Medicine and Health Sciences Commons^™

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Examining The Association Between Smoking Frequency And Long Covid: A Brfss Study, Bhavya Patel

Capstone Experience

Objectives: To examine the relationship between self-reported smoking frequency and the presence of Long COVID among individuals who tested positive for COVID-19.

Methods: A cross-sectional study was conducted using a sample of 44,738 COVID-positive participants from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset. Logistic regression was utilised to compute prevalence odds ratios (pOR) and was adjusted for potential sociodemographic confounders.

Results: Individuals who smoked daily were found to have a greater likelihood of reporting Long COVID in comparison with nonsmokers (Crude pOR=1.22; CI= [1.10-1.35]). However, in the adjusted regression model, daily smoking was no longer significant (Adjusted pOR=1.04; …

A Cross-Sectional Analysis Of Self-Reported Long Covid And Binge Drinking Amongst Covid-Positive Individuals Using The Behavioral Risk Factor Surveillance System (Brfss), 2022, Maire Kirley

Capstone Experience

Objective: Identify an association between Long COVID (exposure) and binge drinking (outcome) amongst COVID-positive individuals.

Methods: COVID-positive respondents (n=116,120) were sampled from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Univariate analysis assessed distribution of Long COVID, binge drinking, and covariates sex, age, race/ethnicity, education, income, rural/urban residency, veteran status and BMI. Bivariate analysis determined crude prevalence odds ratios (POR) between exposure, outcome, and covariates. Multivariate logistic regression determined adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI) for exposure, outcome and covariates.

Results: No association found between Long COVID and binge drinking (aPOR: 0.94 (95% CI: 0.87, …

The Lived Experiences Of Counselors-In-Training Completing Practicum And Internship During Covid-19, Shelby Lauren Dillingham

Counseling & Human Services Theses & Dissertations

COVID-19’s classification as a pandemic in March 2020 changed numerous professions as they adjusted to social distancing expectations. Mental health providers particularly encountered transitions that included higher acuity caseloads, working different hours, and increased exposure to COVID-19. Counselors-in-training (CIT) faced the dilemma of earning their clinical hours in a safe manner, especially CITs working within integrated healthcare settings, such as hospitals or clinics. Despite some research with licensed professional counselors, limited research exists examining CITs' experiences working during the COVID-19 pandemic. This study sought to understand the lived experiences of CITs who completed their clinical hours in an integrated behavioral …

Structure And Function Of Long-Covid Evaluated Using Pulmonary Imaging, Harkiran Kaur Kooner

Electronic Thesis and Dissertation Repository

The COVID-19 pandemic has resulted in millions of global respiratory infections, ranging in severity from asymptomatic to fatal. One of the many consequences of the pandemic is the emergence of long-COVID, which is an umbrella term used to describe the long-term sequelae and poor quality-of-life following recovery from acute COVID-19 infection. However, the pathophysiology and mechanisms responsible for the heterogenous manifestation of long-COVID remain poorly understood. Hyperpolarized ¹²⁹Xe magnetic resonance imaging (MRI) provides a non-invasive and radiation-free method to regionally visualize and quantify inhaled gas distribution and ventilation in vivo. A strong foundation for the use of pulmonary …

Exploring Attrition And Linguistic Shifts: The Impact Of Covid-19 And Anti-Asian Discrimination On The East And Southeast Asian Diaspora, Amy Wan-Ling Lin

University Honors Theses

This thesis investigates the complex interplay of language and identity among speakers of East Asian and Southeast Asian languages in the United States, within the context of the COVID-19 pandemic and the concurrent rise in anti-Asian hate. The study adopts a mixed-methods approach to delve into these complexities, guided by three research questions exploring changes in language use since the onset of the pandemic, changes in perspective on language identity since the onset of the pandemic, and the effect of geopolitical climate, specifically the rise in Asian hate, on language use and perspective on language identity. The qualitative methodology employed …

Race-Related Stress, Medical Mistrust, Covid-19 Worry, And Covid-19 Vaccination Behavior Among African Americans, Lisa A. Cash

Walden Dissertations and Doctoral Studies

In the United States, nearly 104 million cases and over 1.1 million deaths from novel coronavirus disease of 2019 (COVID-19) have been reported overall, but African Americans have been disproportionately affected. Nevertheless, this population has demonstrated the lowest intention to be vaccinated and lowest vaccination rates of all racial/ethnic groups in the United States. The research problem addressed by this study is African American COVID-19 health disparities. The purpose of this investigation was to examine factors that influence COVID-19 vaccination behavior among African Americans, which is important to better understand how to achieve health equity. Using the health belief model …

Life After The Pandemic: Use Of An Educational Coping Strategy Tool Kit For Healthcare Professionals, Christine Thorpe-Gilpin

Electronic Theses and Dissertations

Research has proven that acute care healthcare professionals (i.e., nurses, certified nursing assistants, and respiratory therapists have been experiencing ongoing challenges and ineffective coping mechanisms. The Toolkit for Emotional Coping for Healthcare Staff (TECHS) educational toolkit has introduced practical coping skills that could benefit healthcare workers. Using the TECHS has effectively inspired the development and usage of practical coping skills among healthcare workers. There were three tools included in the TECHS educational material to understand and manage adversity, which can be repeated for new or recurring stressful situations in a personal or team-based approach. These tools were based on cognitive-behavioral …

‘News Reporting On Possible Origins Of The Covid-19 Pandemic: A Critical Review And Case Study’, Raya M. Fanuzzi

Undergraduate Theses, Professional Papers, and Capstone Artifacts

This project is a critical analysis of news reports that discuss the potential origins of the 'COVID-19' pandemic for the purposes of identifying themes and trends in the actual reporting. Around 500 news reports published in the U.S. were analyzed and over 100 of them were selected for the critical review. Articles were found using 'Access News Archive' and Google search engine. Original methods for analyzing and reviewing articles were developed and used. A case study is included aside from the review which focuses specifically on trends in fact-check reporting during the pandemic.

Introducing Mental Health Resources To Nurse Practitioner Residents, Tiffanie Bailey

Doctor of Nursing Practice Projects

This DNP Project identified the increased need for mental health resources after the COVID-19 pandemic. Studies showed the rate of anxiety, depression, and substance use has also been on the rise since the beginning of the pandemic. As the impact of the COVID-19 pandemic began to devastate the country mentally and physically, it became quickly apparent that additional resources to provide support for those suffering from mental illness were essential. This project aimed to introduce a Mental Health First Aid course within the Residency Program at the Center for Family Guidance. Participants were asked to complete a pre-test indicating their …

Impact Of Covid-19 On Individuals With Aphasia: Effects On Quality Of Life And Communication, Kaci L. Gammon

Honors College Theses

Speech-language pathologists (SLPs) help people with aphasia (PWA) manage their communication symptoms and become more independent by supporting them linguistically and emotionally. During COVID-19, speech and language services were not as readily available to PWA due to quarantine restrictions resulting in isolation within this population. Individuals with aphasia had to redirect and find a new way to function daily. This study explored factors that affected quality of communication and quality of life for PWA during the pandemic, including technology, living situation, timing of stroke, and speech-language pathology services. Through an online survey, PWA from across the country expressed how their …

"Shut Down And Closed Off": A Routine Activity Approach To Investigating The Relationship Between Covid-19 School Closures And Child Sexual Abuse Report Characteristics In Georgia, Spencer E. Riner

Electronic Theses and Dissertations

The COVID-19 pandemic of 2020 created a public health crisis that led to an unprecedented number of school closures. A major concern raised by child advocates, law enforcement, and social service providers was the possible increase in undetected child abuse and maltreatment. Undergirding this concern was the belief that this mitigation effort might place child abuse victims and offenders within proximity for extended periods of time. While this was a significant concern, it has rarely been analyzed empirically. To address this gap in the literature, this thesis investigates how school closures impacted the characteristics of child sexual abuse (CSA) reports …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

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 …

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 …

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 …

Developing An Online Questionnaire To Investigate The Covid-19 Pandemic’S Impacts On Social Isolation And Health In Older Adults Living With Multimorbidity: A Pilot Study, Patricia Nistor

Electronic Thesis and Dissertation Repository

Introduction. Social restrictions preventing the spread of COVID-19 possibly increased social isolation and loneliness. The validity and reliability of a questionnaire assessing the COVID-19 pandemic’s impact on social isolation and loneliness in community dwelling older adults with multimorbidity was investigated.

Methods. A conceptual framework was developed to guide questionnaire construction. Participants were recruited through professional networks, comprising a convenience sample. Feedback interviews assessed usability and face validity. Content validity was assessed using a Content Validity Matrix, and construct validity through tests of association. Reliability of validated scales was assessed using Cronbach’s ⍺. Descriptive statistics and logistic regression were computed. …

Crisis Narratives In Crisis? A Comparative Investigation Into National Covid-19 Narratives, Mouse D. Bennett

Graduate Program in International Studies Theses & Dissertations

On January 31, 2020, the World Health Organization (WHO) declared a public health emergency for only the sixth time in its history. On March 11, 2020, it was stated that COVID-19 constituted a pandemic. How did countries respond? This dissertation traces the evolution of national crisis narratives in four states and assesses their relative success. The findings of this study are that pandemic crisis narratives are not generalizable to all crisis situations but require a high level of compliance to be effective in stopping the crisis. There is no formula for government success, there are no decisive variables determining outcomes. …

Social Connectedness, Adolescent Mental Health And Well-Being At The Later Stages Of The Covid-19 Pandemic: A Mixed Methods Exploration, Sarah Abdunnabi

Electronic Thesis and Dissertation Repository

COVID-19 posed novel challenges by limiting in-person interactions and shifting interactions online. Effects of online and offline social connectedness on adolescent mental health and well-being, and the moderating role of the social determinants of health (SDoH) were explored. Canadian adolescents (n=1,586; M_age=15.3, range 13 to 18 years; surveyed summer 2022) reported their social connectedness, psychological distress, and mental well-being. An ordinal logistic regression was performed to examine the association between social connectedness (online and offline) and dual-factor mental health. Responses to two open-ended survey questions were analyzed. Social disconnection was associated with higher odds of being in a …

Trends In Primary Care Visits And Diabetes Control For Type 2 Diabetics Before And During The Covid-19 Pandemic, Carole Berini

MUSC Theses and Dissertations

Community health worker interventions have shown potential to improve health outcomes and reduce inequities particularly for patients with chronic diseases such as type 2 diabetes (T2D). However, there is a lack of support for CHW integration in the delivery of health care. The recent COVID pandemic may have affected outcomes for T2D patients and exacerbated existing inequities in care. This dissertation aimed to address three broad questions through three separate manuscripts. The first one was a systematic literature review to examine the impact of community health workers on health outcomes for rural US populations. The second and third papers used …

An Examination Of The Associations Between Covid-19 Vaccine Hesitancy, Trust In Media, And Trust In Science And Scientists, Jegason Phosphorus Diviant

Psychology ETDs

Recent evidence suggests corroded trust in scientific institutions, but particularly among political conservatives. The current investigation examined the potential role of trust in conservative media sources by capturing associations between trust in politically-biased media sources, trust in science and scientists, and COVID-19 vaccine hesitancy. A total of 1,117 participants completed an online cross-sectional self-report study. Results revealed that: (1) the less trust respondents had in science and scientists, the greater their overall COVID-19 vaccine hesitancy (and perceived risks and fears of COVID-19 vaccines); and (2) the more respondents trusted conservative-leaning news media sources, the greater their overall COVID-19 vaccine hesitancy …

Older Women’S Stories Of Covid-19 Loss: Communicated Narrative Sense-Making Through Photography, Anne Walker

Electronic Theses and Dissertations

The diverse array of challenges associated with the COVID-19 pandemic make it difficult to assess the full impact of this global health crisis. More than 300,000 older Americans died, leaving a nation of grieving survivors in their absence. This profound loss of life will undoubtedly inform the field’s understanding of grief and grieving for many years to come. Pre-pandemic, older women in the United States understood grief to be part of their life stage; COVID-19 amplified the grief experience through both cumulative losses and the isolation particular to the novel coronavirus response. However, few qualitative studies explore older women’s grief, …

Understanding Gendered Risks For Severe Covid-19 Through Surveying The Gender Diverse Community, Arden Kimme

Capstone Experience

Early on in the pandemic, the medical community began noticing that men were more likely to be hospitalized, require admission to the ICU, and die of COVID-19 than women but few studies of COVID-19 make mention of gender diverse people, an often-overlooked population who may have vastly different experiences than non-gender diverse men or women. Their variations in gender and sex characteristics may also help provide further insight into which traits are protective or risk factors for this disease. This project used Poisson regression in order to analyze self-reported survey data. The major associations of interest will be between disease …

The Influence Of Minority Stress, Coping, And A Pandemic On The Relationship Between Sexual Orientation And Mental Health: A Mixed Methods Study, James Michael Macchia

Psychology Theses & Dissertations

For decades, scientific literature has shown that sexual minority individuals across populations are disproportionately affected by negative mental health outcomes when compared to their heterosexual counterparts. These disparities are largely attributable to minority stress. Coping is a significant factor that can impact the content and severity of mental health outcomes and coping behaviors have been shown to vary based on sexual orientation. Mental health outcomes may also differ between sexual minority subgroups due to additional factors such as double discrimination and bisexual invisibility/erasure. Moreover, factors such as internalized homophobia and community connectedness have demonstrated strong associations with sexual minority mental …

Establishing Validity And Preliminary Clinical Utility Of A Behavioral Economic Measure Of Social Risk Discounting For Health Behaviors, Connor A. Burrows

Theses and Dissertations

The COVID-19 pandemic has been the most profound public health emergency of the past several decades and the United States has faced numerous challenges with the timely adoption of mitigating health behaviors. Sustained ambivalence surrounding perceptions of public health recommendations of social distancing, mask wearing, and timely vaccination remain a barrier to slowing the spread of the virus years after its initial onset. Behavior analysis and behavioral economics offer compelling theoretical and quantitative models for framing the relationship between behaviors that are aversive in the short term but beneficial for individual and public good in the long term. The present …

Ontario Adults' Mental Health, Wellbeing, And Prosocial Behaviour During The First 16 Months Of The Covid-19 Pandemic: A Longitudinal Study, Katie J. Shillington

Electronic Thesis and Dissertation Repository

The overall purpose of this dissertation was to provide a detailed assessment of the mental health, wellbeing, and prosocial behaviour of Ontario adults aged 30–59 (those at highest risk for losing years of healthy life due to chronic disease) during the first 16 months of the COVID-19 pandemic (April 2020–August 2021). To address this dissertation’s purpose specifically, four distinct yet thematically connected articles were written. Article 1 provides the starting point of this program of research via an overview of Ontario adults’ inter-related health behaviours (i.e., physical activity, sedentary behaviours, and dietary intake) and outcomes including, mental health, and wellbeing …

Humanity In Trauma, Alyssa K. Thompson

University Honors Theses

The main objective of the literature review is to use the trauma-informed care paradigm to argue that the current implementation of trauma-informed care reinforces hierarchies of harm, leading to feelings of moral obligation and moral injury while perpetuating othering. This literature review criticizes trauma-informed care, emphasizing lived experiences against the characteristics trauma-informed care aspires to reflect. The review centers on the broad themes of understanding, universality, and acceptance of the present trauma-informed care paradigm. The critique comes from the silently excluded group of healthcare workers, with a personal perspective from a professional who worked in an urban hospital emergency department …

Examining The Determinants Of Timeliness In Crises Policy Responses: The Case Of Covid-19 In Egypt, Abdelhalim Abdalla

Theses and Dissertations

Timely responses to crises and pandemics play a significant role in navigating and minimizing the adverse impacts of such critical periods on the public and governments worldwide. COVID-19 could show and prove how a single virus originating in a single country can rapidly spread throughout the world, transforming an epidemic in China into a global pandemic. The virus caused more than 6.5 million deaths and around 660 million confirmed cases worldwide, according to the WHO, and sparked the worst economic catastrophe globally in more than a century, as estimated by the World Bank. Evidence suggests that the extent of the …

Improving Patient Safety For Surgical Clearance: A Preop One Stop Shop, Anna Benedictos

Doctor of Nursing Practice (DNP) Projects

Problem: Medical clearance is required for patients scheduled for surgery, also known as “patient optimization.” Ineffective and inefficient patient optimization is a major contributor to surgery postponements, procedure cancellations, and patient dissatisfaction.

Context: Ambulatory care clinics often lack resources to medically clear patients prior to scheduled surgery. Poor surgical optimization continues to occur on the same day of surgery, resulting in case cancellation or delay in a suburban, 169 bed community hospital with 9 operating rooms and approximately 500 surgical procedures per month.

Interventions: A nurse-led PreOp One Stop Shop (POSS) utilized a standardized checklist to perform preoperative surgical assessment. …