Digital Commons Network^™

Campus Sexual Violence In The Time Of Covid-L9, Hannah Holt

Master’s Theses

Campus sexual assault (CSA) was likely on the rise in the United States (Koss et al., 2022) even prior to the COVID-19 pandemic, during which there was a global increase in violence against women. The present study is a needed addition to the limited rigorous scientific studies on the impact of the COVID-19 pandemic on campus sexual assault (CSA). A mixed-methods, ecological, and critical feminist approach was used to investigate CSA during the mitigation period. The present study specifically utilized the Sexual Experiences Survey (Koss et al., 2007) to assess changes in frequency of victimization within two representative samples of …

Association Of Income, Education, Employment And Covid-19 Mortality In Brazil, Marcelina Machado

Walden Dissertations and Doctoral Studies

The increased mortality rates from COVID-19 in Brazil have adversely affectedvulnerable populations and placed a severe burden on its public health system as compared to other nations. Focusing on socioeconomic status as a risk factor in this retrospective cohort study, I investigated the association between Brazilian COVID-19 mortality rate, income, school enrollment rate, and employment rate after controlling for the demographics and immunization rate. This is an important issue as an increase in incidence and mortality rates affects how governmental and public health leaders can effectively control and prevent disease spread. Using the fundamental causes of disease theory as the …

Conspiracy Theories Are Not Religions: Scrutinizing Religious Exemptions To The Covid-19 Vaccine, Shirley B. Luk

University of San Francisco Law Review

No abstract provided.

Kenyan Healthcare Professionals’ Perceptions Of Global Health Engagements In Relation To The Covid-19 Pandemic, Erick Amick

Graduate Research Theses & Dissertations

Over the past 30 years, there has been a significant increase in opportunities available for individuals living in high-income countries (HICs) to participate in programs that provide health services in low- and middle-income countries (LMICs). These global health engagements (GHEs) have become common in many LMICs around the world, including Kenya. Prior to the advent of the COVID-19 pandemic, much of the research exploring individuals’ perspectives of GHEs were situated from the viewpoint of participants traveling from HICs to participate in global health programs. Few studies have examined perspectives of constituent groups in LMICs, such as healthcare professionals (i.e., healthcare …

Assessment Of Spatio-Temporal Variations In Pm2.5 And Associated Long-Range Air Mass Transport And Mortality In South Asia, Md Sariful Islam, Shimul Roy, Tanmoy Roy Tusher, Mizanur Rahman, Ryley C. Harris

Political Science & Geography Faculty Publications

Fine particulate matter (PM_2.5) is associated with adverse impacts on ambient air quality and human mortality; the situation is especially dire in developing countries experiencing rapid industrialization and urban development. This study assessed the spatio-temporal variations of PM_2.5 and its health impacts in the South Asian region. Both satellite and station-based data were used to monitor the variations in PM_2.5 over time. Additionally, mortality data associated with ambient particulate matter were used to depict the overall impacts of air pollution in this region. We applied the Mann–Kendall and Sen’s slope trend analysis tool to investigate the …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Residential Segregation And County-Level Covid-19 Booster Coverage In The Deep South: Surveillance Report And Ecological Study, Chengbo Zeng, Jiajia Zhang Ph.D., Zhenlong Li, Xiaowen Sun, Huan Ning, Xueying Yang, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Background: COVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation.

Objective: We aimed to evaluate county-level COVID-19 booster coverage …

Using Geospatial Social Media Data For Infectious Disease Studies: A Systematic Review, Fengrui Jing, Zhenlong Li, Shan Qiao Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Geospatial social media (GSM) data has been increasingly used in public health due to its rich, timely, and accessible spatial information, particularly in infectious disease research. This review synthesized 86 research articles that use GSM data in infectious diseases published between December 2013 and March 2022. These articles cover 12 infectious disease types ranging from respiratory infectious diseases to sexually transmitted diseases with spatial levels varying from the neighborhood, county, state, and country. We categorized these studies into three major infectious disease research domains: surveillance, explanation, and prediction. With the assistance of advanced computing, statistical and spatial methods, GSM data …

Recommendations For Climate Adaptation To Preserve Connecticut Drinking Water Quality And Quantity, Matthew Salvatore Di Vitto

Public Health Theses

Climate change impacts drinking water both directly and indirectly. Increases in temperature, drought frequency, and precipitation are among the climate impacts which currently and are projected to affect water quality and quantity in the continental United States. These impacts limit access to clean and abundant water sources by damaging habitat, spreading toxic substances via runoff and favoring the growth of harmful algal blooms. States can learn from one another to adopt best practices and policies to increase water resilience around the country. This paper explores how Connecticut can employ strategies from the States of New York, New Jersey, Massachusetts, Minnesota, …

