Public Health Commons^™

The Impact Of Stress During Adolescence And The Prevalence Of Pediatric Obesity, Olatunbosun Olakunri, Venkat Venkataraman

Rowan-Virtua Research Day

Obesity is a chronic condition that can be attributed to myriad factors including socioeconomic status, biological risk factors, and various environmental factors. These factors can be considered stress factors, and exposure to various levels of stress can impact the development of stress within the pediatric patients. The purpose of this study is to assess the association between the environmental, mental, social, physical, and psychological stress adolescents are exposed to and how they contribute to the prevalence of pediatric obesity throughout the United States. Understanding these risk factors can help us as a community and most importantly as clinicians develop better …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Associations Between Self-Reported Cognitive Decline And Chronic Diseases: A Cross-Sectional Analysis Of Behavioral Risk Factor Surveillance System (Brfss) 2022, Hailey Child

Capstone Experience

Objective: This study seeks to capture how self-reports measure cognitive decline. The association between chronic conditions and cognition with age consideration in individuals aged 45 and older is investigated.

Methods: Univariate analysis generates frequencies and weighted percentages of 2022 BRFSS data. Chi-square tests and polytomous regressions generate odds ratios for bivariate analyses. A weighted multiple logistic regression model stratified by age group analyzes self-reported cognitive decline.

Results: Respondents ages 45 to 54 with three or more chronic diseases have the highest odds (OR = 6.81; 95% CI = 4.42, 10.48) of cognitive decline. Respondents 75 and older …

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

The Prescription Drug Monitoring Program In A Multifactorial Approach To The Opioid Crisis: Pdmp Data, Pennsylvania, 2016–2020, Jenna R. Adalbert, Amit Syal, Karan Varshney, Brandon George, Jeffrey Hom, Asif M. Ilyas

College of Population Health Faculty Papers

Background: Prescription opioids remain an important contributor to the United States opioid crisis and to the development of opioid use disorder for opioid-naïve individuals. Recent legislative actions, such as the implementation of state prescription drug monitoring programs (PDMPs), aim to reduce opioid morbidity and mortality through enhanced tracking and reporting of prescription data. The primary objective of our study was to describe the opioid prescribing trends in the state of Pennsylvania (PA) as recorded by the PA PDMP following legislative changes in reporting guidelines, and discuss the PDMP's role in a multifactorial approach to opioid harm reduction.

Methods: State-level opioid …

Fixing The System: A Comparative Review Of The United Kingdom, Germany, And United States’ Healthcare Systems And Lessons Learned For Potential Improvements In The United States, Jessica Goddard

Senior Theses

In an effort to provide recommendations to the United States’ considerations of a universal healthcare system, this thesis analyzes the United States healthcare system alongside the sophisticated systems of the United Kingdom and Germany. Literature review and an analysis of 10 health outcomes and indicators guided the framework for a set of interview questions to be asked of healthcare professionals in all three countries. The interview response data was then organized and used to guide the suggested recommendations to the United States in its path towards universal healthcare. While a limited number of solutions could be provided given the time …

Comorbidity Burden And Covid-19 Vaccination Intention: Application Of The Health Belief Model, Michael Raymond

Honors Theses

The COVID-19 pandemic impacted many aspects of American’s lives causing over 79 million cases and over 950,000 deaths. Existing research shows severity of COVID-19 infection may be linked to number of underlying health conditions, known as comorbidities. The objective of this study was to determine if comorbidity burden was associated with intention to vaccinate against COVID-19. This relationship was looked at through the Health Belief Model (HBM) and its mediating variables of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Our sample was compromised of 350 individuals recruited from an online platform who were not already vaccinated against COVID-19. …

Harm Reduction In The Heartland: Public Knowledge And Beliefs About Naloxone In Nebraska, Usa, Allison Schlosser, Patrick Habecker, Rick A. Bevins

Department of Psychology: Faculty Publications

Background: Opioid-related overdose deaths have been increasing in the United States (U.S.) in the last twenty years, creating a public health challenge. Take-home naloxone is an effective strategy for preventing opioid-related overdose death, but its widespread use is particularly challenging in smaller cities, towns, and rural areas where it may be stigmatized and/or poorly understood.

