Community Health and Preventive Medicine Commons^™

Pharmacists Provision Of Non-Dispensing Services In Health Professional Shortage Areas, Haley L. Kessinger, Emily R. Landis

ONU Student Research Colloquium

Background: Individuals living in primary care health professional shortage areas (PCHPSAs) experience health inequities. Community pharmacists are healthcare professionals with an opportunity to provide care to underserved populations. The objective of this study was to compare non-dispensing services provided by Ohio community pharmacists in PCHPSAs and non-PCHSPAs.

Methods: An electronic, IRB-approved 19-item survey was sent to all community pharmacists practicing in full PCHPSA counties and a random sample practicing in non-PCHPSA counties in Ohio (n=324). Questions assessed current provision of non-dispensing services as well as interest and barriers regarding such services.

Results: Seventy-three usable responses were received (23% response rate). …

Public Health Interventions For Children Of Incarcerated Parents, Daniel Bullman

GS4 Georgia Southern Student Scholars Symposium

The impact of social and structural determinants of health have lifelong consequences on an individual’s quality of life. Literature focusing on child health and wellbeing of incarcerated parents indicate significant negative health outcomes and adopted detrimental health behaviors. Using a systematic realist review, recent publications were reviewed for their potential discussion or recommendation for interventions in changing health outcomes. This review found that additional research is needed in identifying and testing potential interventions or determining if parallel public health initiatives have had positive impacts in promoting the health behavior change process for children and adolescents of incarcerated parents.

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Scholarly Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

Children Receiving A Nutrition And High-Quality Early Childhood Education Intervention Are Associated With Greater Math And Fluid Intelligence Scores: The Guatemala City Municipal Nurseries, Ana M. Palacios, Lisa A. Villanueva, Matthew B. Flynn, Erik Parker, Stephanie Dickinson, Helen W. Bland, Greg A. Reinhart

Department of Health Policy and Community Health Faculty Publications

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35–10.61)) and (ß = 1.20; 95% CI (0.12–2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09–0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Association Between Serum Lycopene And Lung Cancer Mortality: An 18-Year Follow-Up Study Of A National Cohort, Evans Afriyie-Gyawu, Padmini Shankar, Gulzar H. Shah, Alicia A. Brown, Shannon Cearley, Akwasi Ampofo-Yeboah, Nathaniel Abrams, Jian Zhang

Department of Health Policy and Community Health Faculty Publications

Background: Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited.

Objective: The primary objective of this study was to see if there was a link between lycopene levels in the blood and lung cancer mortality. A secondary goal was to see if dietary factors influence lycopene levels in the blood.

Materials and Methods: A retrospective …

Covid-19 And Social Determinants Of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs, Samuel T. Opoku, Bettye Apenteng, Linda Kimsey, Angela H. Peden, Charles F. Owens

Department of Health Policy and Community Health Faculty Publications

Background

The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined.

Aim

The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic.

Methods

The study was a qualitative study using data from 28 semi-structured …

Examining The Impact Of Financial Incentive Removal On Physical Activity: A Quasi-Experimental Study Of 584,760 Mobile Health Application Users, Sean Kevin Spilsbury

Electronic Thesis and Dissertation Repository

BACKGROUND: Government interest in using financial incentives (FIs) to stimulate physical activity (PA) is increasing. The cost of longer-term incentive interventions may be prohibitive, however. PURPOSE: To examine the impact of FI withdrawal on PA. METHODS: A 25-week retrospective pre-post quasi-experimental study was conducted with users of a FI-based mHealth app. Users from three Canadian provinces were included. Daily FI were removed in Ontario (ON; intervention) but not British Columbia (BC) and Newfoundland and Labrador (NL; control). Simple linear regression models were used to examine weekly mean daily step count after FI withdrawal. RESULTS: The total sample included 584,760 users …

The Governor’S Budget Awareness For Dentistry, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

This editorial highlights the significance of the Governor's proposed budget in February, marking a substantial step forward for oral health awareness in Michigan. The budget allocates funds for long-sought oral health initiatives, including addressing barriers to hospital-based dental care, enhancing Medicaid coverage for adults, and streamlining dental plans. With a focus on workforce availability, the editorial emphasizes the critical role of oral health in employability. The proposed budget, influenced by effective MDA advocacy, reflects a notable achievement in prioritizing dentistry, underscoring the potential for future opportunities.