Depression And Anxiety Among Plurisexual Teens In The U.S., Olivia Goodwin

Public Health Theses

Background: Little research focuses on the mental health consequences of stigma for plurisexual teens, with even less research comparing cisgender plurisexual youth to nonbinary plurisexual youth.Aims: To assess whether having both a marginalized sexual orientation and a marginalized gender identity is associated with greater risk or greater resilience in depression and anxiety outcomes among teens in the US. Methods: Data was analyzed from the 2022 LGBTQ Teen Survey. Inclusion in the study required being an English speaker living in the US, being 13-18 years old, and identifying as cisgender and plurisexual (n=1547) or gender nonbinary and plurisexual (n=1867). Statistical tests …

Modeling Spatial Access To Healthcare, Yaxiong Shao

Graduate Research Theses & Dissertations

Health disparity has been a persistent concern in the United States, and the COVID-19 pandemic has brought more attention to this ongoing challenge. Improving access to healthcare is a crucial step toward achieving health equity and starts with accurately measuring and portraying the existing landscape of access to healthcare. Even though numerous spatial accessibility models have been proposed to measure the spatial accessibility to healthcare, many gaps still exist. The main purpose of this dissertation is to develop novel models and leverage recently available datasets for a more accurate portrayal of true spatial accessibility. Three models were developed to address …

A Coalition-Driven Examination Of Organization Capacity To Address Food Insecurity In Greater Houston: A Qualitative Research Study, Jemima C John, Jennifer Gonzalez, Sara-Grace Chan, Heidi Mcpherson, Jennifer N Aiyer, Esperanza Galvan, Nicole Browning, Shreela V Sharma

Faculty, Staff and Student Publications

BACKGROUND: Economic and social hardships have worsened food insecurity, particularly among low income and racial-ethnic minority groups. Given the core goal of the 150+ member Houston Health Equity Collective (HEC) to reduce food insecurity by 5% in 2025, we explored member organizations' capacity and challenges faced in screening and responding to food insecurity through care coordination efforts.

METHODS: A twice-administered Qualtrics XM survey (Provo, Utah) with 76 organizations, followed by five focus groups with 22 of these organizations, explored reach and response efforts to food insecurity. Qualitative assessments lasted between 0.5 to 1.5 h, were audio-recorded, cleaned, coded, and thematically …

Social Determinant Of Health Impact On Diabetes Device Use And Clinical Outcomes In Youth With Type 1 Diabetes, Emily R Crain, Ryan Ramphul, Ashley M Butler, Xiaofan Huang, Charles G Minard, Maria J Redondo, Daniel J Desalvo

Faculty, Staff and Student Publications

Background: Youth with Type 1 diabetes (T1D) who are Black, Hispanic, or lower socioeconomic status (SES) have lower rates of diabetes device use, higher hemoglobin A1c (HbA1c), and higher rates of diabetic ketoacidosis (DKA). However, the associations of individual-level social determinants of health (SDoH) and neighborhood-level factors with device use and clinical outcomes are unknown. Area deprivation index (ADI) is a neighborhood level measure of SES reported in deciles (range 1-10 with 10 representing most deprived neighborhood).

Methods: We evaluated the association of ADI and other SDoH factors with pump/continuous glucose monitor (CGM) use, HbA1c, and DKA in 1,461 youth …

A Novel Bayesian Spatial-Temporal Approach To Quantify Sars-Cov-2 Testing Disparities For Small Area Estimation, Cici Bauer, Xiaona Li, Kehe Zhang, Miryoung Lee, Esmeralda Guajardo, Susan Fisher-Hoch, Joseph Mccormick, Maria E Fernandez, Belinda Reininger

Faculty, Staff and Student Publications

Objectives. To propose a novel Bayesian spatial–temporal approach to identify and quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing disparities for small area estimation.

