Digital Commons Network^™

Geographic And Systemic Disparities In Maternal Health: A Systems Analysis Of Prenatal Care Access Across Rural Oregon, Cecelia Petrik

University Honors Theses

Objectives: In Oregon, 51% of hospitals providing labor and delivery services are located in rural areas. Consolidation of these hospitals and provider shortages has created severe geographic and systemic disparities in maternal healthcare. This thesis explores how geographic isolation and inadequate prenatal care access contribute to widening disparities in severe maternal morbidity (SMM) and mortality across Oregon's rural and frontier counties.

Methods: This study utilizes data from the Oregon Health Authority (OHA) Center for Health Statistics (2024) and analyzes spatial correlations across all 36 Oregon counties. A bivariate choropleth map was constructed to examine the structural intersection between health infrastructure …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

Strategies For High-Quality Community-Based Participatory Research Partnerships In Public Health Research., Emily M. D'Agostino, Rumour Piepenbrink, Lori Brand Bateman, Dana Keener Mast, Liliane Windsor, Debra Oto-Kent, Alan Wells, Jennifer Goldman, Jennifer E. Schuster, Rachel Kaufmann, Rachel Gurarie, Miriam Nuño

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Community-Based Participatory Research (CBPR) is grounded in trusting, reciprocal, and authentic relationships. We aimed to identify key strategies and actionable next steps to establish and sustain high-quality community-academic partnerships that foster community-based health equity.

STUDY DESIGN: Qualitative thematic analysis.

METHODS: We analyzed three recorded discussions from a roundtable session with community and academic partners from the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program (2020-2025), which supported 142 community-engaged public health research projects aimed at reducing COVID-19-related health inequities.

RESULTS: Key themes identified as most fundamental to support CBPR included establishing a long-term commitment, mutual co-learning among partners, flexible and …

Enhancing Emergency Department Preparedness For Amniotic Fluid Embolism Through Evidence-Based Simulation Training, Olivia M. Smoak

Doctor of Nursing Practice Final Manuscripts

Maternal mortality in the United States remains a significant and worsening public health concern, with increasing reliance on emergency departments (EDs) as access points for maternal care. Emergency clinicians are therefore more likely to encounter high-acuity obstetric emergencies, including maternal cardiac arrest and amniotic fluid embolism (AFE), yet often receive limited formal training in these conditions. Simulation-based education, interdisciplinary training, and cognitive aids have been identified as effective strategies to improve performance in high-risk, low-frequency events.

The purpose of the evidence-based practice project was to evaluate whether an interdisciplinary simulation with obstetric-led debrief and introduction of the AFE checklist improves …

Accessibility And Daily Cigarette Consumption Among Indonesian Adolescents: A Descriptive Study, Noviana Lathifah, Istiqomah Hanifah Rachman, Anisa Isnaini, Gloria Threesia Piliphinsa Simatupang

Journal of Indonesian Health Policy and Administration

Despite restrictive regulations, Indonesia faces a high prevalence of adolescent smoking, facilitated by easy access to tobacco products. This descriptive study aims to describe cigarette accessibility patterns and daily consumption trends among Indonesian adolescents. A cross-sectional study was conducted using secondary data from the 2019 Global Youth Tobacco Survey (GYTS) involving 9,208 respondents. Descriptive analysis was performed to examine the distribution of age at smoking initiation, daily cigarette consumption, and purchasing accessibility. The majority of respondents started smoking at ≥14 years of age. Daily cigarette consumption showed an increasing trend with age, with older adolescents more likely to consume more …

Deadline-Chasing In Digital Health: Forecasting Emr Adoption Dynamics And Regulatory Impact In Indonesian Primary Care, Suryo Satrio, Bukhori Muhammad Aqid

