Public Health Commons^™

A Cross-Sectional Analysis Of Adverse Childhood Experience Exposure On Cancer Diagnosis Utilizing The 2022 Behavioral Risk Factor Surveillance Survey Data, Emma Zipperer

Capstone Experience

Objective: To determine the association between Adverse Childhood Experiences (ACEs) and cancer diagnosis based on ACE exposure levels.

Methods: We utilized data collected in the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey. The study population (n=54,148) was restricted to states that reported on the optional model of experiencing ACEs and those who responded about cancer diagnosis. A univariate analysis, bivariate analysis and a multivariate logistic regression were performed. Odds of cancer diagnosis among those with differing ACE exposure levels were calculated.

Results: High ACE exposure had 20% higher odds of cancer diagnosis when compared to low ACE exposure. White, …

Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu

Walden Dissertations and Doctoral Studies

An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …

Adverse Childhood Experiences (Aces): Assessing Their Impact On Mental Health Outcomes Among Us Children And The Mitigating Role Of Resilience, Glory Okwori

Electronic Theses and Dissertations

ACEs are traumatic life events occurring during childhood that can have negative effects. Common mental disorders that are diagnosed in childhood are attention-deficit/hyperactivity disorder (ADHD), behavior disorders, anxiety and depression. The associations between ACEs and such problems in children have not been significantly examined. There are protective factors that can help reduce the effects of exposure to ACEs that have not been fully explored.

The purpose of this research study was to examine: 1) the prevalence of mental health outcomes in children; 2) the associations between ACEs, resilience and mental health outcomes; and 3) the role of resiliency as a …

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson

Evidence-Based Practice Project Reports

Adverse childhood experiences (ACEs) include 10 traumatic events of abuse, neglect, and household dysfunction that occur before 18 years of age. Adverse childhood experiences affect greater than 60% of the population, and approximately one in six individuals affirm that they have experienced four or more types of ACEs. They are associated with negative, long-term health outcomes in adults, including 9 out of the 10 leading causes of death in the United States (Centers for Disease Control and Prevention, n.d.; Felitti et al., 1998). The purpose of this evidence-based practice project was to implement a tailored, multicomponent intervention to mitigate the …

Adverse Childhood Experiences And Health Related Quality Of Life As Well As Cognitive Decline In Adult Population In Tennessee, Pragya Poudel

Doctoral Dissertations

Adverse childhood experiences (ACEs) have been linked to increased risk of negative health outcomes in later life. At least half of the population in Tennessee experience one ACE. Further, Tennessee ranks amongst the top five states in terms of cognitive decline in adult populations age 45 and above. To our knowledge, there is yet no study that has explored ACEs and adult health outcomes (health-related quality of life (HRQOL) and cognitive decline) in Tennessee.

The goal of this study was to examine the relationship between ACEs [by overall, individual, type/domain, and dose-response effect of ACE] and HRQOL as well as …

Investigation Of Factors Affecting The Hiv Continuum Of Care In Tennessee, Elaine Loudermilk

Electronic Theses and Dissertations

Introduction: Factors contributing to the HIV continuum of care (HCC) for adults in Tennessee (TN) have not been studied in depth with known predictors for HIV risk, specifically adverse childhood experiences (ACEs), among low annual income or sexual minority groups [lesbian, gay, bisexual, or transgender (LGBT)].

Methods: A mixed methods study design was used to assess factors related to the HCC. Quantitative analysis used the TN Behavioral Risk Factor Surveillance System data to examine at risk and ever tested for HIV, to (1) investigate ACEs among adults with low-income (<$25,000 annually) in 2016-2017 and (2) among LGBT in 2018. Descriptive statistics and multiple logistic regression (MLR) analysis stratified by TN grand division were performed. Qualitative analysis included 11 interviews with persons living with HIV (PLWH) receiving care at a local clinic to evaluate surveillance questions related to ACEs and the HCC to develop a culturally appropriate survey.

Results: Quantitative results found that among LGBT (N=262) and low-income …

Improving Internal Reliability Of A Trauma-Informed Care Program Evaluation Instrument, Ashley A. Raposo-Hadley

Capstone Experience

The project has analyzed the recent changes to the trauma-informed care (TIC) curriculum evaluation instrument by assessing the changes in Cronbach’s Alpha scores and effect significance. Data was collected from pre-training and post-training surveys completed at the time of delivery of the TIC curriculum training. Participants included hospital staff and medical or nursing students at Nebraska Medicine, University of Nebraska Medicine Center, and Health Creighton University Medical Center. The three research questions are (1) Did the item edits change item subgroupings? (2) Did the item edits increase instrument reliability? (3) Did the item edits impact statistical significance? 3 subscales, working …

Adverse Childhood Experiences, Homeless Chronicity, And Age At Onset Of Homelessness, Joseph T. Tucciarone Jr.

Electronic Theses and Dissertations

Childhood adversity is associated with numerous negative outcomes across multiple domains, including mental and physical health, interrelationships, and social functioning. Notably, research suggests that childhood adversity has a dose-response relationship with these outcomes; that is, greater numbers of adverse experiences in childhood are associated with worse outcomes. These outcomes overlap with many risk factors of homelessness. This study sought to address two questions: 1) Does a dose-response relationship exist between childhood adversity and chronic homelessness? 2) Does childhood adversity negatively predict the age at which homelessness first occurs? Adults experiencing homeless who are accessing homeless services in the Tri-Cities area …

Risk Factors For Gestational Diabetes In Upstate New York Women & Implications For Practice, Margaret Versteegen

Legacy Theses & Dissertations (2009 - 2024)

Gestational diabetes mellitus (GDM) is a form of diabetes, or abnormal blood glucose (sugar) metabolism, diagnosed during pregnancy. Pregnant, non-diabetic women who are initially noted to experience high blood glucose levels during their pregnancy are considered to have GDM (ADA, 2016b). GDM has significant implications for infant and maternal morbidity and mortality, with adverse pregnancy outcomes such as infant macrosomia, difficult birth requiring cesarean section, and postpartum hemorrhage (Kamana, Shakya, & Zhang, 2015). In the majority of cases, GDM goes away once the baby is born, but around 5-10% of women with GDM go on to have type 2 diabetes …

Impact Of Adverse Childhood Experiences On Maternal Health And Birth Weight In Appalachia, Kristen Baker Dickerson

Walden Dissertations and Doctoral Studies

Adverse birth outcomes and adverse childhood experiences (ACE) are concerns in the United States, with potential to impact health indices now and in the future. The purpose of this study was to quantitatively examine the association between maternal exposure to ACE, low birth weight, and county of residence in the Appalachian population using the Life Course Approach as the theoretical framework. A cross-sectional study design and clustering strategy was used to randomly select potential respondents from a data set that was provided by Ohio Department of Health. Self-administered questionnaires were sent to potential respondents to collect information about ACE in …

Envisioning A Trauma-Sensitive Public Health Department: Implications For Practice, Policy, And Research, Victoria Lopez

Master's Projects and Capstones

Historically, the concept of trauma and long-term sequelae has rested primarily in the fields of psychology and psychiatry. However, recent attention and research around the health implications of trauma have unmasked this concept as a pervasive public health issue. This has catalyzed a movement to create a paradigm shift that transforms a formerly myopic understanding of trauma towards one that acknowledges the complexity and wide reaching impact trauma. At the core of this paradigm shift is an understanding of the interconnectedness between trauma and socio-ecological constructs at the individual, family, community, and organizational level. Public health departments are well positioned …

Social Determinants Of Racial And Ethnic Disparities In Perinatal Morbidity: Social Origins Of Perinatal Health Study, Abraham A. Salinas-Miranda

USF Tampa Graduate Theses and Dissertations

BACKGROUND: The social causation of preterm birth remains elusive, without an adequate explanatory framework. Thus, this study proposed and evaluated a conceptual model of the social determinants of perinatal health for the understanding of perinatal health disparities.

METHODS: A prospective cohort study was conducted with pregnant women between 20 and 35 weeks gestation who were participating in two Healthy Start programs in Central Florida, from July 2011-August 2013. Perinatal health was operationalized based on gestational age, birth weight, and healthy start infant risk screen score. The predictors were: early life adversity, social position, maternal health-related quality of life, maternal stress, …