Public Health Commons^™

"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 …

Assessment Of The Utilization Of Healthcare Services Specific To Pregnancy-Related Complications In Rural And Medically Underserved Georgia, Diana L. Aguirre

Electronic Theses and Dissertations

Maternal mortality is a continuing issue, with rates for the state of Georgia (3.7 per 100,000 live births) are higher than that of the US rates (2.9 per 100,000 per live births) (Centers for Disease Control and Prevention, National Center for Health Statistics, n.d., 2023). However, maternal mortality may not account for health disparity factors, apart from access to quality care and physiological issues, which is a factor in pregnancy-related deaths, Pregnancy-related death, as defined by the US Centers for Disease and Control (CDC), is a death of a woman that occurs during or within one year of pregnancy that …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

Electronic Theses and Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

“My Ob/Gyn Has The Worst Bedside Manner…” A Qualitative Analysis Of Patient-Provider Communication And Mental Health Outcomes Of Women In Rural Georgia, Tobi F. Oloyede

Electronic Theses and Dissertations

Despite technological advances in medicine and public health innovations, maternal mortality in the United States remains significantly higher than in other developed countries. Specifically, Georgia ranks as the second worst place to give birth in the country. Maternal mental health conditions are common, manageable complications that can happen at any point during pregnancy, childbirth, or in the first year following delivery, with 1 in 5 women affected. Unfortunately, 75% of women who experience MMH symptoms are left untreated.

This study focuses on patient-provider communication through the birthing experiences of women who have been pregnant in Georgia to examine how their …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

Electronic Theses and Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Using The Cipp Model Of Evaluation On A Health Disparities Curriculum Delivered To Medical Residents In 12 Residency Programs, Gauri K. Shevatekar

Electronic Theses and Dissertations

Background: Although the Accreditation Council for Graduate Medical Education (ACGME) has provided educational directives on health disparities education during residency program for the medical residents, there is paucity of curricula focused on disparities education within the graduate medical education.

Objective: The purpose of this study was to evaluate a Health Disparities Curriculum (HDC) that was delivered to twelve residency programs at a College of Medicine.

Methodology: The study employed a cross-sectional study design. Stufflebeam’s Context-Input-Process-Product (CIPP) model was utilized as theoretical framework to assess whether the curriculum achieved its stated goals and objectives, the teaching and learning processes, and the …

Medical Providers' Use Of Maternal Mental Health Screening Tools During Prenatal Appointments In Southeast Georgia, Andreka Ewing

Electronic Theses and Dissertations

In the United States, maternal mental health disorders are the most common comorbidities experienced during pregnancy and after childbirth. In particular, the state of Georgia reports that 1 in 7 Georgian mothers experience depression, anxiety, obsessive-compulsive disorders, or psychosis related to these disorders. Research suggests that untreated maternal mental health can have adverse effects on the mother and unborn child. Conditions such as autism, mixed handedness, reduced cognitive ability, and affective disorders can develop while the child is in the womb of a depressed mother. Routine maternal mental health screening using a validated screening tool has been recommended to help …

Factors Associated With Physical Activity Intent Among Adults With Multiple Sclerosis, Biebele Okpeahior

Electronic Theses and Dissertations

Introduction. Although research has highlighted the benefits of physical activity in people with Multiple Sclerosis (MS), they are still more likely to live an inactive lifestyle. There are limited studies that examine the relationship between physical activity and the Theory of Planned Behavior (TPB) among the MS population. This study aimed to explore the factors that associate with physical activity intent of adults with MS utilizing the constructs of the TPB. Methods. This study utilized a cross-sectional online survey done via a social media platform. There were 326 respondents to the survey and ultimately 249 surveys that met the criteria …

Examining The Nexus Of Housing Instability And Neighborhood Within New York City (Nyc), Benjamin Boateng

Electronic Theses and Dissertations

Housing instability within the New York City (NYC) area significantly affects the community's well-being. As a robust and growing city, many families in the low-income bracket face the challenge of spending a significant portion of their monthly income toward housing costs (rent, utilities, insurance). With families spending 50% (extreme housing burden) and more of their monthly income to stay in their housing units, various disparities have presented themselves within the housing context.

