Digital Commons Network^™

Dimensions Of Misinformation About The Hpv Vaccine On Instagram: Content And Network Analysis Of Social Media Characteristics., Philip M. Massey, Matthew D. Kearney, Michael K. Hauer, Preethi Selvan, Emmanuel Koku, Amy Leader

Department of Medical Oncology Faculty Papers

BACKGROUND: The human papillomavirus (HPV) vaccine is a major advancement in cancer prevention and this primary prevention tool has the potential to reduce and eliminate HPV-associated cancers; however, the safety and efficacy of vaccines in general and the HPV vaccine specifically have come under attack, particularly through the spread of misinformation on social media. The popular social media platform Instagram represents a significant source of exposure to health (mis)information; 1 in 3 US adults use Instagram.

OBJECTIVE: The objective of this analysis was to characterize pro- and anti-HPV vaccine networks on Instagram, and to describe misinformation within the anti-HPV vaccine …

What Is Population Health? Ten Years On…., Mitchell Kaminski

College of Population Health Faculty Papers

No abstract provided.

Jefferson Digital Commons Quarterly Report: July-September 2020, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

Included in this Report

• Abington Health Articles
• Articles
• Collaborative Healthcare: Interprofessional Practice, Education, and Evaluation (JCIPE)
• Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)
• Covid 19-: Spread the Science, Not the Virus
• Department of Family and Community Medicine Presentations and Grand Rounds
• Master of Population Health Program Thesis and Capstone Presentations
• Master of Public Health Thesis and Capstone Presentations
• Jefferson Surgical Solutions
• The Medicine Forum
• Sex and Gender Health Education Summit 2020
• Student Papers and Posters
• Misc. Uploads
• What people are saying about the Jefferson Digital Repository

Health Design Thinking: An Innovative Approach In Public Health To Defining Problems And Finding Solutions, Sylvie Abookire, Colin Plover, Phd, Rosemary Frasso Phd, Msc, Cph, Bon Ku

College of Population Health Faculty Papers

No abstract provided.

Jefferson Digital Commons Quarterly Report: April-June 2020, Kelsey Duinkerken, Msi, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Collection: COVID-19 Papers, Posters, and Presentations
• Articles
• Collaborative Research and Evidence Among Therapists and Educators (CREATE) Day Presentations
• COVID-19 Working Papers
• Dissertations
• Doctorate of Occupational Therapy (OTD) Capstones
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• House Staff Quality Improvement and Patient Safety Posters
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstone Presentations
• Posters
• Spread the Science, NOT the Virus Seminar Series
• What People are Saying About the Jefferson the Digital Commons

Jefferson Digital Commons Quarterly Report: January-March 2020, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• New Look for the Jefferson Digital Commons
• Articles
• COVID-19 Working Papers
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• JeffMD Scholarly Inquiry Abstracts
• Journals and Newsletters
• Master of Public Health Capstones
• Oral Histories
• Posters and Conference Presentations
• What People are Saying About the Jefferson the Digital Commons

Shedding Light On Endometriosis: Patient And Provider Perspectives On A Challenging Disease, Madalene Zale, Emily Lambert, Marianna Lanoue, Amy E. Leader

College of Nursing Faculty Papers & Presentations

Background: Endometriosis is a serious yet understudied medical condition impacting millions of women worldwide.

Methods: This mixed methods study aimed to understand health care provider perceptions and patient experiences with endometriosis in the United States. Providers were surveyed to assess their understanding of disease prevalence. A subset of providers also participated in short, open-ended interviews about treating patients who have or are suspected to have endometriosis. Interviews were also conducted with women diagnosed with endometriosis to understand their experiences with the disease. Means and frequencies were calculated for survey data; interviews were transcribed and separately analyzed by two coders using …

Investigating Chronic Illness In Pathways To Housing Clients, Joshua Malerich, Lara Weinstein, Md, Dph

Phase 1

Approximately 553,000 individuals were homeless in the US each night in 2017, each at significant risk for substance use disorder, severe mental illness, and untreated chronic disease. Housing First (HF) is an evidence-based model for reaching high risk homeless individuals by providing a personal home to clients without the requirement for abstinence. HF has been shown as effective as other frameworks in remission of substance use, connectedness in the community, and client perceived quality of life, but there is a gap in the literature regarding the impact of HF services on clinical measures of chronic health, which could help further …

Housing First For People With Opioid Use Disorder (Oud) And Engagement With Medication-Assisted Treatment (Mat) And Harm Reduction Services, Husayn Siddiqui, Ashley Katzenstein, Lara Weinstein, Md, Drph

Phase 1

Intro: Opioid Use Disorder (OUD)is one of the most prevalent and deadly SUD’s in the country and many barriers exist for individuals living with homelessness and concurrent psychiatric illnesses when hoping to engage in Medication-Assisted-Recovery/Treatment (MAR/MAT). The current study evaluates the Pathways to Housing PA’s (PTHPA) Housing First(HF) model which provides scatter-site housing with social and maintenance services to individuals with a history of chronic homelessness and a diagnosis of OUD.

Methods: A retrospective chart analysis was completed for to assess factors relating to MAT engagement using PTHPA’s Credible BH recording system. MAT engagement prior to HF, psychiatric, homelessness, and …

Comorbidities And Treatments In United States Youth With Chronic Musculoskeletal Pain, Matthew T. Taylor, Sabrina Gmuca, Alexis Boneparth, L. Nandini Moorthy, Daniel B. Horton

Phase 1

Introduction: Chronic musculoskeletal (MSK) pain has been associated with chronic illnesses and high rates of pain medication use, often in referral centers, European populations, or studies focused on single drug classes. We aimed to characterize patterns of comorbidities and treatments associated with chronic MSK pain in a nationally-representative sample of US youth.

Methods: We used the National Ambulatory Medical Care Survey (2002-2015) and National Hospital Ambulatory Medical Care Survey (2002-2011), which contain cross-sectional data for US outpatient visits. The study included all visits for youth age 8-24, excluding those with malignancy or sickle cell disease. We compared comorbidities and drugs …

Why Am I Wearing A Mask If I Don't Feel Sick?, Lily-Anna James, Diana Koval, Samuel Latzsch, Chelsea Nowakowski

Foundations of Public Health - Infographics

No abstract provided.

War On The Wards: The Collapse Of Health Care Infrastructure Resulting From Violent Conflict, Nathan Hersh, Amy Hagopian, Barry Levy

Phase 1

Introduction: While utilizing satellite images to verify reports of hospital damage resulting from armed conflict allows for remote assessment, the use of private satellites to gain access to images prohibits widespread use. The questions this study sought to answer were: Is it possible to replicate the findings of previous reports of hospital damage that used the services of private satellite imagery using open source software, such as Google Earth? What variations exist among the different sites where damage to hospitals is visible, and what gradation is possible? Is this methodology applicable to other examples of armed conflict?

Methods: Using the …

Building Connections: Skmc – Ces Medellín International Exchange Program Development, Elias Borne, Kaitlin Demarest, Rosemary Frasso, Phd, Andres Fernandez, Md, Msed

Phase 1

Introduction: To date, there has been no formal evaluation of the exchange program that sends medical students from Sydney Kimmel Medical College (SKMC) to CES University, Colombia. While many medical schools have international exchange partnerships, little is known about what makes a successful global training experience. This project aims to evaluate the SKMC-CES student exchange program with the goal of improving collaboration between the two universities and creating a logic model backbone for the program going forward.

Methods: Surveys and interviews were done with program participants from the 2018 and 2019 academic years (6 students interviewed and 4 surveyed) exploring …

Identifying Protective Factors In Response To Discriminatory Experiences Among Pregnant African American Woman, Effie Mathew, Krys Foster, Md

Phase 1

Adverse maternal-fetal health outcomes, such as low birth weight and preterm delivery, are disproportionately more likely among African-Americans than Non-Hispanic Whites. Experiences of discrimination have been hypothesized as a contributing factor to the large discrepancies in maternal-fetal health outcomes. It is well understood that with increased levels of self-reported discrimination, there are lower ratings of physical and mental health, and higher reporting rates of depressive symptoms; this relationship is stronger in women. In addition to this, skin tone has long been a marker for social class and opportunity, but research on skin tone as a risk factor for African Americans …

Understanding The Attitudes And Perceptions Towards Lung Cancer Screening Amongst United States Veterans: A Qualitative Study, Shannon Nugent, Kristine Pham, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Lung cancer is the leading cause of cancer mortality in the United States, with this rate disproportionately affecting the veteran population. Despite USPSTF recommendations, screening rates are low and underutilized. The purpose of this study is to understand veterans’ knowledge, attitudes and beliefs surrounding lung cancer and lung cancer screening to better address barriers to screening.

Methods: Five interviews were conducted with veteran community members, and three were conducted with key informants for a current total of eight interviews. Key informants included Philadelphia community leaders who work with veterans. Interviews explored lung cancer screening knowledge, motivating factors and barriers …

Perspectives On Lung Cancer Screening In The Philadelphia Lgbtq Community, Kaitlin Demarest, Kristine Pham, Mph, Rickie Brawer, Phd

Phase 1

Introduction: Lung cancer is the leading cause of cancer deaths in the United States, but there are low screening rates across the country. While the prevalence of smoking in the LGBTQ population is disproportionately high, the LGBTQ community may have decreased access to screening, since they are reported to be less likely to have health insurance, more likely to receive inferior care or be denied care. The objective of this project was to better understand the knowledge, beliefs, and attitudes toward lung cancer screening in the LGBTQ community in Philadelphia in order to develop appropriate, community-focused educational materials to increase …

Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki

Phase 1

Introduction: Recent domestic disasters have demonstrated the challenges and vulnerabilities in the US health care disaster preparedness framework, challenges that extend to Thomas Jefferson University Hospital System (TJUH), in Philadelphia, PA. As Israel serves as a global leader in civilian defense and disaster preparedness, this study examines best practices in response to a mass casualty event at Hadassah Hospital in Jerusalem, Israel, and compares them with existing protocol at TJUH. The list of best practices generated from this research allows for a greater understanding of standards that are feasibly employable at TJUH.

Methods: This study examined hospital staff response practices …

Adolescent Hiv Pre-Exposure Prophylaxis Prescribing Practices Among Family Medicine Physicians: Limited Immediate Uptake, Emma T. Cooper, Steven A. Elsesser, Md, Amy Cunningham, Phd, Mph, Marshal Miller, Md

Phase 1

Introduction: In the United States, individuals aged 13-24 made up 21% of new HIV infections in 2016. In 2018, the FDA approved tenofovir/emtricitabine as HIV pre-exposure prophylaxis (PrEP) for adolescents aged 15-17. In 2019, we examined adolescent PrEP prescribing practices among family medicine physicians at an academic family medicine practice.

Methods: Physicians were invited to complete an online questionnaire assessing PrEP knowledge, attitudes, and prescribing practices. Differences in PrEP knowledge and attitudes among providers who prescribe PrEP to adolescents versus those who do not were examined using independent samples t-tests.

Results: 50 out of 99 surveys were completed. Respondents were …

Survey Of Hie Leaders: Assessment Of Hie Research Participation And Perceptions, Brittany Macdonald, Kristin Rising, Md, Ms

Phase 1

Introduction: Health information exchanges (HIEs) allow for healthcare providers to effectively and securely access patient information from various healthcare networks. Some HIEs have acknowledged the important role they can play in research, however, this is not standard practice despite recognition that availability of research and outcomes data is a main limitation to evidence-based practice.

Methods: We created an electronic survey in collaboration with Health Share Exchange (an HIE in Philadelphia) with the aim of assessing HIE leader perceptions regarding the importance of and barriers to participation in research. The survey was disseminated via a Strategic Health Information Exchange Collaborative (the …

Jefferson Digital Commons Quarterly Report: October-December 2019, Kelsey Duinkerken, Msi, James Copeland, Libt, Larissa Gordon, Mslis, Med, Ma

Jefferson Digital Commons Reports

This quarterly report includes:

• Articles
• Dean's Research Development Lunch Conference
• Dissertations
• Educational Materials
• From the Archives
• Grand Rounds and Lectures
• Journals and Newsletters
• Population Health Presentation Materials
• Posters
• Reports
• Symposiums
• What People are Saying About the Jefferson Digital Commons

Veteran Employment: A Study Into Barriers In Healthcare Industry Positions, Javier Saldana, Debby Derricks

Phase 1

Introduction: While there are many challenges veterans face while making the transition to the civilian lifestyle, undoubtedly one of the more frustrating factors is finding employment. While the veteran unemployment rate has dropped in recent years, it currently sits at ~3.4%. Therefore, an estimated 323, 000 veterans are currently unemployed. Given these statistics, what are the common barriers veterans face when seeking employment, specifically in healthcare industry positions?

Methods: Two (30 minute) interviews will be conducted with individuals heavily involved in veteran employment at Jefferson Hospitals. The questions asked the interviewee’s opinions on factors that make veterans successful in gaining …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

Characteristics Of A Food Insecure Population In North Philadelphia, Galicano Kai Inguito, James Gardner, Laura Layer, Karen Fritz

Phase 1

Introduction: A 2018 report by Hunger Free America showed that food insecurity increased in Philadelphia by 22%, even though it decreased nationally. The objectives of this study were to perform food insecurity screens, and to describe the demographic characteristics in terms of age, gender, primary language, body mass index (BMI), and zip code. We hypothesized that older, overweight, Hispanic females would be more likely to be food insecure.

Methods: After obtaining consent, the validated Hunger Vital Sign screening tool was used in the Summer of 2019 in North Philadelphia by teams of trained students in the Summer Medical Institute program. …

Effect Of Sustained Attention On Early Start Denver Model Outcomes, Katherine Mcleod, Giacomo Vivanti, Phd

Phase 1

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes.

Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen …

Identifying The Health Needs Of Latino Youth In East North Philadelphia Through Photovoice, John Mckeegan, Maria Arisi, Vincent Pepe, Caleb Dafilou, Mph, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: The Hispanic population in East North Philadelphia is abounding with risk factors for poor health. These structural risk factors adversely affect the Hispanic adolescents in the area – a demographic that has historically had little say in the research that is done to contextualize the self identified health needs in the community.

Objective: The purpose for this project is to identify the factors that are both helping and preventing healthy development and living of Hispanic adolescents in East North Philadelphia, as well as beginning to find avenues of support for the prioritized self identified needs.

Methods: A Photovoice project …

Predictors Of Negative Outcomes And Causes Of Loss To Follow Up Among Breast Cancer Patients In Port-Au-Prince, Haiti, A. Johnson, R. R. Henderson, G. Jones, Y. Fujii, P. Haley, J. Bernard, V. Degennaro

Phase 1

Objective: To determine predictors of negative outcomes and causes of loss to follow-up (LTFU) in patients with breast cancer in Haiti.

Design and Methods: Patients seen by Innovating Health International’s (IHI) cancer program were designated as LTFU after at least six months of non-contact (n=606). A cohort of LTFU breast cancer patients (n=101) was compared to the larger population of breast cancer patients (n=939), and a regression model constructed in order to identify risks for death and LTFU. Multiple calls were made to contact LTFU patients, and reasons for LTFU were recorded.

Results: Death and LTFU status were associated with …

Examining The Associations Between Addiction Severity And Prior Adverse Childhood Experiences In Pregnant Women Receiving Treatment For Opioid Addiction, Julia Gong, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Opioid use during pregnancy poses risk to both the mother and fetus, including fetal loss and pre-term birth. Prior research suggests that adverse childhood experiences (ACEs) are a plausible antecedent to opioid abuse. However, there is insufficient understanding of the association between prior ACEs, familial history of substance use, and treatment outcomes in pregnant women receiving treatment for opioid addiction.

Methods: A retrospective chart review will be used to review data from 167 MATER patients who entered treatment between 1997 and 2017. Descriptive statistics will be utilized to characterize the study population. Regression and chi-square analyses will be conducted …

Increasing Food Access: Evaluation Of A Food Buying Club In Philadelphia, Kimberly Hoover, Rickie Brawer, Mph, Phd, Mches

Phase 1

Introduction: Children living in food insecure homes are at higher risk of developing a variety of negative health outcomes, including cardiovascular disease, obesity, and cognitive, emotional and behavioral problems. In order to combat these outcomes, Mercy Neighborhood Ministries of Philadelphia (MNMOP) established a Food Buying Club to increase accessibility and affordability of fresh produce. However, the satisfaction with this program among participants needs to be determined in order to strengthen the program.

Objective: The objective of this quality improvement study was to evaluate parental satisfaction with the MNMOP program, specifically regarding produce options, cost, and variety.

Methods: An online survey …

The Effect Of Intrapartum Glycemic Control On The Incidence Of Neonatal Hypoglycemia, Signe Caksa, Amanda Roman, Md

Phase 1

Introduction: 1-2% and 6-9% of pregnancies are complicated by type I/II and gestational diabetes mellitus (DM), respectively, leading to increased risk of adverse neonatal outcomes. Women with DM require glucose monitoring and glycemic control at the time of delivery; however, it remains unclear how variations in intrapartum glucose impact neonatal hypoglycemia.

Methods: This is a retrospective cohort study of women with singleton pregnancies, diagnosed with DM, who delivered >36 weeks gestation after attempting induction of labor at Thomas Jefferson University Hospital between 01/01/2017 and 01/01/2018. Intrapartum DM management included hourly capillary glucose (CG) monitoring until delivery, insulin drip with CG …

Associations Between Oncogenic Risk Markers And Clinical Outcomes Among Black And White Colorectal Cancer Patients, Victoria B. Starks, Edith P. Mitchell, Md, Facp

Phase 1

Introduction: Blacks have a 25% higher incidence of colorectal cancer compared to their white societal counterparts. Additionally, the overall mortality rate among black colorectal cancer patients is 50% higher than that of whites. However, little is known about the biomarkers prevalent among blacks and their possible correlation to treatment response and patient outcomes.

Objective: The objective of this study is to explore disease trends that may unveil a correlation between molecular markers and poor clinical outcomes among black colorectal cancer patients.

Methods: De-identified patient data was obtained from The Oncology Data Services Department (Cancer Registry) of TJUH. The population cohort …