Digital Commons Network^™

Predictors And Missed Opportunities For Blood Glucose Screening Among African Americans: Implications For Church-Based Populations, Alexandria G. Bauer, Jannette Berkley-Patton, Carole Bowe Thompson, Kelsey Christensen

Journal of Health Disparities Research and Practice

African Americans (AAs) are disproportionately diagnosed with prediabetes, diabetes, and related complications. Guidelines for prediabetes/diabetes screening emphasize reaching at-risk adults. The AA church has potential to increase reach of BGS with AA church members and community members. The current study identified predictors of blood glucose screening (BGS) and individuals with missed opportunities for BGS among church-affiliated AA adults. Participants were drawn from a previous pilot study (Project Faith Influencing Transformation) conducted in six AA churches over eight months. Eligibility criteria included self-identifying as AA and being aged 18 or older. Participants who had previously been diagnosed with diabetes were excluded, …

Teaching About Cultural Competence And Health Disparities In An Online Graduate Public Health Course, Anuli Njoku, Drph, Mph, Uchenna Baker, Phd, Med

Journal of Health Disparities Research and Practice

The growing diversity in U.S. society encourages the need for culturally competent healthcare professionals to provide optimal services to a diverse population. This increasing diversity also brings greater awareness to health disparities among distinct subgroups of the U.S. population. Addressing health disparities in the USA will require a multidimensional approach from various sectors, including the field of education. Developing health disparities curricula can help cultivate conscious future health practitioners. Faculty development programs can be integral in equipping faculty to develop curricula on and teach students about health disparities. With a growth in online learning and in the number of adult …

Factors Associated With Participation In The Oregon Summer Food Program: A Mixed Methods Analysis, Alethea Chiappone, Teresa M. Garvin, Casey Blaser, Hollyanne E. Fricke, Lisa Weissenburger-Moser Boyd, Tom Barnard, Amy L. Yaroch

Journal of Health Disparities Research and Practice

The Summer Food Service Program (SFSP) was established to ensure children eligible for the National School Lunch Program (NSLP) continue to receive meals outside of the school year. However, participation in SFSP is relatively low (2.8 million annually) when compared with NSLP participation (30.4 million annually), suggesting that challenges exist in reaching children. Using a mixed methods approach, this study explored factors associated with SFSP participation. A secondary data analysis of the Oregon SFSP identified factors associated with SFSP participation at the Oregon SFSP-, sponsor-, and site-levels. Semi-structured interviews with SFSP sponsors explored barriers and facilitators to SFSP participation. Results …

Dissociation Between The Growing Opioid Demands And Drug Policy Directions Among The U.S. Older Adults With Degenerative Joint Diseases, Pearl Kim Phd, Takashi Yamashita Phd, Mph, Ma, Jay J. Shen Phd, Seong-Min Park Phd, Sung-Youn Chun Phd, Sun Jung Kim Phd, Mhsa, Jinwook Hwang Md, Phd, Se Won Lee Md, Georgia Dounis Dds, Ms, Hee-Taik Kang Md, Phd, Yong-Jae Lee Md, Phd, Dong-Hun Han Dds, Phd, Ji Eun Kim Phd, Hyeyoung Yeom Md, David Byun Do, Tsigab Bahta Md, Ji Won Yoo Md

Public Health Faculty Publications

We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States (U.S.), orthopedic operations and opioid-related hospital stays among seniors increase in the nation. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from 2006 through 2015 measured annual rate per 100,000 populations of orthopedic operations by age groups (45–64 vs 65 and older) as well as annual rate per 100,000 populations of opioid-related hospital …

Risk Of Cancer Death Among White, Black, And Hispanic Populations In South Florida, Paulo S. Pinheiro, Karen E. Callahan, Tulay Koru-Sengul, Justine Ransdell, Layla Bouzoubaa, Clyde P. Brown, Erin Kobetz

Environmental & Occupational Health Faculty Publications

Background: The cancer burden in South Florida, with a population of more than 6 million with a heavily Hispanic and large Afro-Caribbean population, has not been quantified. Methods: We analyzed 2012–2016 cancer mortality data from South Florida for white, Hispanic, and black populations with disaggregation for Cuban, Puerto Rican, South American, African American, and Afro-Caribbean groups. We calculated cancer site-specific and all-sites combined age-adjusted mortality rates, and we used negative binomial regression to determine mortality rate ratios to compare South Florida’s cancer mortality rates with those of the rest of the nation. Results: We analyzed 53,837 cancer deaths. Per 100,000 …

Get Engaged: Results Of Ncpg 2018 National Survey Of Gambling Attitudes & Experiences, Keith Whyte, Don Feeney

International Conference on Gambling & Risk Taking

The National Survey of Gambling Attitudes and Gambling Experiences (NGAGE) is the largest published survey of gambling participation and problems in the US. This unprecedented look into how Americans gamble, what they gamble, how they think about it in every state. Includes a special focus on sports gambling. Presenters will review the findings and implications for everyone involved in gambling issues.

