Medicine and Health Sciences Commons^™

Differences In Mental Health Outcomes And Services By Gender Identity Among Sexual And Gender Minorities During The First Shelter-In-Place Order Of The Covid-19 Pandemic In Texas, 2020, Mariah Victoria Alvarez Ramirez

Open Access Theses & Dissertations

Background: Within the United States, sexual and gender minorities (SGM), face unique barriers when seeking health services, such as uninsurance, postponing care, and lack of competent services. Within SGM, transgender and gender-expansive (TGX) individuals are more vulnerable as they have higher rates of discrimination and face more barriers to accessing healthcare services. Purpose: Identify differences in mental health outcomes and services by gender identity among sexual and gender minorities residing in Texas during the COVID-19 pandemic. Methods: This study is a secondary data analysis of the SGM participants of the COVID-19 and You Survey study (n=1288). Descriptive statistics, bivariate associations …

Perceived Risks And Benefits Of Hpv Vaccination: The Role Of Cues To Action, Numeracy And, Literacy, Sierra Rae Galvan

Open Access Theses & Dissertations

Background & Significance: The Human Papillomavirus (HPV) is a risk factor for both genital warts and cervical cancer. HPV strains 16 and 18 are recognized as precursors of cervical cancer. While strains 6 and 11 are estimated to cause 90% of genital warts. Latinas have the highest rate of cervical cancer in the U.S, approximately 66 % higher than non-Latino whites. These cancers are preventable in many cases through the administration of the HPV vaccine. The advisory committee on immunization practices recommends that children as young as 9 receive at least two doses of the three-dose HPV vaccine series. Consequently, …

Covid-19 Prevention, Testing, And Treatment Seeking Among People Who Inject Drugs (Pwid) On The Us Mexico Border, Jorge Raul Puentes

Open Access Theses & Dissertations

The outbreak of the COVID-19 pandemic exacerbated the negative social determinants of health that affect medically underserved people who inject drugs (PWID) inhibiting their access to services, promoting infectious disease acquisition such as HIV and HCV, and overdose rates. The effects of the pandemic were more pronounced among Latino PWID communities. Participants of this study are 194 PWID residing in El Paso, Texas, and Cd. Juarez, Chihuahua along the US-Mexico border. Cross-sectional surveys were administered assessing environmental risk factors that impact COVID-19 acquisition and engagement in preventive behaviors. The purpose of this secondary data analysis study was to describe the …

The Power Of Voice: The Role Of Target Voice Achievement In Enhancing Quality Of Life For Transgender Individuals In Gender-Affirming Voice Management Lab, El Paso, Texas, 2016-2022, Mehjabin Alam Hridi

Open Access Theses & Dissertations

Background: Gender-affirming voice management is an essential aspect of transgender people and research shows that achieving a congruent voice can significantly improve the quality of life. The role of voice as a central aspect of gender identity and expression and achieving a desired target voice can improve mental health outcomes, social functioning, and overall well-being. Purpose: The project assesses the impact of quality of life and voice treatment completion on voice disorders among transgender people. Methods: This clinical study included records for transgender individuals attending the Gender-Affirming Voice Management Lab in El Paso, TX, from 2016 to 2022. Measures collected …

The Perpetuation Of Hiv Risk In Latinx Immigrations: A Cross-National Perspective, J. M. Aleman

Open Access Theses & Dissertations

Research indicates that migration is a social determinant of health that increases the risk of acquiring HIV. What is less understood, however, are the pathways through which immigration influences HIV risk. This study employed a cross-national perspective and utilized a social determinants of health framework to understand how structural factors, such as economic conditions and immigration policies and their enforcement, influence HIV risk among migrants. While mobility, migration and displacement are associated with increased HIV risk, they are not inherently the cause but rather a condition under which vulnerability is increased indicating that other distal, upstream, or structural forces are …

Exploring The Relationship Between Diabetes, Diabetes Risk, Depressive Symptoms, Chronic Stress, And Inflammatory Markers In Mexican-American Men, Aleli Fernandez

Open Access Theses & Dissertations

Background: Individuals with depression and stress are 60% more likely to develop type 2 diabetes compared to those without (Mezuk et al., 2008). Moreover, biological pro-inflammatory markers associated with psychosocial stress are risk factors for diabetes. Examining the relationship between psychological disorders, inflammation, and diabetes risk among MAH is important as they have high rates of diabetes.

