Digital Commons Network^™

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

Assessing The Effectiveness Of A Modified Cook Together Eat Together Program On Food Resource Management Behaviors In A Rural Setting, Johanna K. Poysti

Theses and Dissertations--Nutrition and Food Systems

This study evaluated the effectiveness of a modified, hybrid Cook Together, Eat Together (CTET) program on food resource management behaviors in a rural setting. A six-week intervention combining virtual and in-person sessions aimed to improve health behaviors, food resource management skills, and self-efficacy. Although most behavioral changes were not statistically significant, participants reported increased confidence in cooking healthy meals on a budget. Positive qualitative feedback from focus group discussions indicated program feasibility and engagement. Strengths and limitations of the study were discussed as well as recommendations for future research were given.

Researching Dementia Indicators Among Rural Populations, Justin S. Yount

Theses and Dissertations--Community & Leadership Development

The study explored potential dementia indicators and risk factors among older adults residing in rural areas who are actively engaged in farming operations. Data was collected in three components a questionnaire, an audiogram test, and a memory impairment screening. 104 people responded to the questionnaire, 133 participants took the audiogram test, and 94 participated in the memory impairment screening. The findings revealed that 80.9% of participants showed no sign of cognitive impairment while 19.1% showed signs of possible impairment. Participants reported moderate levels of physical and social activity, but common risk factors such as elevated BMI, diabetes, hearing loss, and …

Understanding The Impact Of Language Barriers And Visit Duration On Caregiver Satisfaction In Pediatric Primary Care, Gavin Miller, Liz Vazquez, Joyce Ho, Emma Maynor, Emily L. Allen, Marley F. Fradley, Julian Ruiz, Ana J. Bridges

2025 Honors Symposium

Abstract:

Problem. Children from households that speak languages other than English (LOE) face significant challenges in accessing healthcare, which can lead to poorer health outcomes and inadequate medical care (Flores et al., 2005). Language barriers contribute to these disparities, often resulting in diminished communication between healthcare providers and families (Ramirez et al., 2023). In pediatric primary care, visit duration—defined as the amount of time between when a patient is checked into and out of the clinic—may play a crucial role in facilitating effective communication and improving patient satisfaction (Tsiga et al., 2013). Physicians experience significant time pressure and productivity expectations, …

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

An Evaluation Of Frank Brown's Free Market, Leigh Ann Mccormick

Theses and Dissertations

Background: This study aimed to conduct an in-depth evaluation of Frank Brown Hall, Free-Market (Food Pantry), within the grant timeframe from January to April 2024. The central objective was to examine the distinct resource demands of students limited to selecting three items each day. By employing careful observation, effective communication, and active listening, we successfully obtained essential student feedback that enhanced our understanding of their needs and preferences, improving the support provided during that semester. Methods: Throughout the grant, data were systematically classified according to the chosen items, the students’ academic majors, and the cumulative number of visits to the …

Addressing Barriers To Preventive Healthcare Access Through Community Outreach In Underserved Populations, Deneisha Sparks

Theses and Dissertations

Access to preventive healthcare is a significant public health challenge, particularly for underserved populations in Muscogee County, Georgia. This project addresses systemic barriers such as transportation, limited health education, and economic constraints, which contribute to health disparities and reliance on emergency room services. Guided by the Social Determinants of Health (SDOH) framework and the Health Belief Model (HBM), the project aims to enhance access to preventive care, improve health literacy and identify barriers to healthcare access.

This program evaluation report examined a community-based initiative that utilized a mobile health unit to improve access to preventive healthcare in underserved areas of …

Flavorful Foes: Assessing Students’ Perceptions Of Processed And Fast Food And Its Health Implications., Soumi Roy Banerjee

Theses and Dissertations

High fast-food consumption is a common public health concern due to its link to a number of non-communicable diseases and mental health, but increased consumption of processed food, rapid urbanization, and changing lifestyles have led to a shift in dietary patterns. People are consuming more foods high in energy fats and free sugars. This mixed methods study was conducted at a college campus in Georgia, to assess knowledge and understanding of the students between the ages of 18 and 22 years about highly processed Fast Food, and its effects on health. Forty student participants were chosen through convenience sampling and …

Why A Healthy Diet Is Important For Women's Health, Halley Doster

Theses and Dissertations

Nutrition plays a critical role in women’s reproductive health, yet many women face barriers to maintaining a balanced diet. This study aimed to examine the relationship between nutritional intake and reproductive health outcomes among women of reproductive age, as well as to assess their knowledge and challenges related to healthy eating. Using a cross-sectional survey design, data were collected from 50 women at a community health center and analyzed using SPSS to generate descriptive statistics and explore patterns through chi-square and regression analyses. Findings revealed that most participants had moderate to low fruit and vegetable intake, and fewer than half …

