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Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During Covid-19 Pandemic, Philip Ndoki Ndoki

Walden Dissertations and Doctoral Studies

This study was an investigation of how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating an understanding of barriers to uptake. Using intersectionality theory and the social determinants of health framework, this study examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. Household Pulse Survey data from the US …

Decentralized Clinical Trials For Medications To Reduce The Risk Of Dementia: Consensus Report And Guidance, Leanne Howard, Carla Abdelnour, Erin Abner, Ricardo F. Allegri, Hiroko H. Dodge, Serge Gauthier, Camilla M. Hoyos, Gregory Jicha, Patrick G. Kehoe, Catherine J. Mummery, Adesola Ogunniyi, Nikolaos Scarmeas, Xiaoying Chen, Jodie R. Titiner, Christopher R. Weber, Ruth Peters

Neurology Faculty Publications

INTRODUCTION: Recent growth in the functionality and use of technology has prompted an increased interest in the potential for remote or decentralized clinical trials in dementia. There are many potential benefits associated with decentralized medication trials, but we currently lack specific recommendations for their delivery in the dementia field.

METHODS: A modified Delphi method engaged an expert panel to develop recommendations for the conduct of decentralized medication trials in dementia prevention. A working group of researchers and clinicians with expertise in dementia trials further refined the recommendations.

RESULTS: Overall, the recommendations support the delivery of decentralized trials in dementia prevention …

Interdisciplinary Perspectives On Multimorbidity In Africa: Developing An Expanded Conceptual Model, Justin Dixon, Ben Morton, Misheck Nkhata, Alan Silman, Ibrahim Simiyu, Stephen Spencer, Myrna Van Pinxteren, Edna Bosire, Christopher Bunn, Claire Calderwood

Brain and Mind Institute

Multimorbidity is an emerging challenge for health systems globally. It is commonly defined as the co-occurrence of two or more chronic conditions in one person, but its meaning remains a lively area of academic debate, and the utility of the concept beyond high-income settings is uncertain. This article presents the findings from an interdisciplinary research initiative that drew together 60 academic and applied partners working in 10 African countries to answer the questions: how useful is the concept of multimorbidity within Africa? Can the concept be adapted to context to optimise its transformative potentials? During a three-day concept-building workshop, we …

Perceptions Of Communities Of Practice And Sense Of Belonging: Focus Groups Of Academic Pediatric Faculty, Margaret P. Huntwork, Myo T. Myint, Emma Simon, Bonnie Desselle, Amy M. Creel

School of Medicine Faculty Publications

BACKGROUND: Providing the opportunity for collaboration around a central purpose to improve skills and exchange knowledge, the Community of Practice model can be useful for faculty development. A sense of belonging enhances the engagement in communities. Yet, the barriers and contributors to academic medicine faculty's sense of belonging in communities are not as well explored. METHODS: Through focus groups with 21 academic pediatric faculty conducted between January and March 2023, this qualitative study examined knowledge of Communities of Practice and the factors that affect sense of belonging and engagement. The authors iteratively coded transcripts to generate themes. RESULTS: Community accessibility; …

Transgender Women With Suppressed Testosterone Display Lower Burden Of Coronary Disease Than Matched Cisgender Men, Jordan E Lake, Han Feng, Ana N Hyatt, Hongyu Miao, Paula Debroy, Nicholas Funderburg, Kate Ailstock, Adrian Dobs, Sabina Haberlen, Jared W Magnani, Joseph B Margolick, Kate Mcgowan, Frank J Palella, Mallory D Witt, Shalender Bhasin, Matthew J Budoff, Wendy S Post, Todd T Brown

Faculty, Staff and Student Publications

Context: Cardiovascular disease (CVD) in transgender women (TW) may be affected by gender-affirming hormone therapy (GAHT) and HIV, but few data compare TW on contemporary GAHT to well-matched controls.

Objective: We compared CVD burden and biomarker profiles between TW and matched cisgender men (CM).

Methods: Adult TW on GAHT (n = 29) were recruited for a cross-sectional study (2018-2020). CM (n = 48) from the former Multicenter AIDS Cohort Study were matched 2:1 to TW on HIV serostatus, age ±5 years, race/ethnicity, BMI category and antiretroviral therapy (ART) type. Cardiac parameters were measured by CT and coronary atherosclerosis by coronary …

Antenatal Care Utilisation And Receipt Of Its Components In Nigeria: Assessing Disparities Between Rural And Urban Areas—A Nationwide Population-Based Study, Emmanuel O. Adewuyi, Asa Auta, Mary I. Adewuyi, Aaron Akpu Philip, Victory Olutuase, Yun Zhao, Vishnu Khanal

