Digital Commons Network^™

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

Use Of Period- Or Fertility-Tracking Technologies Pre- And Post-Dobbs, Emily Neiman, Marta Bornstein Phd, Mph, Abigail Norris Turner, Megan L. Kavanaugh, Maria F. Gallo

Faculty Publications

Objectives

Study design

The Flourishing Child: Study Protocol For An Acceptability And Feasibility Trial Of A Digital Early Childhood Flourishing Intervention, Zenobia Talati, Jack Kennare, Natasha L. Bear, Lisa Y. Gibson, Robyn Power, Van Zyl Kruger, Desiree Silva, Susan L. Prescott, Jacqueline A. Davis

Research outputs 2022 to 2026

Background: Globally, rates of children with physical and mental health problems are increasing. Health issues in early childhood often persist into adulthood, highlighting the need to ensure children are supported to flourish from the start of life. Objectives: This protocol describes methods used to test the acceptability and feasibility of a novel digital Flourishing Intervention (designed to empower parents and promote child wellbeing), comprising a Flourishing Check (a newly developed online questionnaire) and a Pathway Tool (an online directory of high-quality, evidence-based programmes and resources). Methods: Using a randomised feasibility trial, participants (N = 600 parents of children aged 0–5 …

Ligand-Based Pharmacophore Modeling And Structure-Based Virtual Screening For Identifying Potential Therapeutic Agents Targeting The Sars-Cov-2 Spike Protein-Ace2 Receptor Interaction, Timoteo Delgado-Maldonado, Gilberto Vargas-Salas, Debasish Bandyopadhyay, Adriana Moreno-Rodriguez, Eyra Ortiz-Pérez, Gildardo Rivera-Sanchez

School of Integrative Biological & Chemical Sciences Faculty Publications

Coronavirus disease (COVID-19) remains a global health concern due to its high mortality and morbidity. In this study, we combined ligand-based pharmacophore modeling (LBPM) with structure-based virtual screening (SBVS) to identify novel inhibitors targeting the SARS-CoV-2 spike protein. Ligands from the MolPort database were screened via docking and molecular dynamics simulations at the receptor-binding domain (RBD). Four compounds showed promising docking scores (-8.7 to -6.4 kcal/mol) and dynamic stability (root mean square deviation < 5 Å). In vitro assays confirmed that compounds C3 (IC50 = 0.03 µM) and C4 (IC50 = 10.4 µM) effectively inhibited spike-ACE2 binding with low cytotoxicity (CC50 > 100 µM). These findings show the efficacy of the LBPM technique and highlight 1H-pyrazol-5-ol derivatives as potential building blocks for developing new antiviral agents against SARS-CoV-2.

Sepsis As An Immune Continuum: Cytokine Storm To Lymphopenia And Pics, Chelsey King

Senior Honors Theses

Sepsis is a leading cause of morbidity and mortality worldwide, driven by a dynamic immune continuum that progresses from early hyperinflammation to profound immunosuppression. This review examines the three overlapping phases of sepsis: the inflammation-mediated cytokine storm driven by dysregulated PRR activation, NF-κB signaling, and NETosis; apoptosis-driven lymphopenia involving caspase-mediated lymphocyte death, dendritic cell dysfunction, and metabolic exhaustion; and prolonged immunoparalysis culminating in persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Key mechanisms linking these phases, including the co-existence of hyper- and hypo-inflammatory states, are synthesized alongside relevant clinical biomarkers such as IL-6, HLA-DR, and single-cell immune profiles. This review highlights …

Screening For Hypertension And Diabetes In Laundromats In The Largest Hispanic-Majority City In The U.S, Nicholas A Mccann, Vanessa Schick, Jack Tsai

Faculty, Staff and Student Publications

Purpose: This study aimed to assess the prevalence of hypertension and diabetes among laundromat users in San Antonio, Texas, and explore laundromats as a novel setting for health interventions regarding these 2 conditions.

Design: This descriptive, cross-sectional study involved demographic, blood pressure and HbA1c screenings to assess the health status of laundromat users.

Setting: The study took place in 7 laundromats in low-income areas of San Antonio.

Subjects: A total of 150 adults aged 18 and older who regularly used the laundromats and spoke either English or Spanish were eligible to participate.

>Measures: Hypertension was defined as a systolic BP …

An Integrated Framework For Early Detection And Transmissibility Assessment Of Emerging Variants In Wastewater, Xingwen Chen, Tin Phan, Wei Lin Lee, Katie Clark, Steven F Rhode, Samantha Brozak, Bruce Pell, Tsultrim Palden, Mats Leifels, Anna Gitter, Yang Kuang, Stefan Wuertz, Janelle Thompson, Kristina D Mena, Eric J Alm, Fuqing Wu

Faculty, Staff and Student Publications

Tracking the emergence of new viral variants is critical for epidemic preparedness, but remains challenging because variants typically circulate at low prevalence during the early phase of outbreaks. Here, we present an integrated framework that combines sensitive variant detection in wastewater with quantitative assessment of transmissibility through dynamic epidemic modeling. Using the SARS-CoV-2 Omicron variant as a proof of concept, we developed a novel nested allele-specific RT-qPCR assay (NAS-PCR) that achieved a thousand-fold increase in sensitivity compared with allele-specific RT-qPCR (limit of detection: 0.5 copies/μl). NAS-PCR detected Omicron in wastewater samples from the Greater Boston area starting in September 2021, …

Associations Of Blood Biomarkers Of Glial Cell Dysfunction And Neuronal Injury With Future Cognitive Decline And Incident Dementia, Srishti Shrestha, Xiaoqian Zhu, B Gwen Windham, Kevin J Sullivan, Priya Palta, Rebecca F Gottesman, Russell P Tracy, Clifford R Jack, Petrice M Cogswell, Prashanthi Vemuri, Sudha Seshadri, Thomas H Mosley, Michael E Griswold, Myriam Fornage

Faculty, Staff and Student Publications

Introduction: Prospective studies of blood-based biomarkers reflecting pathogenic processes, other than Alzheimer-specific pathologies, that contribute to dementia in diverse cohorts are lacking.

Methods: We jointly fitted linear mixed-effect models and proportional hazards models to examine associations of midlife glial fibrillary acidic protein (GFAP), chitinase-3-like protein 1 (YKL-40), soluble cluster of differentiation-14 (sCD14), neurofilament light chain (NfL), total tau (t-tau), and ubiquitin C-terminal hydrolase L1 (UCHL1) levels in serum (collected in 1993 to 1995) with cognitive decline and incident dementia (ascertained over 29 years through 2022) in the community-based Atherosclerosis Risk in Communities Study. sCD14 and YKL-40 were measured in 3082 …

Perceived Neighborhood Environment And Objectively Assessed, Habitual Physical Activity Among Us Adults: An All Of Us Research Program Study, Natalia I Heredia, Michael C Robertson, Christopher D Pfledderer, Ethan T Hunt, Timothy J Walker, Deborah Salvo

Faculty, Staff and Student Publications

Introduction: The purpose of this study was to assess the associations between perceived socioenvironmental neighborhood attributes and objectively assessed habitual physical activity among US adults as well as whether associations vary by sociodemographic characteristics.

Methods: We used data from the All of Us research program, a longitudinal cohort study of a diverse sample of Americans. Perceived neighborhood social cohesion, physical and social disorder, walkability, and sociodemographic characteristics were self-reported. Habitual physical activity was ascertained using Fitbit-derived step counts over ≥24 weeks. Generalized additive mixed-effects models were used to test the associations between perceived socioenvironmental neighborhood attributes and daily step counts. …

Addressing Nonignorable Missing Data And Heterogeneity In Prognostic Biomarker Assessment, Xinran Huang, Ruosha Li, Jing Ning, For The Alzheimer's Disease Neuroimaging Initiative

Faculty, Staff and Student Publications

Covariate-specific and time-dependent area-under-curve (AUC) is often used to evaluate the discriminative performance of biomarkers with time-to-event outcomes, particularly when certain covariates influence biomarkers' accuracy. In biomarker research, despite extensive efforts, missing data remain unavoidable, with nonignorable missingness posing significant challenges. This article focuses on estimating the impact of covariates on time-dependent AUC in the presence of nonignorable missing biomarkers. Assuming a parametric model on the missing probability, we leverage instrumental variables to address the identifiable issue and estimate the unknown parameters. We integrate the inverse probability weighting approach into the score equation of a pseudo partial likelihood for estimation …

A Bilingual Ai-Based Chatbot For Nutrition Education In A Food Is Medicine Intervention For High-Risk Pregnant Women: Design And Development Study, Lorena Macias-Navarro, Nalini Ranjit, Gregory W Bounds, Brendon A Providence, Yesmeena Shmaitelly, Naomi M Tice, Shreela V Sharma

Faculty, Staff and Student Publications

Background: Conversational agents (artificial intelligence [AI]-based chatbots) offer a novel approach to health interventions by providing personalized, adaptive interactions that improve over time based on user engagement. In nutrition education, given the wide variation in knowledge, skills, and abilities across participants, AI-based chatbots have the potential to enhance accessibility, engagement, and behavior change. Food is Medicine (FIM) interventions, which aim to improve food security and diet quality among multicultural, at-risk populations, often face challenges related to sustained engagement and use.

Objective: This paper describes the design, development, and iterative refinement of a bilingual AI-driven nutrition chatbot integrated into an FIM …

Associations Between Water Intake, Dietary Quality, And Beverage Consumption Among University Students, Mohammad A. Qazi

Electronic Theses, Projects, and Dissertations

Title: Associations Between Water Intake, Dietary Quality, and Beverage Consumption Among University Students

Background and Aims: Sugar-sweetened beverage (SSB) and ultra-processed food (UPF) consumption significantly contribute to chronic disease risk and is often more common in underserved and racially/ethnically diverse communities. Drinking water is a low-cost, calorie-free behavior that may support healthier beverage and dietary patterns. Previous studies show that increased daily water consumption positively correlates with better diet quality and is inversely correlated with SSB and UPF consumption. This study aims to examine whether (1) increased daily water intake is associated with self-reported diet quality and (2) self-reported hydration …

Certified Health Education Specialist Exam Toolkit For Undergraduate Public Health Students, Briana C. Villari

Electronic Theses, Projects, and Dissertations

The Certified Health Education Specialists (CHES) is a credentialing exam that is offered by the National Commission for Health Education Credentialing, Inc (NCHEC) for public health professionals and students. With the completion of this exam, individuals can demonstrate their mastery of core health education skills and concepts. With the 2025 testing cycle, roughly 63 to 73 percent of test takers passed. The purpose of this project is to create a CHES exam toolkit for undergraduate public health students in preparation for their exam. The development of this toolkit was guided by the Health Education Specialists Practical Analysis (HESPA II 2020), …

Assessing The Needs Of Public Health Professionals In The Inland Empire, Esteban Silva-Garcia

Electronic Theses, Projects, and Dissertations

An effective public health system relies on the need for highly trained professionals with degrees or certifications within the field of public health. As public health continues to evolve, professionals are required to improve and evolve with the pace of technology and knowledge advancements. This project focuses on reviewing literature on the current ongoing needs of public health professionals and providing them with resources that are available at low to no cost. It surveys the needs of public health professionals in the Inland Empire and the solutions created by organizations and federal agencies to support professional development for current and …

The Quantification Of Fluoride Water Quality And Its Significance On Oral Health, Harleen Kaur Maroak

Electronic Theses, Projects, and Dissertations

Fluoride is a naturally occurring mineral and studies have shown that when added to community water supplies, it effectively reduces dental caries. According to the U.S. Public Health Services (PHS), 0.7mg/L is the optimal fluoride level in drinking water to prevent tooth decay. This study focuses on examining the fluoride levels in water in San Bernardino County (SBC) and Riverside County (RC). Data is collected from recently published articles, databases along with assessing the laboratory water sample (n=45) analysis to determine if the fluoride levels are meeting the optimal standards. In SBC, there are total of 154 water systems with …

Evaluating The Impact Of Myplate-Based Expanded Food And Nutrition Education Program (Efnep) On Healthy Dietary Choices Among Low-Income Families, Theresa N. Agbonome

Electronic Theses, Projects, and Dissertations

Dietary behaviors towards healthy food choices remain a major public health issue in the United States, with prevalence among low-income families. The University of California Agriculture and Natural Resources (UCANR) with Expanded Food and Nutrition Education Program (EFNEP) trains both health educators and volunteers to provide community-based nutrition education, which prioritizes low-income families. The initiative employs the MyPlate guidelines that are composed of 5 different food groups which include fruits, vegetables, protein, grains, and dairy products. This project focuses on evaluating nutritional habits of disadvantaged families within San Bernardino County (SBC) by using an evidence-based evaluation tool known as the …

Development Of An Employee Leave Guide Handbook At The California University Of Science And Medicine, Leyal Nidal Fakhreddine

Electronic Theses, Projects, and Dissertations

Employee leave policies play an important role in supporting workforce well-being, organizational compliance, and retention of skilled labor, especially in medical and educational health institutions. However, employees still experience confusion when trying to make sense of complicated leave options such as the Family and Medical Leave Act (FMLA), maternity and paternity leave, and military leave. The lack of clear, centralized guidance can result in delays, miscommunication, and increased workplace stress.

This project was carried out as a part of the Master of Public Health (MPH) program integrative learning experience requirements at California State University, San Bernardino, and was conducted during …

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Plan To Develop A Theory-Based Diabetes Social Media Campaign For Spanish-Speaking Adults In Finney County, Ks: Integration Of A Promotora, Focused Discussion Groups, And Community Feedback To Ensure Cultural Appropriateness, Julevi P. Bernido

Capstone Experience: Master of Public Health

The 2025 Community Health Needs Assessment (CHNA) shows that over 11% of adults in Finney County, Kansas, have diabetes, which surpasses both state and national averages. Census data from 2016-2020 indicate that 42.6% of residents ages five and older speak a language other than English at home, and 36.1% speak Spanish (United States Census Bureau, n.d.). The CHNA further highlights concerns about language and cultural barriers to care, especially among the Spanish-speaking population. Notably, 21.74% of residents have limited English proficiency—much higher than the state’s 12.1% (CHNA, 2025).

