Community Health and Preventive Medicine Commons^™

Disparities In Mortality Between Appalachian And Non-Appalachian Regions Of Kentucky, Sonali S. Salunkhe, Sahal Alzahrani, Beatrice Ugiliweneza

Journal of Appalachian Health

Introduction: In the opioid epidemic, the U.S. faces a significant public health crisis, with some areas of the country, such as rural and Appalachian regions, suffering more than others. The differential regional impact of the crisis in Kentucky—a state with both non-metropolitan/metropolitan and Appalachian/Non-Appalachian statuses—has not yet been documented despite such knowledge being essential to the success of overdose prevention efforts.

Purpose: This study compares all-cause, drug- and opioid-related mortality between counties in different regions of Kentucky: Appalachian non-metropolitan, Appalachian metropolitan, non-Appalachian non-metropolitan, and non-Appalachian metropolitan.

Methods: Age-adjusted mortality data from the Centers for Disease Control and Prevention’s Wide-ranging Online …

Factors Associated With Covid-19 Vaccine Hesitancy In South Central Appalachia, Florence M. Weierbach, Rebecca Adkins Fletcher, Ingrid E. Luffman, Cynthia Meyer, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

Journal of Appalachian Health

Introduction: The newly emergent COVID-19 virus reached pandemic levels in March 2020. By the middle of August 2020, there were over 1 million deaths attributed to COVID-19 in the U.S., with those in rural areas outpacing urban counterparts. Prior to emergency approval of the Pfizer, Moderna and Johnson & Johnson vaccine formulations, mitigation efforts addressing individual behavior were challenging. However, even with the entrance of these three new vaccines, herd immunity was not achieved in rural areas, as vaccine uptake remained low there. Although there has since been an abundance of COVID-19-related research addressing health literacy, vaccine hesitancy and overall …

Review Of: Coal, Cages, Crisis: The Rise Of The Prison Economy In Central Appalachia, Ted Olson Phd

Journal of Appalachian Health

Ted Olson, PhD, is a professor of both Appalachian Studies and Bluegrass, Old-Time and Roots Music Studies at East Tennessee State University. In this piece, he reviews Professor Judah Schept's Coal, Cages, Crisis: The Rise of the Prison Economy in Central Appalachia and discusses the impacts of incarceration on the health of Appalachia and on its residents more broadly.

Changes In Perceptions Of First Responders After Witnessing A Drug Overdose: Individual And Contextual Variations Among People Who Use Opioids In West Virginia, Kathleen L. Egan, Kelly Gurka, Alexandria Macmadu, Herb Linn

Journal of Appalachian Health

Introduction: Success of opioid overdose interventions involving first responders is dependent on the comfort level that bystanders have with first responders and their willingness to call for assistance. Positive or negative experiences with first responders following witnessing an overdose may influence a person’s willingness to call a first responder for assistance in the future.

Purpose: The objective of this study was to examine changes in bystanders’ perceptions of first responders following witnessing an overdose attended by emergency medical services or a law enforcement official. It specifically explored perception changes among a sample of individuals residing in Appalachia who use prescription …

Carbapenem-Resistant Enterobacterales—Kentucky, 2013–2020: Challenges And Successes, Mary Issac, Andrea Flinchum, Kevin Spicer

Journal of Appalachian Health

Introduction: Carbapenem-resistant Enterobacterales (CRE) are considered urgent, antibiotic-resistant threats in the U.S. and are of global concern. Active collaboration between public health authorities and healthcare facilities and providers will be necessary to prevent and contain these organisms.

Purpose: To describe the epidemiology of CRE in Kentucky and to discuss challenges and successes with building and sustaining an effective prevention and containment program.

Methods: Retrospective descriptive summary of CRE isolates reported by healthcare providers, facilities, and laboratories in Kentucky from 2013 through 2020. Data available from case reporting forms and laboratory testing are summarized.

Results: From 2013 through 2020, 1805 CRE …

Assessing And Addressing The Determinants Of Appalachian Population Health: A Scoping Review, David L. Driscoll, Hannah O'Donnell, Maitri Patel, David C. Cattell-Gordon

Journal of Appalachian Health

Introduction: Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities.

