Public Health Commons^™

Demonstrating The Need For Intergenerational Trauma-Specific Substance Use Treatment For Mothers Receiving Substance Use Treatment And Their Children, Brittany Ti-Esha Smith

Graduate Theses, Dissertations, and Problem Reports

For decades the United States has faced substance use epidemics that have devastating public health consequences, with the most recent epidemic being the opioid epidemic. While the substance that is the center of the epidemic’s changes over time, one factor that has been found to be positively related to substance use has remained consistent, that preventable risk factor is adverse childhood experiences (ACEs). Those who experience ACEs are at elevated risk for developing SUD. If the trauma that is a result of experiencing ACE is not treated it can complicate recovery and impact the individuals’ families. The children of individuals …

Understanding The Effects Of The Covid-19 Pandemic On West Virginia Students In Secondary School, Hannah Mckenzye Layman

Graduate Theses, Dissertations, and Problem Reports

Abstract 1

Background: The COVID-19 pandemic negatively impacted the mental health of young people. Mental health disparities among youth are abundant, so understanding how the pandemic may have affected specific sub-groups to develop tailored interventions to mitigate variations in health disparities is essential. Methods: School-based survey data from the Young Mountaineer Health Study (YMHS) was used to create generalized estimating equations models predicting anxiety and depression among early adolescents. The cohort sample included 2,322 students. Waves 1, 2, and 3 were collected ~6 months apart. Independent variables included COVID-19-related emotional impact (scale range: 5-25) and social support. Results: Average age …

Screen Media Use Among Children And Adolescents – Applications Of Supervised And Unsupervised Machine Learning And Sentiment Analysis, Yifan Zhang

Graduate Theses, Dissertations, and Problem Reports

Screen media has become increasingly pervasive in our everyday lives and has profoundly changed the way people communicate and interact with each other. However, we are still unclear about the long-term influence of screen media use on our physical health, mental health, and social wellbeing. Children and adolescents are in an important stage of brain development and are susceptible to the environmental influence that screen media possess. This dissertation pursued three aims to address research gaps related to screen media use among children and adolescents: 1) identify topics and knowledge gaps in screen media use research among children and adolescents …

Examining The Spatial Relationship Between Maternal Morbidity, Access To Health Care, And Community Characteristics In West Virginia, Sarah E. Woolard

Graduate Theses, Dissertations, and Problem Reports

Maternal-related morbidity rates in the United States have risen almost three fold since the early 1990’s. Issues related to rurality, socioeconomic disparities, and pre-existing health conditions increase the risk of poor pregnancy outcomes and introduce barriers to accessing advanced maternal health care. West Virginia (WV) has higher maternal morbidity rates than many other states in the United States (US), and is considered to be driven by all 55 counties being classified as Appalachian, possessing the highest prenatal smoking rate in the US, and having disparities in access to health care. Despite this, no previous studies have evaluated maternal morbidity in …

Psychosocial Influences On And Behavioral Characteristics Of Young Adult Food Addiction, Rachel A. Wattick

Graduate Theses, Dissertations, and Problem Reports

Introduction. Research on food addiction has increased in recent years, but there are few studies focusing on college-attending young adults, who may be at risk of developing food addiction due to the stress of the college environment. Additionally, causes and characteristics of food addiction are under-explored.

Aim. This dissertation aims to 1) determine the impact of adverse childhood experiences (ACEs) and other early life influences on the development of food addiction in college-attending young adults and 2) determine the psychosocial and behavioral characteristics of young adults with food addiction.

Methods. A sequential explanatory mixed-methods design was used for aims 1 …

The Process And Case Study Approach To Implementing A Nutrition-Specific Dissemination And Implementation Science Training In Appalachia, Ayron E. Walker

Graduate Theses, Dissertations, and Problem Reports

Introduction: Nutrition professionals face implementation challenges due to their lack of knowledge to incorporate D&I science into intervention design. To improve intervention outcomes, nutrition professionals must be trained in D&I science, which are currently absent in the field.

Aims: To identify and assess nutrition educators and practitioners perceived motivations, self-efficacy, and attitudes in using D&I science to inform the educational design and strategies of a nutrition-specific D&I curriculum for nutrition educators. Then to test feasibility of the nutrition-specific curriculum in increasing knowledge, self-efficacy, and attitudes by a case study approach, pre/post intervention design.

Methods: First, scoping review methodology involved the …

Implementing Trauma-Informed Care Through A Multi-Agency Learning Collaborative: A Theory-Driven Analysis Of Outcomes And Sustainability, Mira D H Snider M.S.

Graduate Theses, Dissertations, and Problem Reports

Learning collaboratives (LCs) are often used in large-scale implementation initiatives to promote evidence-based practice across provider networks. Although the outcomes and stakeholder perspectives of many LCs have been documented, support for the effectiveness of LCs is equivocal, and the means by which LCs achieve long-term improvements in clinical care are not understood. The current study investigated outcomes and sustainability of a multi-agency LC for implementing trauma-informed care in 23 rural Pennsylvania counties. Changes in outcomes (i.e., trauma symptom screening, trauma-informed care training attendance, clinician confidence with using trauma informed-care, utilization of trauma-related diagnostic codes, retention in service, service unit density) …

Perceptions Of Integrated Mental And Behavioral Health In Pediatric Specialty Care Settings: A Mixed-Methods Study, Desireé Nicole Williford

Graduate Theses, Dissertations, and Problem Reports

Pediatric patients are at an increased risk of experiencing mental and behavioral health concerns, which have direct associations with HRQOL, physiological health, and likelihood that youth will engage in health promoting behavior. Researchers and practitioners have increased their awareness of these concerns and identified strategies for improving the mental and behavioral health of these youth, specifically via implementing organizational efforts (i.e., task forces) and guidelines around integrating psychosocial screening and other services into routine practice. Despite this, there are several identified barriers to families receiving mental/behavioral health care in these settings. These barriers exist at all levels, including at the …

A Phenomenological Photovoice Exploration Of Female Exercisers’ Experiences Of Their Body In Fitness Center Environments, Katherine E. Fairhurst

Graduate Theses, Dissertations, and Problem Reports

For many women, the relationship with their body and exercise is complex. Exercise can have positive effects on body image, however, not all women appear to benefit positively from all types of exercise. To date, body image research has focused on exercise as an activity and less so on the context in which exercise is performed. Women frequently exercise in fitness centers as young adults which, unfortunately, is associated with body dissatisfaction. Using an Interpretative Phenomenological Analysis (IPA) approach with Photovoice methodology, we explored young adult women’s lived body experiences while exercising in fitness centers. A purposive sample of 11 …

Mental Health Service Use In The Kingdom Of Saudi Arabia, Abdulaziz S. Alangari

Graduate Theses, Dissertations, and Problem Reports

Objectives: The goal of this project was to increase knowledge concerning the current prevalence, needs and barriers to mental health service use in the Kingdom of Saudi Arabia (KSA). It’s purpose was to gather data that would help to inform future policy decisions aimed at optimizing the use and availability of these services in the KSA. There were three specific aims: 1) Examine the barriers to initiation and continuation of mental health treatment in people with a disorder diagnosed during the previous 12-months. 2) Explore the prevalence and predictors of mental health treatment dropout. 3) Examine the prevalence and patterns …

Therapeutic Approaches To Recovery In West Virginia, Rachel A. Wattick

Graduate Theses, Dissertations, and Problem Reports

Substance use disorder (SUD) is a prevalent problem in the United States, with 19.7 million Americans aged 12 and older battling an SUD in 2017. Multiple factors influence the risk that someone will develop an SUD, including family history, childhood trauma, community factors, and poverty. West Virginia has the highest rate of overdose deaths in the nation, and individuals in WV are at high risk of SUD due to the aforementioned risk factors. There are a variety of treatment options available to someone with an SUD. These include outpatient or inpatient treatment, detoxification, therapeutic communities, and collegiate recovery programs. Despite …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Accessible Design In Rural Health Care: Usability Profile Of Outpatient Health Care Facilities In Rural West Virginia., Jordan E. Miller

Graduate Theses, Dissertations, and Problem Reports

The Americans with Disabilities Act (ADA) became law in 1990. Since then, research has shown that people with disabilities continue to experience environmental, systematic, and structural barriers to health care. The purpose of this research is to explore the prevalence of barriers in rural West Virginia health facilities and the relationship between building characteristics (like age and purpose) and accessibility. The researcher evaluated ten rural outpatient member-sites of the West Virginia Practice-Based Research Network using a survey to understand building characteristics and a tool to measure essential features for a facility to be considered ‘usable’. Findings included a negative correlation …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …