Public Health Commons^™

Preparing To Break Barriers: A Mixed Methods Exploration Of The Knowledge, Attitudes, And Perceptions Of Hiv, Prep, And Hiv Risk Behaviors Among Women Of Color In Miami, Florida, Amanda C. Ichite

FIU Electronic Theses and Dissertations

The U.S. HIV epidemic is characterized by regional, racial, and ethnic disparities. HIV rates are disproportionately higher in the South and Black and Hispanic populations are most impacted. Moreover, the intersectional identity of being a Black or Hispanic woman living in the South has been associated with profound disparities in HIV impact. Prior to the advent of the biomedical HIV prevention tool pre-exposure prophylaxis (PrEP) in 2012, women were limited in their options for female-controlled HIV prevention strategies. Despite the proven efficacy of PrEP, utilization in women is significantly lower than other at-risk groups. In the present study, secondary analysis …

"I Got To Be Healthy For Me Beyond Covid": The Influence Of The Covid-19 Pandemic On Hypertension Prevention Among Black College Students: A Mixed Methods Study, Talegria Brown

FIU Electronic Theses and Dissertations

Black college students are at an increased risk of developing hypertension resulting from their race, ethnicity, family history, and added stressors of college life. Hypertension is a risk factor for COVID-19 disease severity hence the need to investigate its impact on hypertension risk factors. The purpose of this mixed-methods explanatory study was to understand the influence of the COVID-19 pandemic on hypertension awareness among Black college students.

A cross-sectional, online survey was conducted to study the effect of knowledge, attitudes, and practices on hypertension risk factors among Black college students (Aim 1). The mean hypertension knowledge score was 7.54 (SD …

Local Health Department Capacity To Improve Public Health - The Impact Of Public Health Accreditation And Public Health Funding, Nancy S. Elliott

FIU Electronic Theses and Dissertations

Public health accreditation and public health funding have the potential to transform the way local health departments (LHDs) deliver public health, but it is unclear if they are having their intended impact. Since performance expectations are high and public health funding is scarce, LHD leadership will continually be interested in finding the most effective ways of improving public health. The purpose of this research is to examine whether LHDs are reaching their goal of public health improvement through public health accreditation and public health funding. Data from the National Association of County and City Health Officials Profile Surveys, Public Health …

The Politics Of The Self: Psychedelic Assemblages, Psilocybin, And Subjectivity In The Anthropocene, Joshua Falcon

FIU Electronic Theses and Dissertations

This dissertation examines how psychedelic substances become drawn into particular sociohistorical and political arrangements, and how psychedelic experiences with psilocybin ‘magic mushrooms’ are used as tools of subjectivation. Guided by literatures in philosophy, critical theory, and the social sciences that focus on subjectivity, assemblage theory, and critical posthumanism, I argue that psychedelics are drawn into variegated assemblages, each of which conceptualizes the nature of psychedelics in highly specific ways that reflect implicit conceptions of the world and the self. In developing the concept of psychedelic assemblages, this research provides a window onto the politics of the self in the Anthropocene. …

Determinants Of Waterpipe Smoking Trajectories And The Effects Of Pictorial Health Warning Label Among Young Waterpipe Smokers In The Us, Prem Gautam

FIU Electronic Theses and Dissertations

In recent years waterpipe tobacco (WPT) smoking has increased among young people in the United States (US). Adequate characterization of the WPT smoking trajectories (initiation, progression, and cessation), their predictors, and examination of the effects of a pictorial health warning label (PHWL) on WPT smokers is essential to guide interventions and policies to curb WPT smoking among young people in the US. Using the Population Assessment of Tobacco and Health Study (PATH) and clinical lab data, this dissertation assessed: 1) prevalence and predictors of WPT smoking initiation and progression among adolescents and young adults; 2) magnitude and predictors of WPT …

Changes Of Harm Perception And Effect Of Health Warnings On Electronic Cigarette Use In Us Youth, Wei Li

FIU Electronic Theses and Dissertations

This dissertation 1) assessed the influence of electronic nicotine delivery systems (ENDS) harm perception on ENDS initiation over time among US youth and young adults; 2) tracked the changes in harm perception of ENDS use and examined their predictors among US youth; 3) conducted a pilot study to address the effectiveness of graphic health warning labels (GHWLs) on important outcomes among US young adult ENDS users. Data from 2013-2018 of the Population Assessment of Tobacco and Health (PATH) study were used for aims 1 & 2. Primary data with 26 participants that were collected from university campus during the year …

Examining The Effects Of Individual And Neighborhood Factors On Hiv Transmission Risk Potential Among People With Hiv, Semiu Olatunde Gbadamosi

FIU Electronic Theses and Dissertations

HIV transmission risk significantly increases in late-diagnosed HIV and at HIV viral load (VL) >1500 copies/mL. The objective of this dissertation was to examine factors associated with HIV transmission risk potential for persons with HIV (PWH) using measures of time from HIV infection to diagnosis and trajectories of VL suppression. Additionally, we sought to determine whether a single yearly VL measure—the current standard to track the HIV epidemic in the United States—is reliable in assessing viral suppression for PWH. The first study estimated the distribution of time from HIV infection to diagnosis in Florida using a CD4 depletion model and …

The Impact Of Pre- And Post-Immigration Factors On The Depressive Symptoms And Alcohol Use Severity Of Young Adult Recent Latino/A Immigrants: Examining The Role Of Gender And Traditional Gender Roles, Vicky Rebecca Vazquez-Barrios

FIU Electronic Theses and Dissertations

Over the past decade, there has been a shift in Latino/a immigration patterns to the U.S. including steep increases in South and Central America immigrants. Seeking asylum from political and economic turmoil, many of these immigrants are disproportionately impacted by the compounding conditions of stress, trauma, depressive symptoms, and alcohol use severity (AUS). Most investigations on these conditions have been conducted among Mexican immigrants residing in the U.S. for an extended time period. Far less is known about the cumulative and intersecting effects of these conditions among a diverse group of recent Latino/a immigrants (RLIs) or how cultural factors such …

Physicians Perception Of The Impact Of E-Health Reform On The Saudi Arabian Health System, Saeed A. Alwadei

FIU Electronic Theses and Dissertations

The Ministry of Health (MOH) in the Kingdom of Saudi Arabia introduced E-health system reform in 2011. The national E-health plan has already been in action; the MOH expects to implement the system throughout the country by 2021. The MOH manages about 60% of the hospitals in Saudi Arabia. In 2016, the government of Saudi Arabia introduced vision 2030. One of the main objectives of the reform is to accelerate the implementation of primary and digital infrastructure projects. This research aims to evaluate the effectiveness of the E-health system reform in Saudi Arabia.

This research utilized a questionnaire to collect …

Examining The Effects Of Neighborhood Factors And Geography On Racial/Ethnic Disparities In Achieving Sustained Viral Suppression, Rahel Dawit

FIU Electronic Theses and Dissertations

Sustained viral suppression (all viral load tests/mL in a year) decreases the risk of HIV transmission and disease progression to AIDS for people with HIV. Racial/ethnic minorities living with HIV are particularly challenged by barriers, including neighborhood factors, to maintain viral suppression. This dissertation examined the contribution of neighborhood and geographic factors on racial/ethnic disparities in achieving sustained viral suppression. A cross-sectional analysis of secondary data collected in 2017 for 6491 clients enrolled in the Miami-Dade County Ryan White Program (RWP) was conducted.

The first study examined the moderating role of neighborhood level factors on the association between race/ethnicity and …

Sociocultural Factors Associated With Hpv Vaccine Uptake Among Hispanic Female Emerging Adults, Tanjila Taskin

FIU Electronic Theses and Dissertations

Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the United States (U.S.). College students are at high risk of developing HPV-related diseases and play key roles in transmitting the infection. Fortunately, HPV-related cancers can be prevented through HPV vaccination.

A cross-sectional study was designed to collect data from convenience samples of Hispanic emerging adults from Florida International University (FIU) in Miami, Florida, and the University of Houston (UH) in Houston, Texas. Participants who were 18-26 years old, self-identified as Hispanic or Latino/a, able to read English, and enrolled in FIU or UH were included in the …

Examining The Role Of Knowledge And Cultural Values On Utilization Of Mammograms Among A Sample Of Saudi Women, Afrah Saif

FIU Electronic Theses and Dissertations

Breast cancer is the most frequent malignant tumor that threatens the lives of women globally. In Saudi Arabia, breast cancer incidence was observed among younger and premenopausal women due to diagnosis at advanced stages. The late diagnosis results in poor prognosis and poor outcomes. The survival rates in Saudi women with breast cancer are low. This can be attributed to several reasons such as lack of knowledge and barriers embedded in cultural values. However, low rates of breast cancer screening account for the increasing number of breast cancer detected at much higher stages in Saudi Arabia and resulting deaths, making …

The Impact Of Hiv-Related Stigma On The Racial/Ethnic Disparities Across The Hiv Care Continuum Among Adults Living With Hiv In Florida, Derrick James Forney

FIU Electronic Theses and Dissertations

Background: Florida currently has one of the highest rates of new HIV infections in the U.S. As of 2019, Black and Hispanic HIV-positive individuals in Florida were significantly less likely to receive HIV care, remain in care, and achieve viral suppression than white HIV-positive individuals. Several studies have linked HIV-related stigma to poor outcomes among people living with HIV (PLWH). This study examined the impact of distinct HIV-related stigma subtypes on linkage to care, retention in care, and viral suppression among PLWH in Florida and if these associations differed across race/ethnicity.

