Health Services Research Commons^™

Building Up Cal Poly Global Brigades Student Group: Reflections On Designing And Implementing One Undergraduate-Led Community Info Session, Caroline Nicole Smith, Jafra D. Thomas

Kinesiology and Public Health

Intro: Global Brigades, an international non-profit organization, trains college students and other pre-professionals in community-based health promotion by mobilizing community service trips around the world, which are taught and led by local community groups. Cal Poly’s Global Brigades student group was founded in 2018, and thus far, they have carried out three annual, medically-focused brigades to Honduras (two in-person, one virtual).

Purpose: The aim of this report is to present the findings of one experiential senior project to promote Cal Poly’s Global Brigades student group^[1] (conducted January to March 2023).

Methods: The student designed material for …

Effectiveness Of Machine Learning Classifiers For Cataract Screening, Ronald Cheung

Electronic Thesis and Dissertation Repository

Cataract is the leading cause of blindness and vision loss globally. The implementation of artificial intelligence (AI) in the healthcare industry has been on the rise in the past few decades and machine learning (ML) classifiers have shown to be able to diagnose patients with cataracts. A systematic review and meta-analysis were conducted to assess the diagnostic accuracy of these ML classifiers for cataracts currently published in the literature. Retrieved from nine articles, the pooled sensitivity was 94.8% and the specificity was 96.0% for adult cataracts. Additionally, an economic analysis was conducted to explore the cost-effectiveness of implementing ML to …

Find Your Flow: A Menstrual Health Social Media Campaign, Sarah Hamp-Adams

Kinesiology and Public Health

In many cultures, menstruation is surrounded by silence and shame instead of being celebrated as a sign of health and vitality. Globally, challenges, including stigma surrounding menstruation, create barriers for menstruators (White, 2013; Crawford, 2014; Garg, 2015). It proves to be difficult for young menstruators to navigate menarche due to the taboos and socio-cultural restrictions surrounding menstruation (Sharma,2015). Encouraging women to have open conversations about their periods is necessary to combat these challenges.

To understand how to address the stigmas around menstruation, the researchers first conducted a literature review, revealing that education messages via the Internet, posters, storytelling, and peer …

How Environmental Change Will Impact Mosquito-Borne Diseases, Arsal Khan

Master's Projects and Capstones

Mosquitos, the most lethal species throughout human history, are the most prevalent source of vector-borne diseases and therefore a major global health burden. Mosquito-borne disease incidence is expected to shift with environmental change. These changes can be predicted using species distribution models. With the wide variety of methods used for models, consensus for improving accuracy and comparability is needed. A comparative analysis of three recent modeling approaches revealed that integrating modeling techniques compensates for trade-offs associated with a singular approach. An area that represents a critical gap in our ability to predict mosquito behavior in response to changing climate factors, …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

The Role Of Paraprofessionals In The Mental Health Structure Of India, Amy Abraham

Senior Theses

The mental health treatment gap in India is part of a growing public health crisis, with over 95% of those in need of services never receiving them. Over 197 million Indians suffer from at least one diagnosable mental health disorder, and this number continues to grow given the treatment gap. The treatment gap is a result of four major factors: lack of government support, stigma, limited treatment facilities, and the dearth of professionals able to provide treatment. The current study aimed to analyze several factors of paraprofessional led mental health interventions including setting, treatments delivered, treatment models, and client outcomes. …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

Vaccine Confidence, Coverage, And Hesitancy Worldwide: A Literature Analysis Of Vaccine Hesitancy And Potential Causes Worldwide, Jordan Hammond

Senior Theses

Vaccines are one of the world’s most impactful medical therapies. They are cost-effective, successfully proven, and one of the quickest treatment options available today (Clark et al., 2016). They save millions of lives every year and have eliminated certain diseases on a national and international level. However, millions of people worldwide still remain unvaccinated. In developed nations, mainly The United States (U.S.) and the European countries, many of the unvaccinated are a result of rising vaccine hesitancy of parents in conjunction with the anti-vaccination movement. Vaccine hesitancy is defined as “a delay in acceptance or refusal of vaccines despite availability” …

A Survey Of Patients With Congenital Orthopedic Conditions In Malawi: Factors That Influence Late Presentation, Brianna Wallis

Undergraduate Honors Thesis Projects

Staff at CURE International, a non-profit organization that provides orthopedic care in Malawi, noticed a high prevalence of patients with congenital orthopedic conditions who are presenting late for treatment. Late presentation results in prolonged pain or discomfort for the patient and has the potential for increased cost to the institution, longer duration of treatment, and decreased quality of outcomes. To identify the factors that influenced presentation delays, we surveyed the caregivers of patients with congenital conditions that were seen in out-patient clinics, in-patient wards, and mobile clinics across the country. Sixty-two caregivers were surveyed; forty-two patients had a diagnosis of …

Heat Waves And Heat-Related Mortality In East Tennessee, Taiwo Adesoba

Electronic Theses and Dissertations

Heat waves represent a public health challenge that requires multiple responses and warnings to protect vulnerable populations. Although studies have reported an increasing trend of heat wave occurrence in many areas of the world, no clear trend exists in East Tennessee. Using data from Parameter-elevated Relationships on Independent Slope Models (PRISM), CDC WONDER and the United States Census Bureau, the relationship between mortality rates and year was estimated during heat wave events between 1999 and 2010. Five heat wave definitions were tested. Overall, 2007 and 2010 stand out as the years with the highest number of heat wave days in …

Transition In Occupations Of Refugees During Resettlement, Jacqueline-Elizabeth Cantrell, Kimberley K. Banuelos, Adam Chan, Jennifer H. Daine

Occupational Therapy | Graduate Capstone Projects

Purpose: In 2016, there were 22.5 million refugees worldwide (UNHCR, 2017). California resettled just over 5,000 of those 85,000 (Igielnik & Krogstad, 2017). Limited research has been conducted in the United States (U.S.) focusing on the refugee experience; furthermore, there is a significant gap in research regarding the impact of the refugee experience on the occupations of refugees as they transition to living in the U.S. Smith (2012) explored the adaptation of cultural weaving among Karen refugees to maintain their previous occupations and the impact of daily weaving on their lives within Western culture; however, the study focused only …

Expanding International Health Curriculum For The Internal Medicine Residency At Mmc, Brian King, Hassan Mahmoud, Anthony Pastore

Thinking Matters Symposium Archive

While internal medicine residents at Maine Medical Center provide care for many refugees and immigrants, there is not a formal international health curriculum to equip residents to care for this vulnerable population. Since 2002, 3,793 refugees have arrived in Maine for resettlement. Our aim was to survey residents about their interest in added international health instruction and design an educational curriculum for these physicians.

Exploring Direct And Indirect Effects Of English Proficiency On Access, Utilization, And Health Status Among Californian Adults With Limited English Proficiency (Lep), Renee E. Pierre-Louis

Seton Hall University Dissertations and Theses (ETDs)

Background and Study Purpose: Findings from previous studies suggest that, in a health care delivery context, individuals with limited English proficiency (LEP) are adversely impacted by lack of patient-provider language concordance. Yet, the concept of LEP has been mostly studied in the context of cultural competence and language has been generally considered a demographic or cultural characteristic. There is a growing body of research concerning LEP and health status; however, it is limited. This study sought to evaluate the effects of LEP on access, utilization, and self-rated health status (SRHS) among LEP respondents to a large health interview survey …

Mobile Hiv Units In South Africa: A Systematic Review, Meaghan Doherty

Senior Honors Projects, 2010-2019

Abstract

Objective: To examine existing literature on mobile HIV testing units to determine if they have the potential to increase access to testing, treatment, and HIV education to decrease rates of HIV in South Africa.

Participants: Ten research articles evaluating the HIV intervention method of mobile HIV units in South Africa, including outcome measures.

Analysis: Systematic search of 87 articles from 2000 to 2018 and review of the 10 articles that met inclusion criteria.

Results: Several studies (n=5) showed that mobile testing units are effective at attracting hard to reach populations, such as men and young adults. Studies (n=3) also …

Quality Of Antenatal Care And Its Relationship With Women’S Intended Use Of Their Anc Facility For Delivery: A National Cross-Sectional Study In Kenya, Jisoo Kim

Electronic Thesis and Dissertation Repository

Maternal deaths have been one of the leading causes of deaths in sub-Saharan Africa. Delivering at an institution can prevent the majority of maternal deaths in developing countries. A national cross-sectional survey of Kenya was used to determine if the quality of antenatal care (ANC) provided to women is associated with their intention to deliver at the same facility. Multilevel mixed-effects logistic regression was used to examine this relationship. Quality of ANC variables assessed in this study were not significantly associated with women’s intention to deliver at the same facility. Mothers preferred to deliver at hospitals, rather than clinics/dispensaries. ANC …

Family Planning And Hiv Interventions Among Women In Low-Income Settings, Steven P. Masiano

Theses and Dissertations

This dissertation examines the effectiveness of interventions related to family planning and the uptake of HIV-related preventive services among women in low-income settings. Women in low-income settings and living with HIV face many barriers to care, including limited access to services for family planning and HIV-related preventive care. At the same time, national, regional, and global efforts are looking for interventions to help control rapid population growth, create an HIV-free generation, and provide adequate preventive care for those living with HIV. This dissertation cuts across these issues and can help to inform debate and policies to address these issues.

This …

Three Essays On Maternal And Child Health, Mandar V. Bodas

Theses and Dissertations

This dissertation is a collection of three separate essays on the health of women and children. In the first essay, I along with my co-authors, analyzed the impact of two large, national-level health policies (the Janani Suraksha Yojana (JSY) and the National Rural Health Mission (NRHM)) on maternal health outcomes (proportion of institutional deliveries) in India. We used data from the India Human Development Survey (IHDS) and found that the JSY and the NRHM had a greater impact on institutional deliveries in high-focus states. We also found that the conditions of the public health facilities, did not change after the …

Health Aid In Africa: Placement, Service Utilization, And Benefit, Carrie Dolan

Theses and Dissertations

While the health sector has attracted significant foreign aid, evidence on the effectiveness of this support is mixed. This dissertation examines the allocation of health aid within the context of placement, service utilization, and benefit. The first paper examined the sub-national allocation of Chinese development aid projects across Africa. I determined how political preferencing of Chinese aid specifically, allocating aid to the birth region of the current political leader differs across sectors such as health, education, and transportation. I find some evidence that aid, more broadly defined, is subject to political preferencing in recipient countries, which could potentially limit its …

Understanding Health Issues Among Adolescent Females In A Northeast Province Of Afghanistan, Amina Davlatshoeva

Doctoral Dissertations

The purpose of this study is to develop a deeper understanding of the health issues facing adolescent females (ages 18-21) in rural, northeastern Afghanistan. Incorporating participant observations, in-depth interviews, and narrative inquiries, this study seeks to illustrate adolescent females’ perspectives on health issues. To achieve this goal, ten adolescent females were interviewed in rural, northeastern Afghanistan during 2010. The participants were between 18- and 21-years old. The one-on-one interviews were conducted in a multiple-response format and were structured around three research questions:

• How does a young female’s understanding of health issues shape her identity in northeastern Afghanistan?
• In what ways …

Exploring Obstacles To Perinatal Care-Seeking Behavior In Women Of Rural Odisha, India Using A Community Based Participatory Research Approach, Sarah Law, Runjhun Bhatia

Senior Theses

This project resulted from collaboration between USC student organization GlobeMed and the Alternative for Rural Movement (ARM), a non-governmental organization in Odisha, India. Rajendra Rana, the head of ARM, expressed the need to delineate the factors underlying the tendency of rural Odishan women to deliver with unskilled birth attendants as opposed to institutionally. A literature review was conducted to explore possible economic, cultural, and social factors. During five weeks in Odisha, discussions with women's groups, community health workers, and ARM staff members built on the literature review. A preliminary survey and plan for its dissemination were developed. The community based …

Gods' Diseases: Conceptualizing The Phenomenon Of Hybridity In Sri Lanka, Anfal Yesmien Nyhan

Senior Theses and Projects

No abstract provided.

Challenges Of Containing New Hiv Infections In Ethiopia: Unacknowledged Transmission Route, Dessu Sam

Capstone Collection

As the main goal of the Partnership Framework (PF) between the Government of Ethiopia (GoE) and the U.S. Government (USG), Ethiopia has set a national target of reducing new HIV infections by 50% by the end of 2014 (National Target). Funded by the USG, the PF provides a five-year joint strategic plan (2010-2014) for cooperation to support Ethiopia’s national HIV/AIDS response (PEPFAR, 2010). Ethiopia has an estimated adult prevalence of 1.5% and about a million people living with HIV/AIDS (PLWHA) (ECSA & IFC, 2012), among countries most affected by the epidemic. The International Labor Organization (ILO) projection for 2015 indicates …

Associations Between Alcohol Consumption And Fasting Blood Glucose In Young Adults, Julie Ann Lucca

Master's Theses

Current research shows moderate alcohol consumption is associated with decreased risk of diabetes and excessive consumption or binge drinking can cause insulin resistance and diabetes. In 2010, diabetes was the seventh leading cause of death in the United Statesand was responsible for significant health complications: blindness, kidney failure, and limb amputations, and is a large national economic burden. Fasting blood glucose (FBG) is a tool used to help diagnose diabetes. Abnormally high FBG, ≥100 mg/dl, is indicative of diabetes and pre-diabetes. Few studies have observed diabetic prevalence among young adults or college students. Studying young adults can help provide added …

Exploring The Efficacy Of The Community Organization Health Model As A Tool For Evaluating Sport-For-Development Programs: A Qualitative Content Analysis Of Three Model Programs, Lauren Faye Denman

Master's Theses

The HIV/AIDS pandemic is currently one of the most pressing world-wide concerns regarding the health and well-being of our global population. Due to the lack of a cure, recent efforts have focused on prevention measures for the disease. HIV prevention, particularly with the youth population, has spawned creative programs, such as the use of sport as an educational tool to equip youth with the skills to avoid contracting HIV. Due to the potent effect sport-for-development efforts exhibit on both individual and cultural level change, it can be assumed that HIV prevention sport-for-development programs are worth maintaining. Within the use of …

Assessing The Sensitivity Of The Canadian Adverse Event Following Immunization Surveillance System ( Caefiss), Mina Tadrous

Theses and Dissertations (ETD)

Background: Vaccines are important to public health, but because of the way they are manufactured, their mechanism of action, and their indicated population, careful monitoring of their adverse events is necessary. Canada has a national surveillance system that collects reports on adverse events that may be associated with vaccine administration. Sensitivity is one of the tools used with surveillance systems to study the extent and characteristics of reporting of a surveillance system. To date, the sensitivity of the Canadian system has not been assessed.

Purpose: To assess the sensitivity of the Canadian Adverse Event Following Immunization Surveillance System …