention needs to be brought to these inequalities. For example, Covid-19 reflected the health inequalities that are present in this country; minorities were more likely to become hospitalized due to Covid-19 than other non-minorities. In addition, minorities in women’s health, specifically black women, have been affected in various ways that are related to the inequalities in medicine like dying during childbirth and improper care. This …

Mental Health Burden Among College Students During Covid-19 Pandemic: A Cross-Sectional Study, Jeffrey Bao Truong

Electronic Theses, Projects, and Dissertations

Background: The COVID-19 pandemic is a significant public health issue and has negatively burdened the general population’s health, though assessment among vulnerable groups remain limited. The present study aimed to evaluate the mental health burden of the COVID-19 pandemic among college students.

Method:This study utilized a cross-sectional approach. Courses across multiple departments were used to collect data in order to ensure a diversity of majors. All statistical analyses were conducted using SPSS version 28 with p <.05 denoting significance.

Results: A total of 98 study participants were included in analyses. Among study participants, 32%reported feeling their mental health worsened due to COVID-19 …

Cardiovascular Disease Mortality Among Asian American And Pacific Islander Breast Cancer Survivors In The United States By Socioeconomic Status And Rurality, 2000-2018, Katherine Luis Ho

Public Health Theses

Background: Known racial/ethnic disparities in cardiovascular disease (CVD) mortality among breast cancer survivors exist and it is well-documented that non-Hispanic Black (NHB) breast cancer survivors experience higher incidence of CVD mortality compared to NHW women. However, few studies have examined CVD mortality among Asian American, Native Hawaiian, and other Pacific Islanders (AANHPI) survivors, especially with respect to socioeconomic factors and rurality at the county-level. The aim of this study was to describe how county-level factors influence disparities in CVD mortality among AANHPI breast cancer survivors. Methods: Using Surveillance, Epidemiology, and End Results 18 registries, we analyzed a retrospective cohort of …

Policing And Health: Police Encounters As A Fundamental Cause Of Racial Health Disparities, Richard S. Carbonaro

Doctoral Dissertations

Structural racism has taken many forms throughout American history and to this day continues to drive social, economic, and health inequalities. Mass incarceration is a modern tool of social marginalization with well documented and deep-rooted racial inequalities. Research has continually shown that mass incarceration negatively impacts the health of disadvantaged communities. Even police stops, the most common and mundane form of criminal justice contact has been linked with deleterious health outcomes at the individual and community level. In this dissertation, I identify specific social and biological mechanisms connecting encounters with the police and health outcomes. In the first chapter, I …

Using Population Health Management To Reduce Heart Diseases And Health Disparities Among African Americans: A Narrative Review, Adolfo Gonzalez

Electronic Theses, Projects, and Dissertations

The integration of Population Health Management (PHM) within the U.S. health care system may effectively decrease heart disease and health disparities among African American adults. Population Health Management strategies look at whether the health care system is meeting the needs of health care access, medical coverage, quality of care, and to reducing health disparities within specific population. Population Health Management strategies could be used to mitigate and reduce health disparities.

The purpose of this study is to discuss the potential impacts of Population Health Management within our health care system and how its influence can reduce heart diseases among African …

Racial Disparities In Hypertension Self-Awareness And Hospitalizations For Hypertension-Related Illnesses Among Adult Arkansans, Chimfumnanya Nwanze-Smith

Walden Dissertations and Doctoral Studies

Black individuals in the United States are twice as likely as White individuals to die of cardiovascular diseases. Between 2010 and 2016 in Arkansas (AR), hypertension (HTN) and HTN-related diseases had an age-adjusted death rate of 230.4 deaths per 100,000 population compared to 173.6 deaths per 100,000 population for Whites. The purpose of this quantitative, cross-sectional study was to explore the potential association between HTN self-awareness and emergency department (ED) visits and hospitalization rates for HTN and HTN-related illnesses between Black and White individuals in AR. The socioecological framework was used to explore sociodemographic (SDF) and socioeconomic (SES) factors as …

Increasing Nurse Knowledge Of The Underutilization Of Hospice Services For African Americans, Vicki Schmidt

Walden Dissertations and Doctoral Studies

The focus of this doctoral project was increasing knowledge of underutilization ofhospice services for African Americans (AAs) and the need to increase cultural competence among nurses regarding this issue. The identified gap in practice was nurses’ lack of cultural competence and knowledge regarding the underutilization of hospice specific to AAs. The practice-focused question focused on whether a staff educational intervention increased nurses’ knowledge of the cultural implications regarding the introduction of hospice services for AAs. The education was guided by the Purnell model for culturally competent health care, Healthy People 2030, and the National Hospice and Palliative Care Organizations AA …

Racial Disparities Among Black Women In Maternal Health: A Literature Review, Tatiyana Rich

Honors Undergraduate Theses

African American women are at a higher risk of experiencing maternal health complications than women of other races. Determining the factors that contribute to the severity of their maternal health complications can help bring awareness and exposure to the disparities among black women in maternal health. The purpose of this study was to explore the various elements that contribute to the high pregnancy mortality ratio and infant mortality ratio in black women and black infants. The secondary purpose was to determine the relationship between stereotypes about African American women as healthcare consumers and the disproportionate percentage of black women experiencing …

Occupational Therapists’ Consideration Of Sexual Orientation And Gender Identity When Working With Adolescents: An Exploratory Study, Kristin Willey

Occupational Therapy Doctorate Capstone Projects

Executive Summary

Background: A review of the Occupational Therapy Practice Framework (AOTA, 2020) and scholarly literature within healthcare fields, including occupational therapy, discuss the contextual issues of occupational justice and health disparities in situations when sexual orientation and gender identity (SOGI) are not considered as part of the occupational therapy process.

Purpose: This study explored if occupational therapists (OTs) considered a client’s SOGI when providing services to an adolescent. Subsequent research questions were: do OTs perceive that SOGI influences adolescents’ occupations, and do OTs perceive gaps in their knowledge related to SOGI?

Theoretical Framework: This research project was based on …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

Health Disparities Across Funcitonal Disability Groups, Katherine Sanches

Dissertations & Theses (Open Access)

Background: People with disabilities experience higher rates of chronic disease and poor health status compared to those without disability. People with disabilities do not participate in community health programs to the same degree as those without disability due to social, programmatic, and environmental barriers. The Community Health Inclusion Index (CHII) is a community health assessment tool which evaluates the degree to which community-level health promoting opportunities to promote nutrition and physical activity are inclusive and accessible to people with disabilities. The CHII assess barriers to inclusion across five domains: build environment, equipment, program/services, staff, and policies. Objective: The purpose of …

Reflection And Literature Review On Loving Choices Pregnancy Center Internship, Madison Stave

The Eleanor Mann School of Nursing Undergraduate Honors Theses

This honors thesis involves a personal reflection and literature review of a nurse internship at Loving Choices Pregnancy Center in Fayetteville, AR. The purpose of this internship was to provide a learning experience in women’s and obstetrical health. Responsibilities included completing community resource projects and assisting staff and nurses in the Care Center and Pregnancy Clinic. To satisfy honors requirements, five learning objectives were created during the internship. These objectives were all met and reflected upon in the first part of this thesis. The second portion of this thesis involves a literature review of the socioeconomic and health-related risks of …

Geospatial Analysis Of Drug-Resistant Tuberculosis In Santiago De Cali, Colombia, Oscar Norberto Perales

Public Health Theses

Infectious diseases like tuberculosis are undergoing an epidemiological transformation in developing countries such as Colombia and throughout Latin America. Recent economic and social developments may drive heterogeneous burdens of disease in the region, especially in urban settings. Geographic Information Systems (GIS) may allow us to better appreciate the geospatial distributions of TB in these contexts. In this study, we aimed to identify regions in Santiago de Cali facing disproportionate TB burdens and sought to determine whether the distribution of drug resistant TB differed. Additionally, we aimed to identify patient risk factors that could lead to differential drug resistance testing. This …

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

Risk Factors Of Infant Mortality Disparity In Indian River County, Florida, Cecilia Miguelina Escorbore

Walden Dissertations and Doctoral Studies

Infant mortality in the United States is a great concern to families, communities, and professionals in the public health field. More concerning is the infant mortality racial disparity, prevalent throughout the United States. The purpose of this study was to explore risk factors of infant mortality disparity in Indian River County (IRC), Florida. Using socioecological theory as the theoretical framework, this study explored whether there is an association between infant mortality among Black infants and geographic location as well as measures of socioeconomic status (age, educational level, health insurance status, and marital status) associated with infant mortality among Black infants …

Perceptions And Beliefs Of African American Men And Women 30 Years And Older About The Health Care System In The United States, Jacqueline Chadwick Mcnair

Walden Dissertations and Doctoral Studies

This qualitative study described perceptions and beliefs of African American men and women ages 30 and over regarding their experiences with the health care system in the United States. The health belief model was the theory that drove this research, and it was grounded in the concept of cultural competency. The study used grounded theory methodology as well as phenomenology to describe the lived experiences of the participants and ethnography to describe the cultural characteristics of African American men and women ages 30 and over as related to their perceptions and beliefs about health care in the United States. The …

The Association Between The Medicare Bundled Payments Initiative And Cardiac Rehabilitation Enrollment, Jing Li

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Cardiac rehabilitation (CR) represents a proven-effective intervention in secondary prevention that can stabilize, slow or reverse cardiovascular disease (CVD) progression, facilitate the ability of the patient to preserve or resume an active and functional contribution to the community, and reduce the risk of future cardiovascular events. Despite multiple guideline recommendations for CR and coverage by Medicare and most health plans, participation in CR remains low. Bundled payments are one of the suggested reforms designed to move health care providers toward to value-based care and is very applicable to the CR utilization in patients diagnosed with acute myocardial infarction (AMI) or …

Changing Landscapes: Perspectives Of Young African American Women Of Population-Wide Testing For Hereditary Breast Cancer Mutations, Alesha Henderson

Theses and Dissertations

Young African American women continue to die from breast cancer at higher rates than White women. In an effort to promote breast cancer prevention, population-wide testing (PWT) for all women in the U.S. starting at age 30 is a potential future initiative that is garnering a lot of attention. However, African American women currently utilize genetic testing for hereditary breast cancer at lower rates than White women. Therefore, if young African American women are not prioritized in a future roll out of PWT, then existing breast cancer and genetic testing disparities will likely continue to widen. The purpose of this …