Digital Commons Network^™

Locating Health Inequities: Understanding The Dynamic Role Of ‘Place’ In The Social Determinants Of Health And Healthcare Accessibility, Abbie Sudduth Page

Graduate Theses and Dissertations

Objective. The social determinants of health (SDH) are various non-medical factors that influence health behaviors and health outcomes, and they are measured in variety of different ways. The purpose of this dissertation is to explore the relationship SDH items that may group to form a new domain and may be associated with outcomes of health care accessibility. This dissertation seeks to explain a novel understanding of social determinants of health and healthcare accessibility through the lens of the socioecological model and place-based SDH items.
Methodology. This retrospective study design utilized data from the baseline survey and year-22 wave of the …

Us Or Them: How Covid-19 Vaccine Priority Influences Perceptions Of Local-Migrant Worker Relations, Tengjiao Huang, Haochen Zhou, Liz Jones, Chin Wen Cong

Research Collection School of Social Sciences

The COVID-19 pandemic laid bare pre-existing societal fault lines, placing immense strain on intergroup relations and giving rise to xenophobic sentiments. Drawing on Realistic Conflict Theory (RCT) and Social Identity Approach (SIA), our study examined how the public allocation of COVID-19 variant vaccines could influence the dynamics between local citizens and migrant workers, and under what conditions. One key idea is that valued resource distribution that favour migrant workers may produce increased perceptions of realistic threats among local citizens which could lead to exacerbated negative attitudes and behaviours of high-status local citizens towards low-status migrants, whereas higher fairness perceptions of …

Bridging The Gap: Fostering Open Dialogue On Resource Access And Service Needs, Cameron Castillo

Capstone Projects and Master's Theses

This project investigates whether there are additional resources desired by clients or are needed to better support said clients in their recovery at the Interim, Inc. organization. This agency is a nonprofit organization whose sole purpose is to build community connections through providing services to individuals facing mental health and substance use challenges. While there is a wide range of programs available, there may still be clients with unmet needs. The purpose of this project was to identify any service gaps by conducting separate surveys of clients and staff members. Through the use of open-ended questions, the expectation of receiving …

Analyzing Sars-Cov-2 Wastewater Surveillance Data For Public Health Impact In Southern Nevada, Casey A. Barber

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Early in the COVID-19 pandemic, researchers determined that levels of severe acute respiratory coronavirus 2 (SARS-CoV-2) genetic material in wastewater could provide information about COVID-19 occurrence in communities. Wastewater-based epidemiology (WBE) efforts have subsequently expanded throughout the U.S. and internationally; the U.S. Centers for Disease Control and Prevention (CDC) initiated its National Wastewater Surveillance System (NWSS) in September of 2020 and continues its SARS-CoV-2 wastewater monitoring efforts following the end of the federal COVID-19 public health emergency in May 2023. The field of WBE has reached a critical juncture in determining the future of how SARS-CoV-2 wastewater surveillance data …

Development And Testing The Predictability Of An Instrument Based On The Multi- Theory Model (Mtm) Of Health Behavior Change For Pre-Exposure Prophylaxis (Prep) Uptake Among People Of Color, Siddharth Raich

UNLV Theses, Dissertations, Professional Papers, and Capstones

HIV/AIDS continues to be a significant public health problem in the US and globally. In the US, it disproportionately affects people of color. In 2012, Pre-exposure Prophylaxis (PrEP) was approved by the FDA for HIV prevention. PrEP reduces the chances of acquiring HIV by 99% among people at high risk. However, PrEP uptake among people of color remains low. Therefore, this study aimed to develop and test the predictability of an instrument to describe the intent to initiate and sustain PrEP use among people of color. This research utilized an exploratory sequential mixed methods design based on the fourth-generation, multi-theory …

Protective And Risk Exposures Of Cancers Disproportionately Affecting Hispanics In A U.S. - Mexico Border Population: A Clinical Informatics Approach, Amir Hernandez

