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Predictors Of Complementary Alternative Medicine Usage Among Diabetic Adults In The United States, Erlina Kearse-Lewis

Walden Dissertations and Doctoral Studies

Available data for the last two decades have shown that the use of complementary and alternative medicine (CAM) is increasing, with users including adult diabetics around the world. There is not a strong consensus concerning the influence of socioeconomic factors on the use of CAM by adult diabetics. The purpose of this retrospective cross-sectional study was to examine the use of CAM among U.S. adults 21 years and older diagnosed with diabetes and whether income influences the use of CAM among adult diabetics after adjusting for age, gender, and location. Cross-sectional data from the 2017 National Health Interview Survey represented …

Concepts In Animal Parasitology, Scott L. Gardner, Sue Ann Gardner

Zea E-Books Collection

Note that this version of the textbook has been superceded by the one updated in 2026, available at the UNL Pressbooks site.

The hard copy version that is for sale at lulu.com is the old version.

"This is a textbook covering concepts in animal parasitology. It is meant to be used by students, teachers, professors, researchers, and members of the public who are interested in learning about animal parasite biology, systematics, taxonomy, zoogeography, and ecology. The primary intended audience is upper-level undergraduate or graduate university students who have knowledge of basic biology and, particularly, basic animal biology. (863 pages, …

Predictors Of Complementary Alternative Medicine Usage Among Diabetic Adults In The United States, Erlina Kearse-Lewis

Walden Dissertations and Doctoral Studies

Available data for the last two decades have shown that the use of complementary and alternative medicine (CAM) is increasing, with users including adult diabetics around the world. There is not a strong consensus concerning the influence of socioeconomic factors on the use of CAM by adult diabetics. The purpose of this retrospective cross-sectional study was to examine the use of CAM among U.S. adults 21 years and older diagnosed with diabetes and whether income influences the use of CAM among adult diabetics after adjusting for age, gender, and location. Cross-sectional data from the 2017 National Health Interview Survey represented …

Factors Affecting African Americans’ Participation In Alzheimer’S Disease Clinical Trials, Morounsayo Abimbola Awosika-Olumo

Walden Dissertations and Doctoral Studies

Racial minority U.S. populations are underrepresented in clinical trials. Ensuring people from diverse backgrounds join clinical trials is key to advancing health equity. Participants in clinical trials should represent the patients’ population. The purpose of this quantitative study was to assess the association of individual-level factors (age, sex, marital status, family history of Alzheimer’s disease, living arrangement), health-related factors (smoking and alcohol), and socioeconomic status (years of education, employment status, health insurance status) and the interest in clinical trial participation among African Americans (AAs). The theoretical foundation that grounded this study was the health belief model. Secondary data from 214 …

“I Had To Go There For My Own Safety” Negotiations Of Access And Autonomy Among Dc Birth Settings, Elizabeth Avery Borgmann

Geography Undergraduate Senior Theses

Childbirth experiences are shaped by spatial context. This study considers the relationships between access to, selection of, and experiences with labor and delivery care among Black birthing people in Washington, DC. Informed by Reproductive Justice and reproductive geographies frameworks, I employ a mixed methods GIS design that integrates mapping of potential spatial access with qualitative analysis of community members’ lived experiences. On the quantitative side, nearest-neighbor and 2-step floating catchment area analyses reveal an east-west gradient of potential spatial access to labor and delivery wards, with low access concentrated in predominantly Black and low-income census tracts of Wards 5, 7, …

Assessing The Uptake Of Biosimilar Insulin Glargine Among Physicians For The Treatment Of Diabetes In South Africa, Euganthri Pillay

Walden Dissertations and Doctoral Studies

In South Africa, diabetes is a serious problem where 1 in 9 adults has diabetes, making it the country with the highest diabetes prevalence on the African continent. Even though insulin is an absolute necessity for treating diabetes, it is unaffordable to millions. Biosimilar insulins, however, are innovative medicines that are similar but not exact copies of the originator insulin, making alternative treatment affordable to patients. The problem is that, in South Africa, it is still not known whether patients have access to biosimilar insulin in a country where diabetes is rampant. The diffusion of innovation theory was used to …

Assessing The Uptake Of Biosimilar Insulin Glargine Among Physicians For The Treatment Of Diabetes In South Africa, Euganthri Pillay

Walden Dissertations and Doctoral Studies

In South Africa, diabetes is a serious problem where 1 in 9 adults has diabetes, making it the country with the highest diabetes prevalence on the African continent. Even though insulin is an absolute necessity for treating diabetes, it is unaffordable to millions. Biosimilar insulins, however, are innovative medicines that are similar but not exact copies of the originator insulin, making alternative treatment affordable to patients. The problem is that, in South Africa, it is still not known whether patients have access to biosimilar insulin in a country where diabetes is rampant. The diffusion of innovation theory was used to …

Shea Position Statement On Pandemic Preparedness For Policymakers: Building A Strong And Resilient Healthcare Workforce, Robin L.P. Jump

Faculty Scholarship

Throughout the COVID-19 pandemic, many areas in the United States experienced healthcare personnel (HCP) shortages tied to a variety of factors. Infection prevention programs, in particular, faced increasing workload demands with little opportunity to delegate tasks to others without specific infectious diseases or infection control expertise. Shortages of clinicians providing inpatient care to critically ill patients during the early phase of the pandemic were multifactorial, largely attributed to increasing demands on hospitals to provide care to patients hospitalized with COVID-19 and furloughs.¹ HCP shortages and challenges during later surges, including the Omicron variant-associated surges, were largely attributed to HCP …

Shea Position Statement On Pandemic Preparedness For Policymakers: Introduction And Overview, Robin L.P. Jump

Faculty Scholarship

Throughout history, pandemics and their aftereffects have spurred society to make substantial improvements in healthcare. After the Black Death in 14th century Europe, changes were made to elevate standards of care and nutrition that resulted in improved life expectancy.1 The 1918 influenza pandemic spurred a movement that emphasized public health surveillance and detection of future outbreaks and eventually led to the creation of the World Health Organization Global Influenza Surveillance Network.2 In the present, the COVID-19 pandemic exposed many of the pre-existing problems within the US healthcare system, which included (1) a lack of capacity to manage a large influx …

Client Perspectives On The Development Of A Rapid Prep Initiative At A Sexual Health Center In New Orleans, Louisiana, Aish Lovett, Rose Luder, Rebecca Lillis, Isolde Butler, Julia Siren, Samuel Gomez, Kevin Kamis, Oluyomi Obafemi, Sarah E. Rowan, Stefan Baral, Meredith E. Clement

School of Medicine Faculty Publications

Uptake of PrEP remains suboptimal, especially in the Southern United States. Same-day or “Rapid PrEP Initiatives” (RPIs) in sexual health centers (SHCs) could facilitate access and overcome barriers to PrEP. We studied the adaptation of an RPI from Denver, Colorado to an SHC in New Orleans, Louisiana. Through focus group discussions (FGDs) with local SHC staff and PrEP providers, we developed a preliminary RPI model. In 5 FGDs with SHC clients referred for or taking PrEP, we gathered adaptation recommendations and feedback on model acceptability, feasibility, and utility. Providers and clients voiced unanimous support for the RPI. Clients favored the …

A Multilevel Intervention To Promote Hpv Vaccination Among Young Adults In Texas: Protocol For A Randomized Controlled Trial, Qian Lu, Lenna Dawkins-Moultin, Dalnim Cho, Naomi Q P Tan, Suellen Hopfer, Yisheng Li, Lois Ramondetta, Yusi Xu, Di Lun, Minxing Chen

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol.

METHODS: The study uses a two by three factorial design. …

A One Health Approach To Enhancing Sars-Cov-2 Surveillance, Lauren C. Cybulska

Dissertations and Theses

Background

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus that causes coronavirus disease-2019 (COVID-19) in humans, can also infect domestic dogs (Canis lupus familiaris) and cats (Felis catus). Susceptibility and viral transmissibility in these species are concerns for public health due to the spillover risk to humans or other animals. This dissertation uses a One Health framework to explore key issues on this topic. We aim to identify gaps in understanding of SARS-CoV-2 in companion animals and investigate novel surveillance methods through human, animal, and environmental health perspectives.

Methods

Paper 1 provides an in-depth exploration of …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

Impact Of Telehealth On Type 2 Diabetes Self-Management During The Covid-19 Pandemic, Nancy Olivo Marshall

Walden Dissertations and Doctoral Studies

The incidence of Type 2 diabetes mellitus (T2DM) is on the rise, particularly among adults aged 18 years and older. Glycosylated hemoglobin (HbA1c) levels are commonly used by healthcare professionals to assess glucose variability; fluctuations are associated with an increased risk of adverse effects. The COVID-19 pandemic highlighted the importance of self-directed management of HbA1c levels through telehealth. The purpose of this retrospective quantitative study was to investigate the effectiveness of self-directed management of HbA1c levels using telehealth among T2DM diagnosed adults at a community health service organization in the northeastern U.S. from December 2018 to 2022. Using multivariate regression …

Exploring Associations Between Poverty, Race/Ethnicity, Gender, And Childhood Obesity In Cherokee County, South Carolina, Lillie Mae Hall

Walden Dissertations and Doctoral Studies

Childhood obesity (CHO) rates have increased significantly worldwide over the last decade. The magnitude of CHO extends beyond physical health to include economic stability, social connections, and access to daily living resources. CHO is complex and requires a multifaceted approach that may differ from traditional prevention approaches and treatment. Over the years, interventions have focused on maintaining a balance of healthy eating and active living to reduce weight and promote lifelong behavior change. Body mass index (BMI) surveillance studies have been conducted in Cherokee County, South Carolina since 2012 to assess and inform CHO interventions. However, the data have not …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

Exploring Associations Between Poverty, Race/Ethnicity, Gender, And Childhood Obesity In Cherokee County, South Carolina, Lillie Mae Hall

Walden Dissertations and Doctoral Studies

Childhood obesity (CHO) rates have increased significantly worldwide over the last decade. The magnitude of CHO extends beyond physical health to include economic stability, social connections, and access to daily living resources. CHO is complex and requires a multifaceted approach that may differ from traditional prevention approaches and treatment. Over the years, interventions have focused on maintaining a balance of healthy eating and active living to reduce weight and promote lifelong behavior change. Body mass index (BMI) surveillance studies have been conducted in Cherokee County, South Carolina since 2012 to assess and inform CHO interventions. However, the data have not …

A Retrospective Review: Oxford County Wellness Collaborative's Contributions To Community Health, Emma Schwartz, Rachel M. Gallo Mph

Children, Youth, & Families

Since 2011, Oxford County Wellness Collaborative (OCWC) has been transforming personal, environmental, and economic health by building strong relationships among people and organizations. OCWC contracted with the Data Innovation Project at the Catherine Cutler Institute of Health and Social Policy to synthesize previously collected or reported data and collect primary data to conduct a retrospective evaluation. The evaluation team used this data to convey past successes, better understand the outcomes of the collaborative to date, and provide recommendations for OCWC’s next steps in furthering its impact.

Polarization, The Pandemic, And Public Trust In Health System Actors, Alessandro Del Ponte, Alan S. Gerber, Eric M. Patashnik

Political Science Faculty Articles and Research

Context: Public opinion on the performance of health system actors is polarized today, but it remains unclear which actors enjoy the most or the least trust among Democrats and Republicans, whether the COVID-19 pandemic has influenced how people view their own physicians, and whether doctors have retained the ability to influence public beliefs about policy issues.

Methods: The authors conducted two national surveys in 2022 and 2023 to examine these questions.

Findings: Democrats rated the performance of medical research scientists and public health experts during the pandemic more highly than did Republicans and independents. About three in ten Republicans said …

One Health In The Philippines: A Review And Situational Analysis, Lystra Zyrill A. Dayapera, Jenica Clarisse Y. Sy, Sary Valenzuela, Samantha Julia L. Eala, Ciara Maria Ines P. Del Rosario, Karen Nicole C. Buensuceso, Adrian S. Dy, Danielle A. Morales, Anna Giselle Gibson, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

The Philippines faces a complex and interconnected web of human, animal, and environmental health issues, including zoonotic and reverse zoonotic diseases, antimicrobial resistance, food insecurity and contamination, and threats from environmental degradation. This paper examines these issues, existing interventions, and their implementation challenges. The overall framework used to analyze the level of operationalization of the One Health approach is the Multi-sectoral One Health Coordination Framework developed by the World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health. A two-step process was conducted: literature review, followed by consultations with government and non-government stakeholders across national, subnational, …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

A Mixed-Method Analysis Of The Contribution Of Informal Sport To Public Health In Australia, Ruth Jeanes, Justen O'Connor, Dawn Penney, Ramon Spaaij, Jonathan Magee, Eibhlish O' Hara, Lisa Lymbery

Research outputs 2022 to 2026

Informal sport is a growth area of sport participation but there has been limited examination of how informal and unstructured forms of participation may contribute to health outcomes that are important for public health. This article aims to address the current lack of data examining the health outcomes associated with informal sport participation and consider the potential role of informal sport within efforts to promote healthier communities through sport. The article seeks to broaden understanding of how informal sport participation can contribute to health outcomes, particularly with regard to increasing physical activity and enhancing mental health and social connection. The …

Australian Children's Physical Activity And Screen Time While In Grandparental Care, Michelle I. Jongenelis, Timothy Budden, Ben Jackson, Hayley Christian, Andrea Nathan, David Coall, Emma Glassenbury

Research outputs 2022 to 2026

Objective: The objective of this study was to explore Australian children's engagement in physical activity and screen time while being cared for by their grandparents.

Method: Grandparents (N = 1,190) providing ≥3 hours of weekly care to a grandchild aged 3–14 years completed an online survey assessing their grandchildren's movement behaviours while in their care. Descriptive statistics were computed for frequency of engagement in unstructured and structured physical activities, minutes spent playing outdoors, and minutes spent engaged in screen time. Regression analyses were conducted to assess socio-demographic predictors of movement behaviours.

Results: Playing in the yard was the most common …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

The Relationship Between Healthcare Access And Change In Health-Related Quality-Of-Life Among The General Population Of Five Countries During The Covid-19 Pandemic, Nadja Alexandrov, Emily Stella Scott, Mathieu F. Janssen, Erica I. Lubetkin, John N. Yfantopoulos, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Purpose To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries.

Methods An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and …

Postpartum Recovery After Severe Maternal Morbidity In Kilifi, Kenya: A Grounded Theory Of Recovery Trajectories Beyond 42 Days, Ursula Gazeley, Marvine Ochieng, Onesmus Wanje, Angela Koech, Grace Mwashigadi, Nathan Barreh, Alice Kombo, Mwanajuma Bakari, Grace Maitha, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women’s perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.

Methods This woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either a maternal near-miss event (n=11), potentially life-threatening condition (n=6) or no severe morbidity (n=3). Women were purposively selected between 6 …

Indiana's Public Health Investment Holds Insights For Other States, Nir Menachemi, Lindsay Weaver, Virginia Caine, D Shane Hatchett, Kristina Box, Paul K. Halverson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Indiana has a business-friendly environment, but historical underinvestment in public health has yielded poor health outcomes. In 2023, when trust in governmental public health was strained nationwide, Indiana increased public health spending by 1,500 percent. In this article, we explain how Indiana achieved this unprecedented legislative victory for public health, describing the context, approach, and lessons learned. Specifically, an Indiana University report linking economic vitality and overall health sparked the creation of a governor's commission charged with exploring ways to address Indiana's shortcomings. Working with the Indiana Department of Health, the commission developed multisectoral coalitions and business and government partnerships, …

A Dual-Angle Exploration Towards Understanding Lapses In Covid-19 Social Responsibility, Sean T. H. Lee, Jerome J. X. Mah, Angela K. Y. Leung

Research Collection School of Social Sciences

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health-risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self-perceived infection should provide an impetus to engage in …

Life-Space Mobility, Transportation, And The Companionship Network Of Members Of A Hispanic Senior Center, Rebecca L Mauldin, Rupal Parekh, John P Connolly, Stephen P Mattingly, Aiman Mushtaq, Kayo Fujimoto

Faculty, Staff and Student Publications

Objectives: Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships.

Methods: This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the …