Public Health Commons^™

Self-Reported Covid-19 Diagnosis And Severity And Its Association With Utilization Of And Delays In Needed Medical Care, Mohammad Hesam Alavi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Covid-19, caused by the virus SARS-CoV-2, was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. The pandemic-related disruptions and the pursuant lockdowns have adversely impacted every aspect of people’s lives including access to medical care, cancer care, preventive medicine, mental health, and dental care in an already imperfect healthcare system in the US. This study utilized the 2020 self-reported data from quarters 3 and 4 of the National Health Interview Survey, a cross-sectional interview survey by the Centers for Disease Control and Prevention, to determine the possible association of self-reported COVID diagnosis, test positivity, and …

Payment Profiles: Using Payment Transaction Data To Identify And Characterize Gamblers, Kasra Ghaharian

UNLV Theses, Dissertations, Professional Papers, and Capstones

Payment providers in the gambling industry facilitate transactions, allowing customers to transfer money to and from wagering accounts. Payments transaction data is information that is captured from these transactions, including, for example, the type, amount, time, and location. How this data may be used for gambling harm minimization and prevention has garnered significant interest, particularly due to accelerated payments modernization in the wake of the COVID-19 pandemic. With this study, I explored the utility of payments transaction data to categorize subgroups of gamblers in order to identify individuals who may be at-risk of harm. I benchmarked six cluster analysis methods …

Awareness And Knowledge On Aging And Hiv-Associated Neurocognitive Disorder: Service User And Provider Perspectives In Southern Nevada, Brandon C. Ranuschio

UNLV Theses, Dissertations, Professional Papers, and Capstones

HIV-Associated Neurocognitive Disorder (HAND) is a condition that can affect up to 50% of people living with HIV/AIDS (PLWH) and present as a cluster of neurocognitive difficulties in domains such as attention, memory, concentration, language, information processing, decision-making, problem-solving, and even motor skills. The current study intended to identify awareness and knowledge of HAND among middle-aged and older PLWH and their healthcare or service providers in Southern Nevada. Using a Community-Based Participatory Research approach, participants from the community were recruited to complete a survey that assessed awareness and knowledge of HAND. The survey also assessed the personal experiences of PLWH …

Quality Of Care: A Business Case For Us Hospitals, Iwimbong Kum Ghabowen

UNLV Theses, Dissertations, Professional Papers, and Capstones

The Patient Protection and Affordable Care Act present some threats and opportunities to many hospitals across the USA. Under the Value-Based Purchasing Program, acute care hospitals' rewards are tied to incentive payments for the quality of care provided in the inpatient hospital. In the last 20 years, growing research has examined the effects of the quality of care on the financial performance of hospitals. There is a gap in the literature, particularly exploring the relationship between quality and hospital financial performance using national samples. This dissertation investigates the association between patients' experience of care, 30-day readmission rates, and case-mix-index (CMI) …

The Association Between Neighborhood Social Media Use And Social Cohesion, Sense Of Community And Perceived Safety Among Adults In Clark County, Nevada, Emily Strickler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Place-based health is a concept that suggests where you live has an effect on your health outcomes. Social health factors such as social cohesion, sense of community, and perceived safety are all influenced by the neighborhood environment, and positively associated with health outcomes such as self-reported minutes of physical activity and symptoms of depression. With the increasing popularity of social media sites used specifically for neighborhood purposes, more neighbors are connecting than ever before. The purpose of this study was to determine if use of neighborhood social media sites was associated with the social health factors of social cohesion, sense …

Are Gaming And Gambling Disorders Related? Examining The Roles Of Money, Relative Deprivation, And Upward Mobility, Anthony J. King

UNLV Theses, Dissertations, Professional Papers, and Capstones

Few studies have examined the financial motives and risks involved in modern video games, as well as the psychosocial factors contributing to this type of gaming involvement. Previous research on gambling has shown financial motives alone to be a major risk factor for the development of gambling disorder, with higher levels of personal relative deprivation (PRD) identified as a main contributor to this relationship. Therefore, the present study investigated whether this association applied to US adult video gamers, and if it would predict their problematic gaming behaviors. We hypothesized PRD and gaming disorder severity would have a positive association, with …

Social Emotional Learning As A Universal Upstream Approach To Youth Suicide Prevention: A Secondary Data Analysis Of A Prevention Program Evaluation, Maria Amaris Knight

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Nevada has had consistently high rates of youth suicide in the past decade with 21.2 deaths by suicide per 100,000 population (ages 15-24), over the national rate of 14.5 deaths per 100,000 in 2019. National strategies, state agendas, and best practices in the field prioritize research on upstream strategies to prevent suicide. One such strategy is the use of social emotional learning (SEL) programs for youth to help increase and enhance protective factors against suicide, helping them to cope with negative life events. Research has identified leading outcomes of SEL programs as the improvement of attitudes, behaviors, and academic …

Mapping Nevada's Dental Workforce, Kelvin Chen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Access to care is a concern at the forefront of public health. Due to socioeconomic and geopolitical pressures, the distribution of healthcare providers across a population often does not coincide with the demand for healthcare in a specific geographic area. Rural areas typically do not have enough providers and urban areas typically have too many. This stark reality underscores an inherent inefficiency in the allocation of healthcare resources and is a discrepancy that must be addressed by state-sponsored institutions and programs. From a public health perspective, the problem of insufficient or lack of access to care is the greater of …

Perceptions Of The Built Environment Among Older Adults Who Live In Age-Restricted Communities Compared To Those Who Do Not In Southern Nevada, Sandra Annan

UNLV Theses, Dissertations, Professional Papers, and Capstones

As Americans are living longer, there has been exponential growth in the number of older adults. Growth in the aging population has created unique challenges. As seniors age, they face many changes in their health, financial stability, and lifestyle, making it challenging to remain independent. The inability to remain independent can be a stressful and depressing experience for older adults. Studies show that most seniors prefer to stay in their current living environment as they age, or age in place, rather than move into senior housing or other available housing options designed for aging. This study investigates how perceptions about …

The Relationship Among Sociocultural Assimilation, Dietary Behavior, And Physical Activity In Adult Latinxs In The U.S., Erick Lopez

UNLV Theses, Dissertations, Professional Papers, and Capstones

This dissertation examines the relationship between sociocultural assimilation and health behaviors among adult Latinxs in the United States to address whether different assimilation models promote or hinder Latinx health. Existing research on assimilation and health behaviors among Latinxs relies heavily on the use of proxy measures of assimilation such as length of time in the U.S., nativity, age of arrival, and language preferences for surveys. These studies tend to show that greater assimilation to mainstream U.S. culture among Latinxs is associated with the adoption of poor health behaviors and the erosion of the immigrant health advantage. Research that uses sociocultural …

The Prevalence And Predictors Of Complementary And Alternative Medicine (Cam) Use Among Racially/Ethnically Diverse College Students, Hermella Misiker

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: National data on complementary and alternative medicine (CAM) use, available through the National Health Interview Survey (NHIS), convey higher prevalence of CAM use among college students compared to the general U.S population. NHIS findings also highlight non-vitamin non- mineral (NVNM) products are the most widely used form of CAM in the U.S. The purpose of this study was to identify the socio-cognitive and demographic predictors of CAM and NVNM use among a racially/ethnically diverse college student body.

Methods: An online survey was used to collect data from 392 University of Nevada, Las Vegas (UNLV) undergraduate, graduate, and professional students. …

Stress And Coping In Food-Insecure African Americans In Clark County, Nevada, Johanna Andrews

UNLV Theses, Dissertations, Professional Papers, and Capstones

African Americans have the highest rates of food insecurity than any other racial/ethnic group in the nation as a result of poverty, low household income, unemployment, food injustice, food mirages, and racial segregation. This consistent uncertainty in food access demonstrably results in poor mental health outcomes for food-insecure African Americans. Thus, the Transactional Model of Stress and Coping provides a theoretical framework to investigate how African Americans cope with food insecurity. The purpose of this study was to evaluate processes of coping with food insecurity and determine their impact on emotional well-being for African Americans in Clark County, Nevada. A …

Investigating Attitudes And Beliefs Of University Students Aged 18 To 24 Years That Influence Their Decision To Take Pre-Exposure Prophylaxis Medication, Philip Danquah

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Contemporary research findings affirm that young adults aged 18 to 24 years have high prevalence of new HIV infections. Pre-Exposure Prophylaxis (PrEP) medication is the latest strategy in HIV prevention. Rates of PrEP uptake or use have been negligible among university students aged 18 to 24 years, especially among racial and ethnic minority students.

Objective: The objective of this study is to investigate the attitudes and beliefs that influence the uptake of PrEP medications and the HIV risk behaviors associated with the willingness to take PrEP medications among university students aged 18 to 24 years attending the University of …

Healthcare Access And Utilization By Transgender Populations: A United States Transgender Survey Study, Axenya Kachen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender communities in the United States are highly marginalized and have been systematically and infrastructurally ignored due to the widespread fundamental belief that gender exists as a binary classification. The dichotomous theoretical framework of sex and gender prevented public recognition of this community as a population of interest for public health research and targeted intervention. Sexual and gender minority (SGM) populations have fought for basic human rights, including access to affordable healthcare. The National Center for Transgender Equality (NCTE) was founded in 2003 to advocate for the advancement of equality for transgender people. In 2015, the NCTE conducted the United …

Factors Associated With Food Insecurity Among Individuals, Aged Sixty And Older, In Clark County, Nv, Lisa M. Segler

UNLV Theses, Dissertations, Professional Papers, and Capstones

Food insecurity is defined as a lack of consistent access to enough food for an active, healthy life. In Nevada, an estimated 80,000 individuals, aged 60 years or older, were food insecure in 2016. The primary aim of this study was to identify factors that are associated with food insecurity in older adults, aged sixty and older, in Clark County, NV. The secondary aim of this study was to identify which factors interact with each other to explain food insecurity among individuals aged sixty and older, in Clark County, NV. A secondary data analysis was conducted using data collected by …

Distracted Driving In Clark County, Nevada: Analysis Of An Intervention On College Students, Heidi Ann Manlove

UNLV Theses, Dissertations, Professional Papers, and Capstones

Distracted driving is a growing public health concern. Highlighted in the media, local and government agencies and in peer-review literature are increased associations of motor vehicle crash related injuries and fatalities with distracted driving, especially involving youth drivers. The goal of this thesis was to analyze the effects of a distracted driving intervention on college students at University of Nevada, Las Vegas. Quantitative statistical analysis was performed to compare self-reported pre and post-intervention questionnaire responses of the experimental and control groups. Between-group analysis was performed using independent t-tests and ANOVA. Within-group differences were analyzed with Repeated Measures ANOVA (RM-ANOVA) and …

A Comparison Of Beliefs And Attitudes About Body Image, Eating And Weight Between Incarcerated And Non-~Incarcerated Females, Anne R. Lindsay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Abstract

Incarceration and substance abuse are two of the largest public health issues in America. While the U.S. makes up only 5% of the world’s population, it accounts for 25% of its prisoners. Incarceration affects more than 2.2 million individuals who will eventually return to their families and communities with ongoing family, social and health issues. Women in prison are a particularly vulnerable and underserved population, generally of low education and socio-economic status and although they account for a small percent of the prison population, many are mothers of young children who are likely to become incarcerated themselves. Substance abuse …

Health Impact Assessment Of Proposed Rental Housing Policy Within Clark County, Nevada, Usa, Erika Raquel Marquez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Homes serve as a central function of our everyday lives, they are where most Americans spend a significant amount of time and money. The quality of our homes can impact our health. Poor housing can cause and contribute to preventable diseases and injuries, such as the development or exacerbation of asthma, neurological deficits, cardiovascular diseases, and cancer. According to the American Housing Survey (2013) approximately 5.8 million homes, of 132 million homes in the United States, are in moderate to severe physical disrepair, with rental housing being at a disproportionate burden. According to 2013 U.S. Census, Clark County, Nevada has …

Television Consumption And Child Obesity: Linking Children's Contemporary Television Use, Physical Activity, And Advertising To Putnam's Displacement Hypothesis, Brittany L. Altamirano

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study observed the relationship between television consumption and child obesity through the theoretical construct of Putnam’s displacement hypothesis. It did so by updating the previous research through the investigation of the displacement of both physical activity and advertisements on contemporary television platforms. The inclusion of Putnam’s displacement hypothesis was to provide a foundational framework, not found in previous literature, to study two important paradigms that were represented in previous research: 1) the displacement of physical activity; and 2) the displacement of traditional advertisement exposure.

Several trends became apparent within previous literature. Previous literature did not include an explicitly stated …

The Impacts Of A Smoking Ban On Gaming Volume And Customers' Satisfaction In The Casino Industry In South Korea, Sojeong Lee

UNLV Theses, Dissertations, Professional Papers, and Capstones

A growing number of countries have legislated smoke-free policies in enclosed public areas and have extended the policies to hospitality facilities. However, some states and countries exempt gaming areas from the smoking law fully or partially. Anti-smoking policy is controversial for a number of reasons, such as smokers’ strong opposition, government ordinance, public health, and economic anxiety. Casino management may worry that a smoking ban policy will result in a significant decline of casino revenue because the break for smoking may interfere with continuing play.

This thesis examined a smoking ban impacts on gaming volume and customers’ satisfaction in the …

Listening To The Ranks: Perceptions Of The U.S. Air Force Occupational Health And Safety Training, Melissa Jo Breunig

UNLV Theses, Dissertations, Professional Papers, and Capstones

Occupational health and safety hazards are abundant in military environments. Due to the hazardous occupational settings, injuries remain a public health concern in the United States military. Public health plays a critical role in injury reduction by addressing the need for comprehensive safety education training, and more specifically, exposure related injuries. A secondary data analysis was completed using Communication Theory as the overarching framework to analyze 13 qualitative interviews conducted with Airmen to gain their perceptions of the occupational health and safety training at Nellis and Creech Air Force Base (AFB). Pedagogy and training content were the two main themes …

A Qualitative Study Of The Perceived Health Care Needs Of Undocumented Latino Day Laborers Living In Las Vegas, Nevada, Siboney Zelaya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undocumented (unauthorized, illegal) immigrants seek employment on the street corners near home improvement stores offering their services and selling their labor to the employers who arrive in their cars or trucks to pick them up for a few hours of hard work. The number of undocumented immigrants in the United States continues to increase. By percentage of overall population, Nevada has one of the largest shares of undocumented immigrants in the United States, and the bulk of that percentage is Latino.

The purpose of this phenomenological qualitative research study is to gain knowledge about undocumented Latino day laborers' perceived health …

Sentiments Of Community Stakeholders Living In Southern Nevada Neighborhoods, Erin Sheehy

UNLV Theses, Dissertations, Professional Papers, and Capstones

Community stakeholders provided insight to their local neighborhoods and shared their thoughts about the potential redevelopment of their neighborhoods. This study utilized data from the Southern Nevada Strong ethnographic research project. Ethnographic research was conducted over ten weeks in Summer 2013. Neighborhood observations and interviews with community stakeholders were conducted to understand how neighborhoods are utilized, how residents feel about potential redevelopment, and what areas of the neighborhoods residents would like to see improved in the future. Photographs were also collected to further examine the characteristics, aesthetics, and spatial landscape of the neighborhoods. The purpose of this qualitative research project …

The Effect Of Marriage On Stage At Diagnosis And Survival In Women With Cervical Cancer, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Marriage is associated with improved health outcomes for many conditions. Married persons enjoy financial stability, social and emotional support, and tend to have better control of health risk behaviors compared to the unmarried. The marriage scene is changing continuously. Americans are marrying less or delaying the engagement to an older age. They are divorcing more, they choose cohabitation as an alternative to marriage, or engage in premarital relationships. As a consequence, barely half of Americans were married in 2011 compared to close to three quarters of Americans were married in the sixties. With the increase of the unmarried population - …

An Examination Of Walkability In The Las Vegas Metropolitan Area, Courtney Coughenour

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: The benefits to regular physical activity are well established. Walkability is one element of the built environment that has been correlated with increased levels of physical activity. The auto-centric design of Las Vegas Metropolitan area (LVMA) is unique in ways that may influence walkability. The purpose of this study was to determine which urban design characteristics are associated with walking and physical activity in moderate income neighborhoods in LVMA. Methods: The standard walkability measure developed by Frank et al. (2010) was used to calculate the walkability index of seven neighborhoods. Residents of the two most walkable and two least …

Perceptions Of Police Responses To Domestic Violence, Kelly Rae Stout

UNLV Theses, Dissertations, Professional Papers, and Capstones

Domestic violence, also known as, intimate partner violence (IPV), has become an epidemic in the United States. According to the Center for Disease Control and prevention (CDC), about 24 women and men are victimized by an intimate partner each minute, equaling about 12 million victims every year (2012b). In recent years, the public has become more aware of IPV situations. An increase in public service announcements has helped to inform the public and has brought these dangerous situations out from behind closed doors. In the age of technology, information is more easily distributed and exchanged which has also increased public …

Implementing A Bystander Awareness Program On A University Campus, Robert Joseph Vadovic

UNLV Theses, Dissertations, Professional Papers, and Capstones

Between 17% and 62% of college students experience some form of violence during their time at school. About 25% of female college students experience a sexual assault before graduating. One university had seen an increase in violence, including assaults and bias events. Administrators and nurses implemented a bystander awareness program to help alleviate this growing problem. Members of the college's residence life staff and its Greek organizations (fraternities and sororities) participated in the Step Up program, a prosocial training program to get people to intervene safely when witnessing acts of violence. Participants (N=236) completed surveys prior to the program, immediately …

"Choices" Florida's Version Of Obamacare, Jason Lamarr Wasden

UNLV Theses, Dissertations, Professional Papers, and Capstones

"CHOICES" Florida's version of ObamaCare was a unique case voted in by the public in Alachua County Florida. A mixed methods research design was utilized and provided context in which policy entrepreneurs operated, as well as an explanatory model of internal determinants. Social, economic and political factors were examined to determine the predictor variable in the adoption of the "CHOICES" health services program. The results revealed that voters 51 years of age and older had a greater probability of voting for the Alachua Referendum. "CHOICES" legality has not been under contention but its effectiveness has. This study found that "CHOICES" …

Retrospective Evaluation Of Oral Health Services For Underserved Children In Clark County, Nevada, Earl Taylor Spader

UNLV Theses, Dissertations, Professional Papers, and Capstones

Disparities in utilization of oral health services have been shown to exist through epidemiological investigations and data analysis. Specifically, disparities exist for utilization of preventative dental care (PDC) and unmet dental need (UDN). The disparities in utilization of PDC and UDN are associated with demographic and insurance variables.

To address the oral health disparities, the University of Nevada, Las Vegas-School of Dental Medicine (UNLV-SDM) was created to improve the health of the citizens of Nevada through innovative programs of oral healthcare services to the community. More recently, UNLV-SDM opened a pediatric dental residency training program to provide care directly to …

Perceptions Of Barriers That Inhibit African American Women And Adolescent Girls From Participation In Physical Activity, Sonya Daniels Walker

UNLV Theses, Dissertations, Professional Papers, and Capstones

This study examined the barriers to leisure time physical activity for African American women and their adolescent daughters. Six mother-daughter dyads were interviewed who have access to physical activity opportunity. Three of the dyads participated in a follow-up focus group. A qualitative research design that utilized a grounded theory approach identified two themes for the women and two themes for the girls. Themes for the women include influence of culture and low physical activity IQ. Sub-themes of influence of culture are (a) hair and (b) body image. Sub-themes of low physical activity IQ are (a) mommy guilt, (b) perception of …