Journal of Indonesian Health Policy and Administration

Indonesia is accelerating digital health adoption under Minister of Health Regulation No. 24/2022, which mandates the use and integration of Electronic Medical Records (EMRs) with SATUSEHAT. However, evidence on how quickly primary health care facilities (Fasilitas Kesehatan Tingkat Pertama – FKTP) are adopting EMRs and what the adoption curve looks like remains limited. Survey findings also suggest key barriers and enablers, including security and data migration concerns, as well as human resource and infrastructure constraints. This observational study used provider-network data from a single EMR vendor. Key measures included cumulative registered facilities, monthly registrations, same-month activation (total_active/monthly inflow) as …

Optimizing Vitamin A Intervention: Strengthening Supplementation With Targeted Biscuit Fortification, Mayfa Yemima Simanjuntak, Nadia Amanda, Yuli Berliana Simanjuntak, Carissa Wityadarda, Lesta Livolina Simamora

Journal of Indonesian Health Policy and Administration

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show …

Intervention Levers For Stunting Reduction In Indonesia: Evidence From The 2023 Indonesian Health Survey Data, Iwan Ariawan, Hafizah Jusril, Zahra Izza Afifa, Azka Fitri, Elmarizha Sekar Utami, Mikail Hasan, Dwi Puspasari

Kesmas

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., …

Trends Of Pediatric Psychotropic Polypharmacy In Massachusetts Before And During The Covid-19 Pandemic, Gianna D'Ambrozio

Graduate Doctoral Dissertations

Youth in the U.S. and internationally are increasingly being diagnosed with depression and related psychiatric conditions (Murthy, 2021) many of whom are being subjected to non-evidence-based, or what has been termed irrational, psychotropic polypharmacy (Barnett & Concepcion Zayas, 2019). Psychotropic polypharmacy can be defined as “the use of 2 or more psychiatric medications in the same patient,” (Zito et al., 2021) though definitions can vary. Using data from the Center for Health Information Analysis’ Massachusetts All-Payer Claims Database, this study examined the sociodemographic factors associated with high rates of polypharmacy, a hypothesized increase in pediatric psychotropic polypharmacy rates in Massachusetts …

Referral Patterns From Primary Care To Referral Care By Icd-10 Codes In Indonesia: Cross-Sectional Analysis Of National Claims Data (2017–2024), Della Dwi Ayu, Syarif Rahman Hasibuan, Putu Erma Pradnyani, Nisrina Widyasanti

Journal of Indonesian Health Policy and Administration

Primary health care (PHC) facilities serve as gatekeepers within Indonesia’s tiered health system. However, PHC referral patterns to hospitals still show substantial variation and remain insufficiently characterized by disease groupings based on the International Classification of Diseases, 10th Revision (ICD-10). This study aimed to identify the most frequently referred diagnoses from PHC to secondary or tertiary care facilities and to determine the participant characteristics associated with referrals. This observational study employed a cross-sectional design using secondary data from the National Health Insurance (Jaminan Kesehatan Nasional – JKN) claims database for the period 2017–2024. The unit of analysis was each …

Factors Associated With The Performance Of Essential Public Health Efforts At Primary Health Centers In Jember Regency, Griselda Ardelia Hibatullah, Nuryadi Nuryadi, Yennike Tri Herawati

Journal of Indonesian Health Policy and Administration

Performance assessment of primary health centers is essential to ensure the quality of healthcare services, including the delivery of essential public health efforts. The performance target for essential public health efforts in Jember Regency is set at ≥82%. This study aimed to analyze factors associated with the performance of essential public health efforts. The study employed an analytical cross-sectional design conducted from April to May 2025, with a sample of 37 out of 50 units selected through simple random sampling. Primary data were collected using questionnaires, while secondary data were obtained from primary health center (Pusat Kesehatan Masyarakat – …

The Effects Of Osha State Plans And State Gdp On Occupational Injuries And Illnesses In The United States, Ahmad Abdel Rahman Mohammad Amoorah

