Medicine and Health Sciences Commons^™

Knowledge Of Medicaid Expansion To Recent And Undocumented Immigrants Among Oregon Mexican-Origin Latinos: (Work In Progress), Nancy Ledezma, Grace Parra, Alejandra Nunez, Dr. Blair Darney

OHSU-PSU School of Public Health Annual Conference

Background

Recent and undocumented immigrants are explicitly excluded from federal Medicaid and state insurance exchanges. The first phase of Healthier Oregon was implemented in July 2022 and expanded Medicaid (OHP) benefits to undocumented immigrants ages 19-25 or 55 and older. The second phase was implemented in July 2023 and extended benefits to everyone regardless of age. We assessed understanding of Healthier Oregon among Mexican-origin Latinos. We hypothesize that many potentially eligible people may not know about the program, if they qualify, or how to apply.

Methods

This is a cross-sectional study in collaboration with the General Consulate of Mexico. Our …

Understanding Variation In Provider Referral Rates To Early Intervention For Children With Developmental Delays, Gabriella Tangkilisan, Zoe Kilmer, Michelle Owens, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background:

Early detection and treatment of developmental disabilities (DD), including Autism Spectrum Disorder (ASD), improves language, IQ, and adaptive outcomes. Guidelines recommend immediate referral to Early Intervention (public developmental therapy services) upon positive ASD/DD screening in infant/toddler well child checks. However, children screening positive for ASD/DD are not always referred for Early Intervention services. This project aimed to understand why pediatricians do and do not refer children with positive DD/ASD screens to early intervention.

Methods:

We conducted qualitative interviews with pediatricians who participated in a randomized trial investigating family navigation for children with autism risk. We determined pediatrician referral rates …

Impact Of Two Shift Schedules On Post-Shift Blood Pressure In Firefighters, Ayeisha H. Haswarey

OHSU-PSU School of Public Health Annual Conference

Background: Firefighters have an increased risk of cardiometabolic disease compared to the general population. Blunted blood pressure (BP) dipping during nocturnal sleep is associated with increased cardiometabolic disease morbidity/mortality. Shift work can alter diurnal BP oscillation, but the extent of alteration by different schedules remains debated. No study to date has examined firefighting shift schedules, necessitating a longitudinal evaluation to begin to understand their implications for cardiometabolic health. Thus, this preliminary analysis compares how two common schedules (24/48 hours on/off vs. 1/3/2/3 days on/off) impact post-shift BP and dipping in 20 firefighters.

Methods: 20 participants (10% female; 25-54 years of …

Transgender And Non-Binary Health In Oregon Under A Single-Payer Health System, Amy (Mick) L. Mcveety (They/She)

OHSU-PSU School of Public Health Annual Conference

As the state with the highest percentage of population who identifies as LGBTQ+, Oregon has a duty to provide adequate health protections and services to its transgender and nonbinary (TGNB) residents, particularly given the disparities TGNB individuals face in housing, employment, education, and health. Following recommendations from the Oregon Joint Task Force on Universal Health Care, Oregon should implement a single-payer health care system, with particular attention to:

1. Protecting patient privacy in EHR and other systems, particularly for youth TGNB patients;
2. Expanding the covered gender-affirming services and removing barriers such as cost-sharing and prior authorization, and;
3. Recruiting TGNB providers and …

Gender Affirming Surgery And Pain In Adolescents: Teen And Parent Experiences, Corrin Murphy, Eleanor Battison, University Of Rhode Island, Anna Wilson Phd

OHSU-PSU School of Public Health Annual Conference

Background: Adolescents seeking gender affirming medical care face unique biopsychosocial challenges, including experiences of discrimination and stigma. Transgender and gender diverse (TGD) adolescents often undergo gender affirming surgery (GAS). While there is an increase in GAS for TGD adolescents in the U.S., little is known about the pain experiences in the post-surgical period among these youth. There have been no studies to our knowledge that examine the psychological functioning of parents and their ability to handle their child's distress, which may be affected by their child's post-GAS pain experiences. Parental responses to their children’s pain and distress may, in turn, …

