Digital Commons Network^™

Restoring, Protecting, And Expanding Abortion Access In The United States: Seeking Consensus Through The Delphi Method, Sarah Pickering

Dissertations and Theses

Background: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision exacerbated inequitable access to abortion in the US. Agreement is needed on which strategies should be prioritized to restore, protect, and expand abortion access.

Methods: We convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement >67%) on recommended actions. Using feedback from three rounds of surveys, and input from a select expert advisory group (N=10), we iteratively refined the statements and recommendations.

Results: The panel (N=85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Incarceration Vs Treatment: Is One More Effective Than The Other In Preventing Recidivism For Drug Abuse?, Scott G. Kang

Student Theses

This study aims to determine the most effective approach for reducing recidivism among drug offenders, comparing incarceration with treatment. Two hypotheses were formulated for this research: 1) Drug offenders undergoing residential treatment will experience lower recidivism rates compared to those sentenced to incarceration. 2) Extended therapeutic treatment is more likely to positively influence behavior change among drug abusers compared to longer prison sentences. These hypotheses were tested using data from 263 participants in the Drug Treatment Alternative-to-Prison (DTAP) program, analyzed through logistic regression in SPSS. The results indicate that therapeutic interventions, specifically rehabilitative treatment, are more effective than incarceration in …

Pricks And Pills, Anna A. Charles

Theses and Dissertations

"Pricks and Pills" is a collection of audio pieces designed for an online platform where individuals with diabetes can listen to and find emotional support from others who share their experiences. This audio project provides an intimate look into the lives of people navigating the challenges of diabetes. Through heartfelt interviews with individuals and their families, the podcast highlights their journeys, showcasing both their struggles and triumphs.

Ethnic Minorities And Family Health History: An Autoethnography Of Guyanese Americans And Kidney Disease, Dhaneesha R. Bahadur

Dissertations, Theses, and Capstone Projects

Exploring family health histories (FHHs) has emerged in recent years as an inexpensive genomic tool in public health. Families and clinicians can also use them to uncover family histories and experiences, which could inform better lifestyle choices to prevent or delay the onset of diseases. Exploring family health histories focuses on an individual’s genetic makeup and considers differences in lifestyle and environment. Despite national campaigns, it is an underutilized tool that could lead to engagement in effective strategies and better health outcomes. One important and serious condition that families should be more aware of is chronic kidney disease (CKD). One …

New York City’S Health Governance And Activism From The 1950s To The 1970s, Andres Valcarcel

Theses

New York City's expansive network of hospitals and preventative health services has an intense history outside of the popular narratives of biomedical and technological advancement. This thesis will discuss the period between the 1950s and 1970s and the various movements and parties that shaped the city's health and hospital system. During this period, New York City's healthcare delivery system became increasingly privatized and commercialized; processes that improved the quality of healthcare yet simultaneously barred the poorest from accessing it. Communities, healthcare workers, and civil rights organizations worked to address perceived faults and extend their agency in health and hospital policy; …

Childcare License Not Necessary, Jean C. Brannum

Capstones

Most childcare centers need a license to operate, but many states have loopholes that allow fitness center daycares to forego traditional licensing. The variation in rules lets some kids play in dangerous situations.

“Nadie Nunca Me Habló De Riesgos”: Madres Subrogantes En Eeuu Reclaman Protección, Carla Gloria Colomé Santiago

Capstones

Commercial surrogacy is a growing industry. In the United States, the Centers for Disease Control and Prevention (CDC) reported that by 2020, 90 percent of clinics in the country were offering gestational carrier services. In this report, several surrogate mothers speak of inefficient contracts, poor pay and lack of support, amid a landscape where business takes precedence over the treatment of women.

https://preview.shorthand.com/dN8XSDPrI83UIc8P

The Pima County Jail In A “State Of Full-Blown Crisis”: Inmate Deaths Four Times The National Average, Natalie Robbins

Capstones

Last year, 12 inmates died in custody at the Pima County Jail in Tucson, Arizona. With a 10-year average jail population of 1,827, that is a per capita rate of 656.8 deaths per 100,000 inmates.