Purpose: To examine the relationship between 1) depressive symptoms, chronic stress, and inflammatory markers, 2) inflammation and diabetes risk factors and 3) depression, stress, inflammation, diabetes risk, and metabolic syndrome (MetS).

Methods: A cross-sectional study of 100 adult men from El Paso, Texas …

Associations Between Mental Health Outcomes And Childhood Trauma And Experiences Of Violence During The First Shelter-In-Place For Covid-19 Among Sexual Minority Men Living In Texas, 2020, Sonam Deki

Open Access Theses & Dissertations

Background: The COVID-19 pandemic significantly increased mental health issues, disproportionately affecting men who have sex with men (MSM). The relationship between mental health and experiences of trauma and violence are understudied in this population. Purpose: To assess if rates of childhood trauma and COVID-19-related violence are higher for those with depression and anxiety than those without such experiences among cisgender sexual minority men in Texas. Methods: This secondary data analysis is among the cisgender sexual minority men in the COVID-19 and You Survey Study in Texas during the first shelter-in-place order. Descriptive statistics and bivariate associations between trauma and experiences …

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …

The Power Of A Story: How Emotions And Numeracy Affect Parental Decisions About The Human Papillomavirus Vaccine, Candice Fawn Coffman

Open Access Theses & Dissertations

The Human Papillomavirus (HPV) is the most common sexually transmitted infection (CDC, 2021). There are two strains of HPV known for causing cervical, penile, anal, vaginal, and oropharynx (throat) cancers (CDC, 2020). A vaccine is available to prevent these cancer-causing strains of HPV for individuals between the ages of 9-45. Unfortunately, vaccination uptake and completion rates are below the recommended rates to achieve herd immunity. A primary barrier to vaccination is concern about potential adverse events following vaccination. The purpose of the present study is to examine the influence of anecdotal versus statistical information on parents' intentions to vaccinate their …

Examining The Association Between Emotional Intelligence, Meaning In Life, Stress, And Burnout Among Preâ??Medical Students In The United States, Nayla Paulina Paulina Bejarano Chacon

Open Access Theses & Dissertations

Background and significance: The Association of American Medical Colleges (AAMC) has estimated that by 2034 there will be a physician shortage of around 124,000 physicians. With burnout being one of the main drivers, it is crucial to assess it. Burnout is characterized by high levels of emotional exhaustion and cynicism and low levels of academic efficacy.There has been substantial research on burnout among healthcare providers across different levels of training; however, few studies have examined burnout among undergraduate students who wish to pursue a graduate degree in healthcare. Given the shortage of healthcare providers in the United States, it is …

Implementation And Evaluation Of Obesity Management Tools, Hunter Wayne Turnipseed

Open Access Theses & Dissertations

The demand for obesity treatment and management cannot be met because of the lack of obesity specialists. Therefore, integrating obesity management tools in primary care is an excellent option for obesity treatment. Also, the importance of DPP as a scalable community-based program and that Small Changes provides a structured dietary approach that we hypothesize will improve weight loss outcomes. These two studies evaluated the implementation of obesity management tools in primary care clinics in the Paso del Norte area and a DPP program in Brownsville, TX. The first study explored the key facilitators and barriers to adopting the CDSS and …

Mental Illness And Substance Use Disorder (Sud) Among Pregnant And Postpartum Women In A Women's Residential Treatment Center In El Paso, Texas, Adren Darius Warling

Open Access Theses & Dissertations

Background: Substance use disorders (SUDs) and opioid use disorders (OUDs) are a major public health concern in the United States. SUD/OUDs are often linked to co-occurring physical disorders and serious mental illness (SMI). Stress and trauma are often contributing factors to the development of SUD/OUD and/or co-occurring SMI, which impact pregnant and postpartum women (PPW), who concurrently, may face specific risk factors and barriers to care for these conditions. These risk factors and barriers to care may be exacerbated by Hispanic/Latino identities. Studying social determinants of health based on a social ecological model approach can help increase knowledge about this …

Substance Use Treatment And Providers For Sexual And Gender Minority Populations In A Texas-Mexico Border City, Diana Laura Barraza

Open Access Theses & Dissertations

Sexual and gender minority (SGM) is an umbrella term that refers to lesbian, gay, bisexual, transgender, and gender-diverse populations. These populations face challenges and barriers when accessing health services that further lead to negative health outcomes and an increase in health disparities. For example, rates of substance use are higher among SGM communities compared to heterosexual/cisgender people. Risk factors for substance use problems include lack of social support, Adverse Childhood Experiences (ACEs), rejection and discrimination, and solitary drug use. Various efforts in Texas and the U.S.-Mexico border region have been made to close the gap in health inequalities. In El …

A Thematic Analysis Of Resilient Experiences Of People Who Use Drugs And Are Living With Hiv Adhering To Hiv Medicine, Valeria Duenas

Open Access Theses & Dissertations

Human immunodeficiency virus (HIV) is a disease acquired through sex, from mother to child, sharing needles, and open wound exposure to the blood-borne virus. The disease leads to the rapid weakening of the immune system which renders the individual vulnerable to various opportunistic infections, cancer, disease progression into acquired immunodeficiency virus (AIDS), and possibly death. Unfortunately, US Latinos are disproportionately affected by HIV as they account for nearly 30% of all new HIV infections. A subpopulation disproportionately affected also are people who inject drugs (PWID) which account for 1 in 10 HIV diagnosis in the U.S. Modern medicine has allowed …

Exploration And Analysis Of Attitudes And Determinants Toward Undetectable Equals Untransmittable (U=U) Among Minority Women, Roberta Marie Thimbriel

Open Access Theses & Dissertations

Purpose: To explore and assess awareness of and attitudes toward "undetectable equals untransmittable" (U=U) and associations with social-ecological factors among minority women. Population: Ethnic minority women 18 years and older residing in the El Paso, TX, US - Juarez, Mexico border region. Methods: A cross-sectional convergent parallel mixed methods study using in-depth interviews and a survey instrument was conducted among a purposive sample. Thematic analysis was done on qualitative data, and descriptive, bivariate and binary logistic regression analyses were done on quantitative data. Results: The majority of the participants (66.7% interviewees and 50.7% survey) were Hispanic, in their early-mid thirties, …

Examining Social Determinants Of Health And Cervical Cancer Risk And Outcomes In Ecuadorian Women, Pooja Tewari

Open Access Theses & Dissertations

Background and Significance: The burden of cervical cancer in the Latin American region is high. The crude incidence rate and the crude mortality rate in Ecuador are significantly higher than that of South America and the World. Riobamba, Ecuador, where the Fundación Internacional Buen Samaritano Paul Martel (FIBUSPAM) hospital is located, has been found to be one of the cities most affected with cervical cancer in the country. Risk factors for cervical cancer that have been identified in Latin American women include chronological age, age of first sexual intercourse, number of sexual partners, number of pregnancies, use of oral contraceptives, …

Regulation Of C-C Chemokine Receptor 7 (Ccr7) Ligand-Mediated Internalization And Chemotaxis By G Protein-Coupled Receptor Kinase Family 4 (Grk-4, 5, 6) In Human Pediatric T-Cell Acute Lymphoblastic Leukemia (T-All), Eduardo Elias Chaib

Open Access Theses & Dissertations

Background and Significance: The Hispanic population is disproportionally affected by T-ALL (T-cell acute lymphoblastic leukemia) when compared to other races in the US. C-C Chemokine Receptor 7 (CCR7) in T-ALL is used during disease progression, and may lead to migration of cancerous cells into the Central Nervous System (CNS) of patients. Goals and Objectives: This project aims to find relevant rates and risk factors for T-ALL for the Hispanic population in the US/Mexico border region. The other aim is to assess the effect of the G protein-coupled Receptor Kinase 4 (GRK-4) family proteins on migration and receptor internalization through CCR7 …

Twitter Posts, Gist, And The Perceived Harmfulness Of The Human Papillomavirus Vaccine, Candice Fawn Coffman

Open Access Theses & Dissertations

Individuals frequently encounter two types of information when evaluating the risk of a vaccination: statistical evidence describing the frequency of positive and negative outcomes, and anecdotal evidence describing positive and negative personal experiences. The present study evaluated the relative importance of both types of evidence when considered simultaneously. We predicted that the presentation of even one negative anecdote would have an effect on the key risk information (the â??gistâ??) that subjects extracted from the statistical and anecdotal data. Self-generated twitter posts (tweets) and standard measures of perceived risk were used to test the latter prediction. The current findings partially supported …

