Digital Commons Network^™

Addressing Patient Loyalty Through Their Commitment Influenced By Electronic Word-Of-Mouth And Hospital’S Image, Al Quadhri Upe, Alida Palilati, Sudirman Zaid, Nasrul Nasrul

Kesmas

This article explores the influence of Electronic Word of Mouth (e-WoM) and hospital image on hospital patient loyalty, emphasizing the mediating role of patient commitment. Amidst the development of the healthcare industry sector in Indonesia, this study highlighted that e-WoM and hospital image significantly enhanced patient loyalty, with patient commitment playing an important mediating role. This article suggested practical strategies for hospitals, such as improving the quality of healthcare services, leveraging positive e-WoM, and implementing loyalty programs to elevate patient commitment and loyalty. These findings underscore the importance of hospital image and e-WoM in patient retention, providing valuable insights for …

Multidrug-Resistant Esbl-Producing Escherichia Coli Coexisting With Colistin-Resistance Genes In Pig Farms, Central Thailand, Wipawee Songsaeng, Nutthee Am-In, Nuvee Prapasarakul, Wandee Sirichokchatchawan

The Thai Journal of Veterinary Medicine

The presence of extended-spectrum beta-lactamase and colistin resistance E. coli in food-producing animals is a public health concern. This study was conducted using a rigorous methodology to survey the prevalence of ESBL-producing and colistin-resistant E. coli from pig farms in the central part of Thailand. A total of 519 samples were collected from fecal, feed, and waste in 53 farms located in central Thailand. All samples were inoculated onto selective agar, and species identification was performed using biochemical assays and MAlDI-TOF MS. Antimicrobial susceptibility was determined by broth microdilution, and ESBL production was confirmed by the combination disc diffusion method. …

Exploration Of Positive Deviance In Prevention Of Underweight In The Under-Five: A Qualitative Study On Low-Income Urban Families, Irwan Budiono, Lukman Fauzi, Dewi Sari Rochmayani

Kesmas

Children under the age of five (the under-five) from low-income families are more vulnerable to experience underweight. This nutritional vulnerability is evident in the preliminary study, where 35.1% of the under-five experience underweight, and 28.48% are low-income families. This study aimed to explore Positive Deviance (PD) behaviors in preventing underweight among the under-five. The study applied a qualitative approach with a case study design. Data collection took place in July-August 2022, focusing on low-income families in the Gunung Brintik area. Data were collected through two focus group discussions, seven in-depth interviews, and five key informant interviews. Coding, subtheme, and theme …

Complete Dose Of Hepatitis B Vaccination Among Children In Indonesia And Factors Associated: A Community-Based Study, Putri Bungsu Machmud, Dwi Gayatri, Erni Astutik

Kesmas

Hepatitis B vaccination is widely recognized as the most effective way to prevent hepatitis B infection, yet the rate of complete vaccination among Indonesian children remains low. This study aimed to evaluate the extent of hepatitis B vaccination coverage among children and identify potential associated factors in Indonesia. A community-based cross-sectional study was conducted. The study involved 7,860 Indonesian mothers of children aged 12-59 months, providing data on their children's hepatitis B vaccination status and other relevant factors from the 2017 Indonesian Demographic Health Survey. Overall, the rate of complete hepatitis B vaccination among children was relatively high (89.8%). Several …

Food Hygiene And Sanitation At The Jakarta Pondok Gede Hajj Embarkation Dormitory: Food Safety Efforts For The Hajj Pilgrims, Fauziah Hayati, Al Asyary, Bambang Wispriyono, Harunor Rashid, Z Memish

Kesmas

Several health risks are associated with performing Hajj pilgrimage. Food poisoning is a major cause of diarrhea and vomiting during Hajj. Food hygiene is an effort to control aspects of food, people, places, and equipment that could cause disease or health problems. This study aimed to describe food hygiene and sanitation efforts implemented in 2023 at the Jakarta Pondok Gede Hajj Embarkation Dormitory in Jakarta, implemented in 2023 to safeguard foods for the Hajj pilgrims. Using a descriptive qualitative design with a document analysis approach, this study examined activities during the pre-embarkation and embarkation periods. Pre-embarkation efforts included inspecting the …

Variation And Predictors Of Covid-19 Mortality In Hospitalized Cases In West Sumatra Province, Indonesia: A Retrospective Observational Study, Defriman Djafri, Ade Suzana Eka Putri, Yudi Pradipta

Kesmas

During 2020, the year of the COVID-19 pandemic, different Indonesian provinces had different numbers of COVID-19 infections and fatalities, particularly in West Sumatra Province. This study aimed to investigate the variation of confirmed COVID-19 cases and determine predictors of mortality in hospitalized patients across districts in West Sumatra Province. A retrospective observational study was conducted during the COVID-19 pandemic. From March 2020 to June 2021, 46,005 confirmed cases were collected in the province, of which 42,308 were hospitalized and analyzed. Confirmed cases and deaths were compared by geographic location using spatial analysis. The risk predictors of death were estimated using …

The Open Defecation Free Program Evaluation Using The Context, Input, Process, And Product Model In Jambi, Indonesia, Guspianto Guspianto, Willia Novita Eka Rini, Rizalia Wardiah, Susi Desmaryani, Herlina Herlina

Kesmas

The Open Defecation Free (ODF) program was initiated by the government to increase access to healthy latrines. This study aimed to evaluate the ODF program using the CIPP evaluation model. A qualitative and exploratory descriptive method was adopted to investigate informants' experiences regarding the program's implementation. Data was explored through semi-structured interviews with 17 informants and analyzed using content analysis. The results showed that the program was crucial as numerous people engaged in open defecation due to economic, geographical, cultural, and knowledge factors. The absence of ODF policy was due to lack of priority, limited government and private support, insufficient …

Economic Behavior And Hiv Risk Behavior Among Vulnerable Women: A Prospective Randomized Control Study In Southern Uganda, Joshua Kiyingi

Brown School Graduate Student Theses and Dissertations

In sub-Saharan Africa (SSA), the estimated population of women engaged in sex work (WESW) is 2.5 million, aged 15 to 49 years (Laga et al., 2023). WESW face numerous challenges, including high-risk behaviors that expose them to HIV, sexually transmitted infections (STIs), drug and alcohol abuse, criminalization, discrimination, mental health problems, and limited healthcare access. Globally, WESW are significantly affected by HIV, with new infections continuing to rise. Recent estimates show that although 8% of all new HIV infections are among WESW, 32.8% of them are unaware of their HIV status (UNAIDS, 2021a). The risk of acquiring HIV is 30 …

Teacher Implementation Profiles: A Response To Top-Down Mandate Of Movement Integration, Zack Beddoes, Jeanne Barcelona, Darla Castelli

International Journal of Physical Activity and Health

This study examined teacher implementation practices to meet a state mandate requiring 135 minutes of student physical activity (PA) weekly. Teachers were required to implement a video-based movement integration (MI) program. Using an embedded mixed-methods design, provider characteristics of 42 teachers and the organizational capacity of six schools were developed from interviews, surveys, observations, and artifacts. Data analysis revealed three teacher profiles (a) Dynamic Experientialists, (b) Coachable Constructivists, and (c) Cautious Behaviorists, and three school profiles (a) Whole Child Approach, (b) Grade Level Champions, and (c) Back to Basics. Findings suggest that school, teacher, …

Examining Coping Mechanisms Among Teachers And Administrators After Experiencing Gun Violence At School, Tracey Yvonne Holt

Walden Dissertations and Doctoral Studies

According to recent research, gun violence at schools has become a public health issue. Teachers, administrators, students, and communities are trying to cope with the aftermath of gun violence at schools. The purpose of this qualitative phenomenological study was to identify coping mechanisms among teachers and administrators after experiencing gun violence at school. The theoretical framework was the transactional model of stress and coping, contending that a person’s capacity to cope and adjust to challenges and problems is a consequence of transactions. Data collection included Zoom interviews with 10 participants. Findings from coding and thematic analysis indicated that experiencing gun …

Challenges In Traumatic Spinal Cord Injury Care In Developing Countries - A Scoping Review, Mohammad Hosein Ranjbar Hameghavandi, Elaheh Khodadoust, Mahgol Sadat Hassan Zadeh Tabatabaei, Farzin Farahbakhsh, Zahra Ghodsi, Sabra Rostamkhani, Shahryar Ghashghaie, Mahkame Abbaszade, Arash Arbabi, Seyedeh Maede Hossieni, Mohsen Sadeghi-Naini, Rasha Atlasi, Samuel Berchi Kankam, Alexander Vaccaro, James Guest, Michael Fehlings, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To evaluate the leading challenges in developing countries' traumatic spinal cord injury (TSCI) care.

