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Targeting The Inequality In Quality Improvement, Raquel Maria Davis

Public Health Theses

Objective. To use Casalino et al.’s (2007) proposed causal pathways of how pay-for-performance (P4P) can exacerbate racial/ethnic health care disparities as a framework for analyzing the literature and determine the adequacy of the evidence.

Data Sources/Study Setting. Existing literature (gray and peer-reviewed) on pay-for-performance and racial/ethnic health disparities identified from the Ovid Medline database.

Conceptual Framework. Casalino et al.’s four casual pathways include: “Pathway 1: Reduction in income for physicians in poor minority communities,” “Pathway 2: ‘Color-blind’ quality improvement programs,” “Pathway 3: ‘Teaching to the test’ might disproportionately affect minorities,” and “Pathway 4: Avoiding patients perceived as likely to lower …

Prep Uptake, Adherence, And Persistence: Qualitative Interviews With Women Experiencing Ipv, Ipv Service Providers, And Healthcare Providers, Amy Janet Caplon

Public Health Theses

Background: Intimate partner violence (IPV) has been associated with HIV susceptibility and

acquisition. Studies have found that women who had experienced IPV were at least three times more likely to have a diagnosis of HIV. Women are interested in taking PrEP, however barriers to uptake, adherence, and persistence are not widely known, and present knowledge excludes experiences of healthcare providers and IPV service providers. In this qualitative study, we examined the perceived facilitators and possible solutions to PrEP uptake, adherence, and persistence. This was done using a sample of women experiencing IPV, Reproductive Health Providers, PrEP Providers, and IPV service …

Association Of Age On Diagnosis And Treatment Of Locally Advanced And Metastatic Prostate Cancer, Chi Zhang

Public Health Theses

Background Prostate cancer is an aging-related disease. As the result of the radiation are of STAMPEDE trial came out, major shifts in the use of local therapy (LT) are expected for men newly diagnosed with locally advanced and metastatic disease. This study aims to determine the role of patient age on LT.

Methods We identified 6882 and 37382 locally advanced and metastatic prostate cancer diagnosed in 2004-2014 using the National Cancer Database (NCDB). We used logistic multivariable regression to determine the role of age in the receipt of prostate and/or pelvic radiation or radical prostatectomy after adjusting for demographic and …

Multi-State Analysis Of Unconventional Oil And Gas Development And Rates Of Sexually Transmitted Infections In The United States, Nicholaus Peter Johnson

Public Health Theses

Background

Advances in unconventional oil and gas development (UOGD), including hydraulic fracturing and horizontal drilling, have helped position the United States as a world leader in the production of both crude oil and natural gas hydrocarbons. This significant increase in production would not have been possible, however, without the assemblage of a workforce that is predominantly young, male, and mobile. This is significant given that a number of studies have associated similar types of mobile workforces – especially those employed by resource extractive industries – with impacts on the sexual health of the host communities in which these workers operate …

Declines In Human Papillomavirus (Hpv) – Associated High-Grade Cervical Neoplasia By Sociodemographic Factors After Introduction Of Hpv Vaccines In Connecticut, Usa 2008-2017, Mike Yepes

Public Health Theses

Abstract

Background: In 2006, the FDA approved the first vaccine against human papillomavirus. Trends in HPV-related sequalae are an effective method of analyzing HPV vaccine impact. Our primary objective was to measure trends in cervical neoplasia based on sociodemographic characteristics including race, ethnicity, and socioeconomic status.

Methods: Since 2008, Connecticut has required reporting of cervical intraepithelial neoplasia labeled grade 2+ and adenocarcinoma in situ. CIN 2+ diagnoses trends were modeled by area-based measures of age, race, ethnicity, and socioeconomic status using negative binomial regression and change-point analysis. Incidence rate measurements were adjusted to reflect inclusion of women who had completed …