Social and Behavioral Sciences Commons^™

Ambulance Deserts: Geographic Disparities In The Provision Of Ambulance Services [Chartbook], Yvonne Jonk Phd, Carly Milkowski Mph, Zachariah Croll Mph, Karen Pearson Mlis, Ma

Emergency Medical Services (EMS)

This chartbook begins with a broad overview of ambulance services including common types of organizational structure(s) and workforce and reimbursement issues. The methods section provides our definition of ambulance deserts and describes how ambulance deserts are illustrated in the national and state maps. The results section begins with an overall description of the prevalence of ambulance deserts in rural and urban counties across the 41 states for which data were available at the time, and the variation in the percent of people living in ambulance deserts across the four census regions. States are ranked in terms of the percent of …

Early Childhood Support Specialist Evaluation Report, Emilie Swenson Msw, Rachel Gallo Mph

Children, Youth, & Families

The Early Childhood Support Specialist (ECSS) at MaineHealth builds relationships with families who have children aged birth to three, a timeframe when infants and toddlers are rapidly developing, learning, and benefiting from family and community connections. The ECSS assesses a family’s strengths and needs to understand how that family can be supported and connected. The ECSS connects families to resources, provides referrals, coaches families on children’s social and emotional development, and generally serves as a point of contact to assist families with social, emotional, and medical needs. Ultimately, the intended outcome of this model is to increase family connections, decrease …

Pandemic Review: South Los Angeles, Madeline Carmella Acosta

Whittier Scholars Program

IMPORTANCE The COVID-19 pandemic has deepened the discussion on social inequality and vulnerabilities of the Black, Indigenous, and People of Color (BIPOC) community. The understanding is that inequality is a multifaceted issue that stems from the historical mistreatment of BIPOC individuals—their sociodemographic and economic backgrounds are at the most risk in population studies. Many predictors of contracting COVID-19 included employment status (ability to work from home), education level, income (wealth), and housing conditions (environment) (Rozenfeld et al., 2020). Contracting COVID-19 in South Los Angeles was more likely to happen among those from racial and ethnic minorities and those living in …

Chronic Overlapping Pain Conditions And Long-Term Opioid Treatment, Maria Ukhanova, Robert W Voss, Miguel Marino, Nathalie Huguet, Steffani R Bailey, Daniel M Hartung, Jean O'Malley, Irina Chamine, John Muench

Journal Articles

OBJECTIVES: One in 5 people in the United States lives with chronic pain. Many patients with chronic pain experience a subset of specific co-occurring pain conditions that may share a common pain mechanism and that have been designated as chronic overlapping pain conditions (COPCs). Little is known about chronic opioid prescribing patterns among patients with COPCs in primary care settings, especially among socioeconomically vulnerable patients. This study aims to evaluate opioid prescribing among patients with COPCs in US community health centers and to identify individual COPCs and their combinations that are associated with long-term opioid treatment (LOT).

STUDY DESIGN: Retrospective …

Do Executive Functions Buffer Against Covid-19 Fear And Stress? A Latent Variable Approach, Tina Li Yi Ng, Nadyanna M. Majeed, Verity Yu Qing Lua, Andree Hartanto

Research Collection School of Social Sciences

Levels of COVID-19 stress have soared worldwide as a result of the pandemic. Given the pernicious psychological and physiological effects of stress, there is an urgent need for us to protect populations against the pandemic’s psychological impact. While there exists literature documenting the prevalence of COVID-19 stress among various populations, insufficient research has investigated psychological factors that might mitigate this worrying trend. To address this gap in the literature, the current study seeks to examine executive functions as a potential cognitive buffer against COVID-19 stress. To do so, the study adopted a latent variable approach to examine three latent factors …

Mobility Repertoires: How Chinese Overseas Students Overcame Pandemic-Induced Immobility, Jiaqi M. Liu, Rui Jie Peng

Research Collection School of Social Sciences

The burgeoning field of immobility studies focuses on how migratory aspirations and capabilities shape a given (im)mobility status but devotes scant attention to how people traverse different (im)mobility categories. Through a case study of Chinese students in the United States during the COVID-19 pandemic, this article develops two arguments to shed light on migrants’ experiences and strategies in mobility transitions. First, during the pandemic, while China's restrictive travel policies and unfavorable public discourses made return migration extremely difficult, Chinese overseas students also felt unwelcome in the United States, due to visa restrictions and Sinophobic violence. This dilemma of being unable …

