Digital Commons Network^™

A Disparities Analysis Of Cancer Patients’ Access To Depression Treatment By Health Insurance Status And Type, Stephanie Minbiole-Snider

Walden Dissertations and Doctoral Studies

Research has demonstrated that comorbid conditions like depression in cancer patients reduce quality of life, prolong recovery, and reduce survival time of the cancer patient. Although other studies have investigated the issue of depression among cancer patients, there is a dearth of studies looking at differences in taking depression medication with health insurance as a source of disparity. Using survey data from the National Health Interview Survey (NHIS), and the health belief model as the theoretical framework, this study had two purposes. The first was to determine if there were differences in the likelihood of taking medication for depression based …

Increasing Covid-19 Testing And Vaccination Uptake In The Take Care Texas Community-Based Randomized Trial: Adaptive Geospatial Analysis, Kehe Zhang, Jocelyn V Hunyadi, Marcia C De Oliveira Otto, Miryoung Lee, Zitong Zhang, Ryan Ramphul, Jose-Miguel Yamal, Ashraf Yaseen, Alanna C Morrison, Shreela Sharma, Mohammad Hossein Rahbar, Xu Zhang, Stephen Linder, Dritana Marko, Rachel White Roy, Deborah Banerjee, Esmeralda Guajardo, Michelle Crum, Belinda Reininger, Maria E Fernandez, Cici Bauer

Faculty, Staff and Student Publications

BACKGROUND: Geospatial data science can be a powerful tool to aid the design, reach, efficiency, and impact of community-based intervention trials. The project titled Take Care Texas aims to develop and test an adaptive, multilevel, community-based intervention to increase COVID-19 testing and vaccination uptake among vulnerable populations in 3 Texas regions: Harris County, Cameron County, and Northeast Texas.

OBJECTIVE: We aimed to develop a novel procedure for adaptive selections of census block groups (CBGs) to include in the community-based randomized trial for the Take Care Texas project.

METHODS: CBG selection was conducted across 3 Texas regions over a 17-month period …

How Health Literacy Influences Rural West Virginians Knowledge Of Chronic Disease Prevention And Management, Summer Mitchell

Walden Dissertations and Doctoral Studies

Health literacy can be described as the understanding of own’s own health and understanding of health-related information (Shadid, 2022). In rural communities, health literacy is typically at a lower level than in urban communities. West Virginia is a mostly rural state and in addition to lower health literacy, chronic diseases are high in West Virginia. The target area for this study was rural Greenbrier County, West Virginia. The purpose of the study was to examine perceived barriers to health literacy in Greenbrier County, West Virginia, and how this affects understanding of chronic disease. Research questions focused on participants’ knowledge of …

The Global Epidemiology And Health Burden Of The Autism Spectrum: Findings From The Global Burden Of Disease Study 2021, Global Burden Of Disease Study 2021 Autism Spectrum Collaborators, Lourdes Bernadette Tanchanco, Angel Belle Dy

Ateneo School of Medicine and Public Health Publications

Background

High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods.

Methods

For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence …

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Current Attitudes And Barriers Among Appalachian Patients Towards Orthopaedic Surgery, Dylan Smith Md, Justin B. West Ms, Wade Smith Md, Micah Macaskill Md, Jonathan Lash, Matthew W. Bullock Do, Mpt

Journal of Appalachian Health

Introduction: This study explores the challenges faced by residents of rural West Virginia in accessing orthopaedic care due to geographic and socioeconomic barriers.

Purpose: This study seeks to survey rural West Virginia residents about their attitudes and experiences regarding access to orthopaedic care in southern West Virginia.

Methods: A total of 132 electronic surveys were collected from rural West Virginia residents during an appointment with their primary care provider located at an affiliated outreach clinic. The survey was designed to investigate various factors influencing their access to orthopaedic care.

Results: Delays in seeking orthpaedic care are common in rural West …

An Investigation Of Travel Distance And Timeliness Of Breast Cancer Treatment Among A Diverse Cohort In The United States, Swann Arp Adams, Oluwole Adeyemi Babatunde, Whitney Zahnd, Peiyin Hung, Karen E. Wickersham, Nathaniel Bell Ph.D., Jan M. Eberth Ph.D.

Publications

Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between …

Coronavirus Disease 2019 (Covid-19) Real World Data Infrastructure: A Big-Data Resource For Study Of The Impact Of Covid-19 In Patient Populations With Immunocompromising Conditions, James M. Crawford, Lynne Penberthy, Ligia A. Pinto, Keri N. Althoff, Magdalene M. Assimon, Oren Cohen, Laura Gillim, Tracy L. Hammonds, Shilpa Kapur, Harvey W. Kaufman, David Kwasny, Jean W. Liew, William A. Meyer 3rd, Shannon L. Reynolds, Cheryl B. Schleicher, Suki Subbiah, Catherine Theruviparampil, Zachary S. Wallace, Jeremy L. Warner, Suhyeon Yoon, Yonah C. Ziemba

School of Medicine Faculty Publications

Background. We developed a United States–based real-world data resource to better understand the continued impact of the coronavirus disease 2019 (COVID-19) pandemic on immunocompromised patients, who are typically underrepresented in prospective studies and clinical trials. Methods. The COVID-19 Real World Data infrastructure (CRWDi) was created by linking and harmonizing de-identified HealthVerity medical and pharmacy claims data from 1 December 2018 to 31 December 2023, with severe acute respiratory syndrome coronavirus 2 virologic and serologic laboratory data from major commercial laboratories and Northwell Health; COVID-19 vaccination data; and, for patients with cancer, 2010 to 2021 National Cancer Institute Surveillance, Epidemiology, and …

Geographic Disparities Impacting Oral Vaccine Performance: Observations And Future Directions, Rachel M Burke, Sasirekha Ramani, Julia Lynch, Laura V Cooper, Haeun Cho, Ananda S Bandyopadhyay, Carl D Kirkwood, A Duncan Steele, Gagandeep Kang

Faculty, Staff and Students Publications

Oral vaccines have several advantages compared with parenteral administration: they can be relatively cheap to produce in high quantities, easier to administer, and induce intestinal mucosal immunity that can protect against infection. These characteristics have led to successful use of oral vaccines against rotavirus, polio, and cholera. Unfortunately, oral vaccines for all three diseases have demonstrated lower performance in the highest-burden settings where they are most needed. Rotavirus vaccines are estimated to have >85% effectiveness against hospitalization in children < 12 months in countries with low child mortality, but only ~65% effectiveness in countries with high child mortality. Similarly, oral polio vaccines have lower immunogenicity in developing country settings compared with high-resource settings. Data are more limited for oral cholera vaccines, but suggest lower titers among children compared with adults, and, for some vaccines, lower efficacy in endemic settings compared with non-endemic settings. These disparities are likely multifactorial, and available evidence suggests a role for maternal factors (e.g. transplacental antibodies, breastmilk), host factors (e.g. genetic polymorphisms-with the best evidence for rotavirus-or previous infection), and environmental factors (e.g. gut microbiome, co-infections). Overall, these data highlight the rather ambiguous and often contradictory nature of evidence on factors affecting oral vaccine response, cautioning against broad extrapolation of outcomes based on one population or one vaccine type. Meaningful impact on performance of oral vaccines will likely only be possible with a suite of interventions, given the complex and multifactorial nature of the problem, and the degree to which contributing factors are intertwined.

Racial And Ethnic Disparities In Human Papillomavirus Vaccination Among Us-Born And Foreign-Born Adults Aged 18 To 26 Years In The United States, Itunu Sokale, Jane Montealegre, Ann O Amuta, Abiodun Oluyomi, Aaron P Thrift

Faculty, Staff and Students Publications

Background/objectives: Human papillomavirus (HPV) is linked to multiple cancers that can be prevented through vaccination. While the optimal age for vaccination is in childhood and adolescence, vaccination recommendations include adults through age 26 who missed childhood/adolescent vaccination. There are limited data about disparities among adults eligible for catch-up HPV vaccination. We conducted a comprehensive examination of HPV vaccination among US young adults, disaggregating the group by race/ethnicity and nativity status to identify subgroups that may require additional interventions.

