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Housing Instability Patterns Among Low-Income, Urban Black Young Adults In California And Associations With Mental Health Outcomes: Baseline Data From A Randomized Waitlist-Controlled Trial, Michelle K. Nakphong, D. Jovon Bright, Ala Koreitem, A. Rain Mocello, Nadra E. Lisha, Hannah H. Leslie, Itzel Estrada, Margaret K. Libby, Sheri A. Lippman, Marguerita A. Lightfoot

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Deep-rooted racial residential segregation and housing discrimination have given rise to housing disparities among low-income Black young adults in the US. Most studies have focused on single dimensions of housing instability, and thus provide a partial view of how Black young adults experience multiple, and perhaps overlapping, experiences of housing instability including homelessness, frequent moves, unaffordability, or evictions. We aimed to illuminate the multiple forms of housing instability that Black young adults contend with and examine relationships between housing instability and mental health outcomes.

Methods: Using baseline data from the Black Economic Equity Movement (BEEM) guaranteed income trial with …

Clinician Actions In Response To Adverse Childhood Experience (Ace) Screening, J. Scott Ashwood, Nipher Malika, Stephanie Williamson, Charles Engel, Edward Machtinger, Nina Thompson, Amy Shekarchi, Shannon Thyne, Brigid Mccaw, Marguerita Lightfoot, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background and Objective: Adverse Childhood Experiences(ACEs) have a powerful influence on mental health, physical health, and life expectancy. Screening for ACEs and the clinician response to ACEs are critical to addressing the health and well-being of children; however, little is known about the actions clinicians take in response to ACE screening. Therefore, we aimed to examine clinician responses to ACE screening at five California pediatric clinics in a large public health care system. Methods: Patient demographics, indicators of social and behavioral determinants of health (e.g., housing insecurity), the number of ACEs endorsed on a screening instrument, and the actions clinicians …

Put The Vanc Down, Flip It And Reverse It: Comparison Of Vancomycin And Daptomycin Health Care Utilization And Cost In Outpatient Parenteral Antimicrobial Therapy, Amber C. Streifel, Katie Luis, Monark Nakrani, Diana Yu, Monica K. Sikka, Cara D. Varley, Alyse Douglass, Heather Mayer, Kathleen Young, James S. Lewis Ii

OHSU-PSU School of Public Health Faculty Publications and Presentations

Vancomycin and daptomycin are frequently used in outpatient parenteral antimicrobial therapy (OPAT). We analyze health care utilization and cost to the health care system for vancomycin vs daptomycin in the outpatient setting and find that vancomycin results in significantly higher health care utilization and similar cost per course compared with daptomycin in OPAT.

Reflecting On The Quality Of A Methodologically Pluralist Evaluation Of A Large-Scale Indigenous Health Research Collaboration In Australia, Jodie Bailie, Veronica Matthews, Alison Frances Laycock, Kathleen Conte, Lynette Feeney, Roxanne Bainbridge

OHSU-PSU School of Public Health Faculty Publications and Presentations

Indigenous communities worldwide lead calls for all evaluations of research, programmes and policies affecting their communities to reflect the values, priorities and perspectives of the Indigenous peoples and communities involved. Tools, such as the Quality Appraisal Tool (QAT), are available to assess research quality through an Indigenous cultural lens. Good evaluation requires that evaluation efforts be evaluated. We found that critical reflection on the quality of evaluations from an Indigenous perspective is largely absent from the published literature. To ensure that we strive for quality in evaluation as determined by Indigenous people with whom we work, we examined the quality …

Indiana's Public Health Investment Holds Insights For Other States, Nir Menachemi, Lindsay Weaver, Virginia Caine, D Shane Hatchett, Kristina Box, Paul K. Halverson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Indiana has a business-friendly environment, but historical underinvestment in public health has yielded poor health outcomes. In 2023, when trust in governmental public health was strained nationwide, Indiana increased public health spending by 1,500 percent. In this article, we explain how Indiana achieved this unprecedented legislative victory for public health, describing the context, approach, and lessons learned. Specifically, an Indiana University report linking economic vitality and overall health sparked the creation of a governor's commission charged with exploring ways to address Indiana's shortcomings. Working with the Indiana Department of Health, the commission developed multisectoral coalitions and business and government partnerships, …

Engaging Antiracist And Decolonial Praxis To Advance Equity In Oregon Public Health Surveillance Practices, Ryan J. Petteway, Daniel López-Cevallos, Mira Mohsini, Andres Lopez, Roberta S. Hunte, Tim Holbert, Kusuma Madamala

OHSU-PSU School of Public Health Faculty Publications and Presentations

Public health surveillance and data systems in the US remain an unnamed facet of structural racism. What gets measured, which data get collected and analyzed, and how and by whom are not matters of happenstance. Rather, surveillance and data systems are productions and reproductions of political priority, epistemic privilege, and racialized state power. This has consequences for how communities of color are represented or misrepresented, viewed, and valued and for what is prioritized and viewed as legitimate cause for action. Surveillance and data systems accordingly must be understood as both an instrument of structural racism and an opportunity to dismantle …

Language-Based Acculturation Is Linked With Reproductive Autonomy Among Oregon Mexican-Origin Latinas, Sara Diaz-Anaya, Emily R. Boniface, Grace Parra, Edlyn Wolwowicz, Blair G. Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

We test whether level of acculturation is associated with reproductive autonomy among Mexican-origin Latinas in Oregon.

Assessing Associations Between Individual-Level Social Determinants Of Health And Covid-19 Hospitalizations: Investigating Racial/Ethnic Disparities Among People Living With Human Immunodeficiency Virus (Hiv) In The U.S. National Covid Cohort Collaborativ, Dimple Vaidya, Kenneth J. Wilkins, Eric Hurwitz, Jessica Y. Islam, Dongmei Li, Jing Sun, Sandra E. Safo, Jennifer M. Ross, Cara D. Varley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Abstract Background: Leveraging the National COVID-19 Cohort Collaborative (N3C), a nationally sampled electronic health records repository, we explored associations between individual-level social determinants of health (SDoH) and COVID-19-related hospitalizations among racialized minority people with human immunodeficiency virus (HIV) (PWH), who have been historically adversely affected by SDoH. Methods: We retrospectively studied PWH and people without HIV (PWoH) using N3C data from January 2020 to November 2023. We evaluated SDoH variables across three domains in the Healthy People 2030 framework: (1) healthcare access, (2) economic stability, and (3) social cohesion with our primary outcome, COVID-19-related hospitalization. We conducted hierarchically nested additive …

The Embodiment Of Exclusionary Displacement Pressure: Intersections Of Housing Insecurity And Mental Health In A Hispanic/Latinx Immigrant Neighborhood., Marisa Westbrook

OHSU-PSU School of Public Health Faculty Publications and Presentations

Gentrification, growing income inequality, urban development, and the affordable housing crisis necessitate understanding the impact of the concern of displacement on health - prior to or even in the absence of a displacement event. In this paper, I use the term "exclusionary displacement pressure" to unify the literature on exclusionary displacement and displacement pressure, highlighting the disproportionate and inequitable impacts of displacement pressure among communities of color. Through following 35 residents over 2.5-years (2019-2022) in one predominantly low-income Hispanic/Latinx immigrant neighborhood in Denver, Colorado, I examine how exclusionary displacement pressure shapes their health and wellbeing over time. Through paying attention …

Influence Of Antibiotic Exposure Intensity On The Risk Of Clostridioides Difficile Infection, Michael J. Ray, Luke C. Strnad, Kendall J. Tucker, Jon P. Furuno, Eric T. Lofgren, Caitlin M. Mccracken, Hiro Park, Jeffrey S. Gerber, Jessina C. Mcgregor

OHSU-PSU School of Public Health Faculty Publications and Presentations

Antibiotics are a strong risk factor for Clostridioides difficile infection (CDI), and CDI incidence is often measured as an important outcome metric for antimicrobial stewardship interventions aiming to reduce antibiotic use. However, risk of CDI from antibiotics varies by agent and dependent on the intensity (i.e., spectrum and duration) of antibiotic therapy. Thus, the impact of stewardship interventions on CDI incidence is variable, and understanding this risk requires a more granular measure of intensity of therapy than traditionally used measures like days of therapy (DOT).

Covid-19 Vaccination Uptake, Infection Rates, And Seropositivity Among Youth Experiencing Homelessness In The United States., Diane M. Santa Maria, Nikhil Padhye, Luis Ostrosky-Zeichner, Carolyn Z. Grimes, Adeline Nyamathi, Marguerita Lightfoot, Yasmeen Quadri, Mary E. Paul, Jennifer Torres Jones

OHSU-PSU School of Public Health Faculty Publications and Presentations

People experiencing homelessness are at greater risk of exposure and poor health outcomes from COVID-19. Yet, little data exists on the prevalence and correlates of COVID-19 among homeless populations. To mitigate the spread and severity, uptake of the COVID-19 vaccine is needed. This can be challenging among youth experiencing homelessness who are more likely to be unvaccinated when compared to stably housed youth.

Fixing A Hole: A Retrospective Cohort Study Evaluating Hav, Hbv, Tetanus Screening, And Vaccination During Hospitalization In Persons Who Use Substances, Amber C. Streifel, Jose Eduardo Rivera Sarti, Monica K. Sikka, Michael Conte, Bradie Winders, Cara D. Varley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:Rates of serious injection-related infections in persons who use drugs have increased. Resulting admissions are an opportunity for screening and vaccination of preventable infections such as hepatitis A virus (HAV), hepatitis B virus (HBV), and tetanus. Design and methods:We conducted a retrospective review of adults with documented substance use admitted for bacterial infection between July 2015 and March 2020. We evaluated HAV, HBV, and tetanus vaccination status at admission, along with screening for HAV and HBV infection and immunity. We identified the proportion of patients at risk for infection who received HAV, HBV, and tetanus vaccines during admission and patient-level …

Amelioration Of Age-Related Cognitive Decline And Anxiety In Mice By Centella Asiatica Extract Varies By Sex, Dose And Mode Of Administration, Nora E. Gray, Wyatt Hack, Mikah S. Brandes, Jonathan A. Zweig, Liping Yang, Luke Marney, Jaewoo Choi, Armando Alcazar Magana, Natasha Cerruti, Janis Mcferrin, Seiji Koike, Thuan Nguyen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: A water extract (CAW) of the Ayurvedic plant Centella asiatica administered in drinking water has been shown to improve cognitive deficits in mouse models of aging and neurodegenerative diseases. Here the effects of CAW administered in drinking water or the diet on cognition, measures of anxiety and depression-like behavior in healthy aged mice are compared.Methods: Three- and eighteen-month-old male and female C57BL6 mice were administered rodent AIN-93M diet containing CAW (0, 0.2, 0.5 or 1% w/w) to provide 0, 200 mg/kg/d, 500 mg/kg/d or 1,000 mg/kg/d CAW for a total of 5 weeks. An additional group of eighteen-month-old mice …

Concordance Between Two Monoclonal Antibody-Based Antigen Detection Enzyme-Linked Immunosorbent Assays For Measuring Cysticercal Antigen Levels In Sera From Pigs Experimentally Infected With Taenia Solium And Taenia Hydatigena, Gianfranco Arroyo, Luz Toribio, Sara Garrido, Nancy Chile, Teresa Lopez-Urbina, Luis A. Gomez-Puerta, Miguel Muro, Robert H. Gilman, Yesenia Castillo, Pierre Dorny, Seth E. O’Neal, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Antigen detection in Taenia solium cysticercosis confirms viable infection in the intermediate host (either pig or human). The reference B158/B60 monoclonal antibody (mAb)-based Ag-enzyme-linked immunosorbent assay (ELISA) has acceptable levels of sensitivity and specificity in human neurocysticercosis with multiple brain cysts, although its sensitivity is lower in cases with single brain cysts, whereas in porcine cysticercosis the assay specificity is affected by its frequent cross-reaction with Taenia hydatigena, another common cestode found in pigs. Our group has produced 21 anti-T. solium mAbs reacting against antigens of the whole cyst, vesicular fluid, and secretory/excretory products, identifying TsW8/TsW5 as the most …

Contralateral Second Dose Improves Antibody Responses To A 2-Dose Mrna Vaccination Regimen, Sedigheh Fazli, Archana Thomas, Abram E. Estrada, Hiro A. P. Ross, David Xthona Lee, Steven Kazmierczak, Mark K. Slifka, David Montefiori, William B. Messer, Marcel E. Curlin

OHSU-PSU School of Public Health Faculty Publications and Presentations

BACKGROUND. Vaccination is typically administered without regard to site of prior vaccination, but this factor may substantially affect downstream immune responses. METHODS. We assessed serological responses to initial COVID-19 vaccination in baseline seronegative adults who received second-dose boosters in the ipsilateral or contralateral arm relative to initial vaccination. We measured serum SARSCoV-2 spike–specific Ig, receptor-binding domain–specific (RBD-specific) IgG, SARS-CoV-2 nucleocapsid–specific IgG, and neutralizing antibody titers against SARS-CoV-2.D614G (early strain) and SARS-CoV-2.B.1.1.529 (Omicron) at approximately 0.6, 8, and 14 months after boosting. RESULTS. In 947 individuals, contralateral boosting was associated with higher spike-specific serum Ig, and this effect increased over time, …