Ballad Health: Understanding Appalachia’S Regional Healthcare Monopoly, Meredith A. Bailey

Baker Scholar Projects

The Ballad Health merger of 2018, which combined the now 21 hospitals in the region under one organization, has impacted the healthcare landscape in Northeast Tennessee and Southwest Virginia. Historically, Appalachia has had to persevere through primary physician shortages, a lack of specialty care, geographic obstacles to accessing healthcare, challenges related to substance abuse, and much more. Since the merger of Mountain States Health Alliance and Wellmont Health System, little research has been done to assess the perceived impact the aggregation of providers has had on the population it serves. This study utilizes an online survey to better understand the …

The Pink Tax: A Comparative Case Study Between Tennessee And Washington State, Megha Chitturi

Baker Scholar Projects

The imposition of an additional luxury tax on menstrual health products, otherwise referred to as the “Pink Tax” or the “Tampon Tax”, is present in some states while absent in others. The decision to repeal such a tax is one that has proven to be critical, as it removes the connotation that such products are of “luxury” and make them more accessible to menstruators throughout the state. As of 2023, twenty-three states have eliminated the tax. The state of Washington falls under that parameter while Tennessee does not. The purpose of this undergraduate honors thesis is to explore the potential …

The Development Of Health System Resiliency: How Kenya's Experience With Malaria Impacted Its Reaction To The Covid-19 Pandemic, Zoe A. Ward

Baker Scholar Projects

Public health scholars have recently focused on health system resiliency to explain how previous experiences dealing with public health crises impact the healthcare sector, public behavior, and policy response to novel crises. However, it is unclear how resiliency develops. This study contributes by testing whether a health system’s experience with a health emergency and significant interventions impacts the response to a novel crisis. This research asks, “How has Kenya’s experience with malaria impacted its response to COVID-19?” Using the United States Agency for International Development (USAID) Malaria Indicator Survey (MIS), I develop a malaria adherence score to measure county-level compliance …

Building An Infrastructure For Down Syndrome Care, Kate E. Martin

Instructional Design Capstones Collection

People with intellectual disabilities experience greater obstacles in attaining their full health potential. The most common identifiable cause of intellectual disability is Down syndrome. Established in September 2021, the Down Syndrome Program at The Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas (UNLV) aims to meet the healthcare needs of members of the Southern Nevada community with Down syndrome and their families. However, there is currently no infrastructure in place in Southern Nevada to provide Down syndrome care, or clinical services dedicated to individuals with the condition. This work discusses options that were explored to develop …

Possible Effects Of Sexual Health Education On Health Behaviors And Indicators, Chloe Lafosse

Honors Scholar Theses

Sexual health education has long been evolving, and while a mountain of research has built a compelling case for continuing its improvement, the authors of the present paper were interested in evaluating the efficacy of state education standards in 2009, 2014, and 2019 on a multitude of sexual health outcomes in 2019. We concluded that throughout all three years, states with higher educational requirements could in fact produce better health outcomes, but those outcomes were heavily targeting delaying pregnancy. The educational requirements appeared to have neglected all other aspects of sexual health, including STD prevention, even though STD-based education was …

The Effects Of Multiple Micronutrient Fortified Beverage And Responsive Caregiving Interventions On Early Childhood Development, Hemoglobin, And Ferritin Among Infants In Rural Guatemala, Alysse J. Kowalski, Victor Alfonso Mayen, Silvia De Ponce, Kaley B. Lambden, Nick Tilton, Lisa M. Villanueva, Ana M. Palacios, Greg A. Reinhart, Kristen M. Hurley, Maureen M. Black

Department of Health Policy and Community Health Faculty Publications

Undernutrition and a lack of learning opportunities can jeopardize long-term growth and development among infants in low- and middle-income countries. We conducted a 6-month 2 × 2 cluster-randomized trial to assess the effects of multiple micronutrient-fortified beverages and responsive caregiving interventions among infants 6–18 months in 72 community sectors in southwest Guatemala. We administered baseline and endline assessments of childhood development (Bayley Scales of Infant and Toddler Development) and socioemotional development (Brief Infant Toddler Socio-Emotional Assessment) and measured ferritin and hemoglobin on a subsample. The trial was analyzed using linear mixed models. At the baseline, the mean age (SD) was …

Building Before: Community Resiliency As Emergency Management, Alexandria Rinne

Honors Theses

This project seeks to address gaps in emergency preparedness education related to tornado response. Through an examination of current research about best practices for tornado emergency management response and an examination of the needs of FEMA Regions 7 and 8, the author has identified key strategies and stakeholders to increase positive outcome through building community engagement and resiliency. Three presentations were created for delivery to key community stakeholders—local government officials; non-governmental organizations, social networks, and associations; and individual private citizens. The project offers an overview of background research and provides presentation slide decks, scripts, and discussion guides, all created with …

Evaluating The Feasibility Of Implementing A Prescription Drug Misuse Prevention Intervention In The Community: A Mixed Methods Study, Tamara Al Rawwad, Vaishnavi Tata, Matthew A. Wanat, Danielle Campbell, Douglas Thornton

School of Social Work Faculty Publications and Presentations

Background

This study is part of a state-wide effort to promote the safe disposal of prescription medications and mitigate prescription drug misuse. The objective of this study was to evaluate the implementation of a two-component prevention intervention through Community Prevention Organizations (CPOs) in Texas. The first component involved the distribution of in-home disposal products (IHDP) and the second focused on providing education of the risks of prescription drug misuse.

Methods

This study followed a mixed methods sequential explanatory study design. In the quantitative phase, the extent to which CPOs carried out the intervention was determined by the distribution rate – …

Environmental And Social Factors Associated With High Chronic Kidney Disease Mortality Rates In Municipalities Of Guatemala: An Ecological Study Of Municipal-Level Mortality Data, Alejandro Cerón

Anthropology: Faculty Scholarship

The purpose of this study was to determine the association between social and environmental indicators and high mortality rates from chronic kidney disease (CKD) in municipalities of Guatemala. An ecological study of municipal-level factors associated with CKD mortality in Guatemala was conducted. Crude mortality rates were calculated for the 2009–2019 period for each of the country’s 340 municipalities, by gender and age groups. Municipal-level social and environmental indicators were used as independent variables. Linear regression was used for bivariate and multivariate analysis. A total of 28,723 deaths from CKD were documented for the 2009–2019 period. Average crude mortality rate for …

Psychosocial Interventions Among Patients With Cancer And Their Family Caregivers In The Sub-Saharan Region: A Systematic Review, Ting Guan, Yousef Qan’Ir, Jamie Conklin, Chifundo Colleta Zimba, Agatha Bula, Wongani Jumbo, Kondwani Wella, Patrick Mapulanga, Samuel A.M. Bingo, Evelyn Chilemba, Jennifer Haley, Nilda Peragallo Montano, Ashley Leak Bryant, Lixin Song

Social Work - All Scholarship

Cancer is becoming a public health issue in the Sub-Saharan Africa (SSA).

This systematic review aims to synthesise psychosocial interventions and

their effects on the health outcomes of adult cancer patients and their

family caregivers in SSA. We identified eligible publications in English

language from PubMed, Cumulative Index of Nursing and Allied Health

Literature Plus with Full Text, Embase, APA PsycInfo, Scopus, and

African Index Medicus databases. We included psychosocial

interventions targeted adult cancer patients/survivors or their family

caregivers in SSA. This review identified five psychosocial interventions

from six studies that support adult cancer patients and their family

caregivers in …

Fruit And Vegetable Intake And Home Nutrition Environment Among Low-Income Minority Households With Elementary-Aged Children, Brittni Naylor Metoyer, Ru-Jye Chuang, Minjae Lee, Christine Markham, Eric L Brown, Maha Almohamad, Jayna M Dave, Shreela V Sharma

Journal Articles

Racial/ethnic and socioeconomic differences were shown to have an influence on child fruit and vegetable intake. This study examined the associations between parent and child fruit and vegetable intake and the home nutrition environment among Hispanic/Latino and African American families. Through a cross-sectional study design, self-reported surveys (

Are They Still Determining? Analysis Of Associations Among Gender, Ethnicity, Socioeconomic Status, Neighborhood Factors And Covid-19 Vaccination, Bokyung Kim, Seoyeon Celine Hong, Sojung Kim

College of Communication & Creative Arts Faculty Scholarship

Introduction: This study explores associations among adult vaccination, ethnicity, gender, and socioeconomic variables such as educational attainment and income, as well as neighborhood factors. Methods: A telephone quota sample of New Jersey adults (N = 1,984) was used to text associations among proposed predictors of vaccination behaviors. Results: Our multivariate logistic regression analyses found that certain races/ethnicity, respondents' household income, and perceived safety of one's community were the strongest predictors of COVID-19 vaccination. The odds of COVID-19 vaccination were 52% lower for Black/African American respondents compared to white/Caucasian respondents (p = 0.001) and 44% lower for Hispanic/Latino respondents compared to …

The Effect Of Lockdowns On The Status Of Women In The World, Angelika B. Magno

Angelo King Institute for Economic and Business Studies (AKI)

Coronavirus disease (COVID-19) is an infectious respiratory illness that causes moderate to severe symptoms that can be fatal to older people or those with other underlying health concerns. Considered a global pandemic, this disease spreads rapidly across the world, calling for a need for the implementation of lockdowns. This study examines the effects of lockdowns on joblessness among women, controlling for household conditions, namely, perceived household responsibility, hours allotted for household chores, and safety at home. Data for lockdowns were sourced from Google’s Community Mobility reports, whereas joblessness among women and household conditions were sourced from Facebook’s Survey on Gender …

Extending Immunity For Drug Overdoses, Dixie R. Tabet, Maggie G. Spadaro, Kaylie E. Moss

Belmont University Research Symposium (BURS)

The Tennessee Code 63-1-156 provides immunity to those who suffer from a drug overdose that seek medical assistance, only for the first overdose. After the first overdose, individuals who seek medical assistance do not receive immunity and are subject to criminal charges. Over the past 5 years, drug overdose deaths have increased significantly and in 2021 3,814 Tennesseans died from a drug overdose. In addition, individuals incarcerated for drug-related offenses make up about 20% of the state’s prison population. The state of Tennessee has had a significant increase in drug abuse rates, leading to a rise in overdose deaths and …

Validation Of The Occupational Depression Inventory In Brazil: A Study Of 1,612 Civil Servants, Renzo Bianchi, Danísio Calixto Cavalcante, Cristina Queirós, Blezi Daiana Menezes Santos, Jay Verkuilen, Irvin Sam Schonfeld

Publications and Research

Objective: The Occupational Depression Inventory (ODI) assesses work-attributed depressive symptoms. The ODI has demonstrated robust psychometric and structural properties. To date, the instrument has been validated in English, French, and Spanish. This study examined the psychometric and structural properties of the ODI's Brazilian-Portuguese version.

Methods: The study involved 1612 civil servants employed in Brazil (MAGE = 44, SDAGE = 9; 60% female). The study was conducted online across all Brazilian states.

Results: Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. The general factor accounted for 91% of the common variance extracted. …

Migrants Sans Papiers: The Impact Of Cantonal Program And Policy Discrepancies On Undocumented Migrant Healthcare Utilization In Switzerland, Denise Peng

Independent Study Project (ISP) Collection

While Switzerland houses what is generally considered one of the best healthcare systems globally, regional policy discrepancies leave undocumented migrants (UDM) in precarious conditions that threaten the nation’s claim to universal health coverage. Critical analyses of existing UDM-catering structures in different cantons, the Swiss Confederation member states, reveal that local discrepancies in healthcare utilization are functional gradients of cantonal support and public endorsement. Relationships with these authorities are instrumental in steering health outcomes not only with program funding and outreach but also management of studies to better understand UDM health determinants and inform future preventative measures.

UDM services and initiatives …

Maternal Healthcare Access And Obstetric Complications: A Cause And Effect Relationship?, Lena Sharara

Independent Study Project (ISP) Collection

Poverty-stricken migrant women, named ‘Kayayei or Kayayo’ because of the nature of their job in the informal sector, have high birth rates and are said to have many barriers affecting their access to maternal health resources. In this study, Kayayei in Madina Market were interviewed and both quantitative and qualitative data were gathered to determine whether a relationship exists between access to maternal health and the obstetric complications and outcomes experienced by Kayayei. A Chi-Squared Test of Independence and a Qualitative Content Analysis were both used to analyze the data. Due to a non-significant p-value, it was found that the …

Imagining Gender Euphorias, Willow Wind

Honors College

Our society needs to talk about gender, but we aren’t very good at it. Avoiding these discussions has harmful impacts on body image and various health disparities (The Trevor Project, 2020). What if we have better and regular conversations about ways we can positively experience gender? This study’s model of negotiating gender can be used by families and educators seeking affirming exploratory learning opportunities. Insights into meanings of gender euphoria help validate diverse sets of experiences, informing a broader cultural discourse that increasingly questions gender binarism (Griffin, 2020).