According to the most recent data from the Bureau of Justice Statistics, the 2019 national local jail mortality rate was 167 deaths for every 100,000 inmates, making the Pima County Jail’s 2022 per capita death rate nearly four times as high as the national average in 2019.

In a December 2022 memo to the Pima County Board of Supervisors, Pima County Sheriff Chris Nanos wrote …

Where Did All The Bed Bugs Go?, Lauren Friedman

Capstones

In the early 2000s in New York City, everyone was talking about bed bugs. The disc-shaped, bloodsucking pests had been a common domestic nuisance up to the World War II era, but in the decades since, they’d mostly faded into obscurity. That was until bed bug infestations, which are often psychologically distressing and sometimes impossible to overcome, suddenly became routine across the five boroughs, driving people from their apartments and stoking fear about everything from upholstered theater seats to thrift stores.

But then, just as quickly as bed bugs had invaded, they seemed to fade away. In a 2022 study …

Exploring Opportunities To Expand And Improve Prep Uptake In Vulnerable Us Communities., Pedro B. Carneiro

Dissertations and Theses

The implementation of preexposure prophylaxis (PrEP) in the United States has fallen short of meeting both 2020 and projected 2030 milestones, with less than one-third of those who would benefit most from PrEP choosing to initiate it. High discontinuation rates and persistently elevated HIV incidence underscore the need for improvement. However, opportunities exist to enhance PrEP uptake, supported by a growing pipeline of PrEP innovations. To achieve this, effective implementation of available tools to combat HIV and the inclusion of all communities as stakeholders are essential. One such tool is event-driven (ED) PrEP, also known as PrEP 2-1-1, which is …

A Mixed Methods Approach To Understanding The Links Between Mining, Climate Change And Selected Health Outcomes In India, Mary J. Cheruvillil

Dissertations and Theses

Despite ample evidence of the significant role that mining activities play in determining health outcomes, in India there is a dearth of comprehensive health studies that draw linkages between mining and health. The purpose of the following study is to investigate the impact of mining activities on population health in India using three different methods: ecological multivariable regression, exploratory spatial data analysis (ESDA) and content analysis of government documents using a phenomenological approach. The first aim uses the ecological multivariable regression to examine associations between mining activities and children’s malnutrition outcomes at the district level. Census data, the Demographic Health …

Understanding Influenza Vaccine Hesitancy And Uptake Among U.S. Hispanic Adults During The Covid-19 Pandemic, Helen J. Arteaga

Dissertations and Theses

The health burden caused by seasonal flu is substantial in the general population and each season targeted efforts are needed to decrease the risk of flu illness, hospitalization, and death. Flu risks and the disease burden are disproportionately higher among Hispanic adults, yet little is known about the factors influencing flu vaccine hesitancy and uptake among this marginalized population. This cross-sectional quantitative study used national survey data from the Understanding America Study (UAS) and logistic regression to address three research aims. Aim 1 was to examine the most significant demographic factors associated with flu vaccine uptake among the Hispanic community. …

The Health Impacts Of The Trump Administration Among California Immigrants, Claudia M. Calhoon

Dissertations and Theses

Immigration policy was a marquee issue in the US presidential administration of Donald Trump. Trump’s administration employed both policy and rhetoric related to immigrants to mobilize voters, alter immigration policies and practices, and sustain a narrative of a nation under attack by immigrants. Administration officials were able to undertake these approaches because of existing immigration law, but they did so in more explicitly punitive ways than in recent administrations. The goal of this dissertation is to explore the health impacts of the administration’s practices and their effects. Paper 1 analyzes the immigration rhetoric and policies of US president Donald Trump …

Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman

Dissertations, Theses, and Capstone Projects

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of …

Social Identities And Campus Belonging As Predictors Of Flourishing Among College Students, Christine Gilchrist