Methods: We analyzed data on knowledge and beliefs about drug use and naloxone among the general public in Nebraska, a largely rural state in the Great Plains region of the U.S., drawing on the 2020 Nebraska Annual Social Indicators Survey.

Results: Respondents reported negative beliefs …

Prenatal Dietary Education, Using The Midwifery Model, In Ireland Vs The United States, Allison Erby

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Prenatal dietary education is a very important component of care in healthy pregnancies, but more than that, dietary education can be an indicator of the value a healthcare provider places on holistic care or preventive medicine. The United States and Ireland are compared in this study because they represent high intervention vs. low intervention approaches, respectively, to obstetric care. Healthcare professionals from the United States and Ireland perceive the most important nutrients and method of receiving those differently. Maybe the most telling contrast, healthcare professionals in Ireland perceive food as the way pregnant women should receive vital nutrients, but healthcare …

A Comparative Analysis Of Distribution And Allocation Of Covid-19 Vaccines Between Two Administrations, Leila Halawi, J. Mayanja, J. Chilipamushi, Y. Zhang, B Albury, Jude Edwards

Publications

The pandemic of COVID-19 is a life-threatening disease that entailed all governments but especially the U.S government, to quickly prevent methods of spreading the virus while strategically putting in place a plan for biological testing for a vaccine for immunity. The purpose was to determine how effective the formulation of a COVID-19 vaccine and the distribution would impact the mortality with efficacy rates. Besides, this research paper underlines the principles for ethical and equitable distribution for mass immunization. A comparative analysis between the Trump Administration and the Biden Administration will be presented regarding the funding stream, distribution of vaccinations, and …

Understanding African Americans' Beliefs, Knowledge, Attitudes And Behaviors Regarding High Blood Pressure And Their Use Of Home Remedies As Treatment, Elisa Douglas

Seton Hall University Dissertations and Theses (ETDs)

ABSTRACT

Understanding African Americans’ Beliefs, Knowledge, Attitudes and Behaviors Regarding High Blood Pressure and Their Use of Home Remedies as Treatment

Elisa E. Douglas

Seton Hall University, 2021

Dissertation Chair: Dr. Deborah DeLuca, J.D., MS

Background and Purpose of the Study: African Americans have the highest prevalence of high blood pressure (HBP) in the United States but the lowest blood pressure (BP) control rates of any major race/ ethnic group. Only about 45% of those who use drugs to treat the condition have been able to attain BP control. Over 40% of African Americans are affected by HBP. African Americans …

Shadow Standards And The Logic Of Costs: Care, Stewardship, And Data In U.S. Community Health, Margarite J. Whitten

Dissertations, Theses, and Capstone Projects

This dissertation examines the delegation of responsibility for providing health care to particular categories of marginalized populations in the United States in the absence of a uniform and universal health care system. It explores how the U.S. federal government governs patient populations at a distance by mandating that healthcare providers collect, produce, and report on patient data. Drawing from eighteen months of ethnographic research in Massachusetts clinics for the homeless and the frail elderly between 2014-2015, I argue that when marginalized patients are unable to satisfy the neoliberal ideal of self-governance to maintain their health in cost-effective ways, providers are …

Promising Practices For Boating Safety Initiatives That Target Indigenous Peoples In New Zealand, Australia, The United States Of America, And Canada, Mitchell Crozier, Audrey R. Giles

International Journal of Aquatic Research and Education

Boating-related incidents are responsible for a significant number of the drowning fatalities that occur within Indigenous communities in New Zealand, Australia, the USA, and Canada. The aim of this paper was to identify promising practices for boating safety initiatives that target Indigenous peoples within these countries and evaluate past and ongoing boating safety initiatives delivered to/with Indigenous peoples within these countries to suggest the ways in which they – or programs that follow them - may be more effective. Based upon evidence from previous research, boating safety initiatives that target Indigenous peoples in New Zealand, Australia, the USA, and Canada …

Know Before You Play: Associations Between Race, Education, And Hiv Susceptibility, Anfa Mohamed Diiriye

All Graduate Theses, Dissertations, and Other Capstone Projects

Black women are disproportionately affected by HIV in the United States. This paper analyzes the associations between race, education, and HIV susceptibility, furthering previous research to understand if educational attainment reduces HIV susceptibility and if reduction patterns are similar for Black and White women. The CDC’s National Survey of Family Growth 2015-2017 was used to analyze associations using binary logistic and multiple regression models. HIV susceptibility was operationalized through four measures: condom use, having a partner with concurrent sexual relationships, having had an STD, and age at first sex. Black women were not found to be significantly more susceptible to …

The Impacts Of Medicaid Expansion On Rural Low-Income Adults: Lessons From The Oregon Health Insurance Experiment., Heidi Allen, Bill J. Wright, Lauren Broffman

Articles, Abstracts, and Reports

Medicaid expansions through the Affordable Care Act began in January 2014, but we have little information about what is happening in rural areas where provider access and patient resources might be more limited. In 2008, Oregon held a lottery for restricted access to its Medicaid program for uninsured low-income adults not otherwise eligible for public coverage. The Oregon Health Insurance Experiment used this opportunity to conduct the first randomized controlled study of a public insurance expansion. This analysis builds off of previous work by comparing rural and urban survey outcomes and adds qualitative interviews with 86 rural study participants for …

Expectations For Treatment In Pediatric Weight Management And Relationship To Attrition., Erinn T. Rhodes, Richard E. Boles, Kimberly Chin, Amy Christison, Elizabeth Getzoff Testa, Kimberly Guion, Mary Jane Hawkins, Carter R. Petty, Bethany Sallinen Gaffka, Melissa Santos, Laura Shaffer, Jared Tucker, Sarah Hampl

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Attrition in pediatric weight management negatively impacts treatment outcomes. A potentially modifiable contributor to attrition is unmet family expectations. This study aimed to evaluate the association between adolescent and parent/guardian treatment expectations and attrition.

PATIENTS AND METHODS: A prospective, nonrandomized, uncontrolled, single-arm pilot trial was conducted among 12 pediatric weight management programs in the Children's Hospital Association's FOCUS on a Fitter Future collaborative. Parents/guardians and adolescents completed an expectations/goals survey at their initial visit, with categories including healthier food/drinks, physical activity/exercise, family support/behavior, and weight management goals. Attrition was assessed at 3 months.

RESULTS: From January to August 2013, …

Evaluating The Accountable Health Communities Demonstration Project., Laura Gottlieb, Jeffrey D. Colvin, Eric Fleegler, Danielle Hessler, Arvin Garg, Nancy Adler

Manuscripts, Articles, Book Chapters and Other Papers

Despite substantial evidence documenting the social patterning of disease, relatively little information is available on how the health care system can best intervene on social determinants to impact individual and population health. Announced in January 2016, the Centers for Medicare and Medicaid Innovation's (CMMI) Accountable Health Communities (AHC) initiative provides an important opportunity to improve the evidence base around integrated social and medical care delivery. To maximize learning from this large-scale demonstration, comprehensive evaluation efforts should focus on effectiveness and implementation research by supporting local, regional, and national studies across a range of outcomes. Findings from this demonstration could transform …

West Virginia Needle Exchange Program, Briana Washington, Sara Johnson

Theses, Dissertations and Capstones

Introduction: Needle Exchange Programs (NEPs) have been controversial aspects of public healthcare due to conflicting beliefs and opinions for public policies. NEPs allow Injection Drug Users (IDUs) the ability to exchange their used equipment for clean, unused supplies.