METHODS: We conducted a systematic search in electronic databases of PubMed, SCOPUS, Web of Science, EMBASE, and Cochrane Library on 16 April 2023. Studies that investigated challenges associated with the management of TSCI in developing countries were eligible for review. We extracted related outcomes and categorized them into four distinct parts: injury prevention, pre-hospital care, in-hospital care, and post-hospital care.

RESULTS: We identified 82 articles that met the eligibility criteria including 13 studies on injury prevention, 25 on pre-hospital care, 32 on in-hospital care, and …

Factorial Trial To Optimize An Internet-Delivered Intervention For Sexual Health After Breast Cancer: Protocol For The Wf-2202 Sexual Health And Intimacy Enhancement (Shine) Trial, Kelly M. Shaffer, Jennifer Barsky Reese, Emily V. Dressler, Jillian V. Glazer, Wendy Cohn, Shayna L. Showalter, Anita H. Clayton, Suzanne C. Danhauer, Michelle Loch, Mai Kadi, Caleigh Smith, Kathryn E. Weaver, Glenn J. Lesser, Lee M. Ritterband

School of Medicine Faculty Publications

Background: Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. Objective: Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention …

Multilevel Factors Affecting Covid-19 Vaccination Among African American Communities In South Carolina, Ran Zhang

Theses and Dissertations

Background: Persistent health disparities has led to significant public health challenges, especially for African American (AAs) communities, and have been exacerbated by the COVID-19 pandemic. Achieving high population vaccination rates are crucial to controlling the virus’ spread. However, AAs have higher rates of COVID-19 infection and mortality than Whites, yet their vaccination rates remain relatively low. The dissertation aimed to investigate the multilevel factors and mechanisms that affect AAs’ vaccination behavior. The first objective is to assess the impact of the intrapersonal level factor (i.e., perceived barriers to vaccination) on vaccination behavior. The second objective is to investigate the impact …

The Effect Of Covid-19 Restrictions On The Social Support Experiences Of Black Women Giving Birth In South Carolina Hospitals During The First Year Of The Covid-19 Pandemic (2020) As Compared To A Previous Birth, Tiffany Eva Byrd

Theses and Dissertations

The United States is experiencing a maternal health crisis, which disproportionately affects Black women. Black women die from pregnancy-related causes two to three times as often as their White counter parts, and the majority of maternal death are preventable. In recent years, public health and national governing authorities have devoted resources to monitoring the health crisis and raising the public’s knowledge of warning signs; however, maternal mortality rates continue to rise. Noted contributors to Black maternal mortality include, but are not limited to, racism, delayed treatment and response to health emergencies, and lack of social and emotional support during childbirth, …

The Experience Of Homelessness And Its Effects On Gut Eubiosis, Kamerin Villagomez

University Honors Theses

Microorganisms which populate the human gastrointestinal tract (GIT) have a profound effect on overall human health. The relationship between host health and eubiosis, or balance, of the GIT microbiome is symbiotic and can have reciprocal relationships with quality of sleep, quality of diet, stress and mental health, and the experience of pain. These specific aspects of health are unique in populations experiencing homelessness due to the multi-dimensional and complex nature of their lived experience. Very few studies explore populations experiencing homelessness, with even fewer investigating the intersection between this population and the human GIT microbiome. It is important to do …

Concussions And Their Relationship With Cheerleading, Jazmin Hampton

Walden Dissertations and Doctoral Studies

Concussions are a major public health issue that impacts a variety of persons. Cheerleading is an emerging popular sport that has seen increased participation. Minimal information about cheerleading and concussions is known. This study aimed to investigate sustaining a concussion as a cheerleader while accounting for demographics (age, race, and gender), mechanism of injury, and injury setting. The precaution adoption process model was the theoretical framework for this study. Chi-square analysis and binary logistic regression were applied to address research questions. Data from 3,536 patients were obtained from the 2018-2022 National Electronic Injury Surveillance System. Findings indicated there were associations …

Factors Associated With Elevated Sars-Cov-2 Immune Response In Children And Adolescents, Sarah E Messiah, Rhiana Abbas, Emma Bergqvist, Harold W Kohl, Michael D Swartz, Yashar Talebi, Rachit Sabharwal, Haoting Han, Melissa A Valerio-Shewmaker, Stacia M Desantis, Ashraf Yaseen, Henal A Gandhi, Ximena Flandes Amavisca, Jessica A Ross, Lindsay N Padilla, Michael O Gonzalez, Leqing Wu, Mark A Silberman, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

BACKGROUND: Understanding the distinct immunologic responses to SARS-CoV-2 infection among pediatric populations is pivotal in navigating the COVID-19 pandemic and informing future public health strategies. This study aimed to identify factors associated with heightened antibody responses in children and adolescents to identify potential unique immune dynamics in this population.

METHODS: Data collected between July and December 2023 from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a statewide prospective population-based antibody survey among 1-to-19-year-old participants, were analyzed. Each participant had the following data available for analysis: (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for Nucleocapsid protein antibodies (Roche N-test), (2) qualitative and …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …

Association Between High Health Literacy, Doctor's Recommendation, And Prostate Cancer Screening Among Men In The United States, Felicia Njideka Akunna

Walden Dissertations and Doctoral Studies

To efficiently identify and prevent the advancement of prostate cancer and decrease mortality rates, it is crucial to examine the impact of health literacy. Despite potential advantages associated with enhanced health literacy and early detection, the United States continues to witness a significant rise in both new prostate cancer cases and mortality rates, emphasizing the severity of the condition. However, it is unclear if those with high health literacy are discouraged from participating in prostate cancer screening due to the risks associated with screening. Based on the stimulus organism response model, 2016 Behavioral Risk Factor Surveillance System data were analyzed …

Recruiting Transgender Men In The Southeastern United States For Genital Microbiome Research: Lessons Learned, Olivia Van Gerwen, Z. Alex Sherman, Emma Sophia Kay, Jay Wall, Joy Lewis, Isaac Eastlund, Keonte J. Graves, Saralyn Richter, Angela Pontius, Kristal J. Aaron, Krishmita Siwakoti, Ben Rogers, Evelyn Toh, Jacob H. Elnaggar, Christopher M. Taylor, Nicholas J. Van Wagoner, Christina A. Muzny

School of Medicine Faculty Publications

Background Transgender men (TGM) are underrepresented in genital microbiome research. Our prospective study in Birmingham, AL investigated genital microbiota changes over time in TGM initiating testosterone, including the development of incident bacterial vaginosis (iBV). Here, we present lessons learned from recruitment challenges encountered during the conduct of this study. Methods Inclusion criteria were assigned female sex at birth, TGM or non-binary identity, age ≥18 years, interested in injectable testosterone but willing to wait 7 days after enrollment before starting, and engaged with a testosterone-prescribing provider. Exclusion criteria were recent antibiotic use, HIV/STI infection, current vaginal infection, pregnancy, or past 6 …

Socioeconomic Determinants And Maternal Mortality In Liberia, Monee Sherman

Walden Dissertations and Doctoral Studies

High rates of pregnancies and childbirth contribute to a heightened risk of maternal mortality among women between 15 and 49 in Liberia. Most women are uninformed about their maternal risk behaviors, symptom severity, and delayed care-seeking. The mortality rate for women between 25 and 34 during pregnancy and childbirth is unacceptably high. The highest increase in maternal mortality rates is seen among women between 40 and 44 who choose to delay motherhood. In Liberia, the deaths of 4.5 women a day are caused by complications during pregnancy and childbirth. We examined the influence of participant background characteristics, socioeconomic factors, and …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

Cycle Syncing: Optimizing Women's Quality Of Life, Megan Francois

Theses and Graduate Projects

A woman’s hormones are in constant fluctuation throughout the menstrual cycle. This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each phase is synced with diet, exercise, and complementary medicine utilizing holistic methods. Implications for further research include a need for additional longitudinal and prospective studies. Factors that need to be addressed include further analysis of the windows of vulnerability over the menstrual cycle according to female hormone fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.

Unveiling Healthcare Disparities By Addressing Historical Traumas To Build Inclusive Spaces For Marginalized Communities: An Autoethnographic Study, Helena Humphreys

Theses and Graduate Projects

This paper delves into the pervasive disparities within the healthcare system, rooted in historical injustices that are perpetuated by systemic biases, particularly affecting Black, Indigenous, and People of Color (BIPOC) communities, as well as the LGBTQIA2S+ community. Through a comprehensive literature review and autoethnographic study, the paper examines the deep-seated issues faced by these marginalized groups, including access barriers, discrimination, mistrust of healthcare providers, and the enduring impact these have on health outcomes. Historical traumas such as the Tuskegee Syphilis Study and the use of HeLa cells underscore the enduring impact of past injustices on present-day healthcare experiences. Moreover, the …

Addressing The Increased Prevalence Of Gestational Diabetes Among Hispanic/Latino Pregnant Persons In The Central Valley Of California, Kathleen Janise Farrell Wardell

Master's Projects and Capstones

Gestational Diabetes (GDM) is a preventable noncommunicable disease that has been on the rise over the last 60 years. Pregnant persons with gestational diabetes are 10 times higher of acquiring Type 2 Diabetes after pregnancy (Ionannou et al., 2024). There is an urgent need to address this public health threat because of its increase in mortality. To address this complex chronic disease, this literature review explored multi-level interventions using the socioecological model to mitigate GDM in the Central Valley’s, Tulare County. Tulare County is disproportionately affected by chronic diseases like diabetes especially among the Hispanic and Latinx communities. Therefore, it …

Exploring The Impact Of Weekly Farmers’ Market In The City Of Carson, Ca In Promoting Equitable Access To Locally Grown Fruits And Vegetables, Daisy Lopez Valdez M.P.H.

Master's Projects and Capstones

Despite their many benefits to the community, farmers’ markets suffer from several important limitations. This paper will provide guidance on practices and interventions that can improve the effectiveness of the local Carson, California farmers’ market, known as the South Bay Pavilion Farmer’s Market, in increasing equitable access to and consumption of locally grown fruits and vegetables with the goal of reducing obesity and diabetes rates among residents.

The needs and assets assessment developed will evaluate the success of the City of Carson South Bay Pavilion Farmers’ Market and provide recommendations based on the findings. The proposed research will follow an …

The Mental Effect Of Obesity On Active-Duty Service Members In The United States: A Phenomenological Approach, Tegan M. Quigley

Doctoral Dissertations and Projects

This phenomenological research was intended to explore the impact that obesity has on the mental health of soldiers in the U.S. military. The U.S. military has stringent physical fitness standards that must be met by each soldier regardless of sex. These standards can be challenging to maintain. Obesity is an increasing issue in the United States, and soldiers are not immune. Research regarding the physical issues that occur from obesity has been performed, but this study aimed to explore the behavioral or mental health effects that obesity can have within the military community. This study explored the following questions: In …

Agnotology Of The E-Cigarette Industry: How The E-Cigarette Industry Continues The Tobacco Industry's Legacy Of Creating Controversy And Confusion Within The Scientific Community And The General Population, Calvin Lewis

University Honors Theses

The purpose of this paper is to determine the extent to which the e-cigarette industry follows in the footsteps of the tobacco industry's attempts to disrupt science and cause controversy. Four tactics are described that the tobacco industry uses to disrupt science: funding research that is designed to show results that support their position, criticizing and suppressing research that goes against their position, changing risk assessment and scientific research standards to fit their aims, and spreading data created by their interest groups to politicians and the nonacademic press. Evidence is found to show that both the tobacco industry and e-cigarette …

Telehealth For Healthy Aging: A Multi-Level, Multi-Methods Approach, Vaibhavi Mone

Theses & Dissertations

Telehealth, rapidly adopted during the pandemic, has shown its usefulness and limitations, yet was not designed with older adults in mind. This dissertation encompasses three interconnected studies exploring telehealth utilization for Medicare Annual Wellness Visits (AWVs) among older adults, provider perspectives on telehealth AWVs, and the impact of teleconferencing on primary care providers' knowledge and confidence in geriatric care. The objectives are to determine patient characteristics using telehealth AWV (study 1), understand provider perspectives on telehealth AWV (study 2), and evaluate the effectiveness of geriatrics education through telehealth (study 3). Study 1 investigates the changes in AWV utilization among 18,405 …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …