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A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

Harm Reduction En La Ciudad De Nueva York, Dimitri Fautsch, Jason Gonzalez

Capstones

Entrevistamos especialistas del Educadores de la Reducción de Daños de Nueva York y Sarah Evans quien era un líder del primero centro de la prevención de sobredosis en America Norte. Encontramos que este campo es una solución pragmática para la crisis de addición a los opioides.

Spanish - https://dimitrifautsch.medium.com/la-reducci%C3%B3n-de-da%C3%B1os-en-nueva-york-a0a8c8ccef4a

English - https://jasongonzalez76.wixsite.com/website/post/new-york-s-first-supervised-safe-injection-sites-are-a-first-of-its-kind-in-the-united-states

Serving Our Students: Evidence-Based Sex Education Policies And Practices Needed In Ohio, Lily Mckenzie Rosenberg

Honors Projects

Ohio has very minimal state-wide sex education laws, requiring only venereal disease education that has many similarities with abstinence-only education. Abstinence-only education has been shown to be ineffective in delaying first sex and lowering teen STDs, pregnancy, and birth rates. When students receive ineffective (or no) sex education it can impact them in many ways, leaving them unprepared for sexual lives as adults. To analyze the state of sex education in Ohio, this paper will look at sex education throughout Ohio both in law and in practice. I will then explore the impact of these minimal sex education laws on …

Peer Recovery Support Specialists: Role Clarification And Fit Within The Recovery Ecosystems Of Central Appalachia, Angela Hagaman

Electronic Theses and Dissertations

The Peer Recovery Support Specialist (PRSS), a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorders, plays a key role in the ongoing transformation of SUD treatment from one of acute clinical service provision with documented short-term outcomes including symptom reduction, to a more holistic and comprehensive approach to long-term recovery. Empirical evidence specific to outcomes of PRSS working in the addiction treatment realm is sparse and equivocal, indicating the need for additional research and improved methods designed to explore the nature of the PRSS role and fit within the …

Looking Upstream: Promoting Health Equity In Philadelphia Through Novel Partnership Strategies, Adrea Cope, David B. Nash, Sandra E Brooks, David Platt

College of Population Health Faculty Papers

No abstract provided.

Development And Implementation Of An Opioid Risk-Reduction Strategy, Heather Darmetko

Student Scholarly Projects

Practice Problem: Accidental overdose is a continued concern for those who are prescribed opioids, and it is essential that healthcare members intensify prevention and response measures in order to prevent death or misuse from this medication.

PICOT: The PICOT question that guided this project was: “In adult patients at an outpatient chronic pain management clinic (P), how does development and implementation of a safe opioid risk-reduction office policy (I), compared to usual practice (C), improve patient rates of naloxone availability and health literacy (O) over eight weeks (T)?”

Evidence: The CDC’s Guideline for Prescribing Opioids for Chronic Pain, the …

Unmet Healthcare Need Due To Cost Concerns Among U.S. Transgender And Gender-Expansive Adults: Results From A National Survey, Luisa Kcomt, Kevin M. Gorey, Betty Jo Barrett, Dana S. Levin, Jill Grant, Sean Esteban Mccabe

Social Work Publications

This study examines past-year unmet healthcare need due to cost experienced by transgender and gender-expansive (TGE) adults in the United States in the context of the Patient Protection and Affordable Care Act (ACA). It also aims to estimate the importance of having health insurance among TGE Americans (transgender men, transgender women, nonbinary/genderqueer people, and cross-dressers). Data were from the 2015 U.S. Transgender Survey (N ¼ 19,157 adults, aged 25 to 64 years). Multivariable logistic regression models were used to determine the adjusted odds ratios (AOR) and 95 percent confidence intervals (CI) of TGE individuals’ past-year unmet healthcare need due to …

Transforming Pete’S Initial Standards: Ensuring Social Justice For Black Students In Physical Education., Brian Culp

Faculty Articles

Calls to transform the initial Physical Education Teacher Education (PETE) standards to reflect social justice have garnered little attention. Recent events have magnified the racial injustices inflicted upon Black people in America and their ability to participate as full equals in a society influenced and characterized by white supremacy. Using critical race theory (CRT) as a framework, the authors examine the racial formulation of the historical and current installations of SHAPE America’s initial PETE Standards to illustrate the influence of white supremacy in PETE programs, the relationship to physical literacy, and the impact on Black students. After analysis, the authors …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Advancing Behavioral Health Literacy, James Scollione