Methods: Data from the 2015-2017 Florida Medical Monitoring Project …

Mental Health, Intersectionality Of Religious Identity Struggles, And Islamophobia In Muslim Young Adults In South Florida: An Exploratory Study, Amani Othman

FIU Electronic Theses and Dissertations

This study extended prior research by Bandar Alsaif (2019) on Muslims in South Florida to identify their perceptions of health. Alsaif’s study found that young U.S.-born Muslim Americans reported higher mental distress and perception of being stereotyped and stigmatized than older Muslims. These results call for further investigation into the mental health of this population and exploration of their growing up experiences. Existing literature in this area is sparse. As such, this study aimed to explore the domains of identity struggle and perceptions of anti-Muslim attitudes (Islamophobia) as potential contributors to the reported poor mental health in young Muslim adults …

Identifying Mediators, Moderators And High-Risk Latent Classes Of Preterm Birth And Low Birth Weight Among Pregnant Women In Rural Mysore, India, Sandra Kiplagat

FIU Electronic Theses and Dissertations

This dissertation examined the mediators, moderators, and high-risk latent classes of preterm birth (PTB) and low birth weight (LBW) among pregnant women in rural Mysore District, India. Secondary data analyses of a prospective cohort study conducted between 2011-2014 among 1540 women was performed to complete this dissertation.

In the first study, we examined the association between socioeconomic status (SES) and PTB and LBW. Latent class analysis (LCA) was performed to assess sociodemographic patterns of high-risk pregnant women based on education, income, marital status, primigravida status and number of children. We identified four distinct classes, Class 1 “low SES/early marriage/multigravida/1 child …

Examining The Impact Of Stressors, Depressive Symptoms, And The Moderating Role Of Traditional Latino Gender Norms In Miami Dade County, Gabriella Marie Wuyke

FIU Electronic Theses and Dissertations

Latino men experience disproportionate rates of depressive symptoms, compared to their non-Hispanic White counterparts. Factors related to immigration, culture, and the endorsement of traditional Latino gender norms can have deleterious effects on the mental health of Latino men. The aims of this research study were to examine the moderating role of traditional Latino gender norms among immigration and cultural stressors on depressive symptoms among Latino immigrant men in Miami-Dade County using three distinct data sets.

The first study (N= 279) examined the moderating role of machismo and caballerismo between negative context of reception (NCR) and depressive symptoms. Moderation analysis revealed …

Associations Of Sociocultural Stressors With Psychological Distress And Self-Rated Health Among Hispanic Emerging Adults, Abir Rahman

FIU Electronic Theses and Dissertations

Emerging adulthood (18-25 years) is a distinct period of life, characterized by a high level of instability in the matters of romantic life, work, and challenging developmental undertakings. Various events related to these developmental tasks may leave lifelong impacts on emerging adult’s identities and health across adulthood. Further, due to the unstable nature of this period, individuals in this age group are vulnerable to various mental health problems. Hispanic emerging adults may be particularly at risk of experiencing adverse health outcomes, as on top of normative developmental stressors (e.g., increased autonomy, finding employment), they are often exposed to various chronic …

Intersectional Stigma And Barriers To Engagement In Care Among Haitian Women With Hiv, Edwine Daniel

FIU Electronic Theses and Dissertations

Women account for about half of HIV infections globally. After sub-Saharan Africa, the Caribbean is the most HIV-affected region in the world, with half of the region’s people living with HIV (PLHV) in Haiti and where the overwhelming majority of new HIV infections occur among adolescents and young women. Guided by Turan and colleagues’ conceptual framework for HIV-related stigma, engagement in care, and health outcomes, this cross-sectional study examined the patterns of intersectional stigma and relationships with the ability and willingness of women to stay engaged in care when living with HIV.