Theses

Workplace safety in the United States is governed by a system in which some states operate under federal OSHA oversight, while others administer their own OSHA-approved safety and health plans. This duality raises questions about whether state-level control leads to variation in safety and health outcomes. Economic conditions have also been shown to influence workplace injury rates, yet the interaction between safety and health regulations and local economies remains underexplored. Understanding these relationships is critical to protecting workers in occupational settings. The effects of OSHA state-plan status and state-level economic activity on occupational injury and illness rates across the United …

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Navigating Trust: The Impact Of Social Media Influencers On Gen Z Health Behaviors, Abigail Stelling

Honors Thesis

Social media plays a defining role in the daily lives of Gen Z, influencing how people communicate, access information, and make decisions. More than a form of entertainment, social media is a powerful source that shapes identity, perceptions, and behaviors. As the first generation to grow up fully immersed in a digital world, Gen Z is uniquely impacted by the content and interactions that occur on social media platforms. Within this digital landscape, social media influencers have emerged as powerful figures. These individuals use large online platforms to promote lifestyles, products, and behaviors. Influencers often have the ability to shape …

Resilience And Social Support On Depression Risk For Chronic Obstructive Pulmonary Disease Patients In South Tangerang, Indonesia, Adhityawarman Menaldi, Sali Rahadi Asih, Farah Ainul Mardhiyyah

Kesmas

Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 …

Environmental Contamination Of Methicillin-Resistant Staphylococcus Aureus And Vancomycin-Resistant Enterococcus In Primary Care Clinics: Implications For Occupational Safety, Subki Ahmad, Normah Awang, Ermie Abdull Hamid, Anuar Ithnin, Nurul Farahana Kamaludin, Noraizah Muhd Nor

Kesmas

Methicillin-Resistant Staphylococcus aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE) are major contributors to healthcare-associated infection, yet data from primary care clinics remain limited. This study assessed environmental contamination in eight clinics in the Klang Valley, Malaysia, and evaluated associated environmental factors. Samples were collected from environmental surfaces and equipment in Medical Officer and Patient Treatment Rooms, then cultured and tested for antimicrobial susceptibility. Environmental parameters, including temperature, relative humidity, air movement, and room density, were measured. Data were analyzed using Kruskal–Wallis, Mann–Whitney, and multiple linear regression analyses. MRSA was detected on 19.8% of environmental surfaces (patient treatment beds (47.3%) and side …

Knowledge, Attitudes, And Practices Among Hepatitis B Patients In Jakarta, Indonesia: A Cross-Sectional Study, Hashem S. Arkok, Tri Yunis Miko Wahyono, Nurhayati Adnan Prihartono, Dipo Aldila

Kesmas

Hepatitis B remains a major public health problem in Indonesia. This study assessed the knowledge, attitudes, and practices (KAP) of hepatitis B patients in Jakarta to identify gaps in prevention and control and to explore relationships among KAP components. A cross-sectional study was conducted among 128 patients at a government hospital in South Jakarta, using a structured questionnaire that collected demographic information and assessed knowledge, attitudes, and practices regarding hepatitis B transmission and prevention. Despite moderate knowledge levels, major gaps remained. Only a small proportion (10.9%) correctly identified common symptoms, transmission routes (10.2%), and possible complications (18.8%). Misconceptions about transmission …

Development And Validation Of An Indonesian Questionnaire For Assessing Paracetamol Self-Medication Knowledge, Attitude, And Practice, Widyana Sagita Putri, Rani Sauriasari, Priharika Septyowati

Kesmas

Paracetamol is a widely used over-the-counter medicine for self-medication and is often perceived as completely safe. However, inappropriate use may result in hepatotoxicity and other adverse effects, particularly at high doses. This study aimed to develop and validate a questionnaire to assess the general Indonesian population’s knowledge, attitude, and practice (KAP) regarding paracetamol self-medication. The validation procedure consisted of three stages: content, face, and construct validation. Three experts assessed the relevance of the items using the Content Validity Index, and five respondents were interviewed to assess the linguistic clarity and comprehensibility of the questions. Construct validity and reliability were assessed …