This study explores conceptualizations and enactment of gender euphoria across demographics and …

Refugees Living With Dementia: Assessing The Barriers To Healthcare Access In Crisis-Affected Populations In Lebanon And Switzerland, And The Role Humanitarian Actors Have On Addressing Them, Pedro Gomez

Independent Study Project (ISP) Collection

As life expectancies increase in many places around the world, the prevalence of aging populations has increased. Consequently, increased numbers of people globally, especially in developing countries, have been diagnosed with conditions associated with old age. Dementia, a group of conditions associated with impaired cognitive functions, is among these. Notwithstanding, many developing countries have done poorly with regards to diagnosing and treating dementia, with some cultures not even having a word to describe the condition. (ADI 2022). The lack of a diagnosis and knowledge about dementia for some refugee communities has led to healthcare challenges in their host countries (Corfield …

The Effects Of Stigma Against Hiv And Tuberculosis On Patient Mental Health And Healthcare-Seeking Behavior In Dharamshala, Isabel Powell

Independent Study Project (ISP) Collection

HIV and tuberculosis are highly impactful diseases in India, causing severe morbidity, mortality, and suffering for millions. The stigmatization of these diseases unnecessarily exacerbates suffering for those afflicted and their families, compounding to the existing physical and emotional burden of diagnosis. Individual interviews with healthcare workers were conducted at Delek Hospital and the Tibetan Children’s Village in order to identify the existence and effects of stigma in the Tibetan refugee population in Dharamshala. Respondents reported an extremely high burden of tuberculosis in the community, complicated by the refugee status and unique infrastructural challenges of the population. The burden of HIV …

Conflicting Socio-Cultural Attitudes And Community Factors Resulting In Backstreet Abortion In Cato Manor, Kwazulu Natal, Chloe Sachs

Independent Study Project (ISP) Collection

Abortion in South Africa is a complex topic, rife with augmenting and limiting political, social, religious, and cultural factors. In South Africa, abortion has been legal since 1996; however, abortions have been performed for centuries in the region. Although abortion is legal, many factors influence a woman’s choice and ability to terminate a pregnancy. Religious and cultural norms within morally conservative societies contribute to negative abortion sentiments and hesitation to seek formal medical abortions. This study explored multiple age groups within Cato Manor and whether the attitudes towards abortion and factors impacting the choice of where and whether to receive …

Intergenerational Change In Hiv/Aids-Related Stigma In Cato Manor, Mijin Cho

Independent Study Project (ISP) Collection

In South Africa, the world’s epicenter of the HIV/AIDS pandemic, HIV-related stigma and stigma-enforcing stereotypes continue to serve as major health barriers to receiving adequate HIV prevention and treatment. While there continues to be a rise in research and advocacy, there is a need to study HIV stigma through a multigenerational lens that addresses the changing HIV/AIDS stigma in the post-apartheid era. Using qualitative methodology, this study aims to explore the generational differences in perceived HIV stigma between females in their 20s and above 50 years of age (as denoted by “50s+”) living in Cato Manor, South Africa. The study …

El Empoderamiento De Personas Embarazadas Y Posparto En Arica, Chile: Perspectivas Indígenas Y Biomédicas, Abby Perce

Independent Study Project (ISP) Collection

El parto, sin importar las tradiciones o los procedimientos utilizados, es un proceso transformador tanto para quien da a luz como para el bebé. Si bien los procesos de embarazo, parto y posparto son experiencias individualizadas, el apoyo de la comunidad y la atención médica cuidadosa pueden marcar una gran diferencia en los sentimientos de empoderamiento y satisfacción en la vida de los pacientes. Este estudio exploratorio cualitativo tiene como objetivo comprender los contextos culturales que influyen en el apoyo disponible para las personas embarazadas y puérperas en Arica, Chile, así como investigar las formas en que este apoyo conduce …

Inclusión Cultural En Fonasa: Parto Aymara Como Un Estudio De Caso, Madison Singleton

Independent Study Project (ISP) Collection

Los primeros años de la década de 2000s sirven como un período legal transformador en Chile, debido al auge de los grupos de representación indígena y la introducción de la ley 20.584 que asegura un modelo de interculturalidad en los servicios de salud. El objetivo de esta investigación es comprender los factores que impactaron en la priorización de la inclusión cultural en el sistema público de salud (FONASA), utilizando el parto aymara en Arica como un estudio de caso. Esta investigación toma forma en un diseño de investigación cualitativa y exploratoria utilizando 5 entrevistas y 5 observaciones, así como las …