Digital Commons Network^™

Investigating Drug-Related Violence In Indian Country: The Lumbee Tribe Of North Carolina, Asa Alena Revels

Theses and Dissertations

Drug-related violence (DRV) impacts the over-all wellbeing of communities, with disparate health outcomes observable in many poor, minority communities. The purpose of this study was to better understand the multi-level social and environmental factors influencing elevated rates and prevention of DRV within the Lumbee, a southeastern American Indian Tribe. This was accomplished via in-depth, one-on-one interviews with 37 Lumbee Tribal Members and Key Leaders. The findings align with existing research, revealing the influence of such factors as poor socioeconomic conditions, coping strategies, broken family structures, and the influence of federal policy. Of interest was the substantial influence of the local …

The Importance Of Person And Place In Predicting Prostate Cancer Incidence And Mortality Among United States Veterans Seeking Veterans Health Administration Care, Peter Georgantopoulos

Theses and Dissertations

T Introduction: There are several unique characteristics in the epidemiology of prostate cancer (PrCA) that make it an interesting and important cancer to study. The first is that while prostate cancer is the most common cancer that men develop, it is one of the least common cancers that men die from. This indolent nature of PrCA has led to the idiom among health scientists that “men are more likely to die with PrCA than due to PrCA”. Just like other cancers, several individual-level risk factors (e.g., family history of the disease, age, and race) are well established for both PrCA …

Social Influences Of Suburban Black Residents Food Purchasing Decisions Using Snap Benefits, Carolyn Mccummings

Walden Dissertations and Doctoral Studies

In low-income, suburban Black communities, the prevalence of diet-related chronic illnesses is alarming. Various influences often increase diet-related illnesses among this population. One influence is the use of SNAP benefits to purchase food. In this study, the influences of SNAP as well as other influences affecting food purchase decisions among the study population was examined. A qualitative multicase study approach was used and, face-to-face interviews were conducted, to understand the experiences of 20 low-income, current recipients of SNAP who were Black and lived in suburban, New York. The data indicated the most significant influence, communicated by the participants, was that …

Catheter-Associated Urinary Tract Infection In New York And North Carolina, Kehinde O. Abiodun

Walden Dissertations and Doctoral Studies

In the United States, many hospitalized patients with indwelling urinary catheters acquire catheter-associated urinary tract infections (CAUTI) during their hospital stay. CAUTI negatively affects peoples' health and quality of life and causes a financial burden to individuals and the nation. The purpose of this quantitative cross-sectional study was to explore the relationship between gender, age, and hospital types and CAUTI incidence in New York and North Carolina over a 3-year period. The theoretical framework of choice was the Donabedian model. Simple logistic regression and hierarchical multivariable logistic regression analysis were performed on archival data that was requested from Healthcare Cost …

Financial Strategies And Initiatives For Preventing Rural Hospital Closure, Chinue Uecker

Walden Dissertations and Doctoral Studies

In the United States, rural hospital closures increased 34% since 2015 due to financial reasons, affecting access to healthcare services in rural communities. For rural hospital leaders, improving the hospital's financial performance is a valuable strategic goal. This multiple case study was designed to explore strategies that rural hospital leaders implement to improve their hospital's financial performance in Arizona, Georgia, Illinois, Oklahoma, Pennsylvania, and the United States Virgin Islands. The strategic decision-making framework supported the study because top leaders make decisions that affect the organization's health and survival. Fifteen rural hospital leaders who maintain their hospital's financial stability provided hospital …

Spatial Modelling And Wildlife Health Surveillance: A Case Study Of White Nose Syndrome In Ontario, Lauren Yee

Theses and Dissertations (Comprehensive)

Wildlife data is often limited by survey effort, small sample sizes, and spatial biases associated with collection and missing data. These factors can create unique challenges from a surveillance perspective when trying to extract spatial patterns of habitat suitability and disease distributions for conservation and management purposes. This thesis examined data quality from a wildlife health database in the context of spatial analysis of wildlife disease. Spatial analysis of the data to predict habitat suitability of bats and white nose syndrome afflicted bats was examined by using the MaxEnt modelling method. Methods to reduce spatial bias were examined and specific …

Hepatitis C Testing And Treatment Access Among People Who Inject Drugs, Monika Roerig

Theses and Dissertations (Comprehensive)

Hepatitis C (HCV) remains a global issue as it affects 2-3% of the world’s population. Despite Canada’s universal access to healthcare, barriers to accessing testing and treatment for HCV has contributed to approximately 250,000 Canadians living with chronic HCV. People who inject drugs (PWID) account for about 60% of all HCV cases in Canada, making them the primary target for public health interventions, namely prevention and harm reduction. Harm reduction efforts have proven effective to reduce the incidence of infectious diseases and to prevent overdoses, but there remains a large proportion of individuals living with the virus who are unaware …

Prevalence Of And Factors Associated With Utilization Of Herbal Medicines Among Outpatients In Primary Health Centers In Cambodia, Hattie Pearson, Tyler Fleming, Pheak Chhoun, Sovannary Tuot, Carinne M. Brody, Siyan Yi

BACKGROUND: Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia.

METHODS: A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for …

Strategies To Address The Complex Challenge Of Improving Regional And Remote Children’S Fruit And Vegetable Consumption, Stephanie L. Godrich, Christina R. Davies, Jill Darby, Amanda Devine

Research outputs 2014 to 2021

Fruit and vegetables (F&V) are imperative for good health, yet less than one per cent of Australian children consume these food groups in sufficient quantities. As guided by Social Cognitive Theory (SCT), this paper aimed to: (i) understand key informant perspectives of the amount, types and quality of F&V consumed by rural and remote Western Australian (WA) children; and, (ii) determine strategies that could increase F&V consumption among rural and remote WA children. This qualitative study included 20 semi-structured interviews with health, school/youth and food supply workers, focusing on topics including: quantity and type of F&V consumed and strategies to …

Rare Single Gene Disorders: Estimating Baseline Prevalence And Outcomes Worldwide, Hannah Blencowe, Sowmiya Moorthie, Mary Petrou, Hanan Hamamy, Alan Bittles, Stephen Gibbons, Matthew Darlison, Bernadette Modell, Congenital Disorders Expert Group .

Research outputs 2014 to 2021

As child mortality rates overall are decreasing, non-communicable conditions, such as genetic disorders, constitute an increasing proportion of child mortality, morbidity and disability. To date, policy and public health programmes have focused on common genetic disorders. Rare single gene disorders are an important source of morbidity and premature mortality for affected families. When considered collectively, they account for an important public health burden, which is frequently under-recognised. To document the collective frequency and health burden of rare single gene disorders, it is necessary to aggregate them into large manageable groupings and take account of their family implications, effective interventions and …

The Delivery Of Primary Health Care In Remote Australian Communities: A Grounded Theory Study Of The Perspective Of Nurses, Kylie Mccullough

Theses: Doctorates and Masters

Around 85% of Australia’s landmass is remote and sparsely populated. Across these vast areas of desert, wilderness and tropical islands, nurses provide the majority of health care services. The residents of Australia’s remote communities have poorer health status than their metropolitan counterparts. The proportion of Indigenous people is high and health and social disadvantage is widespread. The characteristics of each remote community are unique and often reflect challenges associated with distance to tertiary health services and limited health resources. As a result, nursing practice within this context is very different to other nursing contexts. Despite recognition of Primary Health Care …

Association Of Body Mass Index With Blood Pressure Among 1.7 Million Chinese Adults, Khurram Nasir

All Publications

No abstract provided.

Temporal Trends In Human Vulnerability To Excessive Heat, Scott C. Sheridan, Michael J. Allen

Political Science & Geography Faculty Publications

Over recent decades, studies have examined various morbidity and mortality outcomes associated with heat exposure. This review explores the collective knowledge of the temporal trends of heat on human health, with regard to the hypothesis that humans are less vulnerable to heat events presently than in the past. Using Web of Science and Scopus, the authors identified all peer-reviewed articles that contained keywords on human impact (e.g. mortality, morbidity) and meteorological component (e.g. heat, heatwave). After sorting, a total of 71 articles, both case studies and epidemiological studies, contained explicit assessments of temporal trends in human vulnerability, and thus were …

The Impact Of Parental Education Level, Wealth Status, And Location On Female Genital Mutilation Prevalence In Northwestern Liberia, Sando Adetunji

Walden Dissertations and Doctoral Studies

Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Sando Adetunji

has been found to be complete and satisfactory in all respects,

and that any and all revisions required by

the review committee have been made.

Review Committee

Dr. Chinaro Kennedy, Committee Chairperson, Public Health Faculty

Dr. Adebowale Awosika-Olumo, Committee Member, Public Health Faculty

Dr. James Rohrer, University Reviewer, Public Health Faculty

Chief Academic Officer

Eric Riedel, Ph.D.

Walden University

2018

Female genital mutilation has been a public health issue in many countries. As a result, researchers across the globe have conducted numerous studies …

Hospital Variation In Costs – A Challenge To The Value Proposition, Aaron B. Caughey, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Mini Commentary on 2017-OG-19978R1: Hospital Variation in Cost of Childbirth and Contributing Factors: A Cross-Sectional Study. To view this article visit https://doi.org/10.1111/1471-0528.15007.

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

Implementation Of A Fruit And Vegetable Voucher Program In San Francisco, Alexandra Kambur

Master's Projects and Capstones

Chronic disease has emerged as the predominant public health challenge of the 21st century. Chronic diseases like cardiovascular disease, cancer, type 2 diabetes and obesity have maintained their top positions as the leading causes of poor health, disability, death, and high health-care expenditures for over a decade. Health and hunger go hand-in-hand. Today over 15 million households in the United States struggle with food insecurity, meaning they do not have sufficient access to food that meets their dietary needs for an active and healthy life. The issue of food insecurity in cities like San Francisco, California is exacerbated by the …

Relationships Between Complex Pediatric Health Conditions And The Built, Physical And Social Environments, Brittany Corley

Theses & Dissertations

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. …

Evaluating Work Place Wellness In Greater Louisville's Technology Organizations : A Case Study., Andrew L. Mccart

Electronic Theses and Dissertations

Employers in the Southern Indiana and Greater Louisville region are looking for strategies to help them become a healthier workplace. Many employers see the expense of paying for an unhealthy workforce and they are looking to limit these expenses. The purpose of the study is to determine the state of workplace wellness activities in organizations in Southern Indiana and Greater Louisville. Due to the poor health statuses of Indiana and Kentucky, 39th and 45th, respectively, this study is significant for a number of stakeholders in our area. The purpose of this case study was to understand the state of health …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

Youth Focus Groups: Design And Analysis Plan For The Bears Project, M. Renee Beacom Claborn

Capstone Experience: Master of Public Health

This capstone project produced a qualitative research design and analysis plan for youth focus groups as part of a Quality Improvement project at OneWorld Community Health Center (OWCHC) School-Based Health Center (SBHC) located at Bryan High School (BHS) in a program called BEARS. The intended use of this project is to serve as a reference guide for BEARS program planners to utilize as part of the data collection and analysis processes. The purpose for collecting qualitative data for this project is three-fold. 1. To explore adolescents’ perspectives of risk behaviors and associated health determinants common to their age group 2. …

Establishing An Active Reproductive Health Center And A Sliding Fee Scale At Bellevue Health Clinic, Gbadero Yerokun

Capstone Experience: Master of Public Health

Abstract

Goal

To collect preliminary data that will be used by Bellevue Health Clinic leadership to make decisions about expanding upon reproductive health services, and creating a sliding fee scale for services provided.

Objectives

To describe aspects of the scope of reproductive health care services provided by Title X-funded clinics in Lincoln, Omaha, Fremont, Grand Island, Tecumseh, Hastings, Gering, Norfolk and North Platte (14 total). The project will also compare and contrast existing sliding scale fees provided at these sites and provide subjective answers from key informants of how Title X funding and a sliding fee scale impact the population. …

Epidemiologic And Spatial Differences In Colorectal, Lung, Breast, And Prostate Cancer Mortality-To-Incidence Ratios Between Blacks And Whites In Louisiana, Anas Almatrafi

Capstone Experience: Master of Public Health

Mortality and Incidence rates are widely used as indicators of health disparities among different racial groups. The current study used the mortality-to-incidence ratio (MIR) to provide a better population-based indicator of survival that can be used as an alternative and more accurate measure of the fatality based on incidence. This study intended to calculate and map MIRs for colorectal, lung and bronchus, breast and prostate cancers in Louisiana by race (Blacks vs Whites), sex, age groups, and geography. Age-adjusted mortality and incidence rates were calculated using the latest data release of the Surveillance, Epidemiology, and End Results (SEER) Program (1973-2014). …

Examining The Relationship Between Park Neighborhoods, Features, Cleanliness, And Condition With Observed Weekday Park Usage And Physical Activity: A Case Study, Kerry Hamilton, Andrew T. Kaczynski, Melissa L. Fair, Lucie Levesque

Faculty Publications

Background. Little research has comprehensively explored how park features, quality indicators, and neighborhood environments are associated with observed park usage and physical activity (PA). This case study examined whether weekday park usage and PA differ by neighborhood type, across numerous categories of park features, and according to park feature condition and cleanliness. Methods. Direct observation was used to capture the number of users and PA levels within 143 park features in 6 parks (3 urban, 3 suburban) over the course of six weeks. Audits of park environments assessed the type, condition, and cleanliness of all features and amenities. …

Tackling The Health Burden Of Air Pollution In South Asia, Bhargav Krishna, Kalpana Balakrishnan, Amna R. Siddiqui, Bilkis A. Begum, Damodar Bachani, Michael Brauer

Community Health Sciences

No abstract provided.