Purpose: The purpose of this literature review was to determine the effectiveness of needle exchange programs and the impact it has had on the reduction of HIV and viral hepatitis infections in people who inject drugs. It further explores if these strategies have had a positive impact on the reduction of HIV and viral hepatitis C in West Virginia.

Methodology …

Physical Activity And Sedentary Behaviors In Urban Chinese Children: Grade Level Prevalence And Academic Burden Associations, Xihe Zhu, Justin A. Haegele, Yan Tang, Xueping Wu

Human Movement Sciences & Special Education Faculty Publications

The objectives of this study were (a) to report grade level prevalence in physical activity and sedentary behaviors and (b) to examine academic burden associations with these behaviors. School-aged children (n = 48,118) reported their physical activity, perception of physical activity sufficiency, factors for activity insufficiency, homework hours, and screen time in a typical week. Data were analyzed using general linear models and logistic regression models of Complex Samples. Prevalence results showed that children had lower physical activity and lower screen viewing time, but higher homework time during transition grades (6th, 9th, and 12th) and high school years. Academic burden …

Update From The Advisory Committee On Immunization Practices., Jennifer E. Schuster, Sean O'Leary, David W. Kimberlin

Manuscripts, Articles, Book Chapters and Other Papers

The Advisory Committee on Immunization Practices (ACIP) consists of medical and public health experts who develop recommendations on vaccine use in the United States. The ACIP meets 3 times per year, and members and Centers for Disease Control (CDC) staff present findings and discuss vaccine research, vaccine effectiveness (VE) and safety, clinical trial results, and labeling/package insert information. Outbreaks of vaccine-preventable diseases and vaccine shortages are also discussed. Nonvoting representatives from the American Academy of Pediatrics and the Pediatric Infectious Diseases Society are present. The ACIP met on June 22-23, 2016 to discuss proposed recommendations for influenza vaccination, for human …

Risk Factors For Sleep-Related Infant Deaths In In-Home And Out-Of-Home Settings., Hilina Kassa, Rachel Y. Moon, Jeffrey D. Colvin

Manuscripts, Articles, Book Chapters and Other Papers

Background and objective: Multiple environmental risk factors are associated with sleep-related infant deaths. Little is known about differences in risk factors for deaths occurring in-home and out-of-home. We sought to compare risk factors for in-home and out-of-home infant deaths.

Methods: We conducted a cross-sectional analysis of sleep-related infant deaths from 2004 to 2014 in the National Child Fatality Review and Prevention database. The main exposure was setting (in-home versus out-of-home) at time of death. Primary outcomes were known risk factors: sleep position, sleep location (eg, crib), objects in the environment, and bed sharing. Risk factors for in-home versus out-of-home deaths …

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Juvenile Justice—Translational Research On Interventions For Adolescents In The Legal System (Jj-Trials): A Cluster Randomized Trial Targeting System-Wide Improvement In Substance Use Services, Danica K. Knight, Steven Belenko, Tisha Wiley, Angela A. Robertson, Nancy Arrigona, Michael Dennis, John P. Bartkowski, Larkin S. Mcreynolds, Jennifer E. Becan, Hannah K. Knudsen, Gail A. Wasserman, Eve Rose, Ralph Diclemente, Carl G. Leukefeld, Jj-Trials Cooperative

Behavioral Science Faculty Publications

Background: The purpose of this paper is to describe the Juvenile Justice—Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS) study, a cooperative implementation science initiative involving the National Institute on Drug Abuse, six research centers, a coordinating center, and Juvenile Justice Partners representing seven US states. While the pooling of resources across centers enables a robust implementation study design involving 36 juvenile justice agencies and their behavioral health partner agencies, co-producing a study protocol that has potential to advance implementation science, meets the needs of all constituencies (funding agency, researchers, partners, study sites), and can be implemented …

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Striving For Cultural Competence In An Hiv Program: The Transformative Impact Of A Microsystem In A Larger Health Network, Judith N Sabino, Timothy Friel, Lynn Deitrick, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

No abstract provided.