Methods. In step 1, we used a Bayesian inseparable space–time model framework to estimate the testing positivity rate (TPR) at geographically granular areas of the census block groups (CBGs). In step 2, we adopted a rank-based approach to compare the estimated TPR and the testing rate to identify areas with testing deficiency and quantify the number of needed tests. We used weekly SARS-CoV-2 infection and testing surveillance data from Cameron County, Texas, between March 2020 …

Assessment Of Factors That Affect Men’S Access And Utilization Of Tuberculosis Services In Zululand District In South Africa, Maureen Fatsani Tshabalala

Walden Dissertations and Doctoral Studies

Tuberculosis (TB) remains the leading cause of death in South Africa, with higher mortality rates among men compared to women, despite the availability of free TB services and a reduction in TB death rates. However, research on the factors influencing men's access to and utilization of TB services is limited. The purpose of this study was to assess the factors affecting men's geographical access and quality utilization of TB services in the Zululand district of KwaZulu Natal province, South Africa. A survey questionnaire was used to collect data from 200 men recruited from selected primary health care facilities. Andersen's model …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Association Between Psychosocial, Obstetric, And Lifestyle Factors And Antenatal Depression, Tomnema Xiong

Walden Dissertations and Doctoral Studies

Antenatal depression, or depression during pregnancy, is a mental health concern in the United States that impacts mothers and their infants. This study examined the associations between psychosocial, obstetric, lifestyle factors, and antenatal depression. This study was guided by social cognitive theory, specifically the reciprocal determinism construct. Secondary data from the 2007–2018 National Health and Nutritional Examination Survey (NHANES) were used in this quantitative cross-sectional study. Every participant of the NHANES completed the Patient Health Questionnaire-9 depression screening form. The study sample consisted of 274 women who were pregnant at the time of participating in the NHANES, approximately 28.8% of …

Disparate Access To Medical Coverage Associated With Type 2 Diabetes Care In Low-Income And Rural Communities In Georgia, Crystal Alexis Symone Edwards

Walden Dissertations and Doctoral Studies

Disparate access to diabetes care in rural and low-income communities among older adults has been an ongoing issue among Americans. Type 2 diabetes in low-income and rural communities has continuously burdened many residents due to age, costs of care, income, geographic location, and education levels. Researchers have demonstrated that providing resources and tools to rural and low-income communities would assist in decreasing type 2 diabetes and increase education and awareness. The purpose of this quantitative cross-sectional study using secondary data was to examine the relationship between health insurance status and lack of access to health care resources and delay of …

Understanding How Multi-Level Factors Influence Cancer Clinical Trial Enrollment Decisions By Patients Living In Higher Disadvantaged Areas, Nicole Caston

All ETDs from UAB

Cancer clinical trials offer current patients with cancer new treatment and novel interventions to treat their cancer, while advancing the care of future patients. Clinical trials test new drugs against the standard of care to determine drug efficacy and safety. There are many groups of patients who are either unrepresented or underrepresented in cancer clinical trials and there is a plethora of reasons they are not represented. One underrepresented population of interest is patients with cancer who live in highly disadvantaged neighborhoods. Previous research found that when compared to patients who live in areas of lower disadvantage, patients living in …

Neighborhood Disadvantage, Sleep Quality, And Shift Work: The Reasons For Geographic And Racial Differences In Stroke (Regards) Study, Rebecca Williams

All ETDs from UAB

The first study used data (n=14,609) from the REasons for Geographic and Racial Differences in Stroke (REGARDS) to test the associations among Area Deprivation Index (ADI) and self-reported total sleep time (TST), sleep efficiency (SE), and number of restless nights within the last week. The second study (n=12,496) tested the associations among ADI, shift work status, and restlessness.Regression models were fit to examine associations between ADI and SE or TST or restlessness, as well as assess the relation between ADI and SE in clinically meaningful categories. Moderation analyses indicated whether sex or race impact the association between ADI and sleep. …

Examining The U.S. Disaster Management Program: A Case Study Of The U.S. Virgin Islands Hurricanes Irma And Maria Evacuation, Victoria F. Vachon

Walden Dissertations and Doctoral Studies

AbstractWhether from natural or human causes, every global community is at risk for overwhelming, destabilizing incidents. Hurricanes Irma and Maria devastated the U.S. Virgin Islands in late August and early September 2017, necessitating the urgent evacuation of hemodialysis patients over 1000 miles to the U.S. mainland. Because the damage and response to the U.S. territory were unprecedented, the public health implications of the government’s strategies on the evacuated population subset were unexplored. However, available information suggested that some evacuees sustained avoidable harm while in the protracted care and custody of the government. This qualitative case study, conceptually framed by Bronfenbrenner’s …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Real-World Performance Of Sars-Cov-2 Serology Tests In The United States, 2020, Carla V Rodriguez-Watson, Anthony M Louder, Carly Kabelac, Christopher M Frederick, Natalie E Sheils, Elizabeth H Eldridge, Nancy D Lin, Benjamin D Pollock, Jennifer L Gatz, Shaun J Grannis, Rohit Vashisht, Kanwal Ghauri, Camille Knepper, Sandy Leonard, Peter J Embi, Garrett Jenkinson, Reyna Klesh, Omai B Garner, Ayan Patel, Lisa Dahm, Aiden Barin, Dan M Cooper, Tom Andriola, Carrie L Byington, Bridgit O Crews, Atul J Butte, Jeff Allen

Faculty, Staff and Student Publications

BACKGROUND: Real-world performance of COVID-19 diagnostic tests under Emergency Use Authorization (EUA) must be assessed. We describe overall trends in the performance of serology tests in the context of real-world implementation.