The 2025 Michigan State Oral Health Plan, Ellen Sugrue Hyman Jd

The Journal of the Michigan Dental Association

This feature article explores the 2025 Michigan State Oral Health Plan (SOHP), a comprehensive initiative developed by the Michigan Oral Health Coalition (MOHC) and a statewide coalition, including the Michigan Dental Association (MDA). With a focus on enhancing oral health for all Michigan residents, the SOHP prioritizes addressing economic and racial disparities. The plan, guided by three key goals—Increasing Awareness and Education, Dental-Health Integration, and Access and Infrastructure—aims to improve oral health outcomes. The article discusses the plan's development process, key findings highlighting existing disparities, workforce challenges, and the strategic implementation of the SOHP through collaborative efforts and workgroups.

Improving Egypt’S Access To Vaccines And Medicines: Communication During Covid-19 / تحسين إتاحة الوصول إلى اللقاحات والأدوية في مصر: سياسة توعية الجمهور خلال أزمة فيروس كورونا, Alaa Abdel-Rahman, Sarah Attef, Helen Gabrah, Reem El-Sayed, Sarah El-Lithy

Papers, Posters, and Presentations

Since the start of the COVID-19 pandemic, the Egyptian government has been following protocol as best as possible when it comes to responding to the needs of the health and economic sectors amid difficult times. From lockdown measures to the WHO’s recommended practices in terms of isolation of cases and treatments, Egypt has been lauded as one of the fastest and most effective countries in terms of COVID-19 emergency response. Authorities have implemented several awareness campaigns directed at citizens to inform them about the pandemic, how to prevent infection, what to do if infected and how to act accordingly. Authorities …

Time For Tobacco-Free Generations In The Western Pacific?, Gianna Gayle H. Amul, Suan Ee Ong, Azrul Mohd Khalib, Joanne Su-Yin Yoong

Ateneo School of Government Publications

No abstract provided.

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

The Program To Reduce Implicit Bias In Carroll Hospital Center Using The Implicit Association Test, Katherine E. Traynor

Capstone Showcase

Natural brain processes make all individuals susceptible to unconscious bias; however, stressful, fearful, or anger-evoking situations as well as the negative influence of media and social surroundings increase the risk of holding obstructive bias, and there is a greater risk of being negatively impacted by this phenomenon when belonging to a minority population (Rose & Flores, 2020). As a result, high rates of infant mortality (10.2 deaths per 1,000 live births for the Non-Hispanic Black population compared to 4.1 in the White population) and cardiovascular related diseases (190.0 cases per 1,000 in the Non-Hispanic Black population compared to 161.3 in …

An Analysis Of Kindergarten Childhood Disease Vaccination Rates And Practices In Bay Area Counties, Janice Zelaya

Master's Projects

Immunizations are the most effective method for preventing communicable diseases, especially among children. Ensuring that children are vaccinated is of the utmost importance but remains a challenge due to misinformation and the growing anti-vaccination movement. With a population of 39.5 million people as of 2020 (Census Bureau, n.d.), California is the most populous state in the United States. In 2020, the San Francisco Bay Area, which includes the counties of Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, and Sonoma, is home to 7.7 million of those people (Census Bureau, 2021). This research will explore how …

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Department of Health Policy and Community Health Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Department of Health Policy and Community Health Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for <2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Low Acceptance Of Helmet-Use And Injuries From Motorcycle Accidents In Rawalpindi And Abbottabad, Pakistan, Maryam Siddiqa, Gulzar H. Shah, A. Munam

Department of Health Policy and Community Health Faculty Publications

Background: Motorcycle accidents are a major cause of head injuries and the current study evaluated the beneficial impact and effectiveness of helmet usage among injured Motorcycle users. This study has been performed to observe the Motorcycle collisions within 6 months in Rawalpindi and Abbottabad cities of Pakistan

Objectives: Implications of helmet usage were assessed and the risk factors for severe injury during motorcycle accidents were identified.

Results: The multivariate analysis indicated that riders without a helmet were more likely to experience severe (AOR, 2.216; 95% CI, 2.02 to 10.5) or moderate injury (AOR, 1.215; 95% CI, 0.84 …

From Pandemic Response To Portable Population Health: A Formative Evaluation Of The Detroit Mobile Health Unit Program, Phillip Levy, Erin Mcglynn, Alex B. Hill, Liying Zhang, Steven J. Korzeniewski, Bethany Foster, Jasmine Criswell, Caitlin O'Brien, Katee Dawood, Lauren Baird, Charles J. Shanley