Attacking Diabetes One Day At A Time, Kyla Duncan

Theses and Dissertations

The "Attacking Diabetes One Day at a Time" initiative targets the growing concern of public health, type 2 diabetes, among under-reserved communities. This comprehensive care program emphasizes the importance of prevention through education, improving lifestyles, and access to care. Based on insights from the Self-Care Management Theory, this initiative seeks to provide individuals with sound, culturally tailored strategies that reduce disease risk and help them manage healthy lifestyles. Major components include educational workshops, and resource navigation. The success of this program, from community engagement through evaluation on a phased implementation plan, is guaranteed. The expected outcomes of this work will …

Prevalence Of Hypertension Among Low-Income Individuals In Muscogee County Columbus, Georgia, Amelia K. Fallah

Theses and Dissertations

This study investigates the prevalence and predictors of elevated blood pressure (BP) among 409 low-income adults in Muscogee County, Columbus, Georgia—a population disproportionately burdened by hypertension. The findings reveal that elevated BP is significantly more prevalent among African Americans (71.4%) compared to non-African Americans (27.1%), highlighting the role of racial disparities influenced by systemic inequities, healthcare access, and chronic stress. Gender differences were modest, with females exhibiting a slightly higher prevalence (77.9%) than males (76.7%), potentially due to age-related hormonal changes post-menopause. Older adults (50+ years) represented most of the sample and showed significantly higher hypertension rates, consistent with established …

Mental Health Trends Among African American High School Students, Alexis Heard

Theses and Dissertations

Adolescent mental health is a major public health issue in the U.S., with African American high school students facing a rapidly worsening crisis. While all youth show increasing rates of depression, anxiety, and suicidality, African American adolescents are at greater risk due to systemic racism, socioeconomic inequality, community violence, and limited access to culturally responsive care. Few national studies have examined mental health trends among this group. This study (1) examines 2011–2021 trends in persistent sadness/hopelessness, suicidal ideation, suicide planning, and suicide attempts among African American high school students; (2) explores gender differences; and (3) compares these patterns to national …

Evaluating A Public Health Program Using The Cdc Framework: A Case Study Approach, Brooke A. Poe

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

In Bourbon County, Kentucky, where rural health challenges and chronic disease burdens persist, a coalition of public health partners set out to improve population-level physical activity through an innovative, community-centered initiative. The Bourbon County Physical Activity Program emerged through collaboration between the Bourbon County Health Department, the University of Kentucky College of Public Health, and UK HealthCare. Together, these partners designed a six-month intervention that combined discounted YMCA memberships, partnerships with employers, a physical activity tracking app with behavioral incentives, and community-wide events to promote accessible and sustained engagement.

Guided by the CDC’s framework for program evaluation in public health, …

Influence Of Perceived Health Provider Communication, Diabetes Duration And Age At Diagnosis With Confidence In Diabetes Self-Care, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, William B. Burrows, Brittany L. Smalls

Family and Community Medicine Faculty Publications

Introduction: Several factors influence individuals’ confidence to perform diabetes-related self-care activities, including perceived patient-provider communication, diabetes duration and age at diagnosis. It has been well-documented that patient-provider communication is essential when managing chronic diseases such as diabetes; however, the impact of this communication with diabetes duration and age at diabetes diagnosis on confidence in performing self-care behaviors is obscure.

Research design and methods: We utilized data from the 2021 Household Component of the Medical Expenditure Survey among participants 18 years or older who had completed the Diabetes Care Survey. Ordinal logistic regression models were utilized to assess the association between …

Empowering Reproductive Health & Access To Enhance College Student Well-Being: A Mixed Methods Community Engaged Proposal, Allison Maladore

CGU Theses & Dissertations

This study is a proposal developed in response to the need for the expansion of reproductive health services in institutions of higher education. College-age young adults in the age group of 18 to 24 are particularly vulnerable to unintended pregnancies, sexually transmitted infections, and participate in risky behaviors such as alcohol usage and illicit drug consumption which can increase the likelihood of unsafe sexual behaviors. Reproductive healthcare access is linked to academic success, improved health outcomes, and holistic well-being. The proposal utilizes a community-engaged socioecological approach to create a roadmap and implementation plan to expand reproductive services and access to …

Polymeric Nanocomposites-Based Advanced Coatings For Antimicrobial And Antiviral Applications: A Comprehensive Overview, Rachid Amrhar, Jaspal Singh, Mostafa Eesaee, Pascal Carrière, Alireza Saidi, Phuong Nguyen-Tri

Revues de littérature, synthèses de connaissances

The rise in microbial infections and viral outbreaks has accelerated the development of advanced antibacterial and antiviral coating that effectively minimize infection risks. Amidst rising global health concerns due to infectious diseases, these coatings have emerged as vital solutions for surface protection across various settings. This review focuses on the recent development and in-depth analysis includes synthesis process, inactivation mechanism in photoreactive antimicrobial and antiviral bio-coatings. This review comprehensively explores the development of different nanocomposite materials, including polymers based on metal oxide nanoparticles, metal nanoparticles, graphene-based materials, and organic-inorganic composites. Their practicality and compatibility with diverse surfaces such as ceramics, …

Evaluating The Early Impact Of Ab 617: Air Pollution, Health Disparities, And Environmental Justice In California, Cherry Cheuk Lam Cheung, Adam Eckerd

School of Public Service Faculty Publications

This study evaluates the initial effectiveness of California’s Assembly Bill 617 (AB 617), enacted to address air pollution impacts in communities designated as environmental justice priorities, a policy approach that has recently been touted as a successful start. These claims of initial success stand in contrast to much of the research on remediation of environmental justice, particularly with respect to air pollution. Despite well-documented disparities in air pollution exposure and its health impacts among racial-ethnic minorities, previous policy efforts to mitigate these effects have had, at best, marginal effects. AB 617 mandates local air districts and the California Air Resources …

An Analysis Of Covid-19 Vaccine Hesitancy In The U.S., Hieu Trung Bui, Sandra Eksioglu, Ruben Proano, Sarah Nurre Pinkley

Industrial Engineering Faculty Publications and Presentations

Reluctance or refusal to get vaccinated, commonly known as Vaccine Hesitancy (VH), poses a significant challenge to COVID-19 vaccination campaigns. Understanding the factors contributing to VH is essential for shaping effective public health strategies. This study proposes a novel framework for combining machine learning with publicly available data to generate a proxy metric that evaluates the dynamics of VH faster than the currently used survey methods. The metric is input to descriptive classification models that analyze a wide array of data, aiming to identify key factors associated with VH at the county level in the U.S. during the COVID-19 pandemic …

“Promoting Safe Firearm Storage Through Media-Based Interventions”, Abigali Bordelon

2025 Honors Symposium

Although often underrepresented in public discussions of gun violence in the United States, unintentional pediatric shootings contributed to the ongoing gun violence endemic. These shootings routinely share characteristics which make them an ideal target for public health and injury prevention efforts. As individual's often learn about unintentional pediatric shootings and form opinions based on media reports of these incidents, it is crucial that we explore how the mainstream media is framing these events and what must be changed in order to better support prevention efforts. This project examines safe firearm storage patterns and attitudes within the U.S. and mainstream media …

Newsletter From The Committee On The Status Of Women In The Economics Profession, Linda Tesar, Caitlin Myers, Sarah Baird, Sarah Hamersma, Kelly Jones, Kosali Simon, Jialan Wang

Global Health Faculty Publications

No abstract provided.

Coronary Artery Disease – Future Tools For Optimizing Primary Prevention, Nick Makosiej

Capstone Showcase

Coronary artery disease (CAD) is a progressive, obstructive, and inflammatory process affecting the endothelial lining of the coronary arteries, which ultimately compromises the perfusion of the myocardium and can lead to ischemic infarction. This narrowing of vasculature which supplies the myocardial tissue leads to a spectrum of anginal syndromes and inevitably, catastrophic consequences. This article is focused on understanding the pathophysiology of this disease process and educating providers on emerging clinical tools that can be utilized to prevent progression, and ultimately reduce morbidity and mortality of this insidious disease process.

Structural And Interpersonal Determinants Of Covid-19 Vaccine Uptake In Vulnerable Populations Of The United States, Alyea Wood

Capstone Showcase

Since its introduction in late 2020, the uptake of the COVID-19 vaccine has had the lowest rates in marginalized populations like minorities, elderly, and those of low socioeconomic status. Decreased rates of vaccination uptake in these groups has resulted in increased burden of disease and subsequently higher rates of hospitalization and death. Many inequities in poor COVID-19 health outcomes can be explained by examining common predictive factors that determine vaccination rates in these United States populations. This special article research aims to explore these various predictive factors with the goal to provide targeted strategies to boost COVID-19 vaccination rates, especially …

The Alcohol Exposome, Nousha H. Sabet, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

Science is now in a new era of exposome research that strives to build a more all-inclusive, panoramic view in the quest for answers; this is especially true in the field of toxicology. Alcohol exposure researchers have been examining the multivariate co-exposures that may either exacerbate or initiate alcohol-related tissue/organ injuries. This manuscript presents selected key variables that represent the Alcohol Exposome. The primary variables that make up the Alcohol Exposome can include comorbidities such as cigarettes, poor diet, occupational hazards, environmental hazards, infectious agents, and aging. In addition to representing multiple factors, the Alcohol Exposome examines the various types …