This study is a secondary analysis of baseline …

Measurement And Predictors Of Mental Health Among Parents Of Children With Intellectual And Developmental Disabilities, Rumi Agarwal

FIU Electronic Theses and Dissertations

Parents of children with intellectual and developmental disabilities (IDD) experience elevated levels of stress, anxiety, and other adverse mental health conditions. Despite extensive literature on parental mental health, this research addressed three gaps. First, a systematic review identified the interventions and respective scales used to address and assess stress and anxiety among parents of transition-aged children with autism spectrum disorder (ASD). This was necessary given that the stressors parents experience vary with the age of the child. Of the 11 studies included in the final review, it was evident that most interventions and scales were not aligned with the unique …

Hiv Risk Factors, Enacted Stigma, And Testing Outcomes Among Men Who Have Sex With Men In Florida, Sarah Suarez

FIU Electronic Theses and Dissertations

Crucial to ending the HIV epidemic is the prompt identification of HIV through testing services. National recommendations suggest everyone should test for HIV at least annually, and those with higher risk should test more often (for example, every 3 to 6 months). An estimated 66% of new HIV infections in 2018 occurred among men who have sex with men (MSM). Florida is third in the nation for HIV diagnoses among adults and adolescents (25.0 per 100,000 population) with an estimated 119,661 persons living with HIV; MSM account for 74% of the cases. This dissertation used the American Men’s Internet Survey …

Gender Differences, Vitamin B6, Polyunsaturated Fatty Acids, And Inflammation-Related Diseases, Hyojung Kim

FIU Electronic Theses and Dissertations

Vitamin B6-restricted diets and low plasma pyridoxal 5'-phosphate (PLP) status altered plasma polyunsaturated fatty acids (PUFA) compositions. The relationship of aging with vitamin B6 status and PUFA metabolism is poorly understood. This dissertation explored the association between vitamin B6 intake and status and plasma PUFA in US young/middle-aged adults and in older adults from NHANES 2003-2004. Future research plans will examine the relationships among vitamin B6, PUFA, inflammatory diseases, including chronic liver diseases; however, there is a gap in plasma PLP data in the Miami Adult Studies in HIV (MASH) cohort data on these relationships. Thus, the relationship between substance …

Food Insecurity Is Associated With Nonalcoholic Fatty Liver Disease, Cognitive Impairment, And Immune Activation In People Living With Hiv, Javier A. Tamargo

FIU Electronic Theses and Dissertations

Food insecurity (FI) is a socioeconomic condition characterized by inadequate access to enough food and nutrition to sustain health and wellbeing. Food insecurity is a risk factor for chronic and age-related conditions, raising concerns for the aging population of people living with HIV (PLWH), in whom food insecurity is disproportionately prevalent. PLWH are at increased risk of nutrition-related complications and chronic co-morbidities, thus food insecurity may exacerbate adverse health outcomes in this population. This study investigated whether food insecurity was associated with nonalcoholic fatty liver disease (NAFLD), cognitive impairment, and immune activation among socioeconomically disadvantaged adults living with and without …

Characterizing The Development And Trajectories Of Nicotine Dependence Among A Cohort Of Adolescent Waterpipe And Cigarette Smokers, Mohammad Ebrahimi Kalan

FIU Electronic Theses and Dissertations

Nicotine dependence (ND) is the fundamental reason that people persist in using tobacco products, which kill more than eight million people every year globally. So far, ND research has primarily focused on cigarettes, yet for many youths worldwide, tobacco use, and addiction is maintained by means other than the cigarette including waterpipe (WP) smoking (a.k.a. hookah). It is important to better understand the WP-associated ND trajectories given its unique use features that can influence ND development such as its time-consuming preparation and consumption, intermittent use, and strong sensory and social cues. Hence, using data from 8 waves (2015-2020) of the …

Border Epidemiological Study Of Aging: The Role Of Psychosocial Factors On Mortality Of Mexican Americans In South Texas, Raed Jannadi

FIU Electronic Theses and Dissertations

Despite Mexican Americans experiencing many chronic illnesses, e.g., diabetes and obesity, they exhibit higher life expectancy than other population groups in the United States. This is known as the Hispanic Paradox. This dissertation aimed to further contribute to the literature on the “paradox” by investigating the association between psychosocial factors rarely investigated in this population, such as social support, self- rated health, and stressful life events, with incident diabetes and all-cause mortality.