Journal of Social, Behavioral, and Health Sciences

Accessing, comprehending, and using information to make informed decisions and improve one’s overall health or well-being are the foci of health literacy. The concept of behavioral health was introduced in the early 1980s and, since then, it has influenced new ideas (e.g., behavioral health literacy and integrated behavioral health care) and gained research and public attention. My aim is to provide an overview of definitions (i.e., health literacy, mental health literacy, and behavioral health literacy) and their connection to each other. I propose an expanded and honed definition of behavioral health literacy to enhance the behavioral health literacy and well-being …

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

The Association Of Demographics, Social And Personal/Family Characteristics With Treatment Utilization Among Young Adults With Opioid Use Disorder In The United States, Marva L. Frederick

Dissertations, Theses, and Capstone Projects

Background

Opioid use disorder is a life-threatening medical condition and an ongoing public health problem in the United States. Treatment is necessary to combat opioid use disorder and to minimize the health-associated problems. Opioid use disorder is treatable with life-extending medications. Studies that examined treatment utilization among young adults with opioid use disorder in the United States was scarce. This study investigated the characteristics posited in the Andersen Behavioral Model of health utilization which may be associated with treatment utilization, among young adults with opioid use disorder in the United States. The urgency posed by the continuing opioid crisis in …

An Observational Analysis Of ‘Me Too’ Narratives From Youtube, Jordan L. Nelon, Mandy N. Spadine, Meg S. Patterson, Sydney E. Brown, Christina L. Bookout, Lauren M. Woods, Sara K. Fehr

Health Behavior Research

The ‘me too’ movement originated to help survivors of sexual violence by providing resources and building a community of advocates to exemplify the magnitude of sexual violence victimization. This movement gained momentum via Twitter due to the viral hashtag—#metoo. YouTube is often used as a means of expression in younger generations, thus sexual violence survivors began using the platform as a way to disseminate ‘me too’ narratives. Therefore, this study aimed to examine how sexual violence narratives resulting from the ‘me too’ movement are being told on YouTube and understand the components of the narratives related to self-blaming mindsets. Based …

Exploring The Impact Of Interpersonal Trust On Health Outcomes In Rapidly Gentrifying Neighborhoods In Portland, Oregon, Julie Ha, Yves Labissiere

McNair Symposium

Social determinants have been recognized to be significant factors contributing to the overall health outcomes of individuals. However, there is limited research on how these factors have directly impacted the mental and physical wellness of people in neighborhoods who are experiencing rapid gentrification. The objective of this study is to determine whether the level of interpersonal trust present between individuals in neighborhoods is associated with the mental and physical health outcomes among its residents. This quantitative study uses the Albina-Rockwood Neighborhood Promise Survey, which uses data from a random sample of families living in two rapidly gentrified neighborhoods in Portland, …

School Police Reform: A Public Health Imperative, Thalia González, Emma Kaeser

SMU Law Review Forum

Out of the twin pandemics currently gripping the United States­—deaths of unarmed Black victims at the hands of police and racialized health inequities resulting from COVID-19—an antiracist health equity agenda has emerged that identifies racism as a public health crisis. Likewise, calls for reform of school policing by those advocating for civil rights, racial justice, and Black Lives Matter have simultaneously intensified. Yet each remains siloed, despite the natural connection and implicit overlap between these separate movements and debates. Indeed, there are documented negative health effects of school policing for Black, Indigenous, people of color (BIPOC) youth. But these have …

“And The Next Day, You Are In Charge”: Policy Recommendations Stemming From A Qualitative Investigation Into The Professional Development Of Early Career Peer Support Specialists In Kentucky., Diane Zero

Electronic Theses and Dissertations

Over the last twenty years, the peer support segment of the behavioral health workforce has grown rapidly. However, few researchers have studied the effects on individuals from transitioning into the role. Likewise, there is limited research examining the professional development process of early career peer support specialists. To begin to fill these gaps in the literature, I conducted a qualitative research study examining workforce development experiences of peer support specialists in Kentucky. This dissertation reports on its findings and includes a policy paper with recommendations for improving policy and practice. Chapter one offers an introduction to the peer support workforce …

Exploring Opportunities For Prevention Of Child Sexual Abuse In A Diverse American Muslim Community., Rishtya Meena Kakar

Electronic Theses and Dissertations

Recognizing the significant mental, emotional, developmental and health consequences for victims of child sexual abuse (CSA) and sociopolitical consequences for families and communities in every cultural, ethnic, and religious group around the world, this study sought to determine key opportunities for prevention of CSA in a diverse American Muslim community using a public health socioecological lens, rooted in aspects of critical theory. While there is considerable research on situational and individual-level risk factors related to CSA cases, there is less research on the societal and community-level processes related to the primary prevention of CSA, especially among minoritized communities. Responding to …

People With Disabilities Still At Risk In Congregate Care Settings, University Of Montana Rural Institute

Health and Wellness

This report provides an analysis of data to better understand where cases and deaths are rising in nursing homes as of August 8 2021. We hope this analysis can help support local community planning and networking among rural partners to improve outcomes.

• COVID-19 cases among residents and staff are on the rise in nursing homes with the steepest increases in urban areas and in the South and Midwest.
• Disabled people are disproportionately overrepresented in the resident populations of unsafe congregate settings, such as nursing homes.
• Vaccination rates across both residents and staff in nursing homes have stagnated.
• Policy priorities should …

Appalachia: Putting The "Critical" In Race And Crowdsourcing A Pathway Model On Institutional Racism, Lauri Andress, Keri Valentine

Journal of Appalachian Health

As the website Understanding and Dismantling Racism: Crowdsourcing a Pathway Model in Appalachia explains, we are seeking assistance in refining a pathway model that elucidates institutional racism from the unique standpoint of Appalachia. We think that Appalachia has a distinctive cultural toolkit that shapes its orientation on issues. Our goal is to use crowdsourcing to harness this unique Appalachian ethos to refine the Pathway model on Institutional Racism based on comments, edits, questions, and ideas left on the website.

Longitudinal Pre-Exposure Prophylaxis (Prep) Acceptability, Initiation And Adherence Among Criminal Justice-Involved Adults In The Usa: The Southern Prep Cohort Study (Specs) Protocol, Katherine Lemasters, Carrie B. Oser, Mariah Cowell, Katie Mollan, Kathryn Nowotny, Lauren Brinkley-Rubinstein

Sociology Faculty Publications

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population.

METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential …

Opioids And Dentistry, Anne E. Wampler

Pacific Journal of Health

Dental professionals are among the leading prescribers of opioids in the United States and play a significant role in the current opioid epidemic. While dental professionals prescribe these potent pain killers to provide relief to patients, the serious implications of their prescription and distribution must be considered. This manuscript covers the science behind opioids, history of the opioid epidemic, the affliction it is currently causing in the U.S., the immense impact dentists have in providing opioid prescriptions along with gross over-prescription practices, and much more. Other topics discussed include alternative pain management, safe prescribing practices, naloxone, and how dentists can …

The Intersection Of Hiv, Covid-19 And Systemic Racism, Gary F. Spinner

Journal of Health Disparities Research and Practice

ABSTRACT

The Human Immunodeficiency Virus (HIV) pandemic has taken the greatest toll on racial and ethnic minorities in the United States. Blacks and Latinxs suffer greater disease incidence, prevalence, morbidity and mortality from HIV as compared with Whites. Similarly, the Covid-19 pandemic caused by SARS-CoV-2 has disproportionately affected Blacks, Latinxs, and Native Americans causing higher rates of infection, more severe disease, and higher rates of mortality as compared with Whites. The pandemic of racism is as ubiquitous as the pandemics of HIV and Covid-19. Its sustaining forces drive wealth inequality, poverty, racially segregated and overcrowded housing, unequal employment opportunities, unequal …

Health Disparities And Covid-19 Pandemic: Increasing Clinical Research Participation Among African Americans, Kashica J. Webber-Ritchey, Abbi D. Lane-Cordova

Journal of Health Disparities Research and Practice

Health disparities in African Americans is a persistent issue. Higher rates and severity of the novel coronavirus-19 [COVID-19] among African Americans only widens health disparities. Effective COVID-19 treatment options are imperative, requiring representation of African Americans in clinical research. However, low participation and under-representation of African Americans is complex in nature. This article describes health disparities, the impact of COVID-19, and participation in clinical research among African Americans. We offer strategies for researchers to enhance the inclusion of African Americans. We also offer strategies in conducting clinical research during COVID-19.

