Digital Commons Network^™

The Association Of Long Working Hours And The Use Of Prescription Sedatives Among U.S. Workers., Emmanuel Ezekekwu

Electronic Theses and Dissertations

BACKGROUND: Meeting the needs of a round-the-clock and globalized society has led to an increase in long working hours. This trend has been accompanied by a corresponding rise in sleep disorders and subsequent use of sedating medications. Overtime hours have been associated with adverse health outcomes such as cardiovascular diseases, symptoms of psychological distress, and health behaviors, including risky intake of alcohol and smoking. Hence, the main objectives of this three-paper dissertation were to examine the multi-faceted relationship between working hours, the use of prescription sleep aids, the onset of psychological distress, and the use of health care services. METHODS: …

Profitable, Alternative Income Generation And Improved Quality Of Life Among Global Beekeepers, Chris Honeycutt

Electronic Theses and Dissertations

Interventions that promote alternative income generation (AIG) to address social determinants of health are associated with increased household income and improved health outcomes. Organizations have used beekeeping to address poverty and other development goals with mixed outcomes. Beekeeping presents a viable option to promote AIG. Organizations increase their risk of failing to achieve positive outcomes when beekeeping interventions are inadequate. This project aims to develop an organizational assessment tool that measures organizational position in relation to evidence-based factors for income generation and improved quality of life among global beekeepers. The assessment is organized into seven domains that correspond with PRECEDE-PROCEED …

Key Determinants Of Using Telehealth Technologies Among Underserved Populations From The Perspective Of Patients And Providers, Johanna Cimilluca

Electronic Theses and Dissertations

Background: The utilization of telehealth has had a substantial impact on transforming and enhancing the methods by which healthcare is presently delivered. The potential benefits of telehealth in improving the health of vulnerable populations and underserved communities are substantial. The aims of this study were to examine the association between social determinants of health and patient perceptions of their experiences with telehealth. We will analyze how perceptions differ across specialization, race, gender, and other key determinants; examine how patient’s self-rated physical health and mental health influences perceptions and attitudes about telehealth utilization; and evaluate differences in perceptions and attitudes, …

Exploring Sexual And Reproductive Health Care In Central Appalachia Through The Experiences Of Transgender And Gender Non-Binary People, Chase Harless

Electronic Theses and Dissertations

Background: Transgender or nonbinary (TNB) individuals in the United States experience higher rates of sexual and reproductive health disparities when compared to their cisgender counterparts, along with lower access to care. TNB people in the south experience higher rates of disparities. Societal, interpersonal, and individual barriers contribute to these disparities in the TNB population. However, there is a paucity of research examining the sexual and reproductive health experiences of TNB people living in Central Appalachia.

Methods: An interpretive phenomenological analysis (IPA) research design was used to collect and analyze semi-structured interviews with TNB individuals living in central Appalachia regarding their …

Emerging Tick-Borne Diseases In Northeast Tennessee, Jacob Schultz

Electronic Theses and Dissertations

Tick populations have been immigrating into northeast Tennessee from east Tennessee, Kentucky, Virginia, and North Carolina. Counties in states bordering northeast Tennessee harbor tick species associated with human illness. Human diseases transmitted by ticks include ehrlichiosis, spotted fever rickettsial group diseases, tularemia, anaplasmosis, babesiosis, Lyme disease, alpha-gal syndrome, Heartland virus, Powassan virus, and southern tick-associated rash illness (STARI). These diseases cause morbidity and mortality in human populations and may pose a high risk to individuals, wildlife, and livestock. The Cherokee National Forest covering the east Tennessee border provides a permissible environment for ticks to immigrate and thrive. Residents of northeast …

Cardiovascular Disease In Central Appalachia, An Exploratory Study Of Behavioral, Community, And Patient-Centered Care Influences, Kristy Gagnon

Electronic Theses and Dissertations

The Central Appalachian region of the United States disproportionately experiences higher rates of cardiovascular diseases (CVD) and associated risk factors. Primary risk factors for CVD include hypertension, hypercholesterolemia, and tobacco use, all of which have the potential to be mitigated through lifestyle behavior changes. Dietary and physical activity practices are the two main driving forces for the development of hypertension and hypercholesterolemia, while tobacco use is a behavioral choice on its own. Subsequentially, shifting lifestyle choices to emphasize healthier living has the potential to reduce CVDs within the Central Appalachian region. Considering behavioral choices are not made in isolation and …

Youth-Friendly, Person-Centered Contraceptive Care For Adolescents: Exploring The Capacity Of Safety-Net Clinics In Alabama And South Carolina, Kristen Surles

Electronic Theses and Dissertations

Introduction: In recent years, high quality contraceptive care for adolescents has shifted away from tiered effectiveness counseling and toward youth-friendly, patient-centered counseling (YFPCCC). YFPCCC is essential in the South, which has higher rates of sexual activity, lower rates of contraception use, and higher teen birth rates. This study examined Southern clinics’ characteristics which support YFPCCC and youth’s perceptions of the contraceptive care they receive.

Methods: This mixed methods study examined secondary data collected in two surveys and primary data collected through key-informant interviews. The first survey examined clinic characteristics impacting YFPCCC, and the second survey examined adolescents’ (aged 16-24) perspectives …

Factors Associated With Skin Cancer Prevention: Primary And Secondary Behaviors., Jeanne Ward

Electronic Theses and Dissertations

Skin cancer, seemingly more innocuous than other cancers, maintains the highest incidence among cancers in the United States. While it is treatable early, metastasized melanoma or other carcinomas present severe illness with high mortality rates and disproportionate 5-year survival rates among ethnic/racial groups. Fortunately, most skin cancer is highly treatable when found in the early stages. However, this necessitates prevention tactics to avoid the causative agent, ultraviolet radiation, and regular skin screening to catch the disease in earlier stages. Unfortunately, these tactics are not widely conducted by adults, despite substantial skin cancer awareness. Therefore, motivating people to perform these health …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

Postpartum Depression In Jamaica: Exploring The Lived Experiences., Shakeyrah Elmore

Electronic Theses and Dissertations

The purpose of this study was to explore the lived experiences of Jamaican women with postpartum depression (PPD). It is estimated globally, postpartum depression impacts 10-20% of women. In Jamaica, rates exceed global averages, with 26-60% of women experiencing PPD. Untreated maternal depression poses a significant physical, social, and economic threat to Jamaican women, children, and society as a whole. This study affirms that maternal mental health and postpartum depression are global public health concerns. There are limited studies that have examined PPD in Jamaican women, especially qualitatively. This research study utilized a qualitative descriptive approach to examine PPD experiences …

An Evaluation Of Hospital-Based Health Technology Assessment Processes In The United States., Scott Skinner

Electronic Theses and Dissertations

This research study explored the practices of hospital-based health technology assessment (HTA) in the U.S., as experienced by healthcare technology management (HTM) professionals. HTA can play an important role in helping to evaluate health technologies at both the macro (e.g., policy) level as well as at the micro (e.g., institutional) level of the public health ecosystem (C. S. Goodman, 2004). HTA seeks to broadly evaluate the effects, properties, and other impacts of various health technologies (C. S. Goodman, 2004). Common goals of HTA are to evaluate the safety, effectiveness, and cost-benefit of health technologies. A primarily phenomenological approach was used …

The Impact Of Controlling Language And Source Similarity On Psychological Reactance, Caroline Yarbrough

Electronic Theses and Dissertations

Persuasive health messages are frequently advertised throughout the pandemic to decrease the spread of COVID-19 while increasing the likelihood of immunity. However, research demonstrates that persuasive health messages may be ineffective because they have the potential to elicit psychological reactance. Reactance is characterized by a state of unpleasant motivational arousal and often occurs when individuals experience or perceive threats to their freedom, and it can be evoked through controlling language (Frey et al., 2021; Grandpre et al., 2003). Additionally, research has shown that similarity is associated with liking (Cialdini & Trost 1998) and people are often more inclined to comply …

Using The Cipp Model Of Evaluation On A Health Disparities Curriculum Delivered To Medical Residents In 12 Residency Programs, Gauri K. Shevatekar

Electronic Theses and Dissertations

Background: Although the Accreditation Council for Graduate Medical Education (ACGME) has provided educational directives on health disparities education during residency program for the medical residents, there is paucity of curricula focused on disparities education within the graduate medical education.

Objective: The purpose of this study was to evaluate a Health Disparities Curriculum (HDC) that was delivered to twelve residency programs at a College of Medicine.

