Community Health and Preventive Medicine Commons^™

Gut Feelings: A Literature Review On The Gut-Brain Axis And Its Potential Influence On Mood, Grace Johnson

University Honors Theses

In recent decades, research on the gut-brain axis has evolved due to an increasing interest in the connection between gut health and mental health. The gut-brain axis presents a new frontier of health for both medical professionals and psychologists as there is expanding evidence illustrating the comorbidity of gut disorders and mood disorders. Due to the complex nature of studying the gut-brain axis and the myriad of influences on mood disorders such as depression, research has yet to find significant results definitively tying the two together. Nonetheless, the current body of literature on the topic provides a promising outlook on …

Final (Year 2) Report To Oha On Sogi Demographic Standards For Minors, Martin Arrigotti, Nell Carpenter, Kieran Chase, Alysia Cox, Itai Jeffries, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Executive Summary

The report synthesizes thoughtful recommendations of the authors to the Oregon Health Authority (OHA) about routine data collection of SOGI† (sex, sexual orientation, and gender) demographic data in minors for clinical and reporting purposes. We see five primary motivations to routinely collect SOGI data, including to:

1. create an inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations,
2. promote health equity between minority and majority SOGI identities,
3. direct group-specific services towards those who need them,
4. represent the actual diversity of Oregon, and its communities, and
5. shift normative expectations about …

Relationship Between Chinese Herbal Medicine Use And Risk Of Sjögren’S Syndrome In Patients With Rheumatoid Arthritis: A Retrospective, Population-Based, Nested Case-Control Study, Hou-Hsun Liao, Hanoch Livneh, Miao-Chiu Lin, Ming-Chi Lu, Ning-Sheng Lai, Hung-Rong Yen, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background and Objectives: Sjögren’s Syndrome (SS) is a common extra-articular feature among subjects with rheumatoid arthritis (RA). While Chinese herbal medicine (CHM) has been used to treat symptoms of RA for many years, few studies have examined its efficacy in guarding against the SS onset. This study aimed to compare risk of SS for RA patients with and without use of CHM. Materials and Methods: Data obtained for this nested case-control study were retrieved from Taiwanese nationwide insurance database from 2000–2013. Cases with SS claims were defined and matched to two randomly selected controls without SS from the recruited RA …

Paid Sick Leave, Chronic Disease, And Systemic Racism: A Systematic Review, Lauren Yee

University Honors Theses

The purpose of this systematic review is to assess the impact of paid sick leave (PSL) availability on chronic disease prevention, treatment, and recovery. Furthermore, this study aims to investigate the role of race on this relationship as a possible source of systemic racism. The findings of this review show a growing body of evidence that affirms the statistically significant association between PSL and chronic disease-related outcomes. The availability of PSL has the potential to remove financial barriers allowing employees to access preventative services for chronic diseases. Access to PSL also increases work resumption by improving financial stability after being …

Building The Foundation For A Community Generated National Research Blueprint For Inherited Bleeding Disorders: Research Priorities In Health Services; Diversity, Equity, And Inclusion; And Implementation Science, Vanessa R. Byams, Judith Baker, Cindy Bailey, Alexis Dinno, Multiple Additonal Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: The National Hemophilia Foundation (NHF) conducted extensive all-stakeholder inherited bleeding disorder (BD) community consultations to inform a blueprint for future research. Sustaining and expanding the specialized and comprehensive Hemophilia Treatment Center care model, to better serve all people with inherited BDs (PWIBD), and increasing equitable access to optimal health emerged as top priorities. Research Design and Methods: NHF, with the American Thrombosis and Hemostasis Network (ATHN), convened multidisciplinary expert working groups (WG) to distill priority research initiatives from consultation findings. WG5 was charged with prioritizing health services research (HSR); diversity, equity, and inclusion (DEI); and implementation science (IS) research …

“I Don’T Have A Pile Of Money To Take Care Of Things”: Financial Stress And Housing Insecurity Among Low-Income Hispanic/Latinx Immigrant Families During Covid-19, Marisa Westbrook

OHSU-PSU School of Public Health Faculty Publications and Presentations

Housing, the single largest expense for low-income individuals, is inherently tied to economic security. During the COVID-19 pandemic, Hispanic/Latinx and Black communities experienced the highest rates of income loss, basic needs insecurity, and COVID-19 hospitalization and mortality. As part of an ethnographic case study, I conducted serial interviews over two years with 35 predominantly low-income Hispanic/Latinx immigrant families in one Denver, Colorado neighborhood during the COVID-19 pandemic. These interviews revealed that very few of these individuals were able to access governmental financial support as a result of limited dissemination despite facing unemployment, underemployment and rising rents. Although governmental financial support …

Association Of Maternal Age 35 Years And Over And Prenatal Care Utilization, Preterm Birth, And Low Birth Weight, Mexico 2008–2019, Laura Jacobson, Evelyn Fuentes-Rivera, Raffaela Schiavon, Blair Darney

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective:

We compared prenatal care utilization, preterm birth, and low birth weight neonates among women 35 years and older compared to women 20-34 years old in Mexico, 2008-2019.

Methods:

We used birth certificate data and conducted a historical cohort study of all singleton live births in Mexico from 2008-2019. Study outcomes were inadequate prenatal care (timing of initiation of care and number of visits), preterm birth, and low birth weight. We compared outcomes among women 35-39, 40-44, and 45-49 with births to women 20-34. We used logistic regression to account for individual and contextual confounders.

Results:

We included a total …

On Epidemiology As Racial-Capitalist (Re)Colonization And Epistemic Violence, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

This commentary reflects upon power-knowledge dynamics and matters of epistemic, procedural, and distributive justice that undergird epidemiological knowledge production related to racial health inequities in the U.S. Grounded in Foucault’s power-knowledge concepts—“objects”, “ritual”, and “the privileged”—and guided by Black feminist philosopher Kristie Dotson’s conceptualization of epistemic violence, it critiques the dominant positivist, reductionist, and extractivist paradigm of epidemiology, interrogating the settler-colonial and racial-capitalist nature of the knowledge production/curation enterprise. The commentary challenges epidemiology’s affinity for epistemological, procedural, and methodological norms that effectively silence/erase community knowledge(s) and nuance in favor of reductionist empirical representations/re-presentations produced by researchers who, often, have never …

Preliminary (Year 1) Report To Oha On Pediatric Sogi: Executive Summary. Report To The Oregon Health Authority, Office Of Equity And Inclusion, Martin Arrigotti, Kieran Chase, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Overview: The enclosed report is the result of collaboration between the authors and the Oregon Health Authority. The report synthesizes the thinking and recommendations of the authors about routine data collection of SOGI data in minors for clinical and demographic purposes. Primary motivations to routinely collect SOGI data include: (1) inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations, (2) to promote health equity between minority and majority SOGI identities, and (3) to direct group-specific services towards those who need them.

Investigation and Findings: These recommendations are informed …

The Impact Of Maternal Nutrition On The Development And Severity Of Generalized Anxiety Disorders In Rodent And Non-Human Primate Studies, Esmeralda H. Cardoso

University Honors Theses

Generalized anxiety has become more prevalent among children and adolescents in the United States which impacts their health and livelihood. Maternal nutrition during pregnancy is purported to play a role in cognitive development and mental health during childhood, adolescence, and into adulthood. The Developmental Origins of Health and Disease theory suggests maternal nutrition before and during pregnancy influences transgenerational susceptibility, onset, and severity of disease through epigenetic mechanisms that then impact the child’s overall health, including cognitive development and mental health later in life. A literature review of rodents and non-human primate studies was conducted to explore the association between …

Investigating The Efficacy & Implications Of Abstinence-Based Drug Education, Sophia Hanken

University Honors Theses

The United States has a long and complex history surrounding substance use. Drug education programs have become widely implemented in American schools and the media. Policy, rhetoric, and ideology have directly affected the curriculum of drug education programs. Drug education in the United States centers around substance abstinence. While well-intended, abstinence-based drug education is not a pragmatic solution for reducing substance-related harm or promoting health. The purpose of this thesis is to critique two of the most widely used abstinence-based drug education programs; Drug Abuse Resistance Education (D.A.R.E) and Project ALERT. These programs often emphasize the dangers of substance use …

Association Of Patient- Provider Language Concordance With Health Care Comprehension Among Latino/As In Oregon: Work In Progress, Grace Parra

OHSU-PSU School of Public Health Annual Conference

Authors: Grace Parra, Sara Diaz-Anaya, & Blair G. Darney PhD, MPH.

Title

Association of patient- provider language concordance with health care comprehension among Latino/as in Oregon: Work in progress

Background

Language concordance in a healthcare setting is a clinical encounter where the patient and provider speak the same language. Health care comprehension is the degree to which individuals understand health-related information given by the provider. Research to date suggests that language barriers in health care negatively impact quality of care .The purpose of this study is to describe need and preferences for language concordant care and test the association …

Prevalence Of Perceived Weight Stigma And Its Psychological Impact On Obese People In Saudi Arabia, Wafi Albalawi

OHSU-PSU School of Public Health Annual Conference

No abstract provided.

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

The Digital Divide And Health: Examining Digital Access As A Social Determinant Of Health, Elizabeth Melissa Withers

Dissertations and Theses

This dissertation is comprised of three papers that consider ways in which one's level of digital access may impact self-rated health. Data are from multiple years of three separate nationally representative cross-sectional surveys: National Health Interview Survey, General Social Survey, and Health Information National Trends Survey to address the primary overarching research question: Is there an association between digital access and health? The examination of the relationship between digital access and health is situated within a social determinants of health perspective and draws on van Dijk's (2005) causal and sequential model of digital access. Education, income, race and ethnicity, work …

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …

Nhanes Iii Mortality Follow Up: Social Determinants Creating Disparity Within The Health Outcomes Of Persons With Diabetes, Claire B. Adams

University Honors Theses

Given the recent research into the social determinants affecting health outcomes, the goal of this thesis is to examine whether a non-urban setting, among other social determinants of health, increases the risk of mortality among the United States diabetic population. We examined the relationship of urban and non-urban diabetes rates among those aged 40-74 years using a national sample of diabetic and nondiabetic Americans. The data was pulled from the Third National Health and Nutrition Examination Survey (NHANES III) which was conducted from 1988 to 1994. After excluding pregnant women, those who did not complete a fasting AM glucose, and …

Understanding The Impact Of The Sars-Cov-2 Pandemic On Hospitalized Patients With Substance Use Disorder, Caroline King, Taylor Vega, Dana Button, Christina Nicolaidis, Jessica Gregg, Honora Englander

School of Social Work Faculty Publications and Presentations

Background: The SARS-COV-2 pandemic rapidly shifted dynamics around hospitalization for many communities. This study aimed to evaluate how the pandemic altered the experience of healthcare, acute illness, and care transitions among hospitalized patients with substance use disorder (SUD).

Methods: We performed a qualitative study at an academic medical center in Portland, Oregon, in Spring 2020. We conducted semi-structured interviews, and conducted a thematic analysis, using an inductive approach, at a semantic level.

Results: We enrolled 27 participants, and identified four main themes: 1) shuttered community resources threatened patients' basic survival adaptations; 2) changes in outpatient care increased reliance on hospitals …

A Comparison Of Safety, Health, And Well-Being Risk Factors Across Five Occupational Samples, Ginger C. Hanson, Anjali Rameshbabu, Todd Bodner, Leslie Hammer, Diane S. Rohlman, Ryan Olson, Nancy Perrin, Bradley Wipfli, Kuehl S. Kerry, Lindsey Alley, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objective: The aim of this study was to present safety, health and well-being profiles of workers within five occupations: call center work (N = 139), corrections (N = 85), construction (N = 348), homecare (N = 149), and parks and recreation (N = 178).

Methods: Baseline data from the Data Repository of Oregon’s Healthy Workforce Center were used. Measures were compared with clinical healthcare guidelines and national norms.

Results: The prevalence of health and safety risks for adults was as follows: overweight (83.2%), high blood pressure (16.4%), injury causing lost work (9.9%), and reported pain (47.0%). Young workers were least …

Shifting Coronavirus Disease 2019 Testing Policy And Research To Include The Full Translation Pipeline, Joseph Catania, Jeffrey Martin, M. Margaret Dolcini, E. Roberto Orellana, Jeffrey Henne

School of Social Work Faculty Publications and Presentations

The current severe acute respiratory syndrome coronavirus 2 testing policy and practice limits testing as a prevention tool. Radical shifts are required to increase the scale of rapid testing strategies and improve dissemination and implementation of venue-based and self-testing approaches. Attention to the full translation pipeline is required to reach high-risk segments of the population.

Provider Perspectives On Persistent Urinary Incontinence Following Obstetric Fistula Repair In Ethiopia, Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

OHSU-PSU School of Public Health Faculty Publications and Presentations

Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, …

Assisting Students And Families During The Covid-19 Crisis: Diversity & Equity In Action Through A Educator-Family-Community Health Worker Intersection, Eric J. López, Oscar J. Muñoz, Eva Menchaca-López

Northwest Journal of Teacher Education

The current COVID-19 crisis has exposed new and existing issues related to access and equity for our students and families. The following article discusses a model for interconnecting educators, families, and community health workers (CHW) that can integrate diversity and equity for practitioners and educator preparation programs. Integrating CHWs provides a unique opportunity to utilize their cultural responsive skills and knowledge. Implications for practitioners and educator preparation programs are discussed.

What You Should Know About Racism-20: A Fact Sheet In The Time Of Covid-19, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

Satire has a history within public health and medical scholarship. However, research and academic works related to COVID-19, health inequities, and structural racism to date have not engaged/explored satire as a critical mode of reflection, analysis, and commentary. Drawing from social epidemiology literature related to structural racism, and rooted in critical race theory and critical theory related to narrative power, this paper—in the form of a "RACISM-20" fact sheet/health promotion flyer—uses satire and humor as critical commentary on mainstream public health discourse of/responses to COVID-19, transposing structural racism and COVID-19 to accentuate how individualist, apolitical, and “colorblind” downstream frames of …

Community-Derived Recommendations For Healthcare Systems And Medical Students To Support People Who Are Houseless In Portland, Oregon: A Mixed-Methods Study, Caroline King, Cameron Fisher, Jacob Johnson, Arum Chun, David Bangsberg, Paula C. Carder

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community.

Methods: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that …

Adherence To Hiv Antiretroviral Therapy Among Pregnant And Postpartum Women During The Option B+ Era: 12-Month Cohort Study In Urban South Africa And Rural Uganda, Lynn T. Matthews, Catherine Orrell, Mwebesa B. Bwana, Alexander C. Tsai, Christina A. Psaros, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Kathleen Bell, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods: We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression …

Differential Effects Of Buprenorphine/Naloxone Vs. Methadone On Quality Of Life Over Time: A Subset Of The Bravo Study (Buprenorphine To Improve Hiv Care Engagement And Outcomes: A Randomized Trial), Ali Mirzazadeh Javaheri

University Honors Theses

Health-related Quality of Life (QoL) is generally poorer in individuals with opioid use disorder (OUD) in comparison with those suffering from other chronic diseases. Little is known about the difference each buprenorphine/naloxone (BUP/NX) or methadone maintenance therapy (MMT) may make in the QoL for the HIV-infected people with OUD who are new to HIV care. The objective of this study is to evaluate the difference in the impact that BUP/NX and MMT treatment delivery models make on the QoL of the HIV-infected participants with OUD in Vietnam.

This study was a subset of the BRAVO study, buprenorphine to improve HIV …

Health And Dental Care Expenditures In The United States From 1996 To 2016, Man Hung, Martin S. Lipsky, Ryan Moffat, Evelyn Lauren, Eric S. Hon, Jungweon Park, Gagandeep Gill, Julie Xu, Lourdes Peralta, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups.

Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or …

Iron-Deficiency Anaemia (Ida): Socio-Cultural Misconceptions Intersect The Health Of Vulnerable Populations In Developing Countries, Samantha G. Alarcon Basurto

University Honors Theses

Iron is a mineral that the human body uses to make hemoglobin, a protein that red blood cells need to carry oxygen from the lungs to all parts of the body. The lack of adequate iron in the blood is known as iron deficiency, which if experienced in greater proportions, can lead to anaemia. Iron-deficiency anaemia is generally understood as a nutritional deficiency that can be treated by diets of food rich in iron content or the ingestion of iron supplements; yet lack of information, restricted access to bioavailable iron-rich foods, minimal awareness of anaemia’s detrimental effects on children’s cognitive …

Pregnancy Outcomes And Documentation Status Among Latina Women: A Systematic Review, Dawn M. Richardson, Sarah B. Andrea, Amber Ziring, Cassandra Robinson, Lynne Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas.

Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, …

A Sexual Health Promotion App For Transgender Women (Trans Women Connected): Development And Usability Study, Christina J. Sun, Kirsten M. Anderson, Tamara Kuhn, Liat Tzvia Mayer, Charles H. Klein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, we designed a prototype mobile app to promote HIV prevention among transgender women.

Objective: This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.

Methods: We engaged in a 3-phase prototype development process. After conducting formative research about the health needs of this population, we outlined a theory-based app framework …