Digital Commons Network^™

Assessing And Advancing Pandemic Emergency Preparedness In New York City's Hospitals: A Strategic Management Toolkit Integrating Policy Analysis, Risk Assessment, And Stakeholder Insight, Irrem Jamal

College of Graduate Studies: Theses & Dissertations

This dissertation examines pandemic emergency preparedness in New York City hospitals, which were severely strained during COVID-19, revealing critical gaps between documented plans and operational readiness. Using a multimethod approach combining a survey of 20 stakeholders across city hospitals, semi-structured interviews, and document analysis of policy frameworks and after-action reports, the study identifies a persistent "documentation-execution paradox": while 80% of respondents confirmed clear pandemic plans, only 45% expressed confidence in staffing adequacy, 55% in surge planning realism, and just 45% confirmed regular drills. Qualitative analysis revealed workforce as the single greatest yet most underinvested vulnerability, supply chain fragility rooted in …

Modeling Accreditation Standards And Evaluation Methods To Inform Strategic Planning In Public Health Education, Debra Rich

College of Graduate Studies: Theses & Dissertations

Public health has long benefited from the relationship between postsecondary education, accreditation, and government employment. Assessment and accreditation are important tools in postsecondary education to ensure fiscal responsibility, professional competencies, and quality assurance. The competency standards implemented in post-secondary education are not under the direct control of the federal government; however, policy amendments aimed at specific accreditation criteria could result in changes to public health curriculum and create eligibility barriers for students who rely on federal financial support. The Central Washington University Public Health program has provided educational support in professional public health for decades, and there is an increased …

Body Image Perception In African American Women, Ages 20-55 Years, Trina Suttles

College of Graduate Studies: Theses & Dissertations

This qualitative study explored the factors that influence body image perception among African American women in the metropolitan Atlanta, Georgia area and examined how these perceptions shape physical activity and dietary behaviors. Body image perception is a critical psychocultural factor influencing obesity-related behaviors, particularly among African American women who navigate culturally specific beauty standards and health beliefs. Guided by the Socioecological Model, this study addressed three research questions: (1) how African American women perceive their body image, (2) how these perceptions influence health behaviors, and (3) what multilevel factors shape body image perceptions. This study employed consensual qualitative research (CQR) …

Identifying The Physical Activity Promotion Practices Of Obstetricians And Gynecologists: Patients With Endometriosis And Polycystic Ovary Syndrome, Allison P. Herman

Theses and Dissertations (Comprehensive)

Despite efforts to promote physical activity, many females in Canada do not meet recommended physical activity guidelines. For individuals with gynecological conditions such as endometriosis and polycystic ovary syndrome (PCOS), physical activity may aid in symptom management and improve daily functioning. Healthcare settings, including obstetrics and gynecology, represent an area of opportunity to promote physical activity among this population. This thesis aims to understand the physical activity promotion practices of Ontario-based Obstetricians and Gynecologists (OBGYNs) to patients with endometriosis and/or PCOS. A cross-sectional online survey was conducted to explore OBGYNs promotional practices and perceived factors influencing their engagement in physical …

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …

Evaluating The Mediating Role Of Gestational Phthalate And Replacement Biomarkers In The Associations Between Race/Ethnicity And Birthweight, Amir J. Lueth, Danielle R. Stevens, Sarahna A. Moyd, Elena Sinkovskaya, Ann Przybylska, Antonia M. Calafat, Julianne C. Botelho, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Background

Gestational exposure to phthalates is higher among non-Hispanic black (NHB) women than non-Hispanic white (NHW) women and may contribute to racial/ethnic differences in birthweight z-scores.

Objective

We aimed to investigate whether gestational phthalate and replacement biomarkers mediate the association between race/ethnicity and birthweight z-scores.

Methods

We analyzed data from 271 pregnancies in the Human Placenta and Phthalates study, a prospective cohort recruited from 2017 to 2020. Urinary phthalate metabolite concentrations were measured at up to eight time points during pregnancy and averaged to represent gestational exposure. Metabolites were grouped by parent compound. Linear regression models estimated associations in phthalate …

Prepregnancy Overweight And Obesity In Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Eelaf A. Husain, Maryam M.Y. Mohammad, Maryem A. Shamsah, Noor Salah Alali, Reem Sharaf-Alddin, Majeda S. Hammoud

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: This study aimed to estimate the prevalence of prepregnancy obesity and overweight, and to identify a set of sociodemographic factors that could guide weight management interventions for women prior to conception.

Design, Sample, and Measurements: Pregnant women (N = 989) were recruited in the Kuwait Birth Cohort Study during the period June 2017 to February 2020. Prepregnancy weight and height were self-reported, while current weight and height were measured in a standardized procedure. Data on sociodemographic factors were collected through face-to-face interviews conducted by a trained data collector. Multinomial logistic regression was used to investigate the association between sociodemographic …

Alcohol Advertising At The Beach: Insights From Young People In Western Australia, Renee N. Carey, Gemma Crawford, Nicola D'Orazio, Gina S.A. Trapp, Lauren Nimmo, Tina Lam, Jonine Jancey, Justine E. Leavy

Research outputs 2022 to 2026

Background: Advertising and marketing by the alcohol industry serve to normalise alcohol use, with exposure to alcohol advertising linked to earlier and riskier drinking among young people. Advertising that portrays alcohol use in and around waterways is of particular concern, with one in five fatal drownings being associated with alcohol. Objective: This study aimed to explore the types of alcohol advertising that young people were exposed to, and to determine whether exposure to alcohol advertising was related to their alcohol use in aquatic environments. Methods: We surveyed 102 young people aged 18 to 25 years attending a free event at …

A Quantitative Analysis Of Barriers To College Students’ Seasonal Vaccination Intentions And Behaviors, Kelly S. Clemens, John Matkovic

Faculty Publications – Health Sciences

Objective
Vaccination is crucial to college student health, but quantitative analyses of barriers in this population are limited. The present study expands the work of Su and Chen to determine the relative influence of structural, psychological, and social vaccination barriers.

Participants
Participants were 650 students from a large, midwestern university during the 2024 vaccination season.

Methods
Participants were recruited from a college campus and randomized to respond to items assessing their barriers to, intentions to receive, and uptake of the COVID-19 or influenza vaccination.

Results
Structural, psychological, and social barriers were differentially important to vaccinations and to intentions vs. uptake …

Sexuality Education In An Age Of Resistance: Reflections At The Nexus Of Education, Health And Rights, Sarah Vrankovich, Katrina Marson, Giselle Woodley, Jordina Quain, Hanna Saltis

Research outputs 2022 to 2026

Comprehensive sexuality education (CSE) is internationally recognised as essential to public health and young people’s rights. Yet its implementation in Australia and globally is increasingly undermined by conservative backlash, moral panic and political interference. This paper offers a critical reflection on the current landscape of CSE, drawing on insights from a panel discussion at the 2025 World Association for Sexual Health congress, and collaborative analysis. As early-career researchers, sexologists and practitioners working across education, communications, public health and sexual violence prevention, we utilise our collective experience to examine how various influences shape and constrain the delivery of CSE. We map …

Parental Psychological Distress And Perceived Child Externalizing Behaviors: Examining Mediators And Bidirectional Effects, Abigail J. Anderson, Christina M. Rodriguez, James M. Henson

Psychology Faculty Publications

Parental psychological distress is a commonly examined risk factor for the emergence of child problem behaviors, but the factors that contribute to that relationship—such as limited parental resources like greater social support and coping skills—have not been adequately explored, particularly with attention to potential bidirectional relations that incorporate child evocative effects. The current longitudinal study examined maternal and paternal psychological distress in relation to perceived child externalizing behaviors, considering parental resources as mediators within a bidirectional model. The sample included a racially and socioeconomically diverse group of 201 primiparous mothers and 151 fathers. Mothers and fathers reported their current psychological …

Una Nueva Herramienta Para Estimar El Volumen Muscular Independientemente De La Edad, El Sexo Y El Nivel De Actividad Física, José J. Rivera-Sánchez, Laura P. Burgos-Morelos, Daniel Castillo-Castillo, Gerardo Méndez-Suárez, Juan C. Lopez-Alvarenga, Damián Carrillo-Ruíz

School of Medicine Publications

Antecedentes: Actualmente, la evaluación del volumen muscular requiere técnicas invasivas o de imagen, lo que aumenta los costos y retrasa la evaluación, y las mediciones antropométricas con frecuencia son inexactas.

Objetivo: Desarrollar una fórmula matemática para estimar el volumen del cuádriceps.

Material y métodos: Se evaluaron 127 sujetos: 40 adultos sedentarios de 20 a 35 años, 47 atletas adultos de 20 a 45 años y 40 adultos sedentarios de 70 a 94 años. Se dividieron en grupos de desarrollo y de validación. Se realizaron mediciones de variables antropométricas y fuerza de agarre, y se desarrolló la fórmula de predicción del …

Accuracy Of The Phenotypic 1g Test To Detect Mycobacterium Tuberculosis And Drug Resistance From Sputa In The Us-Mexico Border, Mia Aguirre, Doris Ayala, Juan Ignacio Garcia, Yoscelina Estrella Martinez-Lopez, Amberlee Hicks, Nadine M. Chacon, Ashley Gay-Cobb, Alyssa Schami, Selena Zavala-Perez, Blanca I. Restrepo

School of Medicine Publications

Background: With >10 million new tuberculosis (TB) cases/year, a limitation to TB control is the lack of simple and accurate tests for TB diagnosis and drug-susceptibility testing (DST) in endemic regions. We evaluated the accuracy of the first-generation, low-complexity phenotypic TB test (1G test), designed for simultaneous Mtb detection and resistance to isoniazid, rifampicin and moxifloxacin, suitable for resource-limited settings.

Methods: A cross-sectional study was conducted using sputa from 426 possible pulmonary TB subjects from two small Mexican cities bordering Texas. The 1G test was compared against phenotypic TB detection tests in the region [acid fast bacilli smear microscopy and …

Promoting The Concept Healthy Ageing For Use In Gerontological Health And Social Care Policy And Practice, Claire Donnellan

Research outputs 2022 to 2026

Aims: The concept of healthy or successful ageing dates back to the 1960s, where its goal is more realistic in today's ageing society as a result of effective interventions to control and reduce disability and health risks. The aim of this paper is to outline the importance of defining ageing, the semantics and indicators used, and to identify common challenges for health professionals' understanding and application of a healthy ageing approach in their everyday clinical practice. Design and Methods: This discursive paper demonstrates how realistic ageing indicators are for highlighting the variation and impact of challenges associated with ageing. It …

Bridging The Gap: How Sociodemographic Factors Shape Adults’ Decisions To Pursue Hearing Aids, Logan Lorié

Graduate Studies Theses and Dissertations 2026

Despite hearing aids becoming more accessible to adults with hearing loss, hearing aid uptake rates remain low, partly due to sociodemographic factors that influence an adults’ decision to pursue amplification. This study systematically reviewed research on how sociodemographic factors – to include age, gender, socioeconomic status, education level, race/ethnicity, and military status – contribute to the decision-making process. This review guided an analysis of these variables using the National Health and Nutrition Examination Survey (NHANES), a large public health database. To ensure enough hearing aid users were included in the analysis, NHANES data were combined across survey cycles from 1999 …

Puff, Puff, Pass? Examining Cannabis Use Among Black American Adults, Christopher B. Walker

Graduate Studies Theses and Dissertations 2026

In the United States, cannabis has become one of the most widely used controlled substances due to its increase in social acceptance, the growing number of states legalizing it for medical and non-medical purposes, and the expansion of consumption methods.  However, little is known about the modes of cannabis use chosen by Black American adults.  This population is of importance due to existing research suggesting their increased risk of developing cannabis use disorder compared to their White counterparts and their underrepresentation in existing literature.  The goal of this study is to examine cannabis use among Black adults in the U.S., …

Large Language Model-Assisted Research Question Development In Public Health: A Case Study In The Special Supplemental Nutrition Program For Women, Infants, And Children (Wic), Qi Zhang, Bidusha Neupane, Priyanka Patel, Futun N. Alkhalifah, Yi He, Leslie Hodges

Health Behavior, Policy & Management Faculty Publications

Objective:

To assess the feasibility of using large language models (LLMs) to develop research questions about changes to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) food packages.

Design:

We conducted a controlled experiment using ChatGPT-4 and its plugin, MixerBox Scholarly, to generate research questions based on a section of the USDA summary of the final public comments on the WIC revision. Five questions weekly for three weeks were generated using LLMs under two conditions: fed with or without relevant literature. The experiment generated 90 questions, which were evaluated using the FINER criteria (Feasibility, Innovation, Novelty, Ethics, …

Co-Designing Impact: Student-Led Prevention Messaging For The Primary Prevention Of Violence Against Women, Narelle Lemon, Lisa Holmes, Christina C. Gray, Jason Goopy

Research outputs 2022 to 2026

Executive Summary:

Violence against women remains one of Western Australia's most serious and persistent social problems, and young adults aged 18–24 represent a pivotal demographic for primary prevention — the work of stopping violence before it starts. The Co-Designing Impact project, funded by the Department of Communities' Family and Domestic Violence Primary Prevention Grants Program 2024/2026 and delivered in partnership between Yourtoolkit.com and Edith Cowan University (ECU), engaged university students aged 18–24 in a six-session co-design program. Participants learned about the drivers of violence against women and the principles of primary prevention, then co-designed social media messaging intended to shift …

Combating Antibiotic Resistance With Plasmid-Dependent Phages, Rhiannon T. Mariano

Electronic Theses & Dissertations (2024 - present)

The alarming rise of carbapenem-resistant bacteria poses an urgent global health threat, driven in large part by the horizontal spread of carbapenemase-encoding plasmids (Ma et al., 2023). These plasmids are often highly mobile and transmissible, enabling rapid dissemination of resistance genes across diverse bacterial populations. Their mobility is largely mediated by conjugation, a process dependent on the formation of pili, which serve as physical bridges for plasmid transfer between cells (Murray et al. 2022; San Millan and MacLean 2017; Virolle et al. 2020). Beyond their role in gene exchange, these pili also act as entry points for a unique class …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

Exploring The Relationships Between Social Influence, Vaping Behaviors, And Susceptibility Across Grade Levels In Kentucky, Raphael Adesiyan, Odunayo O. Omotilewa, Saber Feizy, Melinda J. Ickes

Kinesiology and Health Promotion Faculty Publications

Purpose: This study explored the relationships between social influence, vaping behavior, and susceptibility across different grade levels.   Design: The study design was cross-sectional. Data were collected from middle and high school students who voluntarily participated between September 2022 and April 2023.   Sample: A convenience sample of students in 6^th to 12^th grades in Kentucky (N = 4677).   Measures: Demographic information, including age, grade level, school location, and race/ethnicity, was collected. The outcome variables included social influence, susceptibility, and vaping behavior.   Analysis: Logistic regression analysis was used to explore the relationships between social influence, vaping behavior, and susceptibility.   Results: …

Bringing Pandemic Science To The Classroom: Building Public Health Capacity At A Rural Kentucky High School, Sahar Alameh, Anna G. Hoover, James W. Keck, Scott M. Berry, Sagan Goodpaster, Savannah Tucker, Ashley Goodin

Science, Technology, Engineering, and Mathematics (STEM) Education Faculty Publications

In response to the COVID-19 pandemic, a multidisciplinary team at the University of Kentucky developed an interdisciplinary science, technology, engineering, and mathematics and environmental health unit—the Wastewater Assessment for Coronavirus in Kentucky: Implementing Enhanced Surveillance Technology (WACKIEST) Unit—for high school students in summer 2022. This case study outlines the WACKIEST Unit, which focused on wastewater surveillance and COVID-19, the obstacles faced during development and recruitment, and implementation of the WACKIEST Unit in conjunction with a rural wastewater surveillance initiative. The unit was implemented in spring 2023 at a rural high school in Kentucky, spanning 12 days and engaging 190 students. …

The Development And Pilot Evaluation Of An Out-Of-Hospital Immersive Birthing Simulation Training Application For Paramedics And Ambulance Officers Using Virtual-Reality Technology, Michella Hill

Theses: Doctorates and Masters

Out-of-hospital births (OOHBs) are births which occur outside a hospital setting. This includes planned home births attended by midwives, or unplanned OOHBs where the intention was to birth in a hospital or maternity centre, however, occurs in an unintended location. Prehospital clinicians, inclusive of registered paramedics and volunteer ambulance officers (VAOs) infrequently attend OOHBs, as most births occur in maternity wards as anticipated. OOHBs comprises < 1% of emergency ambulance requests and requires specialised skills for prehospital clinicians to competently manage birthing and potential complications. As exposure to birthing is so rare, these specialised skills and knowledge are underutilised and subject to rapid decay. Compounding the problem, obstetrics is infrequently taught across undergraduate education, in-service training, or within individual clinician’s continuing professional development. Placements shadowing midwives are scarce due to nursing and medical students receiving priority. Previous research regarding OOHBs is limited, nonetheless suggests prehospital clinicians are underprepared to manage an OOHB, which has serious patient safety implications. The present research sought to explore prehospital clinicians’ preparedness and confidence in managing OOHBs. It also investigates whether a digital training solution such as virtual reality (VR) simulation may reduce the theory-practice gap and assist in competency retention.

Publication one provides a comprehensive methodology outline which is applied to Study One; a scoping review of prehospital clinician and birth parent experiences with OOHBs. Risk factors, complications and interventions provided by prehospital clinicians, as …

The Weight Of Stigma, Rebekah A. King, Michael S. Sinha

All Faculty Scholarship

Many health care providers, both implicitly and explicitly, perpetuate stigma in their treatment of patients classified as obese. While medical professionals understand that a one-size-fits-all approach to treatment is ineffective, patients classified as obese are frequently offered limited treatment options that fail to account for their unique needs. Access to a range of effective treatment options has historically been limited, but new GLP-1 receptor agonist medicines like Wegovy (semaglutide) and Zepbound (tirzepatide), have shown incredible promise in addressing the obesity crisis. Unfortunately, these transformative drugs are costly, in high demand, and not widely covered by insurance, rendering them inaccessible for …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

Hyphema Associated With Water Bead Projectile Toys: A Retrospective Comparative Study, Aashri I. Aggarwal, Priya K. Singh, Diego E. Arias, Peter A. Netland

Department of Ophthalmology Faculty Publications

Purpose: Superabsorbent water beads can be used in projectile toy guns. We aimed to characterize water bead-related hyphema and compare the prevalence with other causes of traumatic hyphema.

Methods: In this 10-month retrospective review, we identified 35 consecutive patients with traumatic hyphema presenting to the emergency department. Cases were grouped by injury mechanism, water bead-related compared with all other causes. Clinical data on initial presentation and subsequent visits were compared.

Results: In the patients with traumatic hyphema, 8 (23%) cases were due to water bead trauma. Bead-related cases involved significantly younger patients (16 ± 9 years) compared with other cases …

Comparative Analysis Of Groundwater Quality Based On Chemical Parameters Around Final Disposal Sites Using Open Dumping And Sanitary Landfill Methods, Shiesil Rizqia Amadia, Mika Vernicia Humairo

Preventia: The Indonesian Journal of Public Health

The main environmental issue at landfill sites is the seepage of leachate into the ground, which contaminates surrounding aquifers. Communities residing within one kilometer of landfill sites are at high risk of environmental pollution. This study aimed to analyze differences in groundwater quality around landfills applying open dumping and sanitary landfill methods, and to compare groundwater quality at safe and unsafe distances from these sites. The research was conducted around the Cipayung landfill in Depok (open dumping) and the Talangagung landfill in Kepanjen (sanitary landfill). The study adopted an analytical observational approach using a cross-sectional design. The independent variables included …

Analysis Of Demand And Supply Of Radiotherapy Services At Dr.M.Djamil General Hospital Padang, Viola Shinta Dewi, Catur Suharinto, Zarni Zamzahar, Yulhaini Yulhaini

Preventia: The Indonesian Journal of Public Health

Around 10 million cases of cancer are discovered in the world per year, and it will continue to increase. Half of cancer cases require radiotherapy as treatment therapy. Dr. M. Djamil General Hospital, Padang, in 2021, has only 1 Cobalt radiotherapy. This study aimed to analyze the demand and supply of radiotherapy services at Dr. M. Djamil General Hospital, Padang. This descriptive study was conducted at Dr. M. Djamil General Hospital, Padang from May to December 2022. Data were analyzed using univariate analysis to describe the variables studied. This study reported that 241 patients were registered and received radiotherapy services. …

Associations Between Health-Seeking Behaviors And Social Support For Adult Black Women In The United States, Patricia Saint Cyr-Hager

Walden Dissertations and Doctoral Studies

A persistent gap exists involving health outcomes for Black women in the United States, regardless of socioeconomic status when compared to Black men and White women. This qualitative case study involved exploring the influence of social support on health-seeking behaviors among Black women. Sixteen participants, between ages 22 to 49 from nine states, were recruited. Data was collected using semi-structured interviews based on the social support theory. An analysis of the network composition showed that family members (including mothers, fathers, sisters, and partners), friends, community support groups not connected to social media, and online community support groups were the most …

The Association Between E-Cigarette Use And Community Mattering Among Adolescents In Maine, April Hughes

Walden Dissertations and Doctoral Studies

E-cigarette use among U.S. high school students is a significant public health issue. Factors such as mattering, sexual orientation, and gender identity (SOGI) influence e-cigarette use among adolescents, yet few studies have explored the relationship between mattering and e-cigarette use when considering SOGI. This quantitative study explored the association between past 30-day e-cigarette use and mattering among Maine high schoolers while controlling for SOGI and grade level. This correlational cross-sectional study used the 2023 Maine Integrated Youth Health Survey data, and the socioecological model served as the theoretical foundation. A multivariate binary logistic regression analysis indicated a significant association between …