Methodology: The study employed a cross-sectional study design. Stufflebeam’s Context-Input-Process-Product (CIPP) model was utilized as theoretical framework to assess whether the curriculum achieved its stated goals and objectives, the teaching and learning processes, and the …

“My Ob/Gyn Has The Worst Bedside Manner…” A Qualitative Analysis Of Patient-Provider Communication And Mental Health Outcomes Of Women In Rural Georgia, Tobi F. Oloyede

Electronic Theses and Dissertations

Despite technological advances in medicine and public health innovations, maternal mortality in the United States remains significantly higher than in other developed countries. Specifically, Georgia ranks as the second worst place to give birth in the country. Maternal mental health conditions are common, manageable complications that can happen at any point during pregnancy, childbirth, or in the first year following delivery, with 1 in 5 women affected. Unfortunately, 75% of women who experience MMH symptoms are left untreated.

This study focuses on patient-provider communication through the birthing experiences of women who have been pregnant in Georgia to examine how their …

Factors Associated With Patient Portal Utilization, Preventive Services Utilization, And Health Promoting Behaviors Among Adults In The United States, Elizabeth Ayangunna

Electronic Theses and Dissertations

Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

Electronic Theses and Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Medical Providers' Use Of Maternal Mental Health Screening Tools During Prenatal Appointments In Southeast Georgia, Andreka Ewing

Electronic Theses and Dissertations

In the United States, maternal mental health disorders are the most common comorbidities experienced during pregnancy and after childbirth. In particular, the state of Georgia reports that 1 in 7 Georgian mothers experience depression, anxiety, obsessive-compulsive disorders, or psychosis related to these disorders. Research suggests that untreated maternal mental health can have adverse effects on the mother and unborn child. Conditions such as autism, mixed handedness, reduced cognitive ability, and affective disorders can develop while the child is in the womb of a depressed mother. Routine maternal mental health screening using a validated screening tool has been recommended to help …

Examining The Nexus Of Housing Instability And Neighborhood Within New York City (Nyc), Benjamin Boateng

Electronic Theses and Dissertations

Housing instability within the New York City (NYC) area significantly affects the community's well-being. As a robust and growing city, many families in the low-income bracket face the challenge of spending a significant portion of their monthly income toward housing costs (rent, utilities, insurance). With families spending 50% (extreme housing burden) and more of their monthly income to stay in their housing units, various disparities have presented themselves within the housing context.

Even before the COVID-19 pandemic in March 2020, families within NYC have struggled to maintain their housing stock. Policy and community-based actions are needed to reduce the burden …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Assessment Of The Utilization Of Healthcare Services Specific To Pregnancy-Related Complications In Rural And Medically Underserved Georgia, Diana L. Aguirre

Electronic Theses and Dissertations

Maternal mortality is a continuing issue, with rates for the state of Georgia (3.7 per 100,000 live births) are higher than that of the US rates (2.9 per 100,000 per live births) (Centers for Disease Control and Prevention, National Center for Health Statistics, n.d., 2023). However, maternal mortality may not account for health disparity factors, apart from access to quality care and physiological issues, which is a factor in pregnancy-related deaths, Pregnancy-related death, as defined by the US Centers for Disease and Control (CDC), is a death of a woman that occurs during or within one year of pregnancy that …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

Electronic Theses and Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Factors Associated With Physical Activity Intent Among Adults With Multiple Sclerosis, Biebele Okpeahior

Electronic Theses and Dissertations

Introduction. Although research has highlighted the benefits of physical activity in people with Multiple Sclerosis (MS), they are still more likely to live an inactive lifestyle. There are limited studies that examine the relationship between physical activity and the Theory of Planned Behavior (TPB) among the MS population. This study aimed to explore the factors that associate with physical activity intent of adults with MS utilizing the constructs of the TPB. Methods. This study utilized a cross-sectional online survey done via a social media platform. There were 326 respondents to the survey and ultimately 249 surveys that met the criteria …

Evaluation Of The Loving Support Peer Counseling Program On Breastfeeding Duration Rates Among African American Women Enrolled In The Program (2017-2018), Nancy S. Jeffery

Electronic Theses and Dissertations

Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”-World Health Organization. The aim of this study was to evaluate the effectiveness of the Loving Support Peer Counseling (LSPC) program, under the WIC program in the state of Georgia, on breastfeeding duration rates among African American postpartum primiparas women. This observational study analyzed state-level data from January 2017 through December 2018. A cross-sectional design was used to evaluate the effectiveness of the Loving Support Peer Counseling Program (LSPC) in six of the …

The Relationship Between Urban Green Space Perception And Use Within The Adolescent Population: A Focused Ethnography, Rachel Lyons

Electronic Theses and Dissertations

Introduction: Greenspace is beneficial for improving adolescent mental health, yet we still do not understand the connection between the built environment and subjective mental wellbeing. We also lack understanding of how this population uses greenspace and how they feel when in it. Purpose: The purpose of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace, and to explore how they feel when they are in greenspace. Methods: participated in a focused ethnography that utilized auto photography for photo elicitation. Braun and Clark's (2006), six phases of thematic analysis were used to guide …

The Impact Of Volatile Organic Compound Exposure On Subclinical Biomarkers Of Cardiovascular Injury., Breandon Taylor

Electronic Theses and Dissertations

Pollution has been identified as the leading environmental cause of non-communicable disease and premature deaths globally. Volatile organic compounds (VOCs) are gaseous chemical constituents of pollution derived from a variety of sources, including industrial solvents and byproducts, automobile exhaust, tobacco smoke, cleaning supplies, and personal care products. VOCs are also abundant at various Superfund and Hazardous Waste Sites. Emerging data suggest that VOC exposure is associated with several adverse health outcomes, including cardiovascular disease (CVD). VOCs and their metabolites can potentially damage the endothelial lining of blood vessels, resulting in perturbed vascular function and vascular inflammation. We hypothesize that VOC …

A Mixed Methods Assessment Of Menstrual Hygiene Management And School Attendance Among Schoolgirls In Edo State, Nigeria., Madeline Tomlinson

Electronic Theses and Dissertations

Menstrual hygiene in lower-middle-income countries (LMICs) is limited and has been linked to many health, educational and social effects. However, the prevalence, details, and impact of menstrual hygiene management have not been well characterized in rural and peri-urban settings across Nigeria. The overall purpose of this research was to investigate menstrual hygiene management (MHM) among adolescent schoolgirls in peri-urban areas of Edo State, Nigeria; and to determine the educational consequences associated with poor MHM. MHM was measured using previously validated questions that were adapted after a formative assessment of MHM within the Edo State community. We used a mixed methods …

Correctional Career Pathways: A Reentry Program For Incarceration, Taylor M. Dula

Electronic Theses and Dissertations

For the past several decades, the United States led the world in incarceration rates. With nearly 2.3 million people being held in state or federal prisons or local jails in 2019, incarceration rates in the United States are over four times higher than in other developed countries. Disparities exist by gender, race, ethnicity, and other special populations. Males are 13 times more likely to be incarcerated than females. Additionally, black males are 5.7 times and Hispanic males are 2.8 times more likely to be incarcerated than white males. Individuals who experience incarceration have poorer mental and physical health outcomes. People …

Species Data And Vector Modeling: Evaluating Datasets For Improved Models Of Ixodes Ricinus Tick Distribution In Europe Under A Changing Climate, Steven Jones

Electronic Theses and Dissertations

To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe …

Bayesian Methods For Graphical Models With Neighborhood Selection., Sagnik Bhadury

Electronic Theses and Dissertations

Graphical models determine associations between variables through the notion of conditional independence. Gaussian graphical models are a widely used class of such models, where the relationships are formalized by non-null entries of the precision matrix. However, in high-dimensional cases, covariance estimates are typically unstable. Moreover, it is natural to expect only a few significant associations to be present in many realistic applications. This necessitates the injection of sparsity techniques into the estimation method. Classical frequentist methods, like GLASSO, use penalization techniques for this purpose. Fully Bayesian methods, on the contrary, are slow because they require iteratively sampling over a quadratic …

The Role Of Mmp-3 In Copper Oxide Nanoparticle-Induced Pulmonary Inflammation And Fibrosis., Yuanbao Zhang

Electronic Theses and Dissertations

Copper oxide nanoparticles (Nano-CuO) are wildly used in medical and industrial fields and our daily necessities. However, the biosafety assessment of Nano-CuO is far behind their rapid development. This study was to investigate the potential mechanisms underlying Nano-CuO-induced pulmonary inflammation and fibrosis, especially to determine whether Nano-CuO exposure could dysregulate MMP-3, an important mediator in pulmonary fibrosis, and its roles in Nano-CuO-induced pulmonary inflammation and fibrosis. Aim 1 was to investigate whether exposure to Nano-CuO caused MMP-3 dysregulation in lung epithelial cells and the role of MMP-3 in Nano-CuO-induced alteration of cell junction-associated proteins. The potential mechanisms that might be …