The Association Between Acculturation & C-Reactive Protein In U.S. Immigrants: A Cross-Sectional Study, Jessica Kilinski Bs, Rosol Mikail Bs, Kelly M. Reavis Phd, Mph, Deborah Karasek Phd, Mph

OHSU-PSU School of Public Health Annual Conference

Purpose: Immigrants undergo acculturation as they assimilate to a different culture, potentially leading to immense stress. Our objective was to examine the association between acculturation and C-reactive protein (CRP), a marker of stress-induced inflammation. We hypothesized that U.S. foreign-born adults 20 years and older with higher degrees of acculturation would have higher CRP levels compared to those with lower acculturation.

Method: We used 2017-2018 National Health and Nutrition Examination Survey (NHANES) data from 1526 participants to conduct a cross-sectional analysis. We measured acculturation as language spoken at home (categorized as low, moderate, and high) and examined its association with CRP …

Strong Hearts Program: The Results Of A Novel Primary-Care Based Diagnostic And Referral Program For Chagas Disease In East Boston, Ma, Usa, Javier J. Huerta

OHSU-PSU School of Public Health Annual Conference

Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet

Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.

Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). …

The Cost Of Healthy Eating, Diana Prychyna, Miriam R. Elman, Joy Kim, Karen F. Miller, Deonni P. Stolldorf, Sean P. Collins, Bory Kea

OHSU-PSU School of Public Health Annual Conference

Abstract

Background

Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure (GUIDED-HF), utilized ‘Self-Care Coaches’ who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During the calls, we observed gaps in self-care for retired older …

Exploring Decolonial And Indigenous Mental Health Framework And Practice To Address Complex Trauma Among Palestinian Youth Living Under Violence Of Settler-Colonialism, Vivian L. Duong, Corrin Murphy

OHSU-PSU School of Public Health Annual Conference

The growing settler colonial project of Israel forced indigenous Palestinians to flee from their homeland to further the Zionist movement of establishing a Jewish-majority state. The forced dispossession and displacement of Palestinians at this time was referred to as the Nakba, or catastrophe (Masalha, 2002). From 1947 and 1949, approximately 750,000 Palestinians from a population of 1.9 million were made refugees (Al Jazeera, 2017). Also referred to as the ethnic cleansing of Palestine, Zionists forcibly took over 78 percent of Palestine, destroyed about 530 villages and cities, and killed around 15,000 Palestinians including more than 70 massacres (Al Jazeera, 2017). …

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of Us Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

Employer Voices: Insights On Bolstering Career Development For Graduate Students, Alexandria J. Ashraf Mph, Josh Hodsden Mba, Justin Howe Ba, Danielle Ross Ba, Dalton Wesemann Ba, Lisa K. Marriott Phd

OHSU-PSU School of Public Health Annual Conference

Title: Employer voices: Insights on Bolstering Career Development for Graduate Students

Alexandria J. Ashraf, MPH; Josh Hodsden, MBA, CPH; Justin Howe, BA; Danielle Ross, BA, CPH; Dalton Wesemann, BA; Lisa K. Marriott, PhD

Background: The development of the public health workforce has become increasingly vital as our world faces current and future challenges. The workforce has gained considerable insight into job skills that enhance responses to emergent needs. Building the foundation for a larger scale study on public health workforce needs, this project established processes for engaging with professionals who have hired recent public health graduates.

Methods: Open-ended questions assessed …

The Use Of Extreme Risk Protection Orders Intended To Prevent Mass Violence In Oregon: A Descriptive Study, Rosol Mikail, Rebecca Valek, Shauna Rakshe, Rebecca Teichman, Susan Defrancesco, Kathleen Carlson

OHSU-PSU School of Public Health Annual Conference

Purpose: Firearm violence is a critical public health issue in the United States. Extreme Risk Protection Order (ERPO) laws are an intervention method that have been enacted in many states to prevent firearm violence including mass violence threats. This study examined the characteristics of ERPO petitions filed in Oregon for a 6-year period that involved mass violence threats.