Even before the COVID-19 pandemic in March 2020, families within NYC have struggled to maintain their housing stock. Policy and community-based actions are needed to reduce the burden …

Evaluation Of The Loving Support Peer Counseling Program On Breastfeeding Duration Rates Among African American Women Enrolled In The Program (2017-2018), Nancy S. Jeffery

Electronic Theses and Dissertations

Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.”-World Health Organization. The aim of this study was to evaluate the effectiveness of the Loving Support Peer Counseling (LSPC) program, under the WIC program in the state of Georgia, on breastfeeding duration rates among African American postpartum primiparas women. This observational study analyzed state-level data from January 2017 through December 2018. A cross-sectional design was used to evaluate the effectiveness of the Loving Support Peer Counseling Program (LSPC) in six of the …

Factors Associated With Patient Portal Utilization, Preventive Services Utilization, And Health Promoting Behaviors Among Adults In The United States, Elizabeth Ayangunna

Electronic Theses and Dissertations

Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults …

The Impact Of Controlling Language And Source Similarity On Psychological Reactance, Caroline Yarbrough

Electronic Theses and Dissertations

Persuasive health messages are frequently advertised throughout the pandemic to decrease the spread of COVID-19 while increasing the likelihood of immunity. However, research demonstrates that persuasive health messages may be ineffective because they have the potential to elicit psychological reactance. Reactance is characterized by a state of unpleasant motivational arousal and often occurs when individuals experience or perceive threats to their freedom, and it can be evoked through controlling language (Frey et al., 2021; Grandpre et al., 2003). Additionally, research has shown that similarity is associated with liking (Cialdini & Trost 1998) and people are often more inclined to comply …

Factors Associated With Intention To Disclose Concussive Symptoms In Active Duty Soldiers, Carly Beck

Electronic Theses and Dissertations

Background: Concussion disclosure is a heavily researched topic, and while previous literature has explored predictors of concussion disclosure in numerous populations, research within the active duty Soldier population is limited. This study further explored predictors of concussion disclosure to a medical professional or leadership in the active duty Solider population through the lens of the Theory of Planned Behavior. Methods: A cross-sectional electronic survey was distributed to 181 active duty Soldiers. Descriptive statistics were used to report frequency of high intention to disclose concussive symptoms among demographics, and a multivariate regression model was used to assess significant predictors of intention …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa)., Lisa Ariellah Ward

Electronic Theses and Dissertations

The purpose of this research is to assess the efficacy of employing telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPA). Researchers investigating public health and healthcare systems fully grasp the enormous challenges encountered by vulnerable populations as a result of healthcare access barriers.¹ Prior to the COVID-19 pandemic, F2F visits were most often utilized for healthcare delivery service, which frequently posed barriers for vulnerable populations. When marginalized people, encounter healthcare access barriers, a cascade of events generally occur leading to …

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

Electronic Theses and Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …

Characteristics And Regions Of Hospital Locations And The Risk Of Postpartum Hemorrhage., Zahra Shahin

Electronic Theses and Dissertations

Background: Postpartum hemorrhage (PPH) is one of the contributing factors to maternal morbidity and mortality that in addition to maternal risk factors, may be related to other factors such as obstetric practice and clinical management of postpartum hemorrhage. Therefore, this study aimed to explore the association of postpartum hemorrhage with characteristics and regions of hospital locations across the United States, as the outcomes may create opportunities to improve policies and protocols regarding PPH management more effectively. Method: A retrospective study was performed using the 2018 National Inpatient Sample (NIS) database. Low-risk delivery hospitalizations involving the third stage of labor with …

Becoming A Public Health Professional: Millennials’ Perspective On Organizational Assimilation And Professional Identity, Tony K. Winters

Electronic Theses and Dissertations

ABSTRACT

Public health must confront the ongoing challenge of workforce transitions and the impending exodus of existing employees. The millennial generation rises as an option to fill this workforce gap. Using the Socialization Resource Theory as a framework and qualitative data from in-depth interviews with 27 millennial professionals from federal, state, local, and non-governmental public health agencies, this study describes (a) the organizational assimilation (OA) process for millennial public health professionals, (b) explores the impact of OA on professional identity, and (c) describes how the OA process may impact the retention of public health professionals.

The results from this study …

Correlates Of Risky Sexual Behaviors Among African American Females In Juvenile Detention Centers, Eghosa E. Asemota

Electronic Theses and Dissertations

Introduction: In comparison to other demographics, research shows that African American female adolescents are over-represented in the United States Juvenile Justice System. Studies in this vulnerable population demonstrate higher rates of engagement in unsafe sex, and its attendant negative consequences of HIV infections, sexually transmitted diseases, and mistimed pregnancies. There is a paucity of studies that have specifically examined risky sexual behaviors amongst African American females in Juvenile Detention Centers. Objective: The aim of this study is to assess the relationship between the individual, family, peer, and societal factors, and engagement in risky sex among Black female detainees in Juvenile …

Generalization Of Net Benefit Of Diagnostic Tests Into Multi-Stage Clinical Conditions: A Collapsing Approach, Ferdous Ahmed

Electronic Theses and Dissertations

Evaluating diagnostic tests based on benefit-risk involves both the tests’ accuracy and the clinical implications of the diagnostic errors. Diagnostic tests are commonly classified into two stages: either positive or negative for a clinical condition (diseased or non-diseased). However, some diseases have more than two stages, such as Alzheimer’s. In diseases with more than two stages, the benefits and risks of the clinical consequences could differ from stage to stage. I could not find any investigations to account for the difference in benefits and risks of tests with more than two stages in the literature. The benefit to cost values …

Identifying Strategies To Increase The Recruitment And Retention Of Minority Males In The Public Health Workforce: A Two-State Comparative Case Study Approach, Melicent R. Miller

Electronic Theses and Dissertations

Non-White males have higher rates of morbidity and mortality from chronic health conditions as compared to Whites. An essential element for achieving success in eliminating health disparities is to increase the presence of racial/ethnic minorities (i.e., people of color) within public health careers. One of the most important competencies for a public health professional is the ability to work in culturally and racially diverse populations. Yet, individuals are significantly more likely to receive their care and experience greater satisfaction from providers that are of the same racial or ethnic background. The racial/ethnic composition of the health professions workforce continues to …

"Who's The Man?" Examining The Relationships Between Black Masculinity, Perceived Social Support, And Sexual Behavior In Black Male College Students, James Thomas

Electronic Theses and Dissertations

Introduction: Sexual health disparities in college-aged Black men remains a critical public health issue. Black men are likely to have an earlier sexual debut, acquire sexually transmitted infections (STIs) and HIV at higher rates, and enter fatherhood at earlier ages than their White counterparts. Previous research has identified masculinity and perceived social support as predictors of sexual risk behavior for men in the U.S. However, when exploring masculinity’s influence on sexual behavior, studies that are culturally sensitive to Black men’s experiences and perspectives on manhood are few. The purpose of this study was to explore the relationship between Black masculinity, …

The Association Of Demographic Characteristics And Social Vulnerability With Covid-19 Outcomes, Gloria D. Boone

Electronic Theses and Dissertations

The Association of Demographic Characteristics and Social Vulnerability With COVID-19 Outcomes

by

Gloria Boone

(Under the Direction of Gulzar Shah)

ABSTRACT

This research explored 102 Illinois counties' COVID-19 data to determine whether demographic characteristics and social vulnerability are associated with increased vulnerability to COVID-19 infections and deaths. COVID-19 is disproportionately impacting vulnerable groups and has been deadlier for African American and Hispanic people. The findings of this research will contribute to the knowledge base regarding social vulnerability and assist public health officials in targeting resources and designing interventions. This study used a retrospective cross-sectional design to assess demographic characteristics of …

Qualitative Study Of Factors Contributing To Fertility Service Use Among Cancer Survivors Of Reproductive Age In The Us, Angela Rodgers Moore