A Human-Centered Platform For Hiv Infection Reduction In New York: Development And Usage Analysis Of The Ending The Epidemic (Ete) Dashboard, Ashish Joshi, Chioma Amadi, Benjamin Katz, Sarah Kulkarni, Denis Nash

Publications and Research

Background: Dashboards have been increasingly used in clinic-based interventions, such as clinical performance improvement and monitoring risk of hospital readmissions, and are now gaining traction in population-based interventions, especially in disease assessment.

Objective: We describe the design, development, and usage analysis of a geovisualization dashboard, the Ending the Epidemic (ETE) Dashboard. The ETE dashboard is a tool developed to track New York’s progress towards achieving the goal of its ETE Initiative, to reduce new HIV infections from 3000 per year to 750 per year by the end of 2020.

Methods: The ETE dashboard was adapted from an existing human-centered geovisualization …

Effects Of Global Warming On Work-Rest Routines For Crop Workers In Appalachia, Ken Silver, Ying Li, Emmanuel Odame, Yuqiang Zhang

ETSU Faculty Works

Background: Workers in outdoor occupations are expected to be at high risk of increased morbidity and mortality, and diminished productivity, as a result of global warming in the 21st century. A previous modelling study of geographic variations in heat-related mortality risk in projected U.S. populations mid-century showed the states of Tennessee, Kentucky and North Carolina to be highly vulnerable. Methods: Under both the RCP4.5 and RCP8.5 emissions scenarios of IPCC AR5, we evaluate the effect of future warming on estimated Wet Bulb Globe Thermometer (WBGT) temperatures using model-simulated future climate variables that were dynamically downscaled by a regional meteorology model …

Measuring The Impact Of Patient-Engaged Research: How A Methods Workshop Identified Critical Outcomes Of Research Engagement, Ellis C. Dillon, Leah Tuzzio, Sarah Madrid, Heather Olden, Robert T. Greenlee

Journal of Patient-Centered Research and Reviews

Purpose: While strategies to evaluate the influence of engaging patient partners in research, such as the Patient-Centered Outcomes Research Institute (PCORI) WE-ENACT surveys, are beginning to emerge, a systematic set of measures for assessing the impact of patient engagement in research (PER) on study approaches and outcomes is lacking. This article describes a workshop and process used to identify and develop Critical Outcomes of Research Engagement (COREs). It proposes preliminary measures for assessing the impact of PER on the research process and outcomes of research studies.

Methods: A group of 24 researchers and 5 patient partners participated in a PCORI-funded …

Hospitalization Rates And Predictors Of Rehospitalization Among Individuals With Advanced Cancer In The Year After Diagnosis, Robin Whitney, Janice Bell, Daniel Tancredi, Patrick Romano, Richard Bold, Jill Joseph

Faculty Publications

PurposeAmong individuals with advanced cancer, frequent hospitalization increasingly is viewed as a hallmark of poor-quality care. We examined hospitalization rates and individual- and hospital-level predictors of rehospitalization among individuals with advanced cancer in the year after diagnosis.MethodsIndividuals diagnosed with advanced breast, colorectal, non–small-cell lung, or pancreatic cancer from 2009 to 2012 (N = 25,032) were identified with data from the California Cancer Registry (CCR). After linkage with inpatient discharge data, multistate and log-linear Poisson regression models were used to calculate hospitalization rates and to model rehospitalization in the year after diagnosis, accounting for survival.ResultsIn the year after diagnosis, 71% of …

A Rural/Urban Comparison Of Privacy And Confidentiality Concerns Associated With Providing Sensitive Location Information In Epidemiologic Research Involving Persons Who Use Drugs, Abby E. Rudolph, April M. Young, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Background—Analyses that link contextual factors with individual-level data can improve our understanding of the "risk environment"; however, the accuracy of information provided by participants about locations where illegal/stigmatized behaviors occur may be influenced by privacy/confidentiality concerns that may vary by setting and/or data collection approach.

Methods—We recruited thirty-five persons who use drugs from a rural Appalachian town and a Mid-Atlantic city to participate in in-depth interviews. Through thematic analyses, we identified and compared privacy/confidentiality concerns associated with two survey methods that (1) collect self-reported addresses/cross-streets and (2) use an interactive web-based map to find/confirm locations in rural and …