Redesigning Gambling Treatment Programs For Success: A Model Based Approach Toward Program Development, Jeffrey J. Marotta, Greta Coe

International Conference on Gambling & Risk Taking

Abstract

This presentation will describe a program improvement initiative launched by Oregon Problem Gambling Services to assist with the development of its 47 publicly-funded gambling treatment programs. The development approach incorporated best practices as identified by SAMHSA, the gambling disorders literature, and expert review. The resulting Technical Assistance Visit Toolkit & Gambling Treatment Program Capability Index (GTPCI) offer a streamline program improvement protocol for use specifically with gambling treatment programs. The presenters will share their experience in implementing this program development approach, merits of the model, and program results.

Implications

This presentation will introduce participants to a model and evaluation …

Sub-Region Based Radiomics Analysis For Survival Prediction In Oesophageal Tumours Treated By Definitive Concurrent Chemoradiotherapy, Congying Xie, Pengfei Yang, Xuebang Zhang, Lei Xu, Xiaoju Wang, Xiadong Li, Luhan Zhang, Ruifei Xie, Ling Yang, Zhao Jing, Hongfang Zhang, Lingyu Ding, Yu Kuang, Tianye Niu, Shixiu Wu

Health Physics & Diagnostic Sciences Faculty Publications

Background: Evaluating clinical outcome prior to concurrent chemoradiotherapy remains challenging for oesophageal squamous cell carcinoma (OSCC) as traditional prognostic markers are assessed at the completion of treatment. Herein, we investigated the potential of using sub-region radiomics as a novel tumour biomarker in predicting overall survival of OSCC patients treated by concurrent chemoradiotherapy. Methods: Independent patient cohorts from two hospitals were included for training (n = 87) and validation (n = 46). Radiomics features were extracted from sub-regions clustered from patients' tumour regions using K-means method. The LASSO regression for ‘Cox’ method was used for feature selection. The survival prediction model …

The Environmental Impact And Formation Of Meals From The Pilot Year Of A Las Vegas Convention Food Rescue Program, Samantha To, Courtney Coughenour, Jennifer Pharr

Environmental & Occupational Health Faculty Publications

Annually, millions of tonnes of leftover edible foods are sent to landfill. Not only does this harm the environment by increasing the release of greenhouse gases which contribute to climate change, but it poses a question of ethics given that nearly 16 million households are food insecure in the US, and hundreds of millions of people around the globe. The purpose of this study was to document the amount of food diverted from landfill in the pilot year of a convention food rescue program and to determine the amount of greenhouse gas (GHG) emissions avoided by the diversion of such …

Health Care-Associated Infection Prevention Outcomes: Evaluating The Link Between Infection Prevention Practices In Healthcare Facilities And Their Health Care-Associated Infection Rates, Chidinma Veronica Njoku

UNLV Theses, Dissertations, Professional Papers, and Capstones

Healthcare-associated infections (HAI) are a pressing problem affecting vulnerable individuals who come to the hospital to receive care for one condition only to find that they have contracted another during their stay. Studies point to the importance of training and educating staff in order to implement and comply with recommended infection control and prevention control and prevention practices as lack of training and knowledge about infection control and prevention has been perceived to bring about a limited ability for direct care staff to adhere to recommended processes and activities. Although there are prior studies on the effects of assessments, infection …

Determinants Of Disparities In The Colorectal Cancer Burden, Karen Elizabeth Callahan

UNLV Theses, Dissertations, Professional Papers, and Capstones

Colorectal cancer (CRC) is the third leading cause of cancer incidence and mortality in the United States, with an estimated 140,000 new cases and 51,000 deaths expected in 2018. Like most cancers, the burden of CRC is unequally distributed among population groups. The current dissertation included two studies filling gaps in knowledge about CRC disparities. Study 1 characterized the relationship between educational attainment and CRC mortality by race/ethnicity. Six years of CRC mortality data (2012-2017) from the diverse state of California, with 30,180 deaths were analyzed. Sex-specific mortality rate ratios (MRR) stratified by race/ethnicity as well as by educational level …