Patient And Caregiver Perspectives On Implementation Of Ace Screening In Pediatric Care Settings: A Qualitative Evaluation, Ingrid Estrada-Darley, Peggy Chen, Ryan Mcbain, Gabriela Alvarado, Charles Engel, Nipher Mallika, Edward L. Machtinger, Brigid Mccaw, Marguerita Lightfoot, Multiple Additional Athors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction

This qualitative research study explored the perspectives of adolescents, 12 to 19-years-old, and caregivers of children under 12-years-old on the acceptibility of adverse childhood experiences (ACEs) screenings in five pediatric clinics.

Method

A constructivist grounded theory approach was utilized. One-on-one semistructured phone interviews were conducted with 44 adolescents and 95 caregivers of children less than 12 years old. Interviews were analyzed using thematic analysis.

Results

Most participants reported feeling comfortable discussing ACEs with their providers. Some reported that screening helped build trust. Others expressed privacy concerns and did not receive information about the reason for screening. Adolescent patients …

What Adolescents Say In Text Messages To Motivate Peer Networks To Access Health Care And Sexually Transmitted Infection Testing: Qualitative Thematic Analysis, Marguerita Lightfoot, Chadwick Campbell, Allysha C. Maragh-Bass, Joi Jackson-Morgan, Kelly Taylor

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:While rates of HIV and sexually transmitted infections (STIs) are extremely high among adolescents and young adults in the United States, rates of HIV and STI testing remain low. Given the ubiquity of mobile phones and the saliency of peers for youths, text messaging strategies may successfully promote HIV or STI testing among youths.

Objective:This study aimed to understand the types of messages youths believe were motivating and persuasive when asked to text friends to encourage them to seek HIV or STI testing services at a neighborhood clinic.

Methods:We implemented an adolescent peer-based text messaging intervention to encourage clinic attendance …

Primary Care As A Protective Factor: A Vision To Transform Health Care Delivery And Overcome Disparities In Health, Edward L. Machtinger, Alicia F. Lieberman, Christina D. Bethell, Marguerita Lightfoot

OHSU-PSU School of Public Health Faculty Publications and Presentations

A large body of research demonstrates that experiences of trauma, especially when they occur in the absence of safe, stable, nurturing relationships (SSNRs) and environments— known as protective factors— interrupt healthy development and predispose both children and adults to the most common causes of physical and mental illness and early death.1,2 Because minoritized and low-income populations are exposed to more trauma and have access to fewer protective factors, they experience higher rates of trauma-related health and social problems and severe disparities in health.1–4 Primary care clinicians increasingly recognize the role that trauma plays in the health and well-being of their …

Inclusive Approaches For Measuring Demographics Of Underrepresented Populations In Stem And Biomedical Research Training Programs, Stephanie E. Paris, Alexis Dinno, Mollie C. Marr, Aaron Raz Link, Brandy L. Lentz, Gwen Shusterman, Jerian Abel, Kristen Harrison, James Hook, Dawn M. Richardson, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

As federal strategic plans prioritize increasing diversity within the biomedical workforce, and STEM training and outreach programs seek to recruit and retain students from historically underrepresented populations, there is a need for interrogation of traditional demographic descriptors and careful consideration of best practices for obtaining demographic data. To accelerate this work, equity-focused researchers and leaders from STEM programs convened to examine approaches for measuring demographic variables. Gender, race/ethnicity, disability, and disadvantaged background were prioritized given their focus by federal funding agencies. Categories of sex minority, sexual (orientation) minority, and gender minority (SSGM) should be included in demographic measures collected by …

Antibody Banding Patterns On The Enzyme-Linked Immunoelectrotransfer Blot (Eitb) Assay Clearly Discriminate Viable Cysticercosis In Naturally Infected Pigs, Gianfranco Arroyo, Andrés G. Lescano, Cesar M. Gavidia, Maria Teresa Lopez-Urbina, Miguel Ara-Gomez, Lucho Gomez-Puerta, Seth E. O’Neal, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Enzyme-linked immunoelectrotransfer blot (EITB) detects antibodies against seven Taenia solium larvae antigens in three protein families (GP50, T24/42, and 8-kDa) with different structures and functions. EITB banding patterns against these antigens in pigs provide information about the course of infection and may discriminate viable cysticercosis. We analyzed the banding patterns and infection outcomes (presence of viable cysts, degenerated cysts, and any cysts) of 512 rural pigs. Banding patterns were grouped into homogenous classes using latent class analysis, and relationships with infection outcomes were assessed. Four classes were identified: 1 (n = 308, EITB-negative or positive for the GP50 family), 2 …