Open Access Theses & Dissertations

BACKGROUND: Cancer is the second leading cause of death in the U.S. with over 8 million new cases between 2016 and 2020. A variety of protective and risk exposures are associated with multiple cancers and disparities and inequalities exist in the health outcomes of minority populations. Hispanic populations in the U.S. and Texas have some of the highest rates of cancer incidence and mortality when compared to other populations. The use of Population and Public Health Informatics approaches to address these issues have shown promise when employed in healthcare institutions METHODS: A case-control study design examined associations between multiple cancers …

Promotion And Tenure For Medical Physicists Should Be Based On Article Specific Measures And Not On Journal Impact Factor, Samantha Hedrick, Jinzhong Yang, Yi Rong

Faculty, Staff and Student Publications

No abstract provided.

Trends In Family Planning Uptake In Tanzania: An Analysis Of National Survey Data 2021-2022, Harun Yussuf Ayoub, Sabarinah Prasetyo

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

The purpose of this study is to uncover the socioeconomic and demographic factors that influence the usage of contraceptives by analysing trends and patterns in Tanzania's family planning uptake using data from national surveys. The results show that while Tanzania has made progress in increasing contraceptive prevalence from 27% in 2010 to 39% in 2021-22, disparities persist across socioeconomic and demographic lines. Women in urban areas, from higher wealth quintiles, and with higher educational attainment have significantly higher contraceptive prevalence rates compared to their counterparts. The study also reveals that the majority of women are aware of family planning methods, …

Keunggulan Dan Tantangan Dalam Penggunaan Computer Vision Untuk Diagnosis Pneumonia Pediatri: A Systematic Review, Hafshah Farah Fadhilah, Rico Kurniawan

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Pneumonia pediatrik merupakan penyebab utama kematian anak-anak di bawah usia lima tahun. Teknologi computer vision menawarkan potensi besar untuk meningkatkan diagnosis pneumonia pediatrik dengan menganalisis gambar radiografi dada secara otomatis. Penelitian ini menggunakan metode systematic literature review dengan pendekatan PRISMA, meninjau artikel dari database IEEE Xplore, Science Direct, dan Scopus yang diterbitkan antara tahun 2020 hingga 2024. Studi ini menemukan bahwa algoritma deep learning seperti Convolutional Neural Networks (CNN) menunjukkan akurasi tinggi dalam diagnosis pneumonia pediatrik. Namun, tantangan seperti kebutuhan akan data berkualitas tinggi, interpretasi hasil AI, dan integrasi teknologi ini dengan sistem kesehatan yang ada masih perlu diatasi. Penggunaan …

Mortality Disparities Amongst African American Infants In Wisconsin, Enica C. Saffold

Walden Dissertations and Doctoral Studies

African American mothers have the highest infant mortality rate of any other racial group, in the United States. In Milwaukee, the rates for non-Hispanic African Americans were two to three times higher than those for non-Hispanic Whites and Hispanics between 2016 and 2018. According to the Wisconsin Department of Health Services in 2022, the infant mortality rate in 2021 was 12.9 for every 1,000 live births. This cross-sectional quantitative epidemiological study explores risk factors correlated with high infant mortality rates among Wisconsin African American mothers who gave birth to live infants between 2011 and 2021. To determine whether there is …

Early Detection Of Risk Factor For Suicidal Ideation Among Senior High School Students In Jakarta: Updated Measurement, Nova R. Yusuf, Sabarinah Prasetyo, Byron J. Good

Kesmas

The key strategy to address suicide in adolescents is school-based suicidal prevention by adapting a screening instrument to the local culture and policymakers’ perception of suicide. This study aimed to develop an instrument for the early detection of risk for suicidal ideation and identify influential risk factors for suicidal ideation among high school students in Jakarta, Indonesia. This study was conducted in 2018 with a mixed-method design (quantitative and qualitative approaches). It was found that 5% of students had suicidal ideation in July–November 2018, and 13.8% had a high-risk factor for suicidal ideation. The instrument developed in this study consisted …

Home Births Among Ethnic Minority Communities In Bokeo Province, Lao People's Democratic Republic, Jukkrit Wungrath, Rungrasami Sriwongphan, Krissana Kapheak, Wanchalerm Ritthimon

Kesmas

Home births among ethnic minorities in developing countries pose significant risks to maternal and neonatal health. In Lao PDR, the government has taken steps to manage home births through training traditional birth attendants, improving transportation, and establishing referral systems. However, high home birth rates in regions like Bokeo remain concerning. This review emphasized the need for more skilled birth attendants and better access to emergency obstetric care in rural, ethnic minority areas. This review used 40 articles published between 2000 and 2023 and highlighted gaps in research regarding healthcare access, cultural practices, socioeconomic barriers, and the role of traditional birth …

Telemedicine Adoption In Developing Economies: A Systematic Review On The Enablers And Barriers, Zaidbren Macabato, Lemuel Clark Velasco, Art Brian Escabarte, Mae-Lanie Ong Poblete, Armando Isla Jr., Rentor Cafino, Sarah Lizette Aquino-Cafino, Frevy Teofilo-Orencia

Kesmas

Telemedicine’s adoption has been effective in certain contexts despite being controversial in certain settings because of its tendency to cause misdiagnosis and concerns about data privacy. This study aimed to synthesize the research findings on the factors leading to the adoption of telemedicine among developing economies. The study utilized Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology to analyze 27 related literature and the Unified Theory of Acceptance and Use of Technology to map out the factors considered enablers and barriers in adopting telemedicine. Results showed that performance expectancy, effort expectancy, social influence, and facilitating conditions were significant predictors. …

Advance Care Planning In Rehabilitation: Training Nurses And Social Workers To Facilitate Discussions, Celeste Christiansen

Student Scholarly Projects

Practice Problem: Patients and healthcare workers fail to hold advance care planning (ACP) discussions. Social workers perceive a lack of time and feel unprepared to hold ACP conversations.

PICOT: The PICOT question that guided this project was: Do patients in acute inpatient rehabilitation (P) who receive education and resources about ACP from trained nurses and social workers (I) accept and participate in ACP (O) compared to prior standards of care (C) while on the rehabilitation unit (T)?

Evidence: The public and healthcare workers have limited knowledge of ACPs and their role in these discussions. People are more likely to hold …

Social Media As Health Educator: An Assessment Of The Understandability And Accuracy Of Tiktok Content About Contraception, Julianna Coleman, Maetal Haas-Kogan, Andrea Pelletier, Rachel Stoddard, Natasha Johnson, Julia Beatini, Nora Sun, Alex Keuroghlian, Deborah Bartz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Contraception knowledge and attitudes are largely formed from conversations within one's social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy.

METHODS: This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment …

Neurohospitalist Core Competencies, Jana J Wold, Jetter Robertson, Jerome A Jeevarajan, Molly G Knox, Prateek Thatikunta, Guillermo E Solorzano, Kristin Galetta, Shefali Dujari, Tarini Goyal, Matthew E Ehrlich, Jonathan P Donnelly, Elizabeth Marriott, Vishal A Mandge, Roshni S Dhoot, Matthew W Luedke, Matthew B Maas, Margaret Y Yu, Michel Toledano, Rafid Mustafa, Jamie L Palaganas, Kathryn Kvam, Rachelle Dugue, Ethan Meltzer, Lahoud Touma, Maulik P Shah, Vanja C Douglas, Karen Orjuela, Brian J Scott, Joshua P Klein, David J Likosky, Jennifer R Simpson, Megan B Richie, Carolin Dohle, Jane G Morris, Carl A Gold

Faculty, Staff and Student Publications

The Neurohospitalist Core Competencies comprise a set of competency-based learning objectives that encapsulate the knowledge, skills, and attitudes of neurohospitalitists who specialize in the care of hospitalized patients with neurologic conditions. These competencies serve to characterize the rapidly expanding field of neurohospitalist medicine. The 27 chapters are divided into 3 sections entitled: neurological conditions, clinical interventions and interpretation of ancillary studies, and neurohospitalist role in the healthcare system. Each individual learning objective in the chapters describes a specific concept with an action verb to illustrate the behavior that the neurohospitalist exhibits. The individual neurohospitalist may not exhibit mastery in each …

Intervention Mapping For Refining A Sport-Based Public Health Intervention In Rural Schools, Mckenna G Major, Janette M Watkins, Janelle M Goss, Derek W Craig, Zack Waggoner, Vanessa M Martinez Kercher, Kyle A Kercher

Faculty, Staff and Student Publications

Sport-based youth development programs, delivered through campus-community partnerships, can create impactful experiences for college students, meet university objectives, and improve the health of children in under-resourced rural communities. This study aimed to pilot test intervention mapping (IM), a systematic approach to intervention development and implementation, to refine the Hoosier Sport intervention, which is a local public health initiative that utilizes the Obesity-Related Behavioral Intervention Trials (ORBITs) model to improve physical activity in middle school children. The IM process, which included a diverse IM planning and advisory group of university representatives and local schools, was guided by self-determination theory (SDT) and …

Best Practice Toolkit For Increasing Colorectal Cancer Screenings In At-Risk Adults, Zoe Windfelder

Student Scholarly Projects

Adult individuals at risk for colorectal cancer (CRC) do not have a direct, accessible best-practice toolkit to follow for screening measures. Research showed that at least three guidelines (i.e., American Cancer Society [ACS], American College of Gastroenterology [ACG], and U.S. Preventive Services Task Forces [USPSTF]) are used interchangeably daily by interprofessional staff for individuals with average to high-risk variables. The project was guided by the following PICOT question: For interprofessional staff supporting the at-risk adult population for colorectal cancer (P), how does the development of a best practice for coordination of care toolkit (I) compared to no structured program strategy …

The Effect Of A Virtual Covid-19 Interprofessional Educational Module On Knowledge, Confidence, Attitude, And Practice Among Health And Allied Health Professions Students, Tsu-Yin Wu, Jenni L. Hoffman, Grigoris Argeros, Sarah Lally, Andrea Gossett Zakrajsek, Jillian Graves, Alice Jo Rainville, Olivia Ford, Angela Lukomski, Renuka Roche, John Sonnega, Joan E. Cowdery Phd

Journal of Interprofessional Practice and Collaboration

Purpose: The purpose of this research study was to examine the effect of an innovative, online COVID-19 interprofessional educational module among health and allied health professions students.

Methods: This study utilized a pre- and posttest design with quantitative and qualitative data collected winter 2023 and spring/summer 2023 semesters, and consisted of health and allied health professions students (N=143) from three Midwestern, urban, public universities. Participants completed a pretest, then an IPE module on COVID-19, and a posttest immediately after the educational intervention, and another (the same) posttest one month later. Quantitative and qualitative data were subject to statistical …

Hurricane Evacuation: Navigating Uncertainty During Covid 19 And With Existing Communication Scales, And Considering Public And Expert Perception Of Alternative Scales, Leilani D. Paxton

USF Tampa Graduate Theses and Dissertations

This dissertation investigates the effectiveness of current hurricane warning products and communication strategies, exploring factors influencing public perception of risk and decision-making during evacuations. The study employs a mixed-methods approach, combining survey data, focus group discussions, and interviews with meteorologists and emergency managers. The first paper examines the impact of the COVID-19 pandemic on hurricane risk perception and evacuation decisions. Findings indicate that while COVID-19 concerns played a role in some individuals' decisions, particularly those with pets or concerns about shelter conditions, the majority of participants evacuated for Hurricane Ian. The study highlights the importance of providing clear, consistent, and …

Mitochondrial Heteroplasmy Improves Risk Prediction For Myeloid Neoplasms, Yun Soo Hong, Sergiu Pasca, Wen Shi, Daniela Puiu, Nicole J Lake, Monkol Lek, Meng Ru, Megan L Grove, Anna Prizment, Corinne E Joshu, Elizabeth A Platz, Eliseo Guallar, Dan E Arking, Lukasz P Gondek

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential is the primary pathogenic risk factor for myeloid neoplasms, while heteroplasmy (mutations in a subset of cellular mitochondrial DNA) is another marker of clonal expansion associated with hematological malignancies. We explore how these two markers relate and influence myeloid neoplasms incidence, and their role in risk stratification. We find that heteroplasmy is more common in individuals with clonal hematopoiesis of indeterminate potential, particularly those with higher variant allele fractions, multiple mutations, or spliceosome machinery mutations. Individuals with both markers have a higher risk of myeloid neoplasms than those with either alone. Furthermore, heteroplasmic variants with …

Food Safety, Livestock Health, And Productivity Of A Layer Farm Following Implementation Of A Certified Haccp System In Japan, Hiroshi Akaike, Makoto Nagai, Tomomitsu Alexandre Okatani, Sumalee Boonmar, Yukio Morita

The Thai Journal of Veterinary Medicine

This study examined the safety and productivity of a layer farm over a 3-year period following the implementation of a farm Hazard Analysis and Critical Control Points (HACCP) system in 2019. The critical control point was “automatic egg collection” and no deviations from critical limits were observed, indicating the eggs were safe. In addition, the egg production rate increased and the feed conversion rate decreased. In contrast, the viability after the introduction of a farm HACCP system, in which the replenishment of new hens was discontinued after forced molting, showed an increasing trend. These results suggest that the HACCP system …

Navigating The Aftermath: Understanding Covid Impact & Addressing Health Disparities In The Post-Pandemic Recovery Symposium Executive Report, Ashlee Young, Zuri Dale

COVID Research

While the immediate crisis may have passed, the pandemic exposed significant vulnerabilities in public health systems. A comprehensive examination of the ongoing effects of the pandemic offering insights into the challenges and opportunities that lie ahead as we continue to recover and rebuild four years after the pandemic began is crucial. Our bold vision is to improve health and quality of life and further the science that transforms lives. This reflection is crucial to prepare for future pandemics or global health crises. The 2024 theme, Navigating the Aftermath: Understanding COVID Impact and Addressing Health Disparities in Post-Pandemic Recovery, was a …

Analyzing Longitudinal Trait Trajectories Using Gwas Identifies Genetic Variants For Kidney Function Decline, Simon Wiegrebe, Mathias Gorski, Janina M Herold, Klaus J Stark, Barbara Thorand, Christian Gieger, Carsten A Böger, Johannes Schödel, Florian Hartig, Han Chen, Thomas W Winkler, Helmut Küchenhoff, Iris M Heid

Faculty, Staff and Student Publications

Understanding the genetics of kidney function decline, or trait change in general, is hampered by scarce longitudinal data for GWAS (longGWAS) and uncertainty about how to analyze such data. We use longitudinal UK Biobank data for creatinine-based estimated glomerular filtration rate from 348,275 individuals to search for genetic variants associated with eGFR-decline. This search was performed both among 595 variants previously associated with eGFR in cross-sectional GWAS and genome-wide. We use seven statistical approaches to analyze the UK Biobank data and simulated data, finding that a linear mixed model is a powerful approach with unbiased effect estimates which is viable …

The Southern Nevada Care Economy: Addressing Child Care And Elder Care Challenges, The Lincy Institute

Lincy Institute Events

This community forum examines the economic and societal impact of the “care economy” in Southern Nevada in collaboration with Tripp Umbach, a nationally recognized consulting firm that provides comprehensive services including research and strategic plans to further the operations and activities of healthcare services.

Central to the care economy is elder care and child care. Having access to elder care and child care services is essential to working age adults, many of whom need one or both types of services to continue participating in the workforce. The delivery of child care and elder care services have far-reaching implications for our …

Political Polarization Harms Public Health, Shana Kushner Gadarian, Jay Van Bavel, Kai Ruggeri, Eric Knowles

Population Health Research Brief Series

Political polarization poses considerable risks to well-being. Both ideological polarization (“extremification” of policy positions and ideological orientations) and affective polarization (out-party hate) have increased over the past several decades with detrimental effects on public health. This brief summarizes the impacts of political polarization on public health in the U.S., highlighting the COVID-19 pandemic as a case study on the health risks of polarization. The authors show that, in the United States, one of the strongest predictors of COVID-19 prevention behaviors, such as social distancing and vaccination, was political partisanship. Gaps in these behaviors between Republicans and Democrats increased over the …

Association Of Binge Alcohol Use With Functional Outcomes Among Individuals With Covid-19 Infection, Sebastian T. Tong, Michael Gottlieb, Imtiaz Ebna Mannan, Zihan Zheng, Manisha Sinha, Michelle Santangelo, Kristyn Gatling, Efrat Kean, Phillip Watts, Ralph Wang, Juan Carlos Montoy, Ahamed Idris, Samuel Macdonald, Ryan Huebinger, Mandy Hill, Kelli N O'Laughlin, Nicole L. Gentile, Jocelyn Dorney, Caitlin Malicki, Joann G. Elmore, Kate Diaz Roldan, Gary Chan, Zhenqiu Lin, Robert A. Weinstein, Kari A. Stephens

Department of Medicine Faculty Papers

AIMS: Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.

METHODS: Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection. Eligible patients were those who presented with COVID-19-like symptoms, tested positive for COVID-19, and completed a three-month survey. Binge drinking was identified at the time of infection using the Tobacco, Alcohol, Prescription medication …

Attachment Styles As Moderators Of Loneliness In Remote Work, Brody Tj Loughlin

Doctoral Dissertations

This dissertation investigates the role of attachment styles in moderating the relationship between remote work and loneliness. Drawing on attachment theory, which posits that early life experiences shape attachment styles and influence social interactions, the study examines whether attachment styles (anxious, avoidant, and secure) moderate the association between remote work and feelings of loneliness. The research targets 394 remote workers, using a quantitative, cross-sectional survey design with proportional stratified sampling to reflect the distribution of hybrid and fully remote work arrangements in the U.S. workforce. The Extent of RemoteWork measure, the Three-Item Loneliness Scale, and the Adult Attachment Scale assess …

Hypertension Screening In Dental Settings And The Need To Address Dental Insurance Literacy, Dorothy Nuckols

Journal of Extension

Extension has an active and dynamic health insurance literacy program with certified educators nationwide, but dental insurance literacy is an unmet need. There is an increasing trend of dental practitioners willing to perform basic preventative health measures, particularly hypertension screening. Lack of insurance literacy is a barrier to screening request and follow-up. Participants in our longitudinal study visited their dentists as regularly as they visited their primary health practitioners. This study shows the need for Extension to add dental insurance literacy to the menu of health insurance literacy programs to impact the prevalence of hypertension.

Who Cares For The Caregiver? Exploring Extension’S Role In Informal Caregiving Support, Mckenzie R. Tuttle, Erin L. Martinez, Aimee Fox

Journal of Extension

Family caregivers provide invaluable service by taking on the responsibility of caring for older adults in the United States. With a growing aging population, the need for family caregivers and demands on their time and resources will continue to increase. Although a variety of caregiving resources and support services exist, family caregivers often lack the awareness, time, transportation, or financial resources to connect to services. There is a critical need to address the barriers that prevent caregivers from accessing services. In this commentary, we highlight barriers and make recommendations for improving conversations, research, and practice to meet this growing problem.