Urban Studies and Planning Faculty Research Publications

This article describes our experience developing a novel mobile health unit (MHU) program in the Detroit, Michigan, metropolitan area. Our main objectives were to improve healthcare accessibility, quality and equity in our community during the novel coronavirus pandemic. While initially focused on SARS-CoV-2 testing, our program quickly evolved to include preventive health services. The MHU program began as a location-based SARS-CoV-2 testing strategy coordinated with local and state public health agencies. Community needs motivated further program expansion to include additional preventive healthcare and social services. MHU deployment was targeted to disease “hotspots” based on publicly available SARS-CoV-2 testing data and …

Oral Health For Older Adults: Policy Barriers And Opportunities, Stephanie De Sam Lazaro, Juliette Kline

Occupational Therapy Faculty Scholarship

Tooth decay and gum disease are two of the most common chronic health conditions in the United States, are reversible and preventable, and impact approximately 68% of older adults nationwide (CDC, 2021; World Health Organization, 2020). While the Affordable Care Act added provisions to health prevention services, oral health prevention coverage was only included for children, leaving many adults and older adults without coverage (Nasseh & Vujicic, 2017). The research team used a rapid review process using 17 key search term combinations to identify literature in three medical databases (PubMed, CINAHL, and Consumer Health Complete) to identify system and policy …

J Mich Dent Assoc November 2021

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• Cover stories with a “Focus on Advocacy: Helping Dentistry Succeed”, including “MDA Dental PAC: What It Is and Why It Matters “, “2021 Advocacy Success — and More to Come “, and “Dental Programs Maintained in 2021-22 State Budget”.
• A feature article on “The Anishinaabe Dental Outreach Program”.
• A feature article, “How Your Website and …

Frontline Health Achievements In Harmonizing Measurement And Generating Evidence On Community Health System Performance, Frontline Health Project

Reproductive Health

As the global health community demonstrates an increasing commitment to investing in community health workers (CHWs) to achieve universal health coverage in lower- and middle-income countries, the need to effectively measure community health system performance is paramount. Embedded in the Integrating Community Health partnership (2017–2021), with support from the Bill & Melinda Gates Foundation, the Population Council and Last Mile Health co-led the Frontline Health (FLH) project, a four-year research, policy, and advocacy initiative aimed at developing core metrics and CHW reform processes, advancing their adoption, and promoting institutionalization of robust community health policies. This brief describes the Population Council’s …

The Multi-Step Approach To Covid Prevention In The Casamance Region, Saraí Hernandez Salguero

Independent Study Project (ISP) Collection

Located in the Oussouye Department approximately 43 kilometers away from the city of Ziguinchor in the Basse Casamance region of southern Senegal is the Oussouye commune where I had the pleasure of staying for three weeks. I had learned that the inhabitants of this village were not significantly impacted by the Covid-19 virus since it became global knowledge at the start of 2020. As of March 2020, the village had only reported 69 active cases and the department saw only 8 deaths in total. I sought to figure out what could be the cause of this and through a series …

Helmintos Transmitidos Por El Suelo En Ecuador; La Respuesta Comunitaria Y Las Percepciones A Ellos En Baños Y Puyo, Audrey Chesney

Independent Study Project (ISP) Collection

This investigation was a qualitative study focused on soil-transmitted helminths (STHs) in Baños and Puyo, Ecuador. The perceptions of the communities regarding STHs and the community response to STH and STH infections was studied. The objectives of this study aimed to discover and learn about the perceptions of STHs from the affected communities, to comprehend the barriers that are present against better treatment for STH infections, and to learn about the community action taking place to improve the situation of soil-transmitted helminths (STHs) in the community. Soil transmitted helminths are intestinal worms that are transmitted through the contamination of the …

The Influence Of The Urban Food Environment On Diet, Nutrition And Health Outcomes In Low-Income And Middle-Income Countries: A Systematic Review, Susannah Westbury, Iman Ghosh, Helen Margaret Jones, Daniel Mensah, Folake Samuel, Ana Irache, Nida Azhar, Lena Al-Khudairy, Romaina Iqbal, Oyinlola Oyebode

Community Health Sciences

Introduction: Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.
Methods: We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Department of Health Policy and Community Health Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Department of Health Policy and Community Health Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

Assessment Of The Financial Health Of Rural Hospitals After Implementation Of The Georgia Rural Hospital Tax Credit Program, Bettye A. Apenteng, Samuel T. Opoku, Charles Owens, Emmanuel Akowuah, Linda Kimsey, Angela Peden

Department of Health Policy and Community Health Faculty Publications

Importance In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program’s association with the viability of the state’s rural hospitals is needed.

Objective To examine the association of the tax credit program with the financial health of participating rural hospitals.

Design, Setting, and Participants This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit …