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Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick

Capstone Experience: Master of Public Health

Objective

Human Immunodeficiency Virus (HIV) infection is a global epidemic, and public health efforts are moderately effective to date. This cross-sectional study aimed to determine association between high-risk behavior (intravenous drug use, risky sexual behaviors) and odds of testing for HIV utilizing 2022 Behavioral Risk Factor Surveillance System (N= 445,132).

Methods

Using SAS 3.82, the age-stratified logistic regression model for exposure (high-risk behavior) and outcome (HIV testing) included covariates gender, race, income, mental health and checkup frequency.

Results

High-risk individuals had greater odds of testing compared to low-risk individuals (crude POR 2.98 [2.81 – 3.17]), with greatest odds observed among …

Bayesian Estimation Of Reproduction Numbers From Distributions Of Outbreaks Sizes: Branching Process Approach, Alberta Araba Johnson

Theses and Dissertations

The Generalized Poisson distribution is useful in modeling epidemiological processes as a branching stochastic processes problem. Our goal is to construct accurate and reliable estimators for the reproduction number (R0) (i.e., the number of secondary infections), particularly in the context of disease outbreaks modeled by a Galton-Watson process. Towards this goal, we construct the classical Bayes estimator, the Maximum Likelihood estimator, and the Empirical Bayes (EB) estimator under the Square Error Loss function in Chapter II. We prove that the Empirical Bayes estimator is asymptotically optimal and estimate the rate of convergence. We then proceed to monotonize the Empirical Bayes …

Reimaging Safety After Sexual Violence: A Qualitative Exploration Of Survivors' Experiences With Formal And Informal Crisis Response Networks., Hallie Ruth Decker

Electronic Theses and Dissertations

Sexual violence (SV) is a highly prevalent public health and human rights concern impacting communities across the United States. SV is associated with a myriad of adverse physical, reproductive, sexual, mental, behavioral, financial, and social health outcomes which may be acute or chronic. Health challenges associated with post-traumatic stress and post-traumatic stress disorder are particularly common among victims and survivors of SV. Engagement in early psychological/psychosocial intervention strategies may prevent or reduce PTSD-related symptomatology after experiencing an SV encounter. Despite the availability of crisis response and support options to support individuals who have experienced SV, significant barriers exist across social …

Examining The Relationship Between Mass Incarceration, Gender Norms, And Hiv Vulnerability For Formerly-Incarcerated Black Men Who Have Sex With Men And Women., Adrienne B. Smith

Electronic Theses and Dissertations

In 2018, Black Americans represented 42% of new HIV diagnoses, despite comprising only 13% of the population. Moreover, Black men accounted for three-quarters of new HIV cases in 2016, with Black gay/bisexual men contributing to the majority of incidence among Black Americans. Existing literature suggests that individual behavior alone cannot explain these racial inequities in HIV rates. This study aims to explore the role of the criminal legal system (CLS) as a structural determinant of health, given its historical racial implications that disproportionately affect Black Americans. Additionally, the study examines masculinity’s influence as a predictor of risky sexual behavior. This …

"They Are Who We Thought They Were": The Influence Of White Supremacist Discourse On Voter Suppression And Black Health., Tanisha Howard Lewis

Electronic Theses and Dissertations

Political systems in the United States have contributed to health outcomes in the through the historic and legal doctrine related to race and racism, segregation, housing, employment, and education. In recent years, significant attention has been given to theorizing the political determinants of health and what it means in the overall conversation about health equity. The equity implications of the political determinants of health are innumerable because they are the origin point of the structural determinants of health and the primary drivers of the social determinants of health, which span from environmental conditions to food security. The focal determinant of …

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

Translating Motivational Interviewing For The Hpv Vaccine Into A Computable Ontology Model For Automated Ai Conversational Interaction, Nicole Moore, Muhammad Amith, Ana C Neumann, Jane Hamilton, Lu Tang, Lara S Savas, Cui Tao

Faculty, Staff and Student Publications

Human papillomavirus (HPV) vaccinations are lower than expected. To protect the onset of head and neck cancers, innovative strategies to improve the rates are needed. Artificial intelligence may offer some solutions, specifically conversational agents to perform counseling methods. We present our efforts in developing a dialogue model for automating motivational interviewing (MI) to encourage HPV vaccination. We developed a formalized dialogue model for MI using an existing ontology-based framework to manifest a computable representation using OWL2. New utterance classifications were identified along with the ontology that encodes the dialogue model. Our work is available on GitHub under the GPL v.3. …

Physical Activity Policies At National And Subnational Levels: A Study In Colombia, Costa Rica, Ecuador, And Mexico, Juliana Mejía Grueso, Michael Pratt, Eugen Resendiz, Deborah Salvo, Gloria Isabel Niño Cruz, Nubia Yaneth Ruiz Gómez, Rafael Alexander Leandro Gómez, Inés Revuelta Sánchez, Gerardo Alonso Araya Vargas, Angélica María Ochoa Avilés, Raúl Francisco Pérez Tasigchana, Alejandra Jáuregui, Pedro C Hallal, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Background: National physical activity (PA) policy processes are only beginning to be studied in Latin America, and little attention has focused at the subnational level. This study examined national-subnational relations in the policy process (agenda setting, policy formulation, adoption, implementation, and evaluation) in selected Latin American countries.

Methods: The Global Observatory for Physical Activity's (GoPA!) INTEGRATE-PA-Pol tool was applied in Colombia, Costa Rica, Ecuador, and Mexico. Data were collected in matched pairs of the capital plus one noncapital city among national and subnational policymakers (n = 27), previously identified by the GoPA! Country Contacts. PA policy development and implementation were …

Risk Evaluation In Occupational Safety And Health Research: Results From A Benchmarking Exercise Of Federal And Academic Irbs, Sarah A Felknor, Jessica M K Streit, Angela M Morley, John D Piacentino

Faculty, Staff and Student Publications

OBJECTIVE: Research involving working populations can pose unique ethical and risk evaluation challenges. The purpose of this benchmarking project was to assess how federal agencies and academic institutions approach the interpretation and application of key risk evaluation concepts in research involving workers in their places of employment.

METHODS: Key informant interviews were conducted to ascertain current practices related to assessing soundness of research design, determining risk reasonableness and research relatedness of risks, and evaluating the risk of noninvasive clinical tests in occupational settings.

RESULTS: There were noteworthy commonalities among the approaches described to review and address critical aspects of risk …

Patient Understanding Of Fetal Sex Versus Gender In The Context Of Routine Cell-Free Dna Screening, Mindy Kolodziejski

Dissertations and Theses (Open Access)

Non-invasive prenatal testing (NIPT) is the current standard of care to screen for fetal aneuploidy using cell-free DNA (cfDNA). NIPT screens for sex chromosome aneuploidies (SCAs) and in doing so, can predict fetal chromosomal sex. Despite sex and gender being distinct concepts, many patients refer to NIPT as “the gender test” and elect testing in order to find out predicted fetal sex and assume gender. Our study aimed to evaluate and describe patient understanding of sex and gender in the context of receiving routine prenatal genetics education (PGE) on NIPT. A survey was developed with the goal of assessing patient …

Examining Current Capacity Of Healthcare Systems: Identifying Potential Adaptations For Children And Youth With Special Healthcare Needs, Caitlin Koob

All Dissertations

Children and youth with special healthcare needs (CYSHCN) are a growing proportion of the pediatric population, accounting for 23% of children in South Carolina (SC). Children with medical complexity (CMC) are a subgroup of CYSHCN who experience the most complex conditions and comprise

This dissertation investigates equitable healthcare access, service quality, and health and well-being among CYSHCN and their families, within the context of SC’s healthcare system. Three studies make up this dissertation, focusing on various aspects of healthcare access and experiences of CYSHCN and their families.

Evaluating Mental Health Outcomes In Covid-19 Icu Survivors: A Scoping Review Of Measurement Tools, Kimberly T'Ng, Justin Kenardy, Andree Hartanto

Research Collection School of Social Sciences

Objective: The objective of this scoping review was to map the range of measurement tools used to study the prevalence of common mental health conditions in COVID-19 ICU survivors. Introduction: Increased rates of admission to and survivorship from intensive care units (ICUs) have been observed in recent years, particularly during the global pandemic. ICU patients are at a higher risk of developing depressive, anxiety, and PTSD symptoms. Due to the high burden of disease, an accurate understanding of long-term mental health challenges for this population is key. Unfortunately, there is significant variability in reported prevalence rates. Heterogeneity in measurement tools …

Breaking Barriers: An Innovative Tool To Assess The National And City-Level Physical Activity Policy Development To Practice Disconnect, Eugen Resendiz, Andrea Ramírez-Varela, Juliana Mejía-Grueso, Jane Moon, Josef Mitáš, Ross C Brownson, Deborah Salvo, Michael Pratt

Faculty, Staff and Student Publications

Background: Population-level physical activity increases are improbable without intersectoral collaboration across government levels and sectors to develop and implement physical activity promotion policies. This study aims to provide information about the development of the Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool (INTEGRATE PA-Pol). A framework was created to examine the development and implementation of national and subnational physical activity policies and the (mis)alignment between government levels.

Methods: The work was conducted in 3 phases: (1) a scoping review was carried out to identify local government physical activity promotion policies and instruments …

An Examination Of Products That University Of Mississippi Students Consume For Managing Their Stress, Kiersten Rickard

Honors Theses

Students are notoriously one of the most stressed groups in our society. Stress is a complex topic; causes, mitigation methods, and manifestations of stress all vary in an individual. Being that stress is an universal experience, this research capitalizes on the importance of stress and the methods used to mitigate stress. This study looks at, among other ideas, stress on the University of Mississippi campus in regards to demographics and the products (caffeine, sleep aids, over the counter medicines, stress supplements, and CBD) that students use. Results demonstrate that, overall, higher stress levels correlate to higher product usage rates. The …

Exploring Influencing Factors On The Adoption Of Non-Pharmaceutical Interventions During Pandemics: Covid-19 As An Example., Ahmed Abdulmohsen I Alobaydullah

Electronic Theses and Dissertations

Background: Pandemics are associated with loss of life, hospitalizations, and disruption to people’s social and economic lives. As the 2019 pandemic illustrates, COVID-19 can be prevented by pharmaceutical and non-pharmaceutical interventions (NPIs). Recommended measures such as wearing a mask, washing hands, social distancing, and self-quarantine have been proven to curb the spread of the coronavirus. Identifying the factors associated with adherence to NPIs is the first step in understanding which levers of change to pull when designing health promotion interventions such as health communication campaigns. This dissertation explores these factors and proposes a health communication framework during pandemics. Research Questions: …

Community Health Assessment Collaboration: Implementing A Joint Assessment Between A Healthcare System And A Local Health Department, Briar L. Deen

Dissertations: Doctor of Public Health

Non-profit hospitals and local health departments (LHDs) often complete community health assessments (CHAs) to help understand the needs of their community and develop implementation strategies to address the community needs. Hospitals and LHDs in the same community often develop separate CHAs with similar results leading to overlap in work and funds. This project aimed to address this issue in the Dallas-Fort Worth Metroplex by convening one local health department, Denton County Public Health, and one non-profit healthcare system, Texas Health Resources, to leverage resources from each other to build a joint CHA. The Mobilizing for Action through Planning and Partnerships …

Institutionalized Stigmas: Hiv Stigma, Racism And Heterosexism Among Medical Students In The Southern United States, Krishen D. Samuel