Mercury Concentrations, Health, And Marine Food Consumption Across Four Eastern Caribbean Populations: Insights From A Novel Community-Based Study, Russell Fielding, Catherine Brown, Jessica Dutton, Martin S. Forde, Heather Harewood, Lisa Hunt, Catherine Macdonald, Cameron Mewhirter, Vincent Reid, Madison Smith, Holly Taylor, Katelyn Zimmerman

Gulf and Caribbean Research

Mercury (Hg), as an environmental pollutant, can have harmful effects on human health. A common way that people are exposed to Hg is through seafood consumption. This project was designed to investigate Hg exposure through seafood consumption and its health effects among adults in 4 Caribbean countries: Barbados (n = 117), Grenada (n = 90), St. Lucia (n = 126), and St. Vincent & the Grenadines (n = 77). We applied a novel, community—based method, which involved recruiting and paying local barbers and hairstylists to collect hair samples from their clients who consented to join the project as participants. Participants …

A Systematic Review And Evaluation Of The Tools Measuring Work-Related Psychosocial Factors In Prospective Research On Sickness Absence Of Health Care Workers, Laurent Corthésy-Blondin, Simona Margheritti, Samantha Vila Masse, Andrea Gragnano, Alessia Negrini

Revues de littérature, synthèses de connaissances

Purpose:

This systematic literature review aims to list the validated tools measuring work-related psychosocial factors (WRPFs) influence health care workers’ (HCWs) sickness absence (SA), and to evaluate their psychometric and practical properties.

Methods:

Using the PsycINFO, Medline, and Web of Science databases, the search targeted prospective studies on WRPFs and SA in HCWs published between 2012 and 2023. The validated, self-report tools that measured WRPFs and that yielded at least one significant predictor of SA in HCWs were identified. An evaluation of the psychometric and practical properties was performed.

Results:

Based on inclusion criteria, three prospective studies on HCWs were …

Multidisciplinary Lethal Means Safety Counseling Design And Implementation: Training And Identifying Barriers In A Children's Hospital, Cassandra L. Stegall, Brendon Carnell, Jaime M. Golden, Rupa Kapoor, John H. Fanton, Paul C. Mullan, Alexandra P. Leader

Department of Pediatrics Faculty Publications

Background

Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods

A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and …

The Association Between Pain Sensitivity And Low Energy Availability, Sleep, Mental Health, And Stress In Female Endurance Athletes, Taylor R. Moler

Honors Undergraduate Theses

The disruption of certain physiological functions due to low energy availability (LEA) in female endurance athletes is a prominent concern. This condition resulting from LEA has been described as Relative Energy Deficiency in Sport (RED-S), which can include alterations in metabolism, menstrual function, bone deposition and resorption, mental well-being, and more. The goal of this study was to determine whether pain sensitivity was associated with LEA, sleep, mental health, and stress in female endurance athletes. Participants completed a demographic survey, the Low Energy Availability in Females Questionnaire (LEAF-Q), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-4), and …

Navigating The Intersections: Immigration, Diversity Of The Workforce, Precarious Work, And Vulnerabilities In Occupational Safety And Health, Daniel Côté, Jessica Dubé

Éditoriaux, lettres à l'éditeur

Dans un contexte de mondialisation croissante, la migration est une réalité incontournable qui expose les travailleurs migrants et autochtones à des conditions précaires et à des vulnérabilités accrues en matière de santé et sécurité du travail (SST). Les formes d’emploi précaires – contrats temporaires, travail à temps partiel ou informel – touchent de manière disproportionnée ces travailleurs, limitant leur accès aux droits et protections. Les travailleurs autochtones, particulièrement en milieu rural et dans des secteurs à risque, font face à des défis similaires en raison de marginalisations historiques et structurelles.

Ce texte présente les cinq articles de la section spéciale …

Association Between Rurality And Race/Ethnicity And Pediatric Cancer Early Mortality: A Population-Based Cohort Study Using Seer Data From 2000 To 2021, Kiersten Preuss, Emma Hymel, Melissa Acquazzino, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Pediatric cancer mortality rates have steadily declined since 2009, but over a thousand deaths still occur annually. While existing research highlights the effects of race/ethnicity and rurality on overall survival, few studies have specifically analyzed these factors in relation to early mortality, defined as death within 12 months of diagnosis.

PROCEDURE: This study utilized SEER Research Plus Limited-Field Data (2000-2021) to examine the association between race/ethnicity, rurality, and early mortality in pediatric cancer patients. A cohort of 138,648 individuals was analyzed using Cox proportional hazards regression models to calculate hazard ratios and 95% confidence intervals (CIs).

RESULTS: The results …