Dissertations, Theses, and Capstone Projects

Annual data since 2012 shows college students’ flourishing (a measure of psychological well-being) in continuous decline, with 2022 showing the largest decrease. Since the knowledge base of the predictors of flourishing is limited, how college executives can best address this issue is unclear. Variations in flourishing have been observed in studies that examined the relationship between food insecurity (DeBate et al., 2021), race/ethnicity (Lipson et al., 2018, 2022; Nyunt et al., 2022; Parr, 2022), immigration status (Cadenas & Nienhusser, 2021), as well as gender identity and sexual orientation (Parr, 2022). The intersectional impact of demographic and social identities has not …

The Lived Experience Of Using Opiates Among Young Adults, Catherine Mbewe

Dissertations, Theses, and Capstone Projects

The purpose of this research study is to explore the lived experience of using opiates, as described by young adults aged 18 to 25 years. Over the last 2 decades, opioid use disorders (OUDs) and opiate overdose deaths have increased dramatically in the United States. What used to be a problem primarily contained to minority groups in poor inner-city areas is now increasingly common in all races, genders, ages, and classes. There has also been an alarming increase in opiate use—including fentanyl, both legal and illegal—among young adults. While much of the literature has been focused on the opiate use …

"I Stayed There The Whole Night": Exploring Caregivers' Experiences With The Healthcare System When Caring For A Parent At The End Of Life, Lillian Mehran

Dissertations and Theses

Background: In the United States, there are nearly 53 million individuals serving as caregivers to a loved one. Half of all caregivers are caring for a parent or parent-in-law, and 79% of caregivers are caring for a person aged 50 or older. In New York State, there are an estimated 4.1 million caregivers who collectively provide over 2.6 billion hours of unpaid care, with those caring for a person at the end of life providing twice as many hours of caregiving per week compared to other caregivers. The number of individuals requiring caregiving is expected to increase as a significant …

Evaluation Of A Place-Based Asthma Reduction Initiative On Asthma-Related Morbidity Among Children In East Harlem And The Impact Of The Covid-19 Pandemic On Health Care Utilization And Medication Adherence Among Medicaid-Enrolled Children, Sarah C. Walters

Dissertations and Theses

Background: In New York City, asthma continues to be the leading cause of hospitalizations and emergency department (ED) visits among children, and disproportionally burdens Black and Latino children in low-income neighborhoods. Place-based, or geographically targeted, programs offer upstream strategies for addressing public health issues in these underserved neighborhoods, and given their targeted nature, quasi-experimental or other observational methods are needed to rigorously evaluate their impact. This dissertation uses multiple methodological approaches to assess the impact of the East Harlem Asthma Center of Excellence (EHACE) – an equity-focused, multi-faceted, place-based asthma mitigation initiative in the East Harlem neighborhood of a New …

Obesity Risk And Comorbidities Among Colombians In New York City And In Colombia, Carlos A. Devia

Dissertations and Theses

Introduction: The prevalence of obesity and overweight in adults and children continues to increase worldwide, accounting for the mortality and morbidity from several diseases. Obesity disproportionally impacts Latinos in the United States (U.S.), and despite their diversity in origins, ancestry, and culture, it is still unclear the burden of obesity by specific Latino groups. For example, little information is available about how obesity impacts Colombians in the U.S. (the largest South American population). New evidence also indicates that Latino immigrants may no longer be arriving with healthy weight status to the U.S. because Latin American countries are undergoing epidemiologic and …

Race, Gender, Physical Activity, And Cancer: A Quantitative Investigation, Shawna A. Townsend

Dissertations, Theses, and Capstone Projects

Black women are more likely to die from cancer than any other population in the United States. Physical activity is known to be associated with preventing and reducing cancer burden. However, Black women are less physically active than their White counterparts and have a higher prevalence of diseases related to lack of physical activity than any other female group. To better understand these issues, this study employed the self-and-family management framework and intersectionality as theoretical frameworks through a secondary analysis of the Health Information National Trends Survey (HINTS) dataset and hierarchical regression modeling to examine the relative impact of (a.) …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

Working Conditions, Type 2 Diabetes Mellitus, And Health Behaviors In Latino And Other Minoritized Groups Living In The United States, Tailisha M. Gonzalez

Dissertations and Theses

Background: Type 2 Diabetes Mellitus (T2DM or ‘diabetes’) poses a significant public health challenge to the healthcare system, economy, and well-being of communities in the United States (U.S.). There are also substantial racial/ethnic and social disparities in diabetes incidence and control that have persisted for decades. For Latinos and other minoritized groups in the U.S., diabetes disparities may be linked to working conditions. Globally, work is considered a major determinant of health and yet studies in the U.S. tend to focus on legacy hazards, such as chemical, biological, and environmental factors. In recent years, occupational health scholars have argued …

Engagement Journalism In Action: Supporting New Yorkers With Long Covid, Sarah Luft

Capstones

What do asthma and long COVID have in common? 1 in 13 U.S. adults are living with them. This report is a recap of my efforts to address the information needs of New Yorkers with long COVID as a student in CUNY's Craig Newmark Graduate School of Journalism engagement program. For my final project, I partnered with THE CITY, a nonprofit news outlet serving New Yorkers, to expand the MISSING THEM project. The report details the what, why, and how of my engagement reporting process, including a community engagement framework, a service journalism series, and lessons to carry forward. You …

An Updated Look At Mental Health Services In American Public And Private Prisons, Lieren E. Tyira

Student Theses

People residing in American prisons have the legal right to mental health care while incarcerated (Justia, 2021). This is important, as the prevalence of mental disorders is high in this population (Prins, 2014), and incarceration is a psychologically damaging experience, which hinders a person’s success at rehabilitation. Numerous of issues related to the mental health services (MHSs) in both public and private prison facilities have been reported in recent years, which warrants systematic exploration. The little existing research comparing the presence of MHSs in these facilities has produced mixed results, it uses out-of-date datasets, and none has explored MHSs in …

One Man's Pregnancy Story, Yvonne S. Marquez, Paige A. Perez

Capstones

Pregnancy is a challenging time for anyone. For LGBTQ people there are unique obstacles that make it especially difficult to navigate a medical system that was not built for them. Finn Schubert is trans and six months pregnant. He’s loving the experience but stressed by insurance claim denials, concerns for his safety, and medical incompetence.

This capstone project includes a 20-minute documentary, text, and a photo essay.

Back To The Roots: Black Veganism, Kiara R. Thomas

Capstones

Only 3% of Americans in general, but 8% of Black Americans are strict vegan or vegetarian. Whether it’s to reduce animal cruelty, manage a chronic illness, or connect with their heritage and build a social movement, Black people are embracing plant-based diets. https://kiarathomas429.github.io/portfolio/

Effect Of Body Mass Index, Testosterone, And Insulin On Breast Cancer: A Mendelian Randomization Study And Investigation Of Selection Bias, Kezhen Fei

Dissertations and Theses

BACKGROUND: Female breast cancer is the most studied cancer, and the second leading cause of cancer death in women, whose aetiology is still not completely clear. The parallel increase of incident obesity and breast cancer in women worldwide raises the question of the role of adiposity, measured by body mass index (BMI), and of major anabolic hormones, such as insulin and testosterone, on breast cancer. Observational studies are open to confounding making it difficult to clearly demonstrate causal effects. Several mendelian randomization (MR) studies have shown inverse association of BMI with breast cancer. To assess selection bias in MR …

Understanding Distruptive Change In Health Care: Perspectives From The Front Lines Of Covid, Wendy Vaughon

Dissertations and Theses

COVID-19 dramatically stressed an already overburdened healthcare system. Physicians, susceptible to burnout, bore the brunt of this threat as frontline providers. Limited data are available describing how the pandemic may have affected physician perceptions and beliefs, including experiences of burnout and plans to exit the field. Reddit, a social media website, allows physicians the ability to interact with their peers pseudonymously on a purpose-driven, publicly viewable subreddit (r/medicine). By providing a space for “physicians and other medical professionals” to interact, it is possible to observe unfiltered discourse.

This dissertation explores physician-peer discourse on Reddit prior to and during the COVID-19 …