METHODS: Six health systems estimated the odds of seropositivity and positive percent agreement (PPA) of serology test among people with confirmed SARS-CoV-2 infection by molecular test. In each dataset, we present the odds ratio and PPA, overall and by key clinical, demographic, and practice parameters.

RESULTS: A total of 15,615 people were observed to have at least one serology test 14-90 days after a positive molecular test for SARS-CoV-2. …

Landscaping Wellness At Work: A Participatory Model For Worker-Centered Health, Anya Helena Piotrowski

Antioch University Dissertations & Theses

This study contributes to a body of scholarship that demonstrates the benefits and need of employee-driven and defined wellness at work processes. This participatory action research study brought together a team of employees within a remote-work, start-up organization to define and design a process for implementing wellness at work for their organization. Through a participatory process that allowed outcomes to emerge from the group, employees identified opportunities to foster embodied wellness in their organization in three core areas: organizational, personal, and cross-boundary initiatives. Through a reflective collaboration, employees generated ideas and developed a plan to address employee-identified priorities that will …

Crossing The Decarbonization Chasm: A Call To Action For Hospital And Health System Leaders To Reduce Their Greenhouse Gas Emissions., Hardeep Singh, Walt Vernon, Terri Scannell, Kathy Gerwig

Ambulatory and Primary Care Articles

No abstract provided.

Do Physiological Variables Predict The Need For Transport To Hospital From Music Festivals? An Analysis Of Australian Festival Data, Ned Douglas, Jake Donovan, James Carew, Kayla Brouwer, Ebony Edwards, Mitchell Gibson, Jacqueline Leverett, Joseph Paul, Lachlan Holbery-Morgan, Jessica Pritchard, Elyssia Bourke, Erin Smith

Research outputs 2022 to 2026

Objective:

Using physiological markers to detect patients at risk of deterioration is common. Deaths at music festivals in Australia prompted scrutiny of tools to identify critically unwell patients for transport to hospital. This study evaluated initial physiological parameters to identify patients selected for transport to hospital from a music festival.

Methods:

A retrospective audit of 2045 presentations at music festivals in Victoria, Australia, was performed. Presentation heart rate, systolic blood pressure, respiratory rate, oxygen saturation, temperature, and Glasgow Coma Scale were assessed using area under the receiver operating characteristic curve (AUROC) analysis, with a prespecified threshold of 0.7.

Results:

The …

Assessment Of The Utilization Of Healthcare Services Specific To Pregnancy-Related Complications In Rural And Medically Underserved Georgia, Diana L. Aguirre

College of Graduate Studies: Theses & Dissertations

Maternal mortality is a continuing issue, with rates for the state of Georgia (3.7 per 100,000 live births) are higher than that of the US rates (2.9 per 100,000 per live births) (Centers for Disease Control and Prevention, National Center for Health Statistics, n.d., 2023). However, maternal mortality may not account for health disparity factors, apart from access to quality care and physiological issues, which is a factor in pregnancy-related deaths, Pregnancy-related death, as defined by the US Centers for Disease and Control (CDC), is a death of a woman that occurs during or within one year of pregnancy that …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

Development Of A Scoring Tool For Australian Rural Food Retail Environments, Tracy L. Schumacher, Carissa A. Alderton, Leanne J. Brown, Susan Heaney, Laura Alston, Katherine Kent, Stephanie L. Godrich

Research outputs 2022 to 2026

Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories …

Rethinking Adolescent School Nutrition Education Through A Food Systems Lens, Margaret Miller, Donna Barwood, Amanda Devine, Julie Boston, Sandra Smith, Martin Masek

Research outputs 2022 to 2026

BACKGROUND: Obesity-driven nutrition education in schools does not appear to result in healthier adolescent food choices. This study explored food systems as an alternative pedagogical approach to engage students in nutrition education. METHODS: After playing a food systems computer game, 250 13- to 16-year-old students in 5 Western Australian secondary schools, participated in group discussions to distinguish learning and interests in food systems. Discussion records were thematically coded using constant comparative analysis. RESULTS: Students reported crop growth, food production and food waste, healthier food choices, and food systems as knowledge outcomes of game play. They requested additional content on food …