Determinants Of Musculoskeletal Disorder In Formal And Informal Workers In Indonesia, Herlina J. El-Matury, Nabila Syahlan, Mohd Rafee B. Baharuddin

Kesmas

Musculoskeletal disorders (MSDs) are a leading cause of disability globally and are strongly influenced by occupational conditions. Evidence comparing MSD risk between formal and informal workers remains limited, particularly in developing countries. This study examined the association between individual and job-related factors with MSD symptoms among formal and informal workers in Indonesia. A cross-sectional study was conducted among 1,089 workers in North Sumatra Province, Indonesia, from August 2024 to December 2025. Participants were recruited using stratified convenience sampling from both the formal (office and health workers) and informal (drivers, traders, and farmers) sectors. MSD symptoms were assessed using the Nordic …

Determinants Of Behavioral Intention To Change Sexual And Reproductive Health Practices Among Adolescents: A Hierarchical Multiple Linear Regression Analysis, Md Mizanur Rahman, Gerraint Gillan Ahi, Rafazila Ramli, Rasitasam Safii, Jacey Lynn Minoi, Stephanie Chua Hui Li, Ahmad Sofian Bin Shminan, Lee Jun Choi

Kesmas

Conventional and web-based sexual and reproductive health (SRH) interventions are increasingly used with adolescents, yet their comparative effectiveness and underlying mechanisms remain unclear. This study compared the two formats and examined the Theory of Planned Behavior (TPB) constructs as predictors of changes in intention to adopt health-protective SRH practices (including contraceptive use, service utilization, and parent–child communication) among Malaysian adolescents. A randomized controlled trial allocated adolescents to conventional or web-based SRH education. Intention-to-change behavior towards sexual and reproductive health scores was assessed at baseline, 1 month, and 3 months; change scores were modeled using hierarchical linear regression, including intervention type, …

The Feasibility Of Long-Term Care Within Indonesia’S National Health Insurance Scheme: A Qualitative Study, Atikah Adyas, Wan Aisyiah Baros, Khaterina Kristina Manurung, Dedy Revelino, Dewi Susanna, Vetty Yulianty, Anita Pebrina Lubis, Arum Atmawikarta, Iis Sinsin Nuryasini, Ahmad Jet Alamin

Kesmas

The rising prevalence of chronic diseases and disabilities, along with the aging of the population, has reduced individual independence and increased the demand for long-term care (LTC). This study aimed to assess the feasibility of integrating home healthcare services into Indonesia’s National Health Insurance (NHI) scheme. A qualitative study using purposive sampling was conducted in Bandar Lampung, Yogyakarta, and Jakarta, Indonesia, selected based on disease burden, proportion of older adults, and regional development. Data was collected through in-depth interviews, focus group discussions, and observation between August and September 2024, involving 68 informants, including regulators, community members, and health facility staff. …

Factors Associated With Public Health Centers’ Achievement Of Health Service Target In Yahukimo District, Highland Papua Province, Indonesia, Emaus Heluka, Venty Suryanti, Indasah Indasah, Prima Dewi Kusumawati

Kesmas

The achievement of the Minimum Service Standards (MSS) in Yahukimo District, Highland Papua Province, Indonesia, warrants examination. This study aimed to analyze factors associated with the achievement of health service targets among Public Health Centers (PHCs) in Yahukimo District. An ecological study design was employed. The participants were 400 health workers from 33 PHCs and were examined using Likert-scale questionnaires. Data were processed using Structural Equation Modeling-Partial Least Squares (SEM-PLS) to assess the association of each variable. The results showed that health target indicators were associated with the achievement of health service targets (T = 3.320; p-value = 0.012). Health …

Characteristics Of People Who Inject Drugs Approached For Injection Assistance In Rural Kentucky, April Young, Ryli Hockensmith, Preston T Tolbert, Susan Westneat, Peter Vickerman, Jack Stone, Hilary L Surratt, Kayo Fujimoto, Hannah K Knudsen, Rachel Vickers-Smith, Katherine L Thompson, Laura Fanucchi, Julia Kollitz, Jennifer R Havens, Melvin D Livingston

Faculty, Staff and Student Publications

Objective: This study aims to understand the characteristics of people who inject drugs approached by others for injection assistance.

Method: Peer-referral and outreach were used to recruit rural adults who recently injected drugs in Appalachian Kentucky (n=435). Interviewer-administered questionnaires elicited data on participant characteristics and injection assistance. Descriptive statistics and generalized estimating equations clustered on peer-referral recruitment chain were used for analysis.

Results: Nearly one-third (30.1%) reported others had come to them for injection assistance. People approached for assistance were slightly younger (prevalence ratio [PR]: 0.91, 95% confidence interval [CI]: 0.85-0.99) but otherwise, demographically similar to their counterparts. Those approached …

Extending The Global Impact Of Dnp Education: Integrating Scholarly Dissemination And International Practice Projects, Cynthia Plonien, Pricilla Muisyo, Deborah Behan, Kristine Cope, Cathy Brown

Nursing Faculty Publications & Presentations

The Doctor of Nursing Practice (DNP) Program at the University of Texas at Arlington initiated a global outreach effort in 2024 through two complementary strategies: expansion of a digital repository to support dissemination of DNP scholarly work and implementation of pilot DNP projects in Kenya. Together, these initiatives represent an integrated model for global engagement that combines knowledge dissemination with application of practice-based scholarship. The repository has facilitated international access to DNP projects, demonstrating significant global reach across multiple countries. Concurrently, a pilot project in Kenya was established through a strategic in-country professional partnership, enabling culturally relevant and sustainable implementation …

Modeling The Impact Of Treatment During An Ongoing Tuberculosis Outbreak, Bach Le, Anna Robicheaux, Jude Shive, Alana Wells, Erin N. Bodine

Spora: A Journal of Biomathematics

In response to a significant tuberculosis outbreak in Wyandotte and Johnson Counties, Kansas, this study presents a compartmental model of ordinary differential equations to evaluate the impact of standard antibiotic treatment. The model incorporates latent, active, and treated disease states. Parameter values were informed by epidemiological data and uncertain parameter value ranges were explored systematically through uncertainty analysis using constrained Latin hypercube sampling. Cumulative infections and deaths, and the basic reproduction number, were computed over a five-year simulation period. Sensitivity analyses using partial rank correlation coefficients identified symptomatic treatment rate and transmission rate as primary drivers of cumulative infections and …

The Cannabis Motivation Spectrum: Comparing Medical, Recreational And Dual Intent Users, Addyson Domian, Jacob Borodovsky

Wetterhahn Science Symposium Posters

There is a lack of a standardized definition of “medical” cannabis use in the healthcare industry, which has led to an informal, user-reported definition of medical use. Consequently, individuals who use cannabis for both medical and recreational reasons (dual intent) are not always differentiated from pure medical or pure recreational users. This study compares self-defined medical only and dual intent motivational groups relative to recreational only users to better understand how these groups differ by analyzing sociodemographic and use patterns, clinically relevant factors, and claimed cannabis-related benefits. Using data from the Qualtrics Cannabis Exposure Index survey instrument of 8836 adult …

Evaluating Stroke Recognition And Prehospital Quality Metrics In Emergency Dispatch: A Retrospective Cohort Study Comparing Mimics And Confirmed Strokes, Nedim Leto, Elisabeth Farbu, Paul Barach, Conrad Arnfinn Bjørshol, Martin Kurz, Soffien Ajmi, Annette Fromm, Christopher Kalhagen Bjerkvig, Thomas Lindner

College of Population Health Faculty Papers

OBJECTIVES: Accurate identification of acute stroke by the Emergency Medical Dispatch Centre (EMDC) is essential for timely treatment and efficient resource use. However, stroke mimics-conditions resembling stroke can often lead to overtriage, complicating emergency care. We aimed to quantify EMDC stroke overtriage and compare characteristics of stroke mimics with confirmed stroke cases.