Methods: This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the …

Predictors Of Prescription Opioid Misuse Based On Type Of Healthcare Insurance, Keon Green Drph, Mba, Hca, C.J. Schumaker Phd Lfache

Journal of Social, Behavioral, and Health Sciences

The misuse and abuse of prescription opioid (PO) medications has garnered the attention of lawmakers, healthcare professionals, and public health experts since the opioid epidemic was declared a national public health emergency in 2017. Our purpose in this study was to investigate the types of healthcare insurance that predict PO misuse. We also sought to inform stakeholders of potentially needed changes to the existing inconsistent drug utilization rules necessary to achieve parity among all types of healthcare insurance and minimize loopholes. We performed a secondary data analysis on the 2019 National Survey on Drug Use and Health data of noninstitutionalized …

Obesity, Overweight Rates, And Related Factors Among Adults In The Rustic Realm Of Western India, Monika Patel, Jimmy Kagathara, Eshwar Kumar Gupta, Nancy Kagathara, Jitesh Mehta, Dipesh Parmar

Makara Journal of Health Research

Background: Obesity and overweight pose significant challenges in developing countries, underscoring the need for evidence-based prevention strategies. This study focuses on assessing the prevalence and associated factors of overweight and obesity in the rural areas of Jamnagar district, Gujarat, India.

Methods: Data collection encompassed six tehsils within Jamnagar district, with primary health center selection via simple random sampling. Individual selection employed the consecutive sampling approach. Statistical analysis was conducted using SPSS software. Regression analysis was employed to identify the independent factors linked to overweight and obesity.

Results: The analysis included 408 participants, revealing a higher obesity prevalence …

Attitudes Toward Caring For Older Adults Among Undergraduate Nursing Students At A Public University In Kuala Lumpur, Malaysia, Azera Hasra Ismail, Siti Zuhaida Hussein, Aslina Mohamed Yasi, Nurul Izzati Ishak, Nurul Nazira Mohd Yazar, Nur Syafiqah Sabri

Makara Journal of Health Research

Background: The growing number of elderly members of the population is expected to increase the demand for more dedicated nursing students committed to providing excellent care. This study aims to determine prevailing attitudes toward the care of older adults among undergraduate nursing students at a public university in Kuala Lumpur, Malaysia.

Methods: This is a quantitative cross-sectional survey of 107 undergraduate nursing students enrolled at a public university in Kuala Lumpur, Malaysia. The students were recruited using stratified random sampling. The respondents’ attitudes toward caring for older adults were measured using 14 items from the Geriatrics Attitudes Scale …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Item Generation In The Development Of A Questionnaire For Predicting Multidrug Therapy Compliance In Leprosy, Yulia Siskawati, Sali Rahadi Asih, Aria Kekalih, Sri Linuwih Menaldi, Herqutanto Herqutanto, Kusmarinah Bramono

Journal of General - Procedural Dermatology & Venereology Indonesia

Background: Lengthy therapeutic regimens in leprosy are prone to defaults, contributing to more antibiotic-resistant Mycobacterium. Intervening patients’ medical habits midway would be more complicated than understanding their perception of undergoing such regimens in advance. We study the factors considered relevant to leprosy patients’ compliance to construct a novel self-reporting questionnaire that can predict the patients’ adherence before initiating multidrug therapy.

Methods: According to the Delphi methods, we conducted three rounds of interviews with twenty-three respondents from various backgrounds, including dermatologists, government officials, healthcare workers, and patients with leprosy, to infer the associated factors of the included items. Each …

Microgreens Nutrition Outreach: A Novel Tool For Community-Wide Dietary Disease Prevention, Rayna Marshall, Jessica Nwabeke, Benjamin S. Haslund-Gourley, Cynthia Huang, Talmadge Gaither, Vibhuti Mishra, Sophia Kim, Hannah Xu, Faith Kean, Neiki Rokni, Annette Gadegbeku

Transformative Medicine (T-Med)

Purpose: To investigate how microgreens educational programming impacts the relationship between nutrition attitudes and healthy eating habits. Methods: A three-part workshop in Philadelphia, PA that consisted of a pre-survey, presentation, and microgreens kit assembly session was held. A post-survey was distributed electronically 1 week after the event. Results: 9 participants voluntarily attended the workshop and completed the pre-survey, and one-third of the participants submitted post-survey feedback. Participants were middle-aged, Black women from the Allegheny West neighborhood of Philadelphia, a predominantly (97.5%) Black neighborhood. The survey showed microgreens were well-received and suited for urban communities with little space and cold weather. …

Assessing The Attitudes And Perceptions Of The Old Order Amish Toward Genetic Testing For Familial Defective Apolipoprotein B-100, Erin Sutcliffe, Laura J. Conway, Alan Shuldiner, Toni Pollin

Journal of Amish and Plain Anabaptist Studies

Through a founder effect, one in eight Lancaster County, PA, Amish harbors the pathogenic APOB variant R3527Q, causing Familial Defective Apolipoprotein B-100 (FDB) that is rare in the general population. Affected individuals are at increased risk for high low density lipoprotein (LDL) cholesterol levels and cardiovascular disease and may benefit from early screening and treatment. A qualitative interview approach was used to investigate the genetic risk perceptions of the Amish and their attitudes towards genetic testing for FDB. The goal was to identify elements necessary for a successful program that would identify high risk individuals in the Lancaster County Amish …

Examining The Relationship Between Health Literacy And Preventive Care Use, Xuewei Chen, Guofan Luo, Ming Li, Gary Kreps

Health Behavior Research

We examined the role of health literacy on preventive care among college students and assessed individual health literacy skills from a theory-based multidimensional perspective using both subjective and objective measures. Methods: Participants (n=561) completed our online survey with valid responses. Data collection was conducted from April to June 2020. We assessed participants’ health literacy using different measures, including Health Insurance Literacy Measure (HILM), eHealth Literacy Scale (eHEALS), All Aspect of Health Literacy Scale (AAHLS), and the Newest Vital Sign (NVS). The first three were subjective measures. The last one was an objective test. Preventive care included annual flu vaccinations, annual …

An Evaluation Of A Student Allied Health Professions’ Social Prescribing Scheme, Kirstie A. Goodchild, Anya De Iongh

Internet Journal of Allied Health Sciences and Practice

Purpose: Social prescribing is a core part of healthcare policy within the NHS and requires support and contributions from all healthcare professionals, including Allied Healthcare Professionals (AHPs). The well-established medical student-led social prescribing student champion scheme (SPSCS) has been expanded to include AHPs, and AHP champions were recruited to deliver peer-led activities focused on social prescribing. This article aimed to evaluate the impact of the scheme's expansion on AHP students. Method: Fourteen AHP champions ran 21 activities that reached 524 students. Those participating in the champion-led activities were asked to complete pre- and post-session surveys to capture the impact of …

The Effectiveness Of Student-Driven Pro Bono Physical Therapy Services On Self-Reported Outcomes Of Community-Dwelling Adults With Musculoskeletal Conditions, Elise Harris, Tamara Hefferon, Peyton Oules, Katherine Sarnacki, Benjamin Galaviz, Jake Robert Gaston

Internet Journal of Allied Health Sciences and Practice

Purpose: Student-driven pro bono clinics provide a profound clinical education experience for health professional students while serving members of the community. Currently, there is little research on how the pro-bono clinic impacts the community members involved. The purpose of this study was to examine outcomes following discharge from a pro bono clinic held through an entry-level physical therapy program. Methods: Forty-one volunteer community members, 19 males (M) (46.3%) and 22 females (F) (53.6%), participated in this study. Ages ranged from 20-90 years, with a mean age of 41(17) years. Each community member completed the Wong-Baker FACES Pain Rating Scale (WBFS), …

Evaluation Of A Community Based Teaching Hospital’S Geriatric Emergency Medicine Initiative, Josette Hartnett, Isabel Muronzi-Belfon, Suzanne J. Rose

Journal of Geriatric Emergency Medicine

INTRODUCTION: To accommodate the complex healthcare needs of the rising geriatric population, Stamford Hospital’s (SH) emergency department (ED) began a Geriatric Emergency Medicine Initiative (GEMI) in 2018 to improve our ED environment, practices, and focused assessments for our community-dwelling older adults.

METHODS: This retrospective program evaluation describes SH’s novel ED processes for at-risk older adults and compares GEMI and non-GEMI assessed patient outcomes using aggregate frequencies on throughput metrics such as length of stay (LOS), 72 hour and 30-day re-admission rates, and other outcomes of interest. Chi-square tests and group t-tests were used for all analyses with a p-value of …

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

The Effects Of Night Shift Work On Heart, Gut, And Reproductive Health, A Systematic Review, Courtney Grayson, Preeti Oza

Pacific Journal of Health

Night shift work, a commonplace in today’s society, creates a variety of health-related challenges for individuals who participate in it. Often, the only adverse health effects discussed in relation to night shift work are sleep dysfunction and mental health issues. This systematic review examined the cardiovascular, gastrointestinal, and fertility health effects that plague individuals working night shift. The goal of this work is to illuminate these lesser known, but equally important, health effects in an effort to bring awareness to the issues. By educating night shift workers and health care providers of the acute risks associated with this type of …

Predictors Of Lung Cancer Screening Recommendation In Virginia Using The Community Health Assessment Survey, Aashish Batheja, Carrie Miller, Sunny Jung Kim, Bernard Fuemmeler F., Rajsh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia.

Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality.

Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, …

Promoting Community Health Research Partnerships Through A Small Grants Program: Processes And Lessons Learned, Sophie G. Wenzel, Amanda J. Nguyen, Kristin Miller, Leigh Guarinello, Allison Mckell, Kathryn Hosig

Virginia Journal of Public Health

While there are multiple ways to engage communities in health research, one approach is through partnership-based research in which community representatives are involved as intentional partners in the research process, from conceptualization and co-creation to implementation, analysis, interpretation, and dissemination. However, there remain numerous challenges to supporting and sustaining such partnerships.

Since its launch in 2019, the integrated Translational Health Research Institute of Virginia (iTHRIV) has sought to foster community engaged health research among its four research/clinical institutions through a community partnership-based grant program. Over five funding cycles, iTHRIV has awarded 14 one-year research grants addressing topics such as opioid …

Empowering Community Health Workers In Guatemala, Oswald M. Attin, Gineska Castillo, Grace Sibert, Andrea Harper

Virginia Journal of Public Health

Introduction:

Community health workers (CHW) have been integral in helping middle- and low-income countries. This research paper discusses the benefits of the involvement of CHWs in health screenings.

Methods:

Health screenings were performed for three rural communities in Guatemala, in 2021, alongside a church in Zacapa, to identify community wide health risks. The screenings included a detailed questionnaire that collected demographic data, height and weight, a blood glucose check, a hemoglobin check, and a blood pressure reading. Additional nutritional data was collected to understand diet patterns and habits. In-depth educational sessions were done with the CHWs, emphasizing preventative care, and …

The Evaluation Of Collaborative Disease Prevention And Control Measures For Border Health Between Thailand And Myanmar, Laos, And Cambodia, Orathai Srithongtham, Aomthip Polbupha, Taweewun Srisookkum, Orathai Katkhaw, Thossaphong Buraman

Journal of Health Research

Background: Collaborative disease prevention and control measures for border health between Thailand and three neighboring countries (Myanmar; Lao People’s Democratic Republic (PDR), also known as Laos; Cambodia) were implemented in 2016 - 2017.

Methods: Summative evaluation and a mixed-method design aimed to evaluate the measures for border health between Thailand and three neighboring countries. The participants were public health personnel from provincial, district, and sub-district levels. Data were collected by questionnaire and interview guide. Quantitative data were analyzed by descriptive statistics; and qualitative data were analyzed through content analysis.

Results: The overall collaboration for border health of Thailand …

The Effects Of Cigarette Price Incentive And Regulatory Policies In Taiwan, Che-Ning Yang, Yi-Fan Lin

Journal of Health Research

Background: Price affects the demand for cigarettes, but its direct impact on smoking behaviors remains unclear. This study evaluated the effects of cigarette price increases and non-pricing tobacco control policies on adult smoking behaviors in Taiwan, using data from national annual survey during 2004~2015 with 166,325 valid respondents.

Methods: We established mixed-effects models of logistic regression for each of the three dependent variables, “smoking,” “quit attempts,” and “cessation maintenance,” to characterize smoking behaviors. Socioeconomic and sociodemographic factors were also included in the models.

Results: Non-pricing tobacco control policies had no significant effects on smoking behaviors. Conversely, cigarette price …

What We Know About School-Based Health Centers: Literature On Outcomes, Cost Impact, Implementation, And Sustainability, Michelle R. Coble, Valerie F. Mcdaniel

Pacific Journal of Health

Many children lack access to adequate healthcare in the United States. School Based Health Centers (SBHC) are a useful resource for accessing those needed services. The purpose of this study is to evaluate the available research for the strengths of SBHCs with improving health outcomes and health equity, cost impact of SBHCs, and best practices for implementing and sustaining an SBHC. The focus of this study was on reviewing the current literature on the impact of SBHCs on improving health equity, health outcomes, cost impact, and to establish best practices for implementing and sustaining an SBHC. Although the current literature …

From Life To Life: Transitioning To Freedom After 45 Years Of Incarceration- A Single Subject Case Study, James O. Mackey, Lindsay Gietzen

Pacific Journal of Health

This case study delves into the complex process of reintegrating an elderly parolee who recently emerged from a 45-year-long incarceration within California's state prisons. The research explores this unique individual's reentry experiences and compares them with those of parolees of average age and sentence length. Factors such as family support, educational background, criminal history, health, social support, employment, access to age-appropriate resources, and recidivism rates are meticulously examined to provide valuable insights into the successful reintegration of elderly individuals back into society.

Covid-19 Severity Among American Indians And Alaska Natives In 16 States - January 1, 2020, To March 31, 2021, Jessica Arrazola, Scott Erickson, Chiao Wen Lan, Adrian Dominguez, Sujata Joshi, Andria Apostolou, Ashley Busacker, David Casey, Christiana Coyle, Kathryn Helfrich, Jennifer Kraszewski, Thomas Kim, Genelle Lamont, Richard Leman, Pamela Lemaster, Nick Lehnertz, Mike Mannell, Dakota Matson, Alex Merrill, Tracy Miller, Benjamin Schram, Ozair Naqvi, Samantha Rice, Samantha Hyde-Rolland, Alyssa Rowell, Dean Seneca, Victoria Warren-Mears, Laura Williamson

Journal of Health Disparities Research and Practice

Objective: To compare rates and risk factors of severe COVID-19-related outcomes between American Indian/Alaska Native (AI/AN) and non-Hispanic White people (NHW).

Methods: Aggregate Social Vulnerability Index (SVI), COVID-19-related risk factor, hospitalization, and mortality data were obtained from 16 states for January 1, 2020-March 31, 2021. Generalized estimating equation Poisson regression models calculated age-adjusted cumulative incidences, incidence ratios (IR), and 95% confidence intervals (CI) comparing AI/AN and NHW persons by age, sex, and county-level SVI status.

Results: Race data were missing for 42.7% of COVID-19 cases, 24.7% of hospitalizations, and 10.1% of deaths. Risk of AI/AN COVID-19 mortality …

Pili Pono Practice: A Qualitative Study On Reimagining Native Hawaiian Food Sovereignty Through Malama Backyard Aquaponics, Pahonu Coleman, Samantha Keaulana, J Kahaulahilahi Vegas, Phoebe W. Hwang, Leshay Keliiholokai, Jane J. Chung-Do, Ikaika Rogerson, Ilima Ho-Lastimosa

Journal of Health Disparities Research and Practice

Living in one of the most remote island chains in the world, Native Hawaiians developed sophisticated food cultivation systems that sustained a thriving and robust population for centuries. These systems were disrupted by colonization, which has contributed to the health disparities that Native Hawaiians face today. MALAMA, a culturally-grounded backyard aquaponics program, was developed to promote food sovereignty among Native Hawaiians. This study utilized participant interview and focus group data to identify how participating in the MALAMA program impacts the wellbeing. The findings demonstrate that MALAMA enhanced the participants’ pilina (relationship, connection) to traditional foods, land, cultural identity, family, and …

Pulmonary Specialist-Supported Health Coaching Delivered By Lay Personnel Improves Receipt Of Quality Care For Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial, Rachel Willard-Grace, Danielle Hessler, Beatrice Huang, Denise Devore, Chris Chirinos, Jessica Wolf, Devon Low, Chris Garvey, Doranne Donesky, Stephanie Tsao, David H. Thom, George Su

Journal of Patient-Centered Research and Reviews

Purpose: Half of people living with chronic obstructive pulmonary disease (COPD) do not receive high-quality, evidenced-based care as described in international guidelines. We conducted secondary data analysis of a previously published study to assess the ability of a model of lay health coaching to improve provision of guideline-based care in a primary care setting.

Methods: As part of a randomized controlled trial, we recruited English- and Spanish-speaking patients with moderate to severe COPD from primary care clinics serving a low-income, predominantly African American population. Participants were randomized to receive usual care or 9 months of health coaching from primary care …

To Screen Or Not To Screen: Prostate Cancer In Liver Transplant Candidates, Patrick Twohig, Jared Schober, Timothy Mccashland, Thoetchai Peeraphatdit

Graduate Medical Education Research Journal

Prostate cancer screening is a controversial topic in the general population and is even more contested among liver transplant candidates. Not only should transplant programs be concerned about the risk of false positive screening results but also the competing risks of death and the diagnostic and therapeutic effects of true prostate cancer, which often does not cause significant morbidity or mortality in organ transplant recipients. Our letter highlights a best-practices approach to prostate cancer screening in transplant candidates using available research and consensus guidelines.