Electronic Theses and Dissertations

Cancer remains the second leading cause of death in the United States; however, there has been a decline in incidence and mortality due to advances in screening and treatment. Currently 16.9 million survivors are thriving within the United States, and the population of cancer survivors has been projected to grow to 22.2 million by 2030. Although cancer survivors report an increased surge of vitality and vigor, they often face physical, mental, psychosocial, or financial challenges that threaten their quality of life. A late treatment effect of particular concern for cancer survivors of reproductive age that has both physical and psychosocial …

Thinking Ethically About Hiv Pre-Exposure Prophylaxis: Retention In Care And Sexually Transmitted Infection Testing In A Southeastern United States Local Health Department In The Time Of Covid-19, Ellie Purdy

Electronic Theses and Dissertations

Local Health Departments (LHDs) are critical providers of Human Immunodeficiency Virus (HIV) and sexually transmitted infection (STI) prevention efforts. HIV Pre-Exposure Prophylaxis (PrEP) is an evolving public health initiative and practitioners should consider PrEP interventions in context of ethical decision-making and a broad STI prevention strategy as global incidence of bacterial STIs remains high and those at-risk for HIV are generally at-risk for other STIs. An evaluation of the Thinking Ethically framework and LHD PrEP services was performed to fill a gap in the literature and support program decision-making. A retrospective review of PrEP user medical records from a LHD …

An Exploration Of Depression In African American Adults With Sickle Cell Disease: Symptoms, Coping Strategies And The Potential Benefits Of Religiosity, Delores P. Quasie-Woode

Electronic Theses and Dissertations

Depressive symptoms in adults with Sickle Cell Disease (SCD) often go unrecognized and untreated. SCD is one of the most common inherited hemoglobin disorders in the United States, affecting 1 in 365 African Americans. Individuals with SCD and co-morbid Depression lead to high hospitalization rates and healthcare utilization. The objective of this study is to explore depressive symptoms and preferred coping strategies among African American Adults with SCD. Furthermore, the aim is to explore the acceptability of religiosity among those who self-identify as religious.

Interviews were conducted with 30 African American adults, recruited during their hematology appointment at the Center …

Perceptions Of Local Board Of Health Effectiveness In Georgia, Amber Erickson

Electronic Theses and Dissertations

Objective: The purpose of this study is to examine the perceptions of the local board of health chairpersons in Georgia on their engagement in six governance functions and examining the challenges faced and facilitators perceived by local boards of health in performing the governance functions properly. Methods: For this descriptive mixed method study design, a survey was administered to all local board of health chairpersons and key informant interviews were conducted with a small selection of board of health chairpersons. Descriptive statistics were produced for recoded survey data variables and themes from qualitative data collected through the surveys and interviews …

United States Nursing Homes And Health Equity During The Covid-19 Pandemic, Carla Cooper

Electronic Theses and Dissertations

Objective: The COVID-19 pandemic disproportionately affected older populations, with nursing homes impacted early on by the disease. The contribution of race/ethnicity of nursing home residents and facility characteristics on COVID-19 were unknown. The Donabedian model framework was used to study the relationship between the racial/ethnic characteristics of nursing home residents and COVID-19 outcomes and to examine if this relationship was moderated by the racial/ethnic composition of the county of nursing home location.

Method: Cross-sectional research design merging data from five publicly available sources. Laboratory confirmed COVID-19 cases and deaths were compared by the racial composition of the county and nursing …

Attitudes Toward The Hpv Vaccine Among University Students: Identifying Barriers To Vaccine Uptake, Kristina L. Harbaugh

Electronic Theses and Dissertations

Background: In the United States, the Centers for Disease Control and Prevention (CDC) estimates that 32,000 cancers occur annually that can be directly attributable to the acquisition of the Human Papilloma Virus (HPV). Gender specificity data posits that 21,000 of the annual cancer cases are female and the remaining 11,000 cases occur among males. However, because the implementation and trajectory of HPV vaccination and prevention programs have been historically aimed toward women, vaccination rates for men remain significantly lower. The purpose of this study was to assess gender differences in knowledge attitude, subjective norms and perceived behavioral control about HPV …

Assessing The Percieved Barriers To Early Detection, Treatment, And Management Of Cervical Cancer Among Ghanaian Women, Angela D. Blackwell

Electronic Theses and Dissertations

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to …