DESIGN: Retrospective cohort study.

SETTING: Patients with suspected stroke identified by the EMDC in Western Norway between 1 January 2021 and 31 December 2022.

PARTICIPANTS: A total of 8,261 patients with EMDC suspected stroke were included. Stroke suspicion was determined using the Norwegian Medical Priority Dispatch System, which …

Do Rural-Urban Disparities Translate Into Nursing Complexity At Hospital Admission? Evidence From A Single Tertiary-Care Pediatric Hospital In Italy, Manuele Cesare, Gianfranco Damiani, Gloria Anderson, Jessica Preziosi, Rosemary Frasso, Leonardo Villani, Nursing And Public Health Group, Vittorio Maio, Antonello Cocchieri

College of Population Health Faculty Papers

BACKGROUND/OBJECTIVES: Rural-urban disparities are well documented in pediatric healthcare, influencing access, service organization, and outcomes. However, whether these differences extend to the domain of nursing care remains unclear. This study examined the association between degree of urbanization and nursing complexity among children admitted to a single tertiary-care pediatric hospital, comparing clinical, organizational, and nursing characteristics across geographic groups.

METHODS: Routinely collected electronic nursing documentation and hospital administrative records were retrospectively examined in a tertiary-care pediatric hospital in Rome, Italy. Children aged 2 to < 18 years were consecutively included. Degree of urbanization was defined using the ISTAT-derived DEGURBA classification. The study outcome for nursing complexity corresponded to the number of nursing diagnoses documented at hospital admission. Descriptive analyses and a multivariable negative binomial regression model assessed the association between urbanization and nursing complexity, adjusting for age, sex, DRG weight, number of medical diagnoses, and chronic conditions.

RESULTS: Among 1652 pediatric hospitalizations, those from rural areas showed a higher clinical burden, with significantly higher …

Food Insecurity And At-Home Vegetable And Sugar-Sweetened Beverage Availability: Tx Sprouts Randomized Controlled Trial, Keally Haushalter, Shreela V Sharma, Marissa Burgermaster, Natalie S Poulos, Erin A Hudson, Jennifer M Daspin, Mariela Jimenez Rivero, Jaimie N Davis

Faculty, Staff and Student Publications

Food insecurity and the at-home availability of vegetables and sugar-sweetened beverages both influence dietary intake. However, most research on food insecurity and the at-home availability of vegetables and sugar-sweetened beverages is cross-sectional, which is problematic as both change frequently. Therefore, this study assessed how changes in food insecurity were associated with changes in the at-home availability of vegetables and sugar-sweetened beverages among those in the intervention and control groups of TX Sprouts. Parents who participated in TX Sprouts, a gardening, cooking, and nutrition cluster-randomized trial conducted with primarily Hispanic, low-income 3rd-5th-grade students, completed surveys at baseline and at the nine-month …

Projected U.S. Cardiovascular Disease Burden From Heat Exposure For Future Greenhouse Gas Scenarios, Gokul Parmeswaran, Sai Rahul Ponnana, Santosh Kumar Sirasapalli, Niketh Surya, Tong Zhang, Zhuo Chen, Jean-Eudes Dazard, Salil V. Deo, Sanjay Rajagopalan

Faculty Scholarship

Importance: Climate change may reverse decades of improvements in cardiovascular disease (CVD) mortality in the US; however, comprehensive regional projections of heat-related CVD burden in the US are unavailable. Objective: To use the county-level observed (2010-2016) heat-related CVD burden in the US to obtain the projected rates through 2050 according to the mean (shared socioeconomic pathway [SSP] 2-4.5) and high (SSP5-8.5) greenhouse gas (GHG) emission pathways. Design, Setting, and Participants: This cross-sectional ecological analysis used county-level summary data including all counties in the contiguous US from 2010 through 2016 as baseline data with projections to 2030 and 2050 under SSP …