Digital Commons Network^™

Availability And Distribution Of Stoma Bags For Colorectal Cancer Patients: A Case Study At National Referral And Private Hospitals, Ratna Aryani, Toar Jm Lalisang, Debie Dahlia, Evi Martha, Achir Yani S Hamid, Sukma Wicaturatmashudi, Helen Helen

Kesmas

Stoma bags are essential for colorectal cancer (CRC) patients with stomas. However, access and affordability in Indonesia remain challenging as the National Health Insurance (NHI) does not fully cover these devices. This study aimed to describe the availability and distribution of stoma bags for patients with CRC in national referral and private hospitals, focusing on outpatient access. A qualitative case study was conducted through observations and in-depth interviews with four enterostomal therapy nurses and six patients across three national referral hospitals and one private hospital in the Jakarta Metropolitan Area, Indonesia. Notably, the availability of stoma bags was limited in …

Machine Learning For Preeclampsia Prediction: Enhancing Screening In Primary Health Care, Dwirani Amelia, Asri Adisasmita, Kemal N. Siregar, Detty Siti Nurdiati

Kesmas

Preeclampsia is a leading cause of maternal morbidity and mortality worldwide, with early detection being critical for reducing adverse outcomes. This study aimed to develop a machine learning model for predicting the risk of preeclampsia using readily available maternal characteristics such as body mass index, mean arterial pressure, and clinical history of hypertension or diabetes mellitus. Secondary data from 2,250 pregnancies were analyzed, addressing challenges such as missing data and class imbalance through preprocessing. Various algorithms, including support vector machines, random forest, and logistic regression, were evaluated. Herein, a support vector machines model with threshold adjustment showed the best performance, …

Development Of Audiovisual Media For Reproductive Health Education For Parents Of Adolescents, Tanjung Anitasari Indah Kusumaningrum, Nurul Latifatul Inayati, Setia Asyanti, Ayu Khoirotul Umaroh, Wardhatul Livia, Ramadani Nur Laili, Trijaya Trijaya, Ririn Cahya Dewanti, Yuli Kusumawati, Izzatul Arifah

Kesmas

Parents are the primary source of information for adolescents, but many parents lack an understanding of health materials. For knowledge to be increased, health media, one of which is audiovisual media, are desirable. This study aimed to develop audiovisual media on adolescents’ reproductive health. Media development utilized the analyze, design, develop, implement, and evaluate (ADDIE) model. The respondents in this study were parents of adolescents aged 10–14 years, comprising 10 parents in the small group evaluation, 20 in the field evaluation, and 10 in the implementation stage. The effectiveness of the media was tested through pretests and posttests. Using a …

Development Of An Age-Appropriate Household Dysfunction Measure And Its Concurrent Validity With Multiple Outcomes Among Middle School Adolescents In Southeast Texas, Sumaita Choudhury, Timothy J Walker, Emily T Hébert, Christine M Markham, Ross Shegog, Robert C Addy, Melissa F Peskin

Faculty, Staff and Student Publications

Existing adverse childhood experience (ACE) measures include a limited number of household dysfunction (HD) items and the use of adult-oriented language that is not always appropriate for middle schoolers. We developed an age-appropriate 10-item HD measure informed by previously validated ACE measures and tested its concurrent validity with dating violence (DV) perpetration, lifetime substance use, and mental health outcomes among middle schoolers in Southeast Texas. This cross-sectional study used the baseline data from a DV prevention intervention program for sixth graders (N = 126), Me & You Tech. Baseline data were collected from March 2023 to April 2023. To …

From Childhood To Adult Cognitive Health: Analyzing Adverse Experiences And Subjective Cognitive Decline Using Brfss 2020-2023 Dataset, Kyaolin Rajbhandary

NYMC Student Theses and Dissertations

The chronic impact of early-life experiences on long-term health is a critical area of investigation, especially regarding cognitive health in adulthood. Adverse childhood experiences (ACEs) have been linked to an increased risk of developing various health issues in adulthood, including mental health disorders, substance abuse, and chronic diseases. The connection between ACEs, substance abuse and cognitive health, particularly subjective cognitive decline (SCD), remains relatively underexplored. The aim of this study is to examine the intricate relationships between ACEs, alcohol abuse, and SCD in adulthood. This study draws on trauma theory and the biopsychosocial model to conceptualize the long-term impact of …

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …

Defining Homelessness Through Lived Experiences And Service Providers' Perspectives: Implications For Public Health In New Orleans, Janaki Sundaresan, Kathryn T. Kampa, Katherine Andrinopoulos

Journal of the Louisiana Public Health Association

No abstract provided.

Influences And Implications Of Medical Mistrust On Healthcare Behaviors In A Low Health Outcomes County In The State Of New Jersey, Dale Johnson, Adeena Javed, Nathaniel J Byrnes, Anne C Jones, Kristin N Bertsch

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Medical mistrust is an ongoing concern in the United States, with patient confidence in both individual practitioners and institutions decreasing sharply in recent years. Atlantic County, New Jersey has some of the worst health outcomes in the state and is below the national average. This study sought to investigate medical mistrust by recruiting participants to complete a survey and/or health screening at 12 food pantry distribution events throughout Atlantic County (N = 124). The mean score for the Medical Mistrust Index was 19.06 (SD = 5.6) for participants who reported receiving the annual influenza vaccine and 16.05 (SD = 4.7) …

Leading Change For Transgender And Gender Diverse Healthcare: Assessing Organizational Readiness, Braxten Lovett

Dissertations

Background: Transgender and gender-diverse (TGD) individuals face persistent stigma and systemic discrimination across multiple societal domains, with healthcare settings—intended as safe spaces—often being among the most harmful. Despite increased visibility of TGD populations and growing research on their health inequities, inclusive healthcare remains insufficiently addressed by many healthcare leaders, adding to the urgency to advance equitable, inclusive care. Additionally, structural cisnormativity and binary gender frameworks continue to perpetuate misinformation, erasure, and health disparities. Addressing these entrenched barriers requires systemic reform rooted in cultural humility, inclusive practices, and a commitment to dismantling cisnormative bias within healthcare delivery and policy. This study …

The Lack Of Awareness And Effects Of Peripheral Artery Disease And Systematic Barriers Of Black Americans: The Need To Increase Clinical Trial Recruitment And Retention Of Black Americans 40 Years Of Age And Over, Cheron Jackson

Doctoral Dissertations and Projects

The purpose of this qualitative narrative study was to understand Black American men and women 40 years old and over perceptions of participating in clinical trials and evaluating the extent of awareness about Peripheral Artery Disease (PAD). Normative and explanatory theoretical framework was used to set the norms that understand most Black American behavior and explain causes of behaviors. This in turn helped sponsors, investigators, and researchers improve recruitment plans, outreach programs, and increase marketing to attract this population. Using MAXQDA software this research gathered qualitative data from 20 Black American men and women participants 40 years old and over, …

The Relationship Between Health Status, Physical Activity, And Employment On Life Satisfaction In Adults, Lau Hung Yin

Doctoral Dissertations and Projects

Life satisfaction is influenced by various factors such as health, physical activity, and employment status, emphasizing the multidimensional nature of well-being. The purpose of this quantitative cross-sectional study is to examine the relationship between health status, physical activity level, and employment status on life satisfaction among adults in the U.S. The importance of this study focused on understanding how these factors influence life satisfaction. The research question focused on assessing the interconnectedness of these variables. The participants of the study are non-institutionalized civilian adults residing in the fifty states and the District of Columbia. The study involved a total sample …

Evaluating The Impact Of Anti-Vaccine Online Search Trends During The Covid-19 Pandemic On Adolescent Pertussis-Containing Vaccine Completion, Deborah L. Fisher

Walden Dissertations and Doctoral Studies

Adolescent completion of pertussis-containing vaccines is a public health concern, especially with rising online anti-vaccine misinformation. Incomplete vaccination increases risk for preventable diseases and impacts community health. A gap in the literature on the relationship between online anti-vaccine search trends during the COVID-19 pandemic and adolescent pertussis vaccine completion was addressed in this quantitative, repeated cross-sectional study. Andersen’s behavioral model of health services use guided the study. Secondary data from the 2019 and 2022 National Immunization Survey-Teen (NIS-Teen) compared adolescents aged 13–17 in the five U.S. states with the highest (n=5,464) versus the five with the lowest (n=3.031) population-adjusted anti-vaccine …

Exposure To And Impact Of Unhealthy Food Marketing On Adolescents And Young Adults: A Narrative Review And Research Agenda, Nicholas Freudenberg, Rositsa Ilieva

Publications and Research

Consumption of unhealthy food has become a leading cause of premature deaths and preventable illnesses around the world. Research shows that marketing by the companies that produce, distribute, and sell unhealthy foods and beverages is associated with increased consumption of these products. To date, however, limited research has focused on the cumulative exposure and impact of various modes of marketing employed to reach distinct populations. In this narrative review, we summarize 25 years of scientific evidence and findings from 108 empirical studies and 19 systematic and scoping reviews of various forms of unhealthy food marketing to adolescents (aged 13 to …

The Influence Of Compensation From Wages And Benefits On Healthcare Workers' Performance In Healthcare Services, Jiddan Azizan Hakim, Ghania Danisha Maharani, Riswandy Wasir, Alif Indah Melani, Cahya Arbitera

Journal of Indonesian Health Policy and Administration

This study aims to evaluate the influence of compensation, including wages, incentives, and benefits, on the performance of health workers in primary health centers and hospitals. A literature review was conducted using Google Scholar and PubMed, focusing on articles published in the last 5–10 years. From an initial search yielding 1,021 articles, nine were selected based on inclusion criteria. The results show that direct compensation (salary) and indirect compensation (benefits) have a positive impact on health worker performance. However, the effect of incentives varies depending on implementation. Motivation and job satisfaction were mediating factors that strengthened the relationship between compensation …

It Is Not Clear How Well Physical Activity Promotion Materials Are Understood: Findings From A Rapid Literature Review, Jafra D. Thomas, Jasmine C. Wong, Regina F. Hockert, Yi Sheng Wu, Winston Kennedy

Topics in Exercise Science and Kinesiology

Topics in Exercise Science and Kinesiology Volume 6: Issue 1, Article 6, 2025. Efforts to promote physical activity and other health-related behaviors are more effective when resource materials are understood by a wide and diverse audience. Before our lab’s previous investigations (Thomas et al., 2024), only one study seemed to use the cloze procedure to directly test the comprehension (i.e., readability) of physical activity promotion material (Cardinal & Seidler, 1995). Thus, this rapid literature review sought to (a) determine the extent the cloze procedure has been used to study physical activity promotion material comprehension in lay adults and (b) collate …

Intersectional Analysis Of Vaccination Inequity Among Individuals With Disabilities In The United States During The Covid-19 Pandemic, Philip Ndoki, Heba M. Athar, David O. Anderson

Journal of Social, Behavioral, and Health Sciences

We investigated how disability status, types, sociodemographic indicators, and reasons for not receiving vaccinations influenced COVID-19 vaccination rates among individuals with disabilities in the United States. Despite efforts, vaccination disparities persisted, necessitating a nuanced understanding of the barriers to vaccination. Using intersectionality theory and the social determinants of health framework, we examined the impact of marginalized identities and structural inequalities. Key questions included the association between disability status and vaccination uptake, differences among disability types moderated by sociodemographic factors, and the interaction between disability status and reasons for not vaccinating. We used Household Pulse Survey data from the U.S. Census …

The Association Between Neighborhood Environment, Social Relations, And The Prevalence Of Irritable Bowel Syndrome, Negin Iranfar

Walden Dissertations and Doctoral Studies

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction influenced by biological, psychological, and social factors. Stress and socioeconomic influences on IBS have been studied, however few studies have explored the impact of neighborhood and social environments across racial and ethnic groups and sex at birth. The biopsychosocial framework was used to examine whether built environment and social context contribute to IBS prevalence. A cross-sectional analysis of 80,874 participants from the All of Us Research Program was conducted to assess the associations between IBS and six neighborhood and social factors: safety, structure, cohesion, supportive relationships, social relationships, and perceived …

Strengthening Occupational Health And Safety (Ohs) In Schools To Minimize Risks For Students, Teachers, And Visitors: Policy Recommendation, Wiwik Eko Pertiwi, Hanifa Maher Denny, Yuliani Setyaningsih, Agung Dwi Laksono

Journal of Indonesian Health Policy and Administration

Vocational schools equip students with practical skills and expose them to industry-related hazards, making Occupational Health and Safety (OHS) a crucial aspect of the school environment. This study aims to identify key factors behind the weak implementation of OHS in vocational schools. A literature review used articles published between 2017–2024 from national and international journals. The review found poor OHS implementation stems from lack of awareness, inadequate policies, insufficient infrastructure, weak safety culture, and negligence in accident prevention. To address these issues, the study recommends OHS education and training, improvement of school infrastructure, curriculum integration, formation of safety teams, and …

Reproductive Health In America: A System Ran By Sexism And Male Control, Hailey Mccool

Merge

No abstract provided.

Adhd Diagnosis And Treatment Within Ethnic Minority Groups, Dianthe Hoang

Undergraduate Honors Theses

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is commonly diagnosed in childhood, and the National Survey of Children’s Health reported that ADHD had a prevalence of around 6.1 million children aged 2-17 years old (NSCH, 2016). This review discusses the cultural and socioeconomic barriers that contribute to the underdiagnosis and treatment in members of ethnic minority communities. Black, Hispanic, Native American, and Asian adults received less mental health care compared to White Americans. Previous findings indicated that cultural factors, such as misinterpretation of symptoms from families and teachers and cultural perceptions of mental health, contributed to disparities …

The Impact Of Functional Disabilities On The Quality Of Life Of Older U.S. Adults, Bernadette Lavender

Walden Dissertations and Doctoral Studies

Among older U.S. adults, functional disabilities are critical determinants of quality of life (QoL), influencing mobility, social engagement, and independence. Despite growing evidence of these impacts, limited research examines how healthcare access, social support, and socioeconomic factors moderate this relationship. This quantitative study explored the effects of functional disabilities on QoL, operationalized through self-reported health, while examining the moderating roles of key social determinants. Using a cross-sectional design, secondary data from the Health and Retirement Study (HRS) were analyzed. The sample included 42,405 participants aged 60 years and above from all 50 states. Multiple regression analyses and ANOVA were employed …

Food Insecurity, Myplate Utilization, And Hba1c In United States Adults With Prediabetes, Lindley R. Sharp

Walden Dissertations and Doctoral Studies

The rising prevalence of prediabetes in the United States presents a significant public health challenge, particularly due to its progression into Type 2 diabetes. Despite national dietary guidelines, disparities in dietary adherence persist, especially among food-insecure adults. This quantitative study examined the impact of food insecurity and MyPlate utilization on HbA1C levels in prediabetic U.S. adults, while accounting for structural and intermediary determinants of health. Guided by the Commission on Social Determinants of Health framework, this cross-sectional study utilized secondary data from the 2015–March 