This capstone will develop a theory-based social media campaign plan to support …

Gestational Diabetes And Social Determinants Of Health In Black Women, Darianne Greenwood

Capstone Experience: Master of Public Health

Gestational Diabetes Mellitus (GDM) poses significant health risks, specifically increasing the risk of developing Type 2 Diabetes post-delivery, as well as increasing the risk of adverse neonatal and maternal outcomes. Black women, in particular, experience disproportionately higher rates of GDM incidence, severity, and complications in comparison to White women. Biological factors alone do not account for these disparities, necessitating a deeper examination into how systemic factors, particularly the social environment, influence these inequitable health outcomes. The purpose of this comprehensive literature review is to answer the question: “How do the Social Determinants of Health (SDoH), such as residential segregation, food …

A Literature Review Of Estrogen Synthesis And Metabolizing Enzymes Produced By The Human Gut Microbiome And Their Correlation With Cancer, Rebecca Cederberg

Capstone Experience: Master of Public Health

The link between estrogen and cancer initiation or progression has been well established; such that the World Health Organization’s International Agency for Research on Cancer (WHO IARC) has classified several estrogen therapies and estrogenic compounds as group 1 carcinogens. Estrogen and/or its receptors have been associated with reproductive cancers such as breast, ovarian, endometrial, and prostate, as well as lymphomas, lung, and colon cancers. Additionally, elevated levels of estrogen and altered gut microbiomes are also associated with increased rates of breast cancer. More recently, microbial genes that are capable of synthesizing estrogen and deconjugating estrogen metabolites have been identified, and …

Social Correlates Of Trauma And Posttraumatic Stress Disorder: The Importance Of Context, Lukoye Atwoli, Linnet Ongeri

Internal Medicine, East Africa

Understanding trauma and posttraumatic stress disorder (PTSD) requires a contextual perspective that considers historical legacies, social environments, and cultural realities. This paper draws on empirical evidence from Kenya and Uganda to demonstrate the limitations of applying trauma frameworks developed in high-income countries to African contexts. Findings from the Orphaned and Separated Children’s Assessment Related to Their Health and Well-Being (OSCAR) study challenge assumptions about care environments. The study reveals higher PTSD rates among orphans in family-based settings compared to institutional care, and highlights the protective roles of religion and social support. The Neuropsychiatric Genetics of African Populations-Psychosis (NeuroGAP-Psychosis) study provides …

Observation And Reflection Of Neighborhood And Community 2026: Food Access, Housing, Religious Community, And Health Care Access Reflection, Celene Philip, Michaela Kizy, Haley Montgomery, Akash Dantuluri, Josh Hailo, Abdel Kareem Hilo, Shadi Charara, Sarah Schenck

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Financial And Transportation Barriers, Hassan Hachouche, Matthew Spaulding, Mark Garmo, Michael Hwang, Alondra Prado, Abigail Margolis

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Social Determinants Of Health: Food, Transportation, Healthcare Facilities And More, Eboni Sawyer, Jesse Hawkins, Sephora Dafinescu, Andrew Robinson, Dev Patel, Sara Mccurry, Lauren Collins, Brandon Rogers

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Education Access/Quality, Economic Stability, Built Environment/Infrastructure And Team Reflection, Alan Carbajo, Samiollah Mohammad, Muhammed Zahriyeh, Grace Drexel, Aster Disbrow, Reagan Recchia

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Employment, Education, Fitness, Healthy Food, Pharmacies, And Reflection, Annika Tekumulla, Vamsi Gollapalli, Sebastian Reczek, Alston Prabhu, Matthew Haerens, Ashna Mehra, Susan Dong, Madison Martin

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Observation And Reflection Of Food Availability, Housing, Public Spaces, Recreation, And Healthcare In The Community, Celestino Mangulabnan, Melanie Kajy, Gabriel Hay, George Naguib, Arya Mohanty, Schednah Laraque, Charles Dickson

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Education, Access To Healthy Foods, Neighborhood & Physical Environment, Economic Stability, Taylor Brown, Tanya Bhardwaj, Sara Komaiha, Duncan Mcleod, Jonah Harman, Jai Kukreja, Dominic Marsalese, Elizabeth O'Brien

Patient Education Projects

No abstract provided.

Observation And Reflection Of Neighborhood And Community 2026: Neighborhood & Built Environment, Social & Community Context, Health Care Access & Quality, Courtney Alexander, Sarah Okeke, Bashar Jawich, Joshua Weiss, Shoshana Leflein, Mitchell Finesilver, Liz Ana Palacios

Patient Education Projects

No abstract provided.