Research outputs 2022 to 2026

Introduction Antenatal care (ANC) is crucial for positive pregnancy outcomes, but it is underutilised in Nigeria, suggesting unmet needs, and potentially contributing to the country’s high burden of maternal and neonatal mortalities. This study comprehensively assesses ANC utilisation and receipt of its components in Nigeria, focusing on disparities between rural and urban areas. Methods We used the data disaggregation approach to analyse the Nigeria Demographic and Health Survey 2018. We estimated ANC utilisation, assessed the receipt of ANC components, and identified factors associated with eight or more (≥ 8) ANC contacts nationally and across rural and urban residences. Results Nationwide, …

Evaluation Of Flooding Disaster Risk Initiatives In Vulnerable Homeless Communities, Nicholas W. O'Clair

Walden Dissertations and Doctoral Studies

Homeless individuals, who have limited resources and lack stable lodging, are particularly vulnerable during disasters, further jeopardizing their already precarious health conditions. By examining the effectiveness of existing preparedness and response strategies on the readiness of homeless individuals during flood events, insights can be gained to enhance emergency operations. The purpose of the study was to investigate the experiences and vulnerabilities of homeless populations in a northeastern U.S. city with the goal of promoting inclusivity and resilience. Research questions involved understanding knowledge of dangers of flooding disasters; disaster preparedness, response, and recovery; and how current public promotion practices of disaster …

Evaluation Of Flooding Disaster Risk Initiatives In Vulnerable Homeless Communities, Nicholas W. O'Clair

Walden Dissertations and Doctoral Studies

Homeless individuals, who have limited resources and lack stable lodging, are particularly vulnerable during disasters, further jeopardizing their already precarious health conditions. By examining the effectiveness of existing preparedness and response strategies on the readiness of homeless individuals during flood events, insights can be gained to enhance emergency operations. The purpose of the study was to investigate the experiences and vulnerabilities of homeless populations in a northeastern U.S. city with the goal of promoting inclusivity and resilience. Research questions involved understanding knowledge of dangers of flooding disasters; disaster preparedness, response, and recovery; and how current public promotion practices of disaster …

Indo-Caribbean Youth And Suicidal Behavior: A Systematic Review, Raul Ruiz Camacho, Shiryn D. Sukhram

Publications and Research

The suicide rates in Guyana, Suriname and Trinidad and Tobago are among the highest in the Americas, containing significant Indo-Caribbean populations that are suggested to be most vulnerable to suicide. This systematic review analyzes the existing literature and identifies knowledge gaps in risk and protective factors against suicide in these countries. The literature search conducted followed PRISMA guidelines using the PubMed and APA PsycInfo databases. The PRISMA flow diagram illustrated that eight scholarly papers were eligible for inclusion. Included literature examined stratified data focused on the aforementioned countries, as well as their Indo-Caribbean adolescent populations. Excluded literature did not mention …

The Health Risks Of Deportation: Impacts Of Family Separation On Relationships And Wellbeing In Latinx Communities, Shantay Rhea Rocha

University Honors Theses

Anti-immigration policy and deportation practices create multifaceted implications for Latinx communities in the United States. A comprehensive literature review drawing from public health and immigration studies was used to examine the direct and indirect implications of separation of families due to deportation. This thesis synthesizes existing research to illuminate the health threats pertaining to Latinx wellbeing in the context of being undocumented and fearing being separated from their family. Addressing the dimensions of deportation-related health risks, policy makers, health care professionals, and community organizations can work towards promoting Latinx health and well-being in the U.S. to mitigate the health consequences …

Viral And Host Factors Are Associated With Mortality In Hospitalized Patients With Covid-19, Neil R Aggarwal, Jacquie Nordwall, Dominique L Braun, Lucy Chung, Jordan Coslet, Tatyana Der, Nnakelu Eriobu, Adit A Ginde, Awori J Hayanga, Helene Highbarger, Mark Holodniy, Juan P Horcajada, Mamta K Jain, Kami Kim, Sylvain Laverdure, Jens Lundgren, Ven Natarajan, Hien H Nguyen, Sarah L Pett, Andrew Phillips, Garyphallia Poulakou, David A Price, Philip Robinson, Angela J Rogers, Uriel Sandkovsky, Katy Shaw-Saliba, Jeffrey M Sturek, Barbara W Trautner, Michael Waters, Cavan Reilly

Faculty, Staff and Students Publications

BACKGROUND: Persistent mortality in adults hospitalized due to acute COVID-19 justifies pursuit of disease mechanisms and potential therapies. The aim was to evaluate which virus and host response factors were associated with mortality risk among participants in Therapeutics for Inpatients with COVID-19 (TICO/ACTIV-3) trials.

METHODS: A secondary analysis of 2625 adults hospitalized for acute SARS-CoV-2 infection randomized to 1 of 5 antiviral products or matched placebo in 114 centers on 4 continents. Uniform, site-level collection of participant baseline clinical variables was performed. Research laboratories assayed baseline upper respiratory swabs for SARS-CoV-2 viral RNA and plasma for anti-SARS-CoV-2 antibodies, SARS-CoV-2 nucleocapsid …

“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, …

Spatial Targeting Of Irrigation Development And Water Resource Management To Mitigate Vector-Borne Disease, April Frake, Brad Peter, Grivin Chipula, Joseph Messina

Geosciences Faculty Publications and Presentations

Scaling irrigated agriculture is a global strategy to mitigate food insecurity concerns. While expanding irrigated agriculture is critical to meeting food production demands, it is important to consider how these land use and land cover changes (LULCC) may alter the water resources of landscapes and impact the spatiotemporal epidemiology of disease. Here, a generalizable method is presented to inform irrigation development decision-making aimed at increasing crop production through irrigation while simultaneously mitigating malaria risk to surrounding communities. Changes to the spatiotemporal patterns of malaria vector (Anopheles gambiae s.s.) suitability, driven by irrigated agricultural expansion, are presented for Malawi's rainy and …

Equity In Access For Veterans In The Va Community Care Program, Baligh R. Yehia, Said A. Ibrahim

Department of Medicine Faculty Papers

No abstract provided.

Access To Prostate-Specific Antigen Testing And Mortality Among Men With Prostate Cancer, Hari S. Iyer, Benjamin V. Stone, Charlotte Roscoe, Mei Chin Hsieh, Antoinette M. Stroup, Charles L. Wiggins, Fredrick R. Schumacher, Scarlett L. Gomez, Timothy R. Rebbeck, Quoc Dien Trinh

School of Public Health Faculty Publications

Importance: Prostate-specific antigen (PSA) screening for prostate cancer is controversial but may be associated with benefit for certain high-risk groups. Objectives: To evaluate associations of county-level PSA screening prevalence with prostate cancer outcomes, as well as variation by sociodemographic and clinical factors. Design, Setting, and Participants: This cohort study used data from cancer registries based in 8 US states on Hispanic, non-Hispanic Black, and non-Hispanic White men aged 40 to 99 years who received a diagnosis of prostate cancer between January 1, 2000, and December 31, 2015. Participants were followed up until death or censored after 10 years or December …

Building Trust: The Role Of Place-Based Consciousness In Vaccine Hesitancy, Ramsey W. Ash

Quantitative Social Science Undergraduate Senior Theses

Vaccine hesitancy poses a threat to public health initiatives of the 21st century. Following a stark divide in the rural/urban COVID-19 vaccine uptake and harsh disparities between these areas in COVID-19 moralities and morbidities, further understanding of the drivers of vaccine hesitancy are needed. This study makes use of the framework of place-based consciousness (PBC), pioneered by scholars of rural political science, such as Katherine Cramer, to explore this phenomenon as a mechanism by which to understand vaccine hesitancy. To examine this, an experimental survey was distributed to 300 Americans (150 rural and 150 urban) that inquired about their PBC, …

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.

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 …

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 …

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 …

Covid-19 Vaccine Confidence, Concerns, And Uptake In Children Aged 5 And Older In Calgary, Alberta: A Longitudinal Cohort Study, Emily J Doucette, Leah Ricketson, Tarannum Tarannum, Isabella Alatorre, Joslyn Gray, Cora Constantinescu, Susan Kuhn, Jessica K E Dunn, James D Kellner

Faculty, Staff and Student Publications

OBJECTIVES: Beginning early in the pandemic, there was a worldwide effort to develop effective vaccines against the SARS-CoV-2 virus. Before and after the approval and implementation of vaccines, there were concerns about their need as well as their safety and rapid development. We explored child demographic characteristics and parental concerns to identify factors associated with the decision to vaccinate.

METHODS: A cohort of 1035 children from Calgary was assembled in 2020 to participate in 5 visits every 6 months for survey completion and blood sampling for SARS-CoV-2 antibodies. Visits 1 to 2 occurred before approval of vaccines for children; Visits …

Vaccine Uptake And Intentions: Insights From A Texas Survey On Factors Influencing Covid-19 Vaccination Decisions, Yordanos M Tiruneh, Paula M Cuccaro, Kimberly S Elliott, Jing Xie, Journey Martinez, Mark Owens, Christian R Alvarado, Jose-Miguel Yamal

Faculty, Staff and Student Publications

The effectiveness of COVID-19 vaccines depends on widespread vaccine uptake. Employing a telephone-administered weighted survey with 19,502 participants, we examined the determinants of COVID-19 vaccine acceptance among adults in Texas. We used multiple regression analysis with LASSO-selected variables to identify factors associated with COVID-19 vaccine uptake and intentions to receive the vaccine among the unvaccinated. The prevalence of unvaccinated individuals (22%) was higher among those aged 18-39, males, White respondents, English speakers, uninsured individuals, those facing financial challenges, and individuals expressing no concern about contracting the illness. In a fully adjusted regression model, higher odds of being unvaccinated were observed …

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Virginia Journal of Public Health

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years (23%), males (58%), …

Lyme Disease In The Northeast: The Unintended Consequence Of Suburban Development, Hayden Neubert

Student Theses 2015-Present

This paper addresses the role of suburban development in the suburbs of the Northeastern United States in increasing human Lyme disease infection. Over the past 50 years, Lyme disease has become the most common vector-borne disease in the United States. In 2021, the two states with the most Lyme disease cases were New York and New Jersey, with a collective 6,524 cases, with Connecticut still representing 541 total cases. It is not a coincidence that case numbers are concentrated in suburban areas with high forest fragmentation. Chapter 1 of this essay analyzes how human land development disrupts bioregulatory ecosystem actors …

Impact Of Temperature On Children’S Nutrition: A Comparative Study Of Three Ecological Regions Of Nepal, Prakriti Shakya

Master's Theses

Nutrition obtained during the growth period of childhood significantly influences long-term well-being and overall productivity, ultimately contributing to the economy of a society. However, weather shocks can wreak havoc by damaging crops, changing yields of important crops and disrupting market access, which directly impacts the food intake of both adults and children. When these adverse events occur during childhood, short term and long term inadequacy in nutrition as well as disease incidence can cause malnutrition leading to stunted growth and cognitive impairment that may persist into adulthood, affecting the labor market and increasing health expenditure. To address this issue, we …

The Impact Of Female Political Leadership On Intimate Partner Violence In India, Khushboo Patel

Master's Theses

Abstract:

This study employs an instrumental variable approach to examine the impact of female political leadership on women’s experiences of Intimate Partner Violence (IPV). It finds that in rural areas with more female leaders, incidents of sexual and psychological IPV increase. The analysis investigates the drivers behind this impact, revealing that entrenched gender norms and expectations, such as a husband’s preference for more sons, may exacerbate IPV. Additionally, despite the increase in female leaders, attitudes toward violence remain largely unchanged. These findings highlight the need for research and policy initiatives that not only encourage female political participation but also specifically …

Inequality And Opportunity: Ranking Community Health In Florence County, Sc, Stephen Borders, Lauren Carter, Brandy Hayden, Mary Elizabeth Magyar

Public Health

Florence County is at the heart of the seven-county Pee Dee Region of South Carolina with a diverse population of about 136,000 residents. Home to McLeod Regional Medical Center and MUSC Health Florence Medical Center, the area boasts more than 750 licensed beds. Despite being home to world-class medical care, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach addresses these challenges …

Spatial Associations Of Lung Cancer Rates And Socioeconomic, Health, And Environmental Factors In Georgia, Nguyet Le, Jun Tu

Symposium of Student Scholars

According to CDC, Lung and Bronchus Cancer ranks the highest by the rate of cancer deaths among different types of cancers in the United States with the rate of 31.8 per 100 thousand people, and also for Georgia with the rate of 33.4 per 100 thousand people. Thus, to reduce the death rate of lung cancer, it is quite important and urgent to understand its risk factors. Smoking and inhaling radon are among the top risk factors of lung cancer for individuals. The socioeconomic, health, and environmental characteristics of communities might be also related to the likelihood of getting …

A Study On The 2016 And 2022 Ms And Oh Populations: How Obesity Is Related To The Co-Mingling Of Median Household Income, Limited Access To Healthy Foods And Limited Access To Exercise Opportunities, Ben Schlessel, Justice Williams

Scholarship in Medicine - All Papers

Background: Obesity has plagued the United States for decades, and while the implications of obesity have drastically changed over time (from a sign of wealth to a possible implication of mal/low nutrition), its impacts on the country’s population are abrasive and costly. Objective: The aim is to address and investigate how factors such as Median Household Income (MHI), Limited Access to Healthy Food and Limited Access to Exercise interplay with and correlate to obesity. Methods: Data acquired from the County Health Rankings was analyzed using several analysis strategies (paired and unpaired T-tests, and regression plots, etc.). Only Mississippi and Ohio …