Graduate Theses and Dissertations

Background: Intersecting and related forms of stigma, including HIV-related stigma, racism, and heterosexism, disproportionately impact both communities vulnerable to acquiring HIV and people living with HIV (PLHIV), ultimately impacting more distal outcomes related to HIV prevention, treatment, and epidemiological patterns in the United States (US). The Southern US is the region most impacted by new HIV diagnoses, mainly among Black men who have sex with men (MSM). However, there is a paucity of research on medical students, specifically those in the Southern US, regarding stigmatizing attitudes they may hold towards PLHIV, and how these associate with racism and heterosexism. This …

Sexual Satisfaction, An Indicator Of Sexual Health And Well-Being? Insights From Sti/Hiv Prevention Research In European Men Who Have Sex With Men, Karel Blondeel, Massimo Mirandola, Lorenzo Gios, Cinta Folch, Christiana Noestlinger, Maddalena Cordioli, Petra Sutter, Marleen Temmerman, Igor Toskin

Centre of Excellence in Women and Child Health

Introduction Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.

Methods The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013–2014 among men who have sex with men. Sexual satisfaction was explored using one single item: ‘How satisfied are …

The Naked Truth: Policy On Tackling The Std Crisis Among Young Adults In Louisiana, Chijindu Eke, Matthew Kelley, Madeline Barclay

Journal of the Louisiana Public Health Association

No abstract provided.

Behavioral Health, Mental Health, And Overall Well-Being Of Informal Caregivers Before And After The Covid-19 Pandemic, Zahra Mojtahedi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Informal caregivers, such as relatives or close friends, are vital for maintaining the welfare of the individuals they provide care for. However, caregiving can be difficult and stressful that adversely impacts caregivers’ health. The extra stress brought on by the COVID-19 pandemic can potentially aggravate health problems, particularly mental health. The current research aimed to nationally analyze whether the COVID-19 pandemic was significantly associated with behavioral health (physical activity and smoking), mental health (worrying, nervousness, hopelessness, little interest, and psychological distress score), and the perception of overall well-being among informal caregivers in the United States. Whether behavioral health could mediate …

Examining The Risks And Resilience Of Older Adults Living With Hiv/Aids: Qualitative Community-Based Participatory Research Studies In Southern Nevada, Brandon Ranuschio

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since the height of the HIV pandemic in the 1980s, medical interventions have significantly increased the life expectancy of people living with HIV/AIDS (PLWH) and made HIV/AIDS a livable, chronic health condition. Because of this, PLWH have been living longer lives and thriving with the help of HIV sector healthcare and service providers. However, with their longer life expectancy, older PLWH have been experiencing other health challenges. One such challenge is the risk of developing HIV-Associated Neurocognitive Disorder (HAND), which is a condition that affects up to 50% of PLWH at some point in their lifetime, with middle-aged and older …

Assessing The Relationship Between Racism In Medicine, Medical Mistrust And Cardiovascular Disease Among Black American Adults., Osayande Agbonlahor

Electronic Theses and Dissertations

Cardiovascular disease (CVD) persists as the leading preventable cause of death and disability among Black Americans in the United States. Structural and psychosocial factors such as racism have been highlighted as a fundamental cause of persistent cardiovascular health disparities in the U.S. This study examined the associations between racism in medicine, medical mistrust and CVD among Black Americans using the Minority Stress Theory as a theoretical framework. This study evaluates the sociodemographic differences in the quality of care received among Black Americans. Data from the Health Information National Trends Survey, 2022 and the Consumer Assessment of Healthcare Provider and Systems …

Perceptions Of Metabolic Syndrome Management Utilization In Relation With Patient Characteristics And Health-Related Quality Of Life, Olajide Adekunle

Pharmaceutical Sciences (PhD) Dissertations

Challenges in managing MetS include untreated risk factors and ineffective management, resulting in poor health-related quality of life (HRQoL). A significant factor contributing to these challenges is the underutilization of management services, possibly due to patients' perceptions of disease management resource utilization (PMU). Therefore, understanding patients' PMU is crucial for improving health outcomes. The study investigated PMU, explored PMU predictors, and investigated the impact of PMU and patients’ demographics on HRQoL. Using a cross-sectional design, data on perceptions of healthcare, medication, and pharmacy service utilization, prior experience with pharmacy services, demographics, and HRQoL were collected from adult individuals with obesity …