Methods: We analyzed 2019 and 2022 data of individuals aged 18-26 years from the National Health Interview Survey. Generalized linear models using …

Decriminalizing Disease: A Health Justice Approach To Infectious Diseases And Criminal Law, Sean E. Bland

Arkansas Law Review

Infectious diseases, also called communicable diseases, are largely a public health issue and should not be criminalized. This Article seeks to re-frame the discussion around the legal framework for infectious diseases in a way that moves beyond a punishment mindset and toward a health justice mindset. The focus in this Article is on health justice rather than traditional understandings of public health, defined as the science and practice of improving the health of people and their communities. The Article makes three novel contributions. First, it applies a health justice framework to the critique of infectious disease criminalization. Second, the Article …

Adverse Childhood Experiences: Healing Through Storytelling And Mindful Narrative Therapy, Julie Kemp

Mindfulness Studies Theses

This study presents research about the nature and prevalence of adverse childhood experiences (ACEs), the mental and physical impacts to individuals exposed to ACEs, and incorporating mindfulness practices into therapeutic approaches to treating them, particularly Mindfulness-Based Narrative Therapy (MBNT). It is important because ACEs have become a global crisis, with the potential for interfering with psychological and physical development, early mortality, and other harmful life outcomes. This thesis provides critical information for mindfulness teachers and practitioners, therapists, educators, regulators, parents, and individuals subjected to ACEs.

The methodology includes extensive literature searches for narrative therapy and mindfulness-based interventions (MBIs) in peer-reviewed …

A Proposed Mhealth Intervention To Address Patient Barriers To Colposcopy Attendance: Qualitative Interview Study Of Clinic Staff And Patient Perspectives, Jennifer Hemler, Rachel Wagner, Brittany Sullivan, Myneka Macenat, Erin Tagai, Jazmarie Vega, Enrique Hernandez, Suzanne Miller, Kuang-Yi Wen, Charletta Ayers, Mark Einstein, Shawna Hudson, Racquel Kohler

Department of Medical Oncology Faculty Papers

BACKGROUND: Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural and psychosocial barriers to following up with colposcopy are problematic for minoritized women. Evidence-based interventions using patient navigation and tailored telephone counseling, including the Tailored Communication for Cervical Cancer Risk (TC3), have modestly improved colposcopy attendance. However, the efficacious TC3 intervention is human resource-intense and could have greater reach if adapted for mobile health, which increases convenience and access to health information.

OBJECTIVE: This study aimed to describe feedback from clinic staff members involved in colposcopy processes and patients referred for colposcopy regarding adaptions …

Gateways, Barriers, And Facilitators To Opioid Use Treatment For Low-Income Pregnant And Postpartum Women In The State Of Alabama, Lindsey Allison Rice Bender

All ETDs from UAB

Low income, pregnant and postpartum women who misuse opioids in the state of Alabama face potentially life-threatening challenges when seeking substance misuse treatment and recovery support services. Our study used an explanatory sequential mixed-methods approach to explore gateways, barriers, and facilitators to opioid use disorder (OUD) treatment for pregnant and postpartum women in the state of Alabama. Surveys from 32 pregnant and postpartum individuals and in-depth interviews with 15 pregnant and postpartum individuals (four pregnant, four 0-6 months postpartum, four 7-12 months postpartum and three 13-18 months postpartum) were used to identify gateways, barriers, and facilitators to OUD treatment. Our …

Covid-19 Vaccine Hesitancy Among Black Women In The Us, Brittany C Slatton, Farrah G Cambrice, Serwaa S Omowale

Faculty, Staff and Student Publications

IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.

OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.

DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely …

An Evaluation Of Nhmrc Funded Dementia And Diabetes Research, Etienne Vignola-Gagné Phd, Dmitrii Malkov, Elisabeth Browning, Jörg Hellwig Phd, Luigi Rocco Phd, Henrique Pinheiro, Alexandre Bédard-Vallée

Public Reports

This report, commissioned by the National Health and Medical Research Council (NHMRC), provides comprehensive insights into the research outputs, outcomes, and impacts of NHMRC-funded health and medical research in the areas of dementia and diabetes to support NHMRC's mission of ‘building a healthy Australia.’

Examining The Relationship Between Teen Pregnancy And Educational Outcomes In Ohio, Andrea Szep, Maryyam Durrani

Scholarship in Medicine - All Papers

Objective: The aim of this study is to explore the relationship between educational outcomes,school funding, and teen birth rates in Ohio counties between 2020 and 2024. Methods: Usingdata from County Health Rankings, we performed regression, correlation, and paired t-testanalyses through the SPSS software. Results: The results of our tests showed significantnegative correlations between markers of educational success, including high school graduationrates math and reading standardized test scores, and teen birth rates in both 2020 and 2024.Between 2020 and 2024, the teen birth rate decreased in the state of Ohio, and in 2024, publicschool funding was able to predict 14.8% of …

Burnout In The Emergency Room: Corrective Measures Vs. The Absence Of Solutions, Zane Walters, Zachary Woodall

Theses, Dissertations and Capstones

Introduction: Physician burnout has become an increasingly prevalent and critical issue in healthcare systems worldwide, particularly among emergency room physicians who face high-stress, high-demand working conditions. Burnout manifests as emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment, leading to negative outcomes for physicians’ mental health, job satisfaction, and overall career longevity. This phenomenon not only threatens the well-being of physicians but also compromises patient care quality and contributes to costly turnover within healthcare organizations.

Purpose of the Study: The aim of this study was to systematically investigate the impact of burnout interventions on emergency room physicians. …

Transportation Barriers To Healthcare Access: A Scoping Review Of Measurement Approaches And Associated Health Outcomes, Josiane Kabayundo, Muskan Ahuja, Snehal Jadhav, Lisa C. Smith, Farzana A. Bithi, Shamim Shahi, George Johnson, Siddhi Munde, Kendra L. Ratnapradipa

Journal Articles: Epidemiology

Background

Objectives

Methods

Building Place-Based Experiential Learning Into The Honors Curriculum At Ohio University, Geoffrey L. Buckley, Nicole Finnicum, Michelle O'Malley, Jennifer Bowie, Yolonda Youngs

Honors in Practice Online Archive

Observing the demand for interdisciplinary experiential learning opportunities post-COVID, authors present a place-based curriculum in honors. Workshop-style special topics classes provide students with an immersive and flexible learning environment, energize faculty, and engage alumni and community partners. Coursework, fieldwork, internships, and study abroad opportunities all contribute to the development of an informed and engaged citizenry. Authors address challenges in funding, access, and equity, and they suggest ways these challenges might be met.

Regional Variation And Correlation Of Big Five Personality Traits With Rates Of Insufficient Sleep And Diabetes In The United States, Isabella Chirakos, Brennan Schroeder

Scholarship in Medicine - All Papers

Background: Diabetes and insufficient sleep are prevalent health concerns, and determining potential contributing factors could help decrease the incidence of these issues. This study aims to explore potential associations between insufficient sleep and diabetes mellitus, examining whether these negative health outcomes can be linked geographically and by personality traits. Results could help create more effective programs to combat diabetes and insufficient sleep.
Materials and Methods: The study utilized longitudinal health data and roadmaps from 2016 and 2023 for each state, categorizing the data into four regions: Northeast, Midwest, South, and West. We incorporated personality data from the Synthetic Aperture Personality …

Drone Medical Package Delivery For Improved Transportation And Better Patient Outcomes Final Implementation Report, Amro El-Adle, Madeline Alden, Yin-Hsuen Chen, Melissa Davidson

Information Technology & Decision Sciences Faculty Publications

The Drone Medical Package Delivery for Improved Transportation and Better Patient Outcomes planning and prototyping grant involves five partners, including Accomack-Northampton Planning District Commission (A-NPDC), Riverside Health System, Old Dominion University (ODU), Virginia Institute for Spaceflight & Autonomy (VISA), Virginia Innovation Partnership Corporation (VIPC), and DroneUp. The partners worked together to address access, safety, reliability and sustainability for medical and emergency response package delivery via drone, specifically, where the use of aerial drones could lead to better patient outcomes and improved safety and emergency response.

The goal of the project was to develop an operational prototype that woul evolve into …

Burnout At University: Cross-Sectional Study Among Dental Students, Manal Elhijazi, Hajar Nafia, Ihsane Benyahya

Health Sciences

Context: The university constitutes a demanding and competitive learning environment which can impact the well-being of students. The objective of this survey is to assess the burnout of students at the faculty of dentistry.

Materials and methods: A cross-sectional study was conducted via an anonymous questionnaire with 3 sections: socio-demographic data, lifestyle and habit, and burnout through the Maslach burnout inventory-student survey (MBI-SS) . Continuous variables were presented as means and standard deviations,categorical variables as numbers and percentages. The variables were tested in univariate analysis to assess predictive factors related to burnout using the Khi-2 test. The significance level was …

Adaptation For Whom? Understanding The Impacts Of Dyke Policies On Small-Scale Farmers In Ca Mau Province Of Vietnam, Nguyen Minh Quang, Nguyen Van Minh, Nguyen Vo Chau Ngan, Martha B. Lerski

Publications and Research

Low-lying deltas worldwide are extremely vulnerable to sea-level rise. As the risks of climate-induced flooding become increasingly clear, the thirst for infrastructure-driven adaptation increases. This highlights a patent need to understand the impacts of engineering adaptation solutions, especially those targeting built structures such as dykes and sluices, on farmers from a bottom-up, farmer-centred perspective. The study addresses this call by examining cases where dyke policies, while successful in some dimensions, have undermined small-scale farmer livelihoods in Ca Mau ― Vietnam’s southernmost rural province. It identifies areas in need of attention and adds empirical data related to this group of farmers. …

Oregon Doula Workforce Analysis, Aisha K Gilmore, Apoorva Somayazulu, Lindsay Dickey, Rosemelty Jimenez Medal

Articles, Abstracts, and Reports

No abstract provided.

High-Resolution Geospatial Database: National Criteria-Air-Pollutant Concentrations In The Contiguous U.S., 2016–2020, Tianjun Lu, Sun-Young Kim, Julian D. Marshall

Epidemiology and Environmental Health Faculty Publications

Concentration estimates for ambient air pollution are used widely in fields such as environmental epidemiology, health impact assessment, urban planning, environmental equity and sustainability. This study builds on previous efforts by developing an updated high-resolution geospatial database of population-weighted annual-average concentrations for six criteria air pollutants (PM_2.5, PM₁₀, CO, NO₂, SO₂, O₃) across the contiguous U.S. during a five-year period (2016–2020). We developed Land Use Regression (LUR) models within a partial-least-squares–universal kriging framework by incorporating several land use, geospatial and satellite–based predictor variables. The LUR models were validated using conventional …

Social And Structural Determinants Of Mammography Screening Rates Among Female Medicare Beneficiaries: A Retrospective Analysis, Stephen Fuglsang, Rakhsha Khatri

Scholarship in Medicine - All Papers

Introduction: Despite Medicare fully covering annual mammogram costs, less than one half of female Ohio residents aged 65-74 sought yearly mammograms. As such, our analyses explore which social and structural determinants of health predict the likelihood that a woman aged 65-74 on Medicare will receive an annual mammogram.
Methods: This retrospective analysis utilized data from the County Health Rankings database, focusing on female Medicare enrollees aged 65-74. Mammography screening rates were compared across counties within Ohio, Michigan, and Missouri. Pearson and Spearman correlation tests were employed to examine relationships between English non-proficiency, high school graduation rates, residential segregation, primary care …

From Fields To Fast Foods: Food Culture, Identity, And Health In Puerto Rico Under The U.S. Empire, Ivanna Morales Mercado

CMC Senior Theses

Operation Bootstrap, launched in 1947, fundamentally altered Puerto Rico’s economy, just as much as its food culture. Prioritizing manufacturing over agriculture led to the collapse of the island’s farming sector, increasing reliance on food imports and leading to a rise in diet-related diseases such as obesity, type 2 diabetes, and cardiovascular issues. This thesis examines the legacies of Operation Bootstrap on Puerto Rico’s food system, health outcomes, and cultural identity by emphasizing the need to value intergenerational knowledge. The oral history research in this study highlights the importance of intergenerational knowledge in reclaiming sustainable agricultural practices and healthy, culturally significant …

Examining Intersectional Factors In Infant Mortality: The Role Of Race, Geography, And Socioeconomic Status In Ohio, Catherine Tran, Rebekah Murray

Scholarship in Medicine - All Papers

Background: Aspects of a mother’s identity such as race, socioeconomic status, and geographical location can impact healthcare access and outcomes, especially infant mortality.
Objective: The aim of this study is to identify how different variables relating to a mother’s identity intersect with one another to impact infant mortality rate in Ohio.
Methods: Data for infant mortality rate, racial residential segregation index, patient race by percentage, and median household income was collected from County Health Rankings, and data was analyzed using IBM SPSS Statistics.
Results: A linear regression found that the best fitting model including median household income and percent Black …

A Qualitative Study Of End-Stage Liver Disease And Liver Transplant Referral Practices Among Primary Care Providers In Nonurban America, Vashisht Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R. Garcia, Natalie D. Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

Surgery Faculty Publications

Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider’s (PCP’s) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).

Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.

Findings: …