Trends In The Use, Sociodemographic Correlates, And Undertreatment Of Prescription Medications For Chronic Obstructive Pulmonary Disease Among Adults With Chronic Obstructive Pulmonary Disease In The United States From 1999 To 2010, Earl S. Ford, David M. Mannino, Anne G. Wheaton, Letitia Presley-Cantrell, Yong Liu, Wayne H. Giles, Janet B. Croft

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: The extent to which patients with COPD are receiving indicated treatment with medications to improve lung function and recent trends in the use of these medications is not well documented in the United States. The objective of this study was to examine trends in prescription medications for COPD among adults in the United States from 1999 to 2010.

METHODS: We performed a trend analysis using data from up to 1426 participants aged ≥20 years with self-reported COPD from six national surveys (National Health and Nutrition Examination Survey 1999-2010).

RESULTS: During 2009-2010, the age-adjusted percentage of participants who used any …

The Characteristics Of Women Seeking Funding From The Dc Abortion Fund, Karin Elizabeth Bleeg

GW Research Days 2013

Objectives: To determine whether the population DCAF serves, based on current research, are those most in need of its financial services. Describe the population that DCAF is supports by age, race and ethnicity, poverty, educational attainment, union status, contraceptive method used, referral source, and number of prior pregnancies.

Methods: An adapted version of The Guttmacher Institute's National Patient Survey will be used to collect data from women who contact DCAF for financial assistance for their abortion (n=150). The data will be collected for one month and then analyzed in SPSS.

Results: Between January and March 2013 approximately 400 women contacted …

Identifying Environmental Health Priorities In Underserved Populations: A Study Of Rural Versus Urban Communities, M. C. Bernhard, M. B. Evans, S. T. Kent, E. Johnson, S. L. Threadgill, S. M. Becker

Community & Environmental Health Faculty Publications

Objectives- Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members' concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities: defined the term environment; their perceptions of environmental exposures as affecting their health; specific priorities in their communities; and differences in urban versus rural populations.

Study design- A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities.

Methods- A total of eight …

Neighborhood Socioeconomic Deprivation And Mortality: Nih-Aarp Diet And Health Study, Jacqueline M. Major, Chyke A. Doubeni, Neal D. Freedman, Yikyung Park, Min Lian, Albert R. Hollenbeck, Arthur Schatzkin, Barry I. Graubard, Rashmi Sinha

Chyke A. Doubeni

PURPOSE: Residing in deprived areas may increase risk of mortality beyond that explained by a person's own SES-related factors and lifestyle. The aim of this study was to examine the relation between neighborhood socioeconomic deprivation and all-cause, cancer- and cardiovascular disease (CVD)-specific mortality for men and women after accounting for education and other important person-level risk factors. METHODS: In the longitudinal NIH-AARP Study, we analyzed data from healthy participants, ages 50-71 years at study baseline (1995-1996). Deaths (n = 33831) were identified through December 2005. Information on census tracts was obtained from the 2000 US Census. Cox models estimated hazard …

The Clinical Gaze In The Practice Of Migrant Health: Indigenous Mexican Migrants In The United States, Seth M. Holmes Phd, Md

Seth M. Holmes PhD, MD

This paper utilizes eighteen months of ethnographic and interview research undertaken in 2003 and 2004 as well as follow-up fieldwork from 2005 to 2007 to explore the sociocultural factors affecting the interactions and barriers between U.S. biomedical professionals and their unauthorized Mexican migrant patients. The participants include unauthorized indigenous Triqui migrants along a transnational circuit from the mountains of Oaxaca, Mexico, to central California, to northwest Washington State and the physicians and nurses staffing the clinics serving Triqui people in these locations. The data show that social and economic structures in health care and subtle cultural factors in biomedicine keep …