The Importance Of Framing The Context Of Black/African Americans' Livelihood To Enhance Health Outcomes And Mitigate Health Inequalities, Elvis Gyan

Theses, Dissertations and Culminating Projects

This study investigates the portrayal of Black/African Americans in Health Marriage and Relationship Education (HMRE) programs, which predominantly follow Eurocentric models while examining how social and structural determinants (e.g., community context) influence stress levels, general health, and relationship satisfaction through two main objectives. Firstly, it aims to scrutinize the acknowledgment of biases towards non-Eurocentric communities in published Administration of Children and Families HMRE programs, analyzing 39 research studies. Secondly, it examines the interplay between perceived community context, stress as a mediator, general health, and relationship satisfaction among Black/African Americans across three distinct articles by testing hypothesized process models. Results for …

Healthcare Providers’ Screening And Counseling For Tobacco Use Among Youth In The United States: Prevalence, Practices, And Providers’ Perspectives, Adeola Omolade Ayo

Electronic Theses and Dissertations

Youth tobacco use is a public health concern in the United States (U.S.) with about 2.8 million middle and high school youth reporting current tobacco use in 2023. Healthcare providers (HCPs) can play a crucial role in addressing youth tobacco use through screening and counseling, yet rates of these interventions are suboptimal. Tennessee has a high prevalence of youth tobacco use and not much is known about these interventions in Northeast Tennessee. This study has several objectives: 1) conduct a scoping review of available evidence on screening and counseling for youth tobacco use and identify related gaps; 2) assess youth …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

End-Of-Life Patient Communication: Exploring Comfort, Communication And Education Of Healthcare Professionals For End-Of-Life Care, Madison Gremillion

Undergraduate Honors Theses

Historically, the medical field has viewed death and dying as incurable ‘medical failures,’ and as a result, many healthcare professionals have difficulties when facing a patient who is dying or at the end of their life. These individuals will use avoidant behavior to avoid end-of-life (EOL) patients or can have difficulty providing essential aspects of care including communication, that contribute to building a strong relationship between the healthcare provider and patient. For the healthcare professional (HCP), this can stem from anxiety related to thoughts of death and a lack of educational support or experience. The study of death is where …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

An Assessment Of The Current State Of Nursing Homes In The United States, Southern Region, And Tennessee, Nicole Galler

Electronic Theses and Dissertations

Introduction: Nursing homes throughout the U.S. have faced unprecedented challenges in recent years because of staffing shortages, and under-investment, especially since the COVID-19 pandemic. To gain insight into the current state of nursing homes, this study examined nursing home characteristics, quality, and accessibility from a national, regional and state perspective.

Methods: This cross-sectional study used secondary data from the Centers for Medicare and Medicaid Services, American Community Survey, Medicare Beneficiary, and the Tennessee Department of Health. Nursing home characteristics and quality were assessed through bivariate and multivariate regression in the U.S. Assessment of HHS Region 4 nursing home characteristics and …

Exploring The Correlates And Predictors Of Covid-19 Vaccine Hesitancy And Uptake Among People Living With Hiv/Aids In Tennessee, Charles Olomofe

Electronic Theses and Dissertations

Background

The administration of the COVID-19 vaccines has met with resistance and hesitance from different population groups including people living with HIV/AIDS (PLWHA). It is concerning to know that PLWHAs are showing a higher rate of COVID-19 vaccine hesitancy than the general population. The objective of this study is to synthesize the literature and determine the correlates and predictors of COVID-19 vaccine hesitancy among PLWHA using primary and secondary data.

Methods

A scoping review was conducted to identify and summarize studies on COVID-19 vaccine hesitancy among PLWHA using the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Extension for …