Lessons From The Health Care Innovation Awards: Productively Engaging Vulnerable Populations To Address Social Determinants Of Health, Maysoun Freij, Megan Skillman, Caitlin Cross-Barnet, Rachel Friedman Singer, Christina Rotondo, Michelle Dougherty, Sarah Ruiz, Adil Moiduddin, Lynne Page Snyder

Journal of Health Disparities Research and Practice

Objectives: This paper examines productive interactions—a cornerstone of the Chronic Care Model—between health care providers and vulnerable populations with chronic illnesses and/or disabilities. Methods: We conducted qualitative analysis of 16 focus groups and 29 interviews with patients and/or caregivers and 195 interviews with program leadership and providers across 15 Health Care Innovation Awards that targeted vulnerable populations. We analyzed how awardees addressed health concerns and social determinants of health (SDOH), and identified key components of productive interactions. Results: Providers achieved productive interactions through four primary strategies: establishing trust and showing respect; solving problems; building accuracy in health …

"Man Up": Male Survivors Of Intimate Partner Violence Through The Eyes Of Their Providers, Xavier S. Borsato

Electronic Thesis and Dissertation Repository

Intimate partner violence (IPV) is a complex phenomenon that is often understood with women as the primary recipients of violence and men as the primary perpetrators. However, emerging literature on heterosexual relationships suggests that men also experience interpersonal violence, most often from their female partners. Drawing on research data gathered through semi-structured interviews with service providers (n = 4), this qualitative inquiry explores how gender, power, and the stigma associated with interpersonal violence impact men who have experienced abuse through the perspectives of the service providers who work with them. The findings from this study highlight how traditional constructions …

Management Of Intimate Partner Violence In Health Care Settings: A Training Manual For Health Care Providers, Division Of Reproductive And Maternal Health

Reproductive Health

Intimate partner violence (IPV) is any behavior by an intimate partner that causes physical, sexual, or psychological harm. In healthcare settings where providers are well trained, caring, and sensitive, most survivors respond positively to being asked about their exposure to violence. Healthcare providers are in a unique position to identify survivors and offer appropriate management and referrals. The World Health organization developed clinical guidelines to provide evidence-based guidance to healthcare providers on the identification and appropriate response to IPV and sexual violence. Based on this guidance, the Ministry of Health developed a comprehensive training manual to empower healthcare providers with …

Developing A Diagnostic Tool Of A Community’S Health, Ruth Kurtycz

Dissertations

Where we live can affect nearly every aspect of our lives, including how long those lives will be. Previous studies have demonstrated large health disparities between communities in the United States; since the health of a community can significantly impact its residents, evaluating and predicting community health is of interest to many people. Currently the Federal government collects and publishes data on community-level demographics, housing, crime rates, and disease. State-level and non-governmental agencies track and share community housing prices, school performance, neighborhood safety, and other characteristics. In short, there is a wealth of information but the work being done around …

Identifying The Cost Of Preventable Chronic Disease In Prison: Can Illness Prevention Of Adults In Custody Save Money?, Molly Bineham

Dissertations and Theses

This study investigates the cost of preventable health problems and ailments when compared to other costs of incarceration. The purpose of this study is to examine the impact of imprisonment on the costliest chronic illness. The health of adults in custody related to the general population and the overall fiscal cost of the deadliest chronic illness among incarcerated adults is discussed. Linear regression is used to analyze the occurrence of heart disease and diabetes among adults in custody while controlling for other factors. The results of this analysis provide insight that chronic diseases like heart disease and diabetes should be …

Review Of Fetal Alcohol Spectrum Disorder (Fasd) Among Aboriginal And Torres Strait Islander People, Sharynne Hamilton, Michael Doyle, Carol Bower

Australian Indigenous HealthBulletin

Fetal Alcohol Spectrum Disorder (FASD) is a preventable, lifelong disability that disproportionately affects Aboriginal and Torres Strait Islander people. This review provides a comprehensive synthesis of the available information on FASD among Aboriginal and Torres Strait Islander people, with reference to the limitations on population-based data and evaluated programs. The review outlines; the harms of alcohol use in the context of colonisation, cultural perspectives on assessment and diagnosis, effective prevention programs and a summary of state and national policies. Health impacts, educational outcomes and the effects of FASD on vulnerable populations such as children in protection and young people in …