Method: ERPO petitions included in court records obtained through the Oregon Judicial Case Information Network, from January 1, 2018, to December 31, 2023 were abstracted; a 20% random sample of records was double-coded to ensure interrater reliability. An epidemiologic analysis of cases …

Self-Reported Follow-Up Care Needs Can Be Met In Both Facility And Self-Managed Abortion: Evidence From Low- And Middle-Income Countries, Laura E. Jacobson Mph

OHSU-PSU School of Public Health Annual Conference

Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.

Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.

Results: A total of n=67 …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investing In Family Planning, Education, And Empowering Of Women And Girls To Mitigate The Impact Of Climate Change: An Exemplary Case Of Rwanda., Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Countries where population growth is high are often highly impacted by the climate crisis despite not being a significant contributor to historical greenhouse gas emissions. This has created a global inequality in that countries with poorly developed infrastructure are 15 times more likely to have deaths due to climate related disasters such as floods, droughts, and storms compared to wealthy countries that can better protect against similar events. While the climate crisis impacts everyone, women and girls are at a higher risk because of their unique health needs and roles in the community. The effects of climate change can be …

Map The System: Presence And Impact Of Ppcps In Water, Emma Vandermeulen, Ruby Mitchell

OHSU-PSU School of Public Health Annual Conference

In a changing climate, there is growing emphasis on protecting our water sources and developing systems for conserving and reusing water. While many contaminants of concern are monitored and addressed by water treatment systems, pharmaceuticals and personal care products (PPCPs) are generally not accounted for. PPCPs in water systems have been an increasing concern as detection of these products has increased over the last few decades. Studies have been exploring the impact of antibiotics, antidepressants, contraceptives, and other anthropogenic products on our water system and how these substances interact with local ecosystems. Our main research questions are to understand what …

Impact Of Industrial Disasters On The Mental Health Of Vietnamese Americans On The Gulf Coast, Vivian L. Duong

OHSU-PSU School of Public Health Annual Conference

An explosion on the Deepwater Horizon oil rig caused 200 million gallons of crude oil to spill on the Gulf Coast over a five-month span. About 16,000 miles of coastline, ecosystem and marine life along Alabama, Florida, Louisiana, Mississippi, and Texas were contaminated. This disaster and the recovery process caused social, financial, and ecological shocks, resulting in adverse psychosocial and physical health outcomes, health disparities, and socioeconomic inequality. Among the oil spill's most affected and vulnerable populations are the Vietnamese American communities that settled on the Gulf Coast after the end of the Vietnam War in 1975. The plight of …

Qualitative Evaluation Of Medical Student Perceptions Of Chronic Disease, Mallory A. Decampos-Stairiker, Viviane Cahen, Sarah Dzubay, Saffron Evergreen, Rachel Shore

OHSU-PSU School of Public Health Annual Conference

Background:
Chronic disease is becoming increasingly common around the world. Students in different US medical training programs are exposed to varying amounts of chronic disease education and are taught unique ways of approaching chronic disease management. The purpose of this study is to investigate allopathic and naturopathic medical students’ attitudes, understandings, and perceptions of chronic diseases and their management.

Methods:
This study was conducted as a class project for UNI 504: Qualitative Methods for Health Professionals. We conducted virtual interviews during February 2023 with five allopathic and five naturopathic medical students from around the United States. Demographic information on …

Housing Quality In Philadelphia, Pa: An Urban Health Equity Indicators Approach, Jennifer Piacentini

OHSU-PSU School of Public Health Annual Conference

Philadelphia is also the poorest large city in the country, and many residents live in substandard housing. Poor housing quality is associated with poor physical health outcomes as well as mental health issues (Schilling et al., 2022). Many homes in Philadelphia are of poor quality partially due to the median house age being 93 years, and the fact that 75% of homes are more than 50 years old (Jay, 2017). It has also been found that Black households are disproportionately impacted by housing quality issues. The Habitat for Humanity Philadelphia’s Home Repair programs are invaluable, and work with homeowners to …

Consensus Panel For Assessing Usability And Acceptability Of Mobile Health Autism Screeners, Gabriella Tangkilisan, Luis Andres Rivas Vazquez, Sarabeth Broder-Fingert, Plyce Fuchu, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Abstract:

Background:

Parents go online to assess whether their child has symptoms of autism. Though early autism identification is important, language, cultural, and technological barriers may impede equitable access to online autism screening tools.

Objective:

To create consensus recommendations for equitable design of autism screening apps and websites using an online panel of parents, autistic self-advocates, health and educational providers, autism researchers, and online screening tool developers.

Methods:

We invited 6 parents (4 of autistic and 2 of typically-developing children), 2 autistic adults, 3 early intervention providers, 3 pediatric primary care providers, and 3 autism online screening app/website developers to …

Client-Reported Quality Of In-Facility Medication Abortion Compared With Pharmacy-Based Self-Managed Abortion In Bangladesh, Laura E. Jacobson Mph, Sarah E. Baum, Erin Pearson, Rezwana Chowdhury, Nirali M. Chakraborty, Julia Goodman, Caitlin Gerdts, Blair Darney

OHSU-PSU School of Public Health Annual Conference

Objective: We used the newly developed Abortion Care Quality (ACQ) Tool to compare client-reported quality of medication abortion care by modality (facility-based versus pharmacy-based self-managed abortion (SMA)) in Bangladesh.

Study Design: We used the abortion client ACQTool exit and 30-day follow-up surveys and bivariate statistics to compare 18 client-reported quality indicators grouped in six domains and eight abortion outcomes, by service modality. We used multivariable logistic regression to identify factors associated with selected quality indicators and outcomes (abortion affordability, information provision, and knowing what to do for an adverse event), controlling for client socio-demographic characteristics.

Results: Of 550 abortion clients, …

Telehealth Family Navigation For Early Autism Services Access: The Autism Alert Project, Mohadeseh Solgi, Avneet Sidhu, Annie Hoang, Alicia Feryn, Joseline Raja-Vora, Patricia Cavanaugh, Michelle Tae, Eric Fombonne, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Delays in access to educational services for autism are common and more likely among children from families of color and/or with low income. In-person family navigation accelerates autism diagnosis; however, the effectiveness of telehealth autism diagnostic navigation is unknown.

Objectives: To test preliminary feasibility and efficacy of a telehealth autism navigation program.

Method: This was a site-randomized pilot trial of autism family navigation for Oregon children in 2021-2022. The intervention used layperson family resource specialists based at Oregon’s Help Me Grow program as navigators for families of children with autism symptoms. Pediatric clinics with >30% Medicaid, located in 5 …

Association Between Abdominal Aortic Calcification Severity And Depressive Symptoms: Cross-Sectional Study Findings From Nhanes 2013-2014, Shabir Sarwary

OHSU-PSU School of Public Health Annual Conference

Association between Abdominal Aortic Calcification Severity and Depressive Symptoms: Cross-Sectional study findings from NHANES 2013-2014

Shabir Sarwary, MPH

BACKGROUND

Abdominal aortic calcification (AAC) is an asymptomatic condition in which calcium deposits build up in abdominal aorta. AAC is detectable only by imaging. When present, severe AAC increases the risk of developing major coronary heart disease compared to no or minimal AAC. Depression affects nearly 10% of U.S. adults and is often present among those who have experienced a major coronary heart disease event, such as myocardial infarction. It is unknown if the prevalence of depression is elevated in adults who …

The Effects Of Running On Arithmetic Problem Solving, Kayia C. Snyder, Nicholas Smith

OHSU-PSU School of Public Health Annual Conference

In this work, we propose to examine the effects of physical activity on academic performance as physical activity is shown to improve mood, energy levels, confidence, and memory retention. We propose to recruit a sample of 200 psychology students from Portland State University. Each student will be asked to take an arithmetic problem-solving test then asked to study the material for three weeks. Of the 200 students, 100 will be randomly assigned to a physical activity condition, in which they will be asked to run 30 minutes prior to studying, then all students will be asked to take a timed …

Provider Perspectives On Benefits And Challenges Of Mhealth Autism Screeners​ In Underserved Families, Yesenia Morales

OHSU-PSU School of Public Health Annual Conference

Background: Mobile-health (mHealth; using mobile devices) screening tools for autism are becoming more prevalent, and have potential benefits such as video content, eye tracking, and adaptive design. However, it is unclear whether such tools will ameliorate disparities in access to autism diagnosis and treatment for children from under-privileged backgrounds, instead of improving treatment only for those already advantaged in autism care.

Objective: To understand factors affecting equity in use of mHealth autism screening tools from the perspective of primary care providers (PCPs) and Early Intervention/Early Childhood Special Education providers (EIPs).

Design/Methods: We conducted qualitative interviews about mHealth autism screening tools, …

Examination Of An Individual-Level Stigma Reduction Tactic In Front-Line Service Encounters, Christopher J. Waterbury, Nicholas A. Smith Phd., Larry Martinez Phd., Shi (Tracy) Xu Phd.

OHSU-PSU School of Public Health Annual Conference

Minority stress theory links short- and long-term negative health outcomes to stigma and discrimination. It is important that workers have the agency to effect change in the processes of discrimination as a social determinate of health. Identity management strategies are elective tactics that workers may wish to use to reduce discrimination. Front line service workers may be discriminated against by customers in the form of negative customer service evaluations. Group-level stereotypes may influence customer service perceptions more than objective service quality. In this poster, we report findings from two studies in which we examined the effectiveness of an individual-level stigma …

Building Resistance And Sustainability To Improve Population Health In Tokyo, Japan., Ma'adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

The use of policy decisions and urban health indicators can promote a more healthy and equitable city. Over a period of ten weeks, stories and activities going on in Tokyo, Japan, were followed to identify pressing urban health issues in the city. Disaster preparedness measures, city sustainability initiatives, and ageing population health improvement were selected and focused on for this poster presentation. Through policy actions and urban redevelopment plans, Tokyo, a super-aged society, and a city prone to natural disasters like tsunamis and earthquakes, is developing structures that will reduce the impact of disasters, improve the living conditions of the …

Association Of Patient- Provider Language Concordance With Health Care Comprehension Among Latino/As In Oregon: Work In Progress, Grace Parra

OHSU-PSU School of Public Health Annual Conference

Authors: Grace Parra, Sara Diaz-Anaya, & Blair G. Darney PhD, MPH.

Title

Association of patient- provider language concordance with health care comprehension among Latino/as in Oregon: Work in progress

Background

Language concordance in a healthcare setting is a clinical encounter where the patient and provider speak the same language. Health care comprehension is the degree to which individuals understand health-related information given by the provider. Research to date suggests that language barriers in health care negatively impact quality of care .The purpose of this study is to describe need and preferences for language concordant care and test the association …

Prevalence Of Perceived Weight Stigma And Its Psychological Impact On Obese People In Saudi Arabia, Wafi Albalawi

OHSU-PSU School of Public Health Annual Conference

No abstract provided.

Effect Of Sin Lek Rice Intervention On Cognitive Function, Dietary Patterns, And Fecal Microbiota Of Elementary School Children In Chiang Rai, Thailand, Angie Setthavongsack, Siam Popluechai, Jackilen Shannon, Justin Denny, Eleni Gentekaki, Kongkiat Kespechara, Lucsame Gruneck, Thomas J. Sharpton, Kullawong Niwed, Lisa K. Marriott

OHSU-PSU School of Public Health Annual Conference

Thailand has struggled with malnutrition rates in young children. Rice is a key component of Southeast Asian diets and a whole grain rice varietal (Sin Lek) may support improved nutrition. Diet can influence cognitive function and human gut microbiota, which were explored in the context of a rice intervention. We conducted a pilot study using a non-randomized, crossover clinical trial of Sin Lek rice versus traditional white rice consumption in elementary school children in Chiang Rai, Thailand. Outcomes related to diet, anthropological factors, cognitive function (e.g., short-term working memory, attention, impulsivity), and gut microbial populations were measured at baseline and …