Data for this dissertation are from the Border Epidemiological Study of Aging, known as BESA, a population based longitudinal study consisting of four waves conducted in South Texas …

Nrf1 Transcriptomic Signatures Contribute To The Pathogenesis Of The Most Aggressive Brain Cancer - Glioblastoma, Kaumudi M. Bhawe

FIU Electronic Theses and Dissertations

Glioblastomas (GBMs, grade IV astrocytoma or glioma) are the most aggressive and lethal of all brain cancers. GBM patients have short survival and poor clinical prognosis. Despite decades of research, the standard of care for GBM treatment has not changed significantly. The lack of curative treatment modalities for patients with this type of brain tumor highlights the importance of research that helps to discover novel therapeutic targets. Nuclear respiratory factor 1 (NRF1) transcription factor (TF) has been reported to be one of the top active TFs in human cancer, but its role in GBM remains unknown. This thesis research focuses …

Investigation Of Dna Damage And Genomic Organization In The Cellular Response To Platinum Chemotherapy, Abdulhadi Abdulwahed

FIU Electronic Theses and Dissertations

Ovarian cancer (OC) is the primary reason for gynecological cancer-related deaths among women. This cancer rarely has specific symptoms making early detection challenging. Platinum compounds have been used as the first-line treatment for OC. However, OC patients often develop chemoresistance to current platinum/taxane chemotherapy regimens upon recurrence, leaving patients with no alternative treatment options. The purpose of this thesis was to investigate the molecular basis of chemoresistance in OC by analyzing the damage of DNA response and gene positioning after treatment exposure. A modified comet assay was used to measure interstrand cross-link (ICL) formation and repair in chemoresistant (CR) (SKOV-3) …

Laboratory And Epidemiological Characteristics Of Zika Virus Infections In Florida, Stephen L. White

FIU Electronic Theses and Dissertations

Until recently, Zika virus (ZIKV) was an obscure virus that rarely caused infections and was unknown to most. In 2015 and 2016, ZIKV came into the public spotlight as Brazil and other countries began to report large increases in infections with ZIKV and reported potential complications with developing fetuses and neurologic manifestations. In 2016, the state of Florida identified and responded to an outbreak of locally acquired ZIKV infections in Miami-Dade County. This dramatic increase in infections demonstrated both its importance as an emerging infectious disease and the paucity of knowledge surrounding ZIKV. This study seeks to utilize the data …

Carbapenem-Resistant Enterobacteriaceae (Cre): Epidemiology, Duration Of Carriage, And Progression To Infection In A Large Healthcare System In Miami, Fl, Adriana Jimenez

FIU Electronic Theses and Dissertations

Carbapenem-resistant Enterobacteriaceae (CRE) are multidrug-resistant organisms (MDRO) considered by the CDC as an urgent public health threat that is spreading globally. Little is known about the epidemiology of CRE in Miami, FL. The purpose of this dissertation was to 1) Evaluate trends in the epidemiology of CRE among patients admitted to the acute care facilities of the largest healthcare system in Miami, FL between 2012 and 2016, 2) Identify factors associated with progressing to infection among patients colonized with carbapenemase-producing Enterobacteriaceae (CPE), and 3) Determine the duration of CPE carriage and factors associated with long-term carriage in our cohort.

A …

Formation And Repair Of Environmentally-Induced Damage To Mitochondrial And Nuclear Genomes, Yunhee Ji

FIU Electronic Theses and Dissertations

All living organisms are continually exposed to various environmental stressors, be they anthropogenic or natural in origin. Many stressors share a common toxic mechanism, generating highly reactive chemical species that can have detrimental effects. A proportion of these chemical species evade the cell’s defenses and damage cellular components, including DNA. Measurement of global genome levels of DNA and cellular damage has implicated environmental stressors in major human health issues (e.g., cancer, aging, cardiovascular, and neurodegenerative diseases). Current associations between DNA damage and disease are based upon crude assessments of global genome damage, which provide limited mechanistic information on how damage …

Predictors Of Persistent And Recurrent Bacterial Vaginosis (Bv) Among Young African American (Aa) Women In The United States, Makella S. Coudray

FIU Electronic Theses and Dissertations

Bacterial vaginosis (BV) is a common vaginal dysbiosis among women of reproductive age. Literature presents discordant findings with respect to the predictors of BV and there is a paucity of literature examining the mechanisms by which multiple episodes of BV occur. This dissertation summarized current literature on BV, identified BV incidence patterns over a twelve-month period, and estimated the risk of sexually transmitted infections (STI) among women with episodic and persistent BV. Previously collected randomized clinical trial data were analyzed, where oral metronidazole was the administered treatment. Latent class analysis (LCA) was used to assess BV incidence patterns. Multinomial Logistic …