Telomeres, Nutrition And Mortality: Risk Factors For The Rate Of Telomere Length Decline And The Associations Between Telomere Length, Nutrition And Mortality, Saruna Ghimire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Telomeres are nucleoprotein structures located at the ends of eukaryotic chromosomes, thought to protect the DNA from damage. As a person experiences stressors, harmful exposures, and other diseases throughout their life, telomeres are thought to become damaged and their length shortened, decreasing their ability to protect the DNA. Nutrition is an important aspect of healthy aging. Preservation of telomere length (TL) is thought to be one of the mechanisms by which good nutrition can delay or prevent the development of chronic disease and death. Recent evidence of preservation of TL with good nutrition is promising. Thus, the aim of …

Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. In Nevada, an estimated 80,000 individuals, aged 60 years or older, were food insecure in 2016. The primary aim of this study was to identify factors that are associated with food insecurity in older adults, aged sixty and older, in Clark County, NV. The secondary aim of this study was to identify which factors interact with each other to explain food insecurity among individuals aged sixty and older, in Clark County, NV. A secondary data analysis was conducted using data collected by …

An Analysis Of Postmastectomy Breast Reconstruction Due To Breast Cancer In Nevada And The United States From 2008-2013, Jenna Webb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In the United States, female breast cancer was the leading cause of new cancer cases from 2011-2015. Since the Women’s Health and Cancer Act of 1998 (WHCRA), the federal government mandates employee and private health insurance providers to cover breast reconstruction if they cover mastectomies. Postmastectomy breast reconstruction (PBR) rates increased after the WHCRA, but these rates have remained relatively low throughout recent years. Objective: The objective of this study was to determine factors associated with women having PBR due to breast cancer in Nevada and the United States from 2008 to 2013. Methods: Using two HCUP database, NIS …

Public Exposure To Outdoor Bioaerosols In Particulate Matter In Las Vegas: Daily And Seasonal Variations, Karey Renee Fortier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Bioaerosols are airborne particles of biological origin including viruses, bacteria, pollen, fungi, and fragments of their metabolic products. Bioaerosol exposure may represent a health risk, in particular for risk groups such as immunosuppressed persons, and those suffering from allergies or respiratory diseases. Bioaerosols of sizes

This study seeks to assess outdoor bioaerosol number concentrations and size distributions in Las Vegas, NV, as the first step in understanding their health risks. PM2.5 and PM10 were collected on black polycarbonate filters for 24-hour duration using MiniVol air samplers on UNLV campus in the spring and fall of 2017. Bioaerosols in these samples …

Health Disparities Among Sexual And Gender Minorities, Jennifer Keeley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Decades of research has shown that sexual and gender minorities (SGMs) experience adverse health and mental health outcomes to a greater extent than their heterosexual peers. The need to better understand and eliminate health disparities in the SGM population was recognized by the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The Secretary of Health at the Department of Health and Human Services approved the designation of the SGM population as a health disparities population in 2016 and called for SGM studies to examine the health needs of the SGM population across SGM subgroups via large representative …

A State Of Uncertainty: An Analysis Of Recent State Legislative Proposals To Regulate Preventive Services In The United States, Maxim Gakh, Cody Cris, Prescott Cheong, Courtney Coughenour

Public Health Faculty Publications

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. …

Social Vs. Practical Problems In Attaining A Colonoscopy: Different Patient Profiles?, Barbara A. Curbow, Evelyn C. King-Marshall, Nora Mueller, Travis Hyams, Shahnaz Sultan, Thomas J. George Jr

Journal of Health Disparities Research and Practice

Background: Colonoscopy is an effective procedure for identifying precancerous polyps and cancerous lesions, but it is unlike other cancer screening tools in that it requires sedation and thus assistance from at least one other individual. The intent of this paper was to identify logistical problems in completing the colonoscopy and to examine their relationships with sociodemographic characteristics.

Methods: All eligible patients (n = 2500) from two academic-affiliated colonoscopy centers (one free standing, one hospital-based) were invited to participate in an onsite, pre-colonoscopy survey; patients agreeing to participate (n = 1841, RR = 73.6%) received a $5.00 gift card. Multiple correspondence …

Prescription Medication Misuse Among American Indians In The Midwestern Us, Charley S. Lewis, Jordyn Gunville, Ryan Goeckner, Brian Chase, Lauren Clark, Jianghua He, Won S. Choi, Christine M. Daley

Journal of Health Disparities Research and Practice

Background: Prescription medications, particularly opioids, are often abused rather than used as intended by the prescribing physician. This is well-documented, though little data are available on American Indians. Misuse of other prescription medications is far less documented, but does occur and can have wide-spread effects.

Methods: We used a cross-sectional survey of American Indians in the Midwestern US (N=361) to begin to understand misuse of prescription medications, not necessarily to get high, but for any reason. Participants were recruited for this touchscreen computer-based survey at powwows, health fairs, and other community events through a convenience sample. We asked questions …

Cancer Risk Factors And Screening Behavior Among Korean Americans In The Sf Bay Area, Nhayoung Hwang, Hyunju Kim, Eugenia Yoo, Denny Cha, Winston Tseng Phd, Susan L. Ivey Md, Mhsa

Journal of Health Disparities Research and Practice

Background: Korean Americans (KA) have the highest prevalence of death from cancer among Asian American ethnic groups in the U.S. This KA prevalence rate is also substantially higher than that of non-Hispanic whites, yet little is known about their cancer risk factors. This paper is one of the first studies to explore cancer risk factors and screening behaviors of Korean Americans in the San Francisco Bay Area.

Methods: A survey instrument was created using items from the California Health Interview Survey (CHIS) from 2009-2012, which were translated into Korean. A cross-sectional survey assessing the prevalence of cancer risk factors and …

Examining The Impact Of Race And Rurality On Health Differences Among Overweight Youth Accessing Pediatric Endocrinology Care, Kelsee Halpin, Janelle R. Noel-Macdonnell, Yun Yan

Journal of Health Disparities Research and Practice

Methods: This study examines the impact of race and rurality on health differences, including prevalence of prediabetes and type 2 diabetes (T2D), among overweight children accessing pediatric endocrine specialty care. Cross-sectional analysis of overweight/obese youth 10 to 18 years of age receiving pediatric endocrinology consultation for weight gain, hyperglycemia, and/or T2D from 2013 to 2016 at a Midwest tertiary pediatric center.

Results: The 722 patients were 42% white, 25% black, 22% Hispanic; 88% lived in urban areas and 12% in rural areas. Rurality was determined using zip code approximation of Rural-Urban Commuting Area (RUCA) codes. After adjusting for confounders, black …

Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd

Journal of Health Disparities Research and Practice

In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2^nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …

Utilization Of Media-Driven Technology For Health Promotion And Risk Reduction Among American Indian And Alaska Native Young Adults: An Exploratory Study, Todd M. Sabato

Journal of Health Disparities Research and Practice

Across the developmental spectrum, American Indian and Alaska Native (AI/AN) adolescents and young adults experience considerable behavioral and mental health disparities, including substance abuse, depression, and engagement in sexual behaviors which enhance risk of pregnancy and sexually transmitted infections. Health-focused interventions utilizing digital and media technology hold significant promise among tribal communities, as they have the capacity to eliminate geography-based barriers. Utilizing a sample of 210 self-identified AI/AN students attending tribal colleges, this study identified the most effective technologies and intervention strategies, as well as health seeking patterns and preferences, which may impact implementation and sustainable use in tribal settings. …

Five-Year Trend In Diabetes Clinical Care And Self-Management Among Adults With Diabetes In West Virginia: 2010-2014, Ranjita Misra 2934168, Usha Sambamoorthi

Journal of Health Disparities Research and Practice

Objective: To examine the five-year trend in clinical care and diabetes self-management activities among adults living in the Appalachian state of West Virginia.

Methods: This study used a cross-sectional design with data from the Behavioral Risk Factor Surveillance System in 2010 (N=685) and 2014 (N=958), among noninstitutionalized adults with diabetes. Five-year trend in recommended diabetes clinical care, diabetes self-management activities and diabetes education was analyzed after adjusting for sex, education, income, insurance, age, obesity, comorbid hypertension, race and lifestyle behaviors (exercise and smoking).

Results: A significant increase in percentage of adults with 2 or more A1C tests was …

Native American Weight Loss Movement: Pilot Test Of A Culturally Tailored Weight Loss Program For American Indians, Christine M. Daley, Jason W. Hale, Shelley Bointy, Kelly Berryhill, Joseph Lemaster, Byron J. Gajewski

Journal of Health Disparities Research and Practice

American Indians (AIs) have higher rates of obesity than other racial/ethnic groups, placing them at heightened risk for cardiovascular diseases, diabetes, and certain cancers. Culturally appropriate weight loss interventions may be the key to reducing risk. The most successful program used in AI communities has been the Diabetes Prevention Program (DPP), which limits enrollment to individuals with a clinical diagnosis of pre-diabetes. The purpose of this pilot project was to modify and culturally tailor a weight loss intervention to AI communities in Kansas to improve weight loss related behaviors among those who do not qualify for the DPP. The Native …

Two-Stage Optimal Designs With Survival Endpoint When The Follow-Up Time Is Restricted, Guogen Shan, Hua Zhang

Public Health Faculty Publications

Background: Survival endpoint is frequently used in early phase clinical trials as the primary endpoint to assess the activity of a new treatment. Existing two-stage optimal designs with survival endpoint either over estimate the sample size or compute power outside the alternative hypothesis space. Methods: We propose a new single-arm two-stage optimal design with survival endpoint by using the one-sample log rank test based on exact variance estimates. This proposed design with survival endpoint is analogous to Simon’s two-stage design with binary endpoint, having restricted follow-up. Results: We compare the proposed design with the existing two-stage designs, including the two-stage …

"The Great Debate" 2019 - Brookings V. Unlv Debate Team, Brookings Mountain West, University Of Nevada, Las Vegas

Brookings Scholar Lecture Series

Brookings Mountain West, in partnership with the UNLV Debate Team, was proud to host the inaugural UNLV - Brookings Institution event, “The Great Debate.” Representatives from the nationally ranked UNLV Debate Team engaged colleagues from the Brookings Institution in a battle of ideas and policy positions destined to be remembered as one of the great intellectual forums of the 21st century. Featured speakers participated in a modified format of intercollegiate debate rules that allowed teams and individual members the opportunity to craft their arguments and responses in an open and respectful exchange of information to persuade, inform, and entertain audience …

A Qualitative Study On Parental And Community Stakeholder Views Of The Link Between Full-Day Kindergarten And Health In Southern Nevada, Courtney Coughenour, Jennifer Pharr, Maxim Gakh Jd, Mph, Sheila Clark, Prescott Cheong

Public Health Faculty Publications

Studies show that children who attend full-day kindergarten (FDK) experience both academic and developmental benefits compared to children who attend half-day programs. Sectors outside of health, such as education, can have important intended and unintended impacts on health. The purpose of this qualitative study was to understand perceptions of parental and other stakeholders in Southern Nevada (USA) about the education–health link, and to understand priorities regarding how FDK access could affect health. Two 90-minute focus groups were conducted with 14 adult stakeholder participants representing parents, current and former teachers, and community members. Transcripts were analyzed using conventional content analysis. Eight …

Analysis Of Self-Reported Walking For Transit In A Sprawling Urban Metropolitan Area In The Western U.S., Courtney Coughenour, Hanns De La Fuente-Mella, Alexander Paz

Public Health Faculty Publications

Walkability is associated with increased levels of physical activity and improved health and sustainability. The sprawling design of many metropolitan areas of the western U.S., such as Las Vegas, influences their walkability. The purpose of this study was to consider sprawl characteristics along with well-known correlates of walkability to determine what factors influence self-reported minutes of active transportation. Residents from four neighborhoods in the Las Vegas Metropolitan Area, targeted for their high and low walkability scores, were surveyed for their perceptions of street-connectivity, residential-density, land-use mix, and retail–floor-area ratio and sprawl characteristics including distance between crosswalks, single-entry-communities, high-speed streets, shade, …

Two-Stage Bagging Pruning For Reducing The Ensemble Size And Improving The Classification Performance, Hua Zhang, Yujie Song, Bo Jiang, Bi Chen, Guogen Shan

Environmental & Occupational Health Faculty Publications

Ensemble methods, such as the traditional bagging algorithm, can usually improve the performance of a single classifier. However, they usually require large storage space as well as relatively time-consuming predictions. Many approaches were developed to reduce the ensemble size and improve the classification performance by pruning the traditional bagging algorithms. In this article, we proposed a two-stage strategy to prune the traditional bagging algorithm by combining two simple approaches: accuracy-based pruning (AP) and distance-based pruning (DP). These two methods, as well as their two combinations, “AP+DP” and “DP+AP” as the two-stage pruning strategy, were all examined. Comparing with the single …