The Use Of Person-First Language In Diabetes Care & Research. How Far Have We Come Since Ada & Adces Recommendations?: A Systematic Review, Denise Nicole Portillo

Open Access Theses & Dissertations

Background: Diabetes is a chronic medical condition that affects more than 34 million people across the United States (Centers for Disease Control and Prevention (CDC), 2020). Diabetes is characterized as the inability to create or regulate insulin adequately (Costabile et al., 2020). There are three main types of diabetes, type 1 diabetes mellitus (T1D), type 2 diabetes mellitus (T2D), and gestational diabetes (CDC, 2020). Of the more than 34 million people with diabetes, 5 to 10% have T1D, while the remaining 90-95% have T2D (CDC, 2020). In 2017, the Association of Diabetes Care & Education Specialists (ADCES) and the American …

The Influence Of Violence, Policing, And Substance Use Stigma On Sexual And Substance Use Risk Engagement In Substance Using Men Along The U.S.-Mexico Border, William Campillo Terrazas

Open Access Theses & Dissertations

Background: Cities along the U.S.-Mexico border are unique environments where structural level variables place residents at risk for increased substance use subsequently impacting HIV rates and acquisition. Growing evidence emphasizes the importance of understanding how structural drivers of infectious diseases impact community and social networks to develop interventions to reduce HIV transmission among hard-to-reach populations.

Aims and Objectives: The goal of this study was to investigate the influence of structural factors such as neighborhood disruption, harsh policing, and substance use stigma on engagement of HIV risk behaviors among social networks of people who use drugs and who reside in El …

Associations Between Living On The Texas-Mexico Border, Drug Use, And Sexual Behaviors Among Sexual Minority Men During The First Shelter-In-Place Order Of The Coronavirus Pandemic, Nqobile Nzama

Open Access Theses & Dissertations

Background: There have been changes in drug use and sexual behaviors among sexual minority men since the coronavirus pandemic. At this time, there is not adequate literature focusing on the state of Texas. Aims and Objective: The aims of this secondary data analysis and exploratory study are to determine associations between sociodemographic characteristics and living on the Texas-Mexico border, drug use, sexual behaviors, and use of dating/hook-up apps among sexual minority men who completed the COVID-19 & You Survey conducted between May 1, 2020 to July 31, 2020, during the first shelter-in-place order of the Coronavirus pandemic. Hypotheses: The hypotheses …

Influence Of Political Affiliation, Distrust Of Government And Pharmaceutical Companies On Hpv Vaccination Intentions And Uptake, Alyssa Andrea Martinez

Open Access Theses & Dissertations

Background and Significance: The Human Papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States. Currently, approximately 79 million people in the United States are infected with HPV. The CDC estimates that there are nearly 31,500 cases of cancers caused by HPV each year in the United States. Cervical cancer is the most common HPV-related cancer and almost all cervical cancers are caused by a few strains of HPV. Research suggests that Latinx women residing in the U.S.-Mexico border may be at increased risk of contracting HPV types that cause cervical cancer. Although there is no …

Translation And Validation Of The Spanish Version Of The Quality Of Life Inventory For Adolescents (Qolie-Ad-48), Perla Michelle Martinez

Open Access Theses & Dissertations

Background: In 1999, an instrument was developed to assess quality of life (QoL) among adolescences with epilepsy. To our knowledge there is not a validated Spanish version of this questionnaire. There is a gap in the literature about QoL and epilepsy among speaking Spanish populations. Objectives: 1) To conduct an English-Spanish translation of the QOLIE-AD-48; 2) to evaluate the reliability of the Spanish version of the QoLIE-AD-48; and 3) to assess the validity of the Spanish version of the QoLIE-AD-48. Method: Phase 1 translation: Methods followed the published work of Sousa and Rojjanasrirat (2010). Phase 2 Pilot study: the sample …

Systematic Review Of Alternative Interventions For Construction Workers To Manage Work-Related Musculoskeletal Pain And Discomfort, Isaac Abraham Rodriguez

Open Access Theses & Dissertations

Background: The prevalence of Work-Related Musculoskeletal Pain and Discomfort (WRMSPD) among construction workers in 2017 was almost 20,000 injuries. Close to 60% were overexertion, others included lifting and lowering. The most common form of WRMSPD could originate from the upper back to lower back and neck pain. It was reported that the highest prevalence of WRMSPD were in the upper extremities (nearing 60%) because of the physically demanding factor of the job (heavy lifting and repetitive movement). Over 250,000 cases were reported to be WRMSPD in the private sector of the U.S. Purpose: The purpose of this systematic review was …