The Feasibility, Acceptability, And Preliminary Impact Of Real-Time Monitors And Sms On Tuberculosis Medication Adherence In Southwestern Uganda:Findings From A Mixed Methods Pilot Randomized Controlled Trial, Angella Musiimenta, Wilson Tumuhimbise, Esther Atukunda, Aaron T. Mugaba, Nicholas Musinguzi, David Bangsberg, J. Lucian Davis, Conrad Muzoora, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

We conducted a pilot randomized controlled trial among patients initiating treatment for drug-sensitive tuberculosis (TB). Participants received real-time electronic adherence monitors and were randomized (1:1:1) to: (i) daily SMS (reminders to TB patients and notifications to social supporters sent daily for 3 months, then triggered by late or missed dosing for 3 months); (ii) weekly SMS (reminders to TB patients and notifications to social supporters sent weekly for 3 months, then triggered by late or missed dosing for 3 months); or (iii) control (no SMS). Feasibility was mainly verified by the technical function of the intervention at Month 6. The …

A Guaranteed Income Intervention To Improve The Health And Financial Well-Being Of Low-Income Black Emerging Adults: Study Protocol For The Black Economic Equity Movement Randomized Controlled Crossover Trial, Sheri A. Lippman, Margaret Libby, Michelle K. Nakphong, Abigail Arons, Monica Balanoff, Rain Mocello, Emily A. Arnold, Starley B. Shade, Marguerita Lightfoot, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Economic inequity systematically affects Black emerging adults (BEA), aged 18–24, and their healthy trajectory into adulthood. Guaranteed income (GI)–temporary, unconditional cash payments–is gaining traction as a policy solution to address the inequitable distribution of resources sewn by decades of structural racism and disinvestment. GI provides recipients with security, time, and support to enable their transition into adulthood and shows promise for improving mental and physical health outcomes. To date, few GI pilots have targeted emerging adults. The BEEM trial seeks to determine whether providing GI to BEA improves financial wellbeing, mental and physical health as a means to address …

Spatial Transferability Of An Agent‑Based Model To Simulate Taenia Solium Control Interventions, Francesco Pizzitutti, Gabrielle Bonnet, Eloy Gonzales-Gustavson, William K. Pan, Hector H. Garcia, Armando E. Gonzalez, Seth E. O’Neal, Sarah Gabriël, Cysticercosis Working Group Peru

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Models can be used to study and predict the impact of interventions aimed at controlling the spread of infectious agents, such as Taenia solium, a zoonotic parasite whose larval stage causes epilepsy and economic loss in many rural areas of the developing nations. To enhance the credibility of model estimates, calibration against observed data is necessary. However, this process may lead to a paradoxical dependence of model parameters on location-specific data, thus limiting the model’s geographic transferability.

Methods

In this study, we adopted a non-local model calibration approach to assess whether it can improve the spatial transferability of …

Awareness Of The Public Charge, Confidence In Knowledge, And The Use Of Public Healthcare Programs Among Mexican-Origin Oregon Latino/As, Edlyn Wolwowicz-Lopez, Emily Boniface, Sara Díaz-Anaya, Yareli Cornejo-Torres, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective We describe awareness about the modified “public charge” rule among Oregon’s Mexican-origin Latino/a population and whether concerns about the rule influenced disenrollment from state-funded programs, which do not fall under the public charge. Methods We conducted a cross-sectional survey of adults (ages 18–59) recruited at the Mexican consulate and living in the state of Oregon. Our outcomes were awareness (of the public charge, source of knowledge, and confidence in knowledge of the public charge) and disenrolling self or family members from state-funded public healthcare programs due to concerns about the rule. We described outcomes and used logistic regression and …

Supporting Care Partners Of People Living With Dementia, Sherril Gelmon, Walter Dawson, Jenn Hollandsworth Reed

OHSU-PSU School of Public Health Faculty Publications and Presentations

This report addresses the need to better support care partners of people living with dementia, including a proposal for a new Dementia Care Partner Hub (the “Hub”) that will facilitate care partner access to information, supports, services and activities. This work is the culmination of the “Supporting Care Partners of People Living with Alzheimer’s Disease and Related Dementias (ADRD)” project funded by the Portland State University Institute on Aging’s “Gerontology Education & Research Initiative” (GERI) faculty grant, conducted from June 2022 to October 2023. The project focused on addressing concerns and needs of care partners and people living with dementia …

Musculoskeletal Pain, A Possible Indicator Of Central Sensitization, Is Positively Associated With Lower Urinary Tract Symptom Progression In Community-Dwelling Older Men, Angela Senders, Scott Bauer, Yiyi Chen, Barry Oken, Howard A. Fink, Nancy E. Lane, Kamran P. Sajadi, Lynn M. Marshall

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Musculoskeletal pain, a possible marker of central sensitization, is associated with higher prevalence of lower urinary tract symptoms (LUTS) among older men. We investigated whether musculoskeletal pain is associated with LUTS progression.

Methods

Participants were 5 569 men age ≥65 years enrolled in the prospective, multicenter Osteoporotic Fractures in Men (MrOS) Study. Self-reported musculoskeletal pain within 12 months before baseline was categorized as any pain and multilocation pain. Pain interference within 4 weeks of baseline was assessed with the SF-12 questionnaire. LUTS were assessed repeatedly with the American Urological Association Symptom Index (AUA-SI). Men with severe LUTS at baseline …

Respecting Tribal Voices In The Development Of A Gestational Diabetes Risk Reduction Preconception Counseling Program For American Indian/Alaska Native Adolescent Females: A Qualitative Study, Kelly R. Moore, Sarah Stotz, Martha Ann Terry, Ellen Seely, Kelly Gonzales, Gale Marshall, Jay Nadeau, Aletha Akers, Yesenia Garcia-Reyes, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new …

Racial/Ethnic And Gender Inequities In The Sufficiency Of Paid Leave During The Covid‐19 Pandemic: Evidence From The Service Sector, Julia M. Goodman, Daniel Schneider

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Access to paid family and medical leave (PFML), including leave to care for a seriously ill loved one or recover from one's own serious illness, conveys health and economic benefits for workers and their families. However, without a national PFML policy, access to paid leave remains limited and unequal. Previous work documenting inequitable access by socioeconomic status and race/ethnicity primarily focuses on parental leave, measures theoretical access to paid leave rather than actual leave uptake, and lacks an accounting for why workers of color and women may have less access to PFML. We extend this literature by looking at …

Melanoma Literacy Among The General Population Of Three Western Us States, Sancy A. Leachman, Elizabeth Stoos, Brian Detweiler-Bedell, Jerusha B. Detweiler-Bedell, Adrienne Zell, Elizabeth Wenzel, Emile Latour, Jack T. Wiedrick, Jodi Lapidus, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Melanoma is a significant cause of cancer death, despite being detectable without specialized or invasive technologies. Understanding barriers to preventive behaviors such as skin self-examination (SSE) could help to define interventions for increasing the frequency of early detection. To determine melanoma knowledge and beliefs across three high-incidence US states, 15,000 surveys were sent to a population-representative sample. We aimed to assess (1) melanoma literacy (i.e., knowledge about melanoma risks, attitudes, and preventive behaviors) and (2) self-reported SSE and its association with melanoma literacy, self-efficacy, and belief in the benefits of SSE. Of 2326 respondents, only 21.2% provided responses indicating high …

Multidrug Resistance Of Escherichia Coli From Outpatient Uncomplicated Urinary Tract Infections In A Large United States Integrated Healthcare Organization, Katia J. Bruxvoort, Jennifer H. Ku, S. Bianca Salas, Cara D. Varley, Joan A. Casey, Eva Raphael, Sarah C. Robinson, Keeve E. Nachman, Bruno J. Lewin, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Urinary tract infections (UTIs) cause significant disease and economic burden. Uncomplicated UTIs (uUTIs) occur in otherwise healthy individuals without underlying structural abnormalities, with uropathogenic Escherichia coli (UPEC) accounting for 80% of cases. With recent transitions in healthcare toward virtual visits, data on multidrug resistance (MDR) (resistant to ≥3 antibiotic classes) by care setting are needed to inform empiric treatment decision making.

Methods

We evaluated UPEC resistance over time by care setting (in-person vs virtual), in adults who received outpatient care for uUTI at Kaiser Permanente Southern California between January 2016 and December 2021.

Results

We included 174 185 individuals …