Digital Commons Network^™

Greening And Mental Distress: Effect Modification By Housing Tenure, Saira Prasanth

Public Health Theses

Access to high-quality residential greenspace is associated with improved long-term health, particularly mental health. However, many interventions to promote “greening” or increased greenspace in urban areas have been shown through numerous qualitative studies to exacerbate environmental and health inequities, primarily through green gentrification. Our objective was to quantify the association between greenspace and mental distress in the U.S. as well as evaluate whether the association between greenspace and mental distress is modified by housing tenure. We hypothesized that increased greenspace was associated with reduced mental distress, and that this effect was more protective among homeowners than non-homeowners. Mental distress and …

Using Focus Groups To Explore Older Black Men's Perception Of Dietary Interventions., Ashley R Shaw, Eric D Vidoni, Mickeal N Key, Brandon A Yates, Roland Thorpe

Faculty, Staff and Student Publications

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer’s disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

Access To And Service Utilization Of Alabama Medicaid's Section 1115 Demonstration Waiver Program, Sarah Lee Bowler

All ETDs from UAB

Background: Much research has been done investigating health disparities in the field of publicly-funding family planning. However, no longitudinal analysis has been conducted to examine the impact of Alabama Medicaid’s Section 1115 demonstration waiver on access to care, experience of barriers reported by enrollees, and repeat utilization of services. Methods: Medicaid enrollment and visit claims data were used to answer the questions related to access and service utilization. Annual Plan First survey data were used to investigate the experience of barriers to care among enrollees. For all three research questions, descriptive statistics were calculated, and linear probability models were used …

Risk Factors Of Under-Five And Infant Mortality: An Umbrella Review Of Systematic Reviews And Meta-Analyses, Bereket Kefale, Jonine Jancey, Amanuel T. Gebremedhin, Sylvester Dodzi Nyadanu, Daniel G. Belay, Gavin Pereira, Gizachew A. Tessema

Research outputs 2022 to 2026

Background: Ensuring child survival is a critical global challenge, requiring a robust and comprehensive understanding of the risk factors contributing to under-five mortality (U5M). We aimed to synthesise and summarise the current available evidence on risk factors of U5M and infant mortality worldwide to inform global child health programmes.

Methods: We searched six major databases (Embase, Medline, Scopus, CINAHL, Web of Science, and Global Health) and repositories of systematic reviews, as well as grey literature sources to identify systematic reviews and meta-analyses that examined the associations between risk factors of U5M and infant mortality between 1 January 1990 and 4 …

Exposure To Urban Green Spaces And Mental Health During The Covid-19 Pandemic: Evidence From Two Low And Lower-Middle-Income Countries, Muhammad Mainuddin Patwary, Mondira Bardhan, Hüseyin Ertan İnan, Matthew H E M Browning, Asma Safia Disha, Md Zahidul Haque, Mai Helmy, Sadia Ashraf, Angel M Dzhambov, Faysal Kabir Shuvo, Md Ashraful Alam, Sharif Mutasim Billah, Md Pervez Kabir, Md Riad Hossain, Md Golam Azam, Md Mijanur Rahman, Sarya Swed, Ranjit Sah, Juan J Montenegro-Idrogo, D Katterine Bonilla-Aldana, Alfonso J Rodriguez-Morales

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic has had a significant impact on mental health globally, with limited access to mental health care affecting low- and middle-income countries (LMICs) the most. In response, alternative strategies to support mental health have been necessary, with access to green spaces being a potential solution. While studies have highlighted the role of green spaces in promoting mental health during pandemic lockdowns, few studies have focused on the role of green spaces in mental health recovery after lockdowns. This study investigated changes in green space access and associations with mental health recovery in Bangladesh and Egypt across the …

Beyond The Strong Black Woman: Navigating Resilience And Mental Health Using Social Media For Culturally Tailored Resources, Muchaneta N.M. Chikawa

College of Graduate Studies: Theses & Dissertations

Society views the strength of Black women as commendable as it shows positive qualities such as resilience and perseverance. While these traits are characterized as positive, Black women’s survival in American society has heavily depended on their strength, resulting in mental health illnesses such as anxiety and depression. The idea that Black women must exude strength and fortitude through adversity is labeled the Strong Black Woman Schema (SBWS). The SBWS is a race-gender schema that prescribes culturally-specific feminine expectations for Black women.

There are limited culturally-tailored resources for Black women to address mental health at collegiate institutions. As a result …

Beyond Borders: Exploring The Lived Experiences Of International Migrant Women In Nigeria, A Deep Dive Into Healthcare Realities And Utilization, Juliet Nwafor, Rowland Edet, Ezebunwa Nwokoch

Department of Sociology: Faculty Publications

This study explored access to and utilization of healthcare facilities among migrant women in an urban slum community in Nigeria, focusing on factors influencing healthcare-seeking behaviors and the implications for public health interventions. A qualitative case study-oriented research design was employed, involving in-depth interviews with 21 migrant women of reproductive age and 4 key informant interviews with healthcare workers in the Ayobo community of Lagos State, Nigeria. Data collection occurred from June to September 2018, and thematic analysis was used to interpret the findings. Three main themes emerged: living conditions, pattern of healthcare utilization, and factors influencing accessibility and utilization …

Optimizing The Community Health Worker (Chw) Program In Belize And Understanding Its Unique Intermediary Position Within The Health System: Perspective From The World Health Organization (Who) Health Systems Approach, Andrei R. Chell

Electronic Theses & Dissertations (2024 - present)

Human resources for health (HRH) are the backbone of a well-functioning and resilient health system. Issues related to HRH recruitment, retention, planning, leadership and governance have been amplified by the coronavirus disease 2019 (COVID-19) pandemic and have posed additional and unprecedented challenges in many countries. Community health workers (CHWs) in particular, are uniquely positioned to be frontline health care workers (HCWs) that are considered a vital link between communities and the formal health system. Globally, the benefits of CHW programs have been well documented, and there is substantial evidence of the efficacy and effectiveness of these programs. However, countries are …

Geospatial Hotspots And Coldspots In Us Cancer Disparities And Associated Risk Factors, 2004-2008 To 2014-2018, Lei Guo, M. Courtney Hughes, Margaret E. Wright, Alyssa H. Harris, Meredith C. Osias

Faculty Articles, Papers, and Other Scholarship

Introduction

Despite declining cancer death rates in the US, cancer remains the second deadliest disease and disparities persist. Although research has focused on identifying risk factors for cancer deaths and associated disparities, few studies have examined how these relationships vary over time and space. The primary objective of this study was to identify cancer mortality hot spots and cold spots — areas where cancer death rates decreased less than or more than neighboring areas over time. A secondary objective was to identify risk factors of cancer mortality hot spots and cold spots.

Methods

We analyzed county-level cancer death rates from …

Reducing Food Scarcity: The Benefits Of Urban Farming, S.A. Claudell, Emilio Mejia

Journal of Nonprofit Innovation

Urban farming can enhance the lives of communities and help reduce food scarcity. This paper presents a conceptual prototype of an efficient urban farming community that can be scaled for a single apartment building or an entire community across all global geoeconomics regions, including densely populated cities and rural, developing towns and communities. When deployed in coordination with smart crop choices, local farm support, and efficient transportation then the result isn’t just sustainability, but also increasing fresh produce accessibility, optimizing nutritional value, eliminating the use of ‘forever chemicals’, reducing transportation costs, and fostering global environmental benefits.

Imagine Doris, who is …

Foreword From Editor - 14th Edition, Yandi Andri Yatmo

ASEAN Journal of Community Engagement

This edition of AJCE brings together discussions on the various roles and effectiveness of research and community engagement programs in strengthening local identity, developing skills, and enhancing quality of life towards a resilient society. Expanding such roles, this issue consists of four research articles, one review article, and three case-based articles. The authors of this edition emerge from the background of language, engineering, economy, policy, education, and health, providing different outlooks and methods in overseeing the processes of community-related programs.

Health Insurance Determinants Of The Working-Class, Lall Ramroo

Student Theses

Abstract:

This research delves into healthcare coverage disparities within the working class, spotlighting challenges in accessing essential services. Leveraging data from the 2021 American Community Survey, we scrutinize coverage intricacies for those above Medicaid eligibility yet unable to afford private insurance. Findings unveil a worrisome trend: the working class faces limited healthcare access due to income thresholds, placing them in precarious situations. Those earning too much for Medicaid but lacking private insurance means or employer-sponsored coverage grapple with significant obstacles. This paper underscores the need for targeted policies to bridge healthcare gaps for the working class, advocating for equitable access …

Rapidiron Trial Follow-Up Study - The Rapidiron-Kids Study: Protocol Of A Prospective Observational Follow-Up Study, Richard Derman, Roopa Bellad, Mrutyunjaya Bellad, Jesse Bradford-Rogers, Michael Georgieff, Zubair Aghai, Simal Thind, Michael Auerbach, Rupsa Boelig, Benjamin Leiby, Vanessa Short, S. Yogeshkumar, Umesh Charantimath, Manjunath Somannavar, Ashalata Mallapur, Ramesh Pol, Umesh Ramadurg, Radha Sangavi, Basavaraj Peerapur, Nasima Banu, Praveen Patil, Amaresh Patil, Subarna Roy, Phaniraj Vastrad, Dennis Wallace, Hemang Shah, Shivaprasad Goudar

Global Health Articles

BACKGROUND: Anemia is a worldwide problem with iron deficiency being the most common cause. When anemia occurs in pregnancy, it increases the risk of adverse maternal, fetal, and postnatal outcomes. It induces preterm births and low birth weight (LBW) deliveries, long-term neurodevelopmental sequelae, and an increased risk of earlier onset of postnatal iron deficiency. Anemia rates are among the highest in South Asia, and India's National Family Health Survey (NFHS-5) for 2019-2021 indicated that over half of pregnant women, and more than 65% of children, in the country are classified as anemic (Sciences IIfP, National Family Health Survey-5, 2019-21, India …

Feasibility Of Using Podcasts For Knowledge Dissemination To Reduce Health Disparities For Women Targeting Preventative Initiatives And Lifestyle Medicine Interventions, Kristin Stovern

Doctor of Nursing Practice Scholarly Project

The purpose of this feasibility project was to look at podcasts to shed light on the issues that affect the well-being of women with gender-based disparities in healthcare. Women face persistent obstacles when it comes to the quality of healthcare they receive. One of the barriers that has been ever-present is with failure of the medical system to rigorously study the effects of diseases and drugs on women or to fund studies on women’s health conditions. Implicit biases and lack of access to care inhibit the quality of healthcare. Collectively, these issues result in unnecessary sickness, disability, and decreased quality …

Inequality In Opportunities And Outcomes: Indicators To Inform Data-Driven Community Systems For Youth Physical Activity, Ann Essay

Theses & Dissertations

Indicators illuminating whole-of-community and setting system physical activity (PA) outcomes and drivers are needed to inform population health improvement efforts. This multi-study dissertation examines inequalities in PA resources, opportunities, and outcomes and the factors influencing inequalities across multiple temporal and geospatial scales (e.g., community, setting). First, a scoping review examined community-level variability in PA resource and opportunity availability by community sociodemographic characteristics (e.g., race). Across 46 included studies, 41 unique indicators characterizing community PA systems were identified, and 29.8% of relationships assessed indicated greater resource/opportunity availability in communities of higher socioeconomic status or lower minority population prevalence. The indicators synthesized …

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …

Oral Lactoferrin Administration Does Not Impact The Diversity Or Composition Of The Infant Gut Microbiota In A Peruvian Cohort, Luis González, Jose Luis Paredes Sosa, Susan Mosquito, Yesenia Filio, Pedro E Romero, Theresa J Ochoa, Pablo Tsukayama

Faculty, Staff and Student Publications

Previous studies have suggested that oral lactoferrin enhances diversity in the gut microbiota in infants while inhibiting the growth of opportunistic pathogens. However, the effect of lactoferrin on infant gut microbiota over time has yet to be thoroughly studied. Our study suggests that lactoferrin oral treatment in infants aged 12-18 months does not affect gut microbiome diversity and composition over time. to our knowledge, this is the first study to report the effect of lactoferrin on infant gut microbiome composition over time and helps elucidate its impact on infant health and its therapeutic potential.

Employing Telepsychiatry Services To Assess The Prevalence And Identify Mental Health Disorders Using The Phq-9 And Gad-7 In Resource-Constrained Regions Of Dadar Mansehra, Pakistan: An Observational Cross-Sectional Study, Iffat Zafar Aga, Sara Saeed Khurram, Mahek Karim, Muhammad Muzzamil, Shahkamal Hashmi, Kashif Shafique

Medical College Documents

Objective: This study aims to measure the prevalence of mental health disorders in low-resource settings through telepsychiatry and evaluate data from Pakistan's Sehat Kahani nurse-assisted online clinics serving low-income communities. This will help to understand the magnitude and nature of the demand for contextual therapies to promote mental health. The paper will discuss the challenges faced in these settings, such as limited access to mental health facilities, stigma and opportunities telemedicine brings.
Design: An observational cross-sectional study of telepsychiatry consultations using Patient Health Questionnaire-9 and Generalised Anxiety Disorder-7 to screen for depression and anxiety was conducted between October and December …

Detection Of Suicide Clusters Using Small-Area Geographic Data From The Virginia Violent Death Reporting System, 2010 – 2015, Kurtis M. Anthony, Allison Ertl, Rachel A. Leavitt, Alexander E. Crosby, Ryan M. Diduk-Smith, Kevin A. Matthews

Virginia Journal of Public Health

Introduction: From 1999 to 2020, the suicide rate in Virginia increased from 13.1 to 15.9 per 100,000 persons aged 10 years and older. Few studies have examined spatial patterns of suicide geographies smaller than the county level.

Methods: We analyzed data from suicide decedents aged ≥10 years from 2010 through 2015 in the Virginia Violent Death Reporting System. We identified spatial clusters of high suicide rates using spatially adaptive filtering with standardized mortality ratio (SMR) significantly higher than the state SMR (p < 0.001). We compared demographic characteristics, method of injury, and suicide circumstances of decedents within each cluster to decedents outside any cluster.

Results: We identified 13 high-risk suicide clusters (SMR between 1.7 and 2.0). Suicide decedents in the clusters were …

Healthcare Professionals’ Perspectives Of Barriers To Cancer Care Delivery For American Indian, Rural, And Frontier Populations, Brandon M. Varilek, Sarah Mollman Phd, Rn, Chpn, Cne

College of Nursing Faculty Publications

Objective: This descriptive qualitative study sought to understand the barriers affecting cancer care delivery from the perspective of healthcare professionals (HCPs) serving American Indian (AI), rural, and frontier populations.
Methods: One-on-one, semi-structured interviews with multidisciplinary HCPs (N = 18) who provide cancer care to AI, rural, and frontier populations were conducted between January and April 2022. Interviews were conducted via Zoom. Data were analyzed following thematic content analysis methodologies. Results: Thematic content analysis revealed three major themes: (a) Access, (b) Time, and (c) Isolation. The themes represent the HCP perspectives of the needs and barriers of persons with cancer to …

Cancer Disparities In Southeast Asia: Intersectionality And A Call To Action, Erin Jay G. Feliciano, Frances Dominique V. Ho, Kaisin Yee, Joseph A. Paguio, Michelle Ann B. Eala, Janine Patricia G. Robredo, Kenrick Ng, Jasmine Lim, Khin Thuzar Pyone, Catherine A. Peralta, Jerickson Abbie Flores, J. Seth Yao, Patricia Mae G. Santos, Christian Daniel U. Ang, Gideon Lasco, Jeffrey Shi Kai Chan, Gary Tse, Enrico D. Tangco, T. Peter Kingham, Imjai Chitapanarux, Nirmala Bhoo-Pathy, Gerardo D. Legaspi, Edward Christopher Dee

Ateneo School of Medicine and Public Health Publications

No abstract provided.

An Intersectional Approach To Quantifying The Impact Of Geographic Remoteness And Health Disparities On Quality-Adjusted Life Expectancy: Application To Australia, Peter Lee, Steven J. Bowe, Lidia Engel, Erica I. Lubetkin, Nancy Devlin, Lan Gao

Publications and Research

Objectives

Methods

The Power Of Voice: The Role Of Target Voice Achievement In Enhancing Quality Of Life For Transgender Individuals In Gender-Affirming Voice Management Lab, El Paso, Texas, 2016-2022, Mehjabin Alam Hridi

Open Access Theses & Dissertations

Background: Gender-affirming voice management is an essential aspect of transgender people and research shows that achieving a congruent voice can significantly improve the quality of life. The role of voice as a central aspect of gender identity and expression and achieving a desired target voice can improve mental health outcomes, social functioning, and overall well-being. Purpose: The project assesses the impact of quality of life and voice treatment completion on voice disorders among transgender people. Methods: This clinical study included records for transgender individuals attending the Gender-Affirming Voice Management Lab in El Paso, TX, from 2016 to 2022. Measures collected …

Traditional And Emerging Modifiable Lifestyle Risk Behaviors For Non-Communicable Diseases In A Sample Of Hispanic/Latino American Adolescents Living In The U.S.-Mexico Border Region, Silvia Salinas Lopez

Open Access Theses & Dissertations

Background: Non-communicable diseases (NCDs) pose a significant global health threat, with modifiable lifestyle risk behaviors (mLRBs) contributing substantially to their onset. This study examined traditional and emerging mLRBs and their distribution on cross-sectional health outcomes among Hispanic/Latino in-school adolescents living on the U.S.-Mexico border. Methods: This secondary data analysis used information from the cross-sectional 2019 El Paso YHBS obtained through online surveys. The secondary data analyzed the prevalence, clustering, and co-occurrence of mLRBs of 539 Hispanic/Latino high school students. Results were compared to mLRBs findings corresponding to Hispanic/Latino adolescents who participated in the national and state 2019 CDC YRBSS. An …

The Social Determinants Of Health And Genocide: Towards A Public Health Integrated Framework Of Genocide And Mass Violence, Sian Persad, Cheng Xu

Genocide Studies and Prevention: An International Journal

This paper makes a normative argument about transformations of public health as a necessary condition required in any transitional justice process. We seek to bridge the gap between the fields of genocide and public health to understand the recursive relationship between genocide and the social determinants of health. We show that structures and institutions established during genocide create enduring impacts on the public health outcomes of victim and survivor groups even after the ousting of the original perpetrators. Our comparative analysis of the Rwandan Genocide and the colonial genocide of Indigenous communities in Canada surveys the available public health literature …

Spatial Associations Of Liver Disease Rates With Socioeconomic And Health Risk Factors In Georgia, Nguyet Le

Symposium of Student Scholars

According to the CDC Cancer Statistics Report in 2020, Liver and Intrahepatic Bile Duct is the 6th leading cancer in both USA and the State of Georgia ranked by Rates of Cancer Death. Aflatoxin-containing foods, alcohol consumption, smoking, overeating, and other risky behaviors are among the factors linked to liver diseases. They have also been related to the socioeconomic status (SES) of individuals. The behaviors and SES of individuals are affected by the socioeconomic characteristics of the communities where they live. However, the relationships between the rates of liver diseases and community-level socioeconomic factors are not well studied. The objective …

Pili Pono Practice: A Qualitative Study On Reimagining Native Hawaiian Food Sovereignty Through Malama Backyard Aquaponics, Pahonu Coleman, Samantha Keaulana, J Kahaulahilahi Vegas, Phoebe W. Hwang, Leshay Keliiholokai, Jane J. Chung-Do, Ikaika Rogerson, Ilima Ho-Lastimosa

Journal of Health Disparities Research and Practice

Living in one of the most remote island chains in the world, Native Hawaiians developed sophisticated food cultivation systems that sustained a thriving and robust population for centuries. These systems were disrupted by colonization, which has contributed to the health disparities that Native Hawaiians face today. MALAMA, a culturally-grounded backyard aquaponics program, was developed to promote food sovereignty among Native Hawaiians. This study utilized participant interview and focus group data to identify how participating in the MALAMA program impacts the wellbeing. The findings demonstrate that MALAMA enhanced the participants’ pilina (relationship, connection) to traditional foods, land, cultural identity, family, and …

Maternal Age Extremes And Adverse Pregnancy Outcomes In Low-Resourced Settings, Paul Nyongesa, Osayame Ekhaguere, Irene Marete, Constance Tenge, Milsort Kemoi, Carla Bann, Sherri Bucher, Archana Patel, Patricia Hibberd, Farnaz Naqvi, Sarah Saleem, Robert Goldenberg, Shivaprasad Goudar, Richard Derman, Nancy Krebs, Ana Garces, Elwyn Chomba, Waldemar Carlo, Musaku Mwenechanya, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Marion Koso-Thomas, Janet Moore, Elizabeth Mcclure, Edward Liechty, Fabian Esamai

Global Health Articles

INTRODUCTION: Adolescent (years) and advanced maternal age (>35 years) pregnancies carry adverse risks and warrant a critical review in low- and middle-income countries where the burden of adverse pregnancy outcomes is highest.

OBJECTIVE: To describe the prevalence and adverse pregnancy (maternal, perinatal, and neonatal) outcomes associated with extremes of maternal age across six countries.

PATIENTS AND METHODS: We performed a historical cohort analysis on prospectively collected data from a population-based cohort study conducted in the Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia between 2010 and 2020. We included pregnant women and their neonates. We describe the …

Community Health Workers, Stress Reduction, And Racial Equity In Infant Vitality, Justin Rex

ICS Fellow Lectures

How can communities help mothers reduce stress during pregnancy and provide the social supports that contribute to infant vitality? This talk presented findings from an evaluation of the Northwest Ohio Pathways HUB program, a nationally recognized best practice program model that pairs at-risk mothers with community health workers (CHWs) who connect mothers to services that reduce pregnancy risks. The talk included stories from mothers and CHWs about the challenges and stresses they face as well as data from interviews and surveys that quantify the impact CHWs have for reducing mothers' stress and providing supports that help mothers and their children …