A Critical Analysis On Mexican Americans Associated With Gangs Living In San Antonio, Texas, Rubi Guadalupe Gonzales

Open Access Theses & Dissertations

The U.S has a major national concern of mass incarceration. Mass incarceration poses a threat to achieve health equity as there are many adverse health effects documented related to incarceration (i.e., posttraumatic stress disorder, depression, anxiety, hypertension, diabetes, asthma, hepatitis, HIV, tuberculosis, etc.,). There is a great need to conduct research on incarceration with a critical lens. The present study examined the incarceration trajectories of Mexican American men who were associated with gangs during their youth and lived in the west side of San Antonio. This cohort of males were followed at three different timepoints in their life using retrospective …

Surveillance Of Ticks And Associated Pathogens In Central Texas, Alexa Mendoza

Open Access Theses & Dissertations

Background: Ticks are the second most common vector of human and veterinary pathogens, after mosquitoes, which results in a number of different diseases around the world. These diseases, referred to as tick-borne diseases (TBDs), are increasing in their prevalence around the world as the geographical distribution of ticks change due to environmental and human factors. Increased testing for pathogens and a better comprehension of their relationship to different tick species will be crucial in deepening our understanding of TBDs and protecting our human and animal populations. Increasing surveillance of ticks and the potential pathogens they may be vectors for and …

Exploring The Relationship Between The Distance Of Parks And Rates Of Adult Obesity In El Paso, Texas, Shawna Payan

Open Access Theses & Dissertations

Background: In El Paso, areas of the city do not have access to parks within walking distance. The rates of people suffering from obesity and the comorbidities that come with obesity are rising annually. Physical activity has been shown to increase lifespan and provide positive health outcomes for the individual. Increasing physical activity in adults by using the parks can decrease their risk for heart disease and diabetes. Objectives: The overall aim of the procedure is to determine a relationship between park density and distance from residence to the nearest park, adult population density, and the obesity rate density within …

Key Performance Indicators Of Health Cte Students At For-Profit Colleges And Public Community Colleges, Souraya Hajjar

Open Access Theses & Dissertations

The advent of for-profit colleges to the higher education scene in the U.S. has challenged public community colleges on all levels; financial, academic, and consumerism. Research has shown that key performance indicators are more favorable at public community colleges than at for-profit colleges. Determining size and type of colleges, ethnicity and gender differences that contribute to total graduation rate of health Career and Technical Education (CTE) students will add to the limited research on the relationship between these constructs and provide information to prospective health CTE students about college enrollment. The study aims to examine institutional performance variables to assist …

Evaluating The Impact Of The In-Store Programming And Outreach Coalition (Ipoc) On Increasing Access To Healthy Food And Healthcare Services In Paso Del Norte Region: First-Person Account Of Stakeholders' Perspective, Dennis Nyachoti

Open Access Theses & Dissertations

Grocery stores can provide a conducive environment for interventions targeting healthy eating and access to health services, particularly in low-income communities. Nationally, several organizations have implemented grocery store interventions and have shown impact on perceptions of purchasing nutritious food, especially by raising awareness of fruits and vegetables. However, most of those programs have not been implemented in a coordinated manner despite being delivered in the same location. Collaboration of local health promotion organizations with grocery stores could increase consumers' access to and selection of healthy foods, as well as access to and use of services.

This evaluation of the In-Store …

The Associations Between Socioeconomic Status And Childhood And Adult Psychosocial Experiences Among Men Living In El Paso, Texas, Sophia Marie Ornelas

Open Access Theses & Dissertations

BACKGROUND: Substantial evidence indicates that low levels of Socioeconomic Status (SES) can have adverse psychosocial health implications in early childhood that can persist into adulthood. While there is extensive research about this relationship very little is known about the relationship between SES characteristics and adult psychosocial burden among Hispanic men. OBJECTIVE: This research aims to explore the associations between SES characteristics and childhood adverse experiences, adult perceived stress burden, and depressive symptoms among Hispanic men living in El Paso, Texas. METHODS: This research used data from a cross-sectional study of 100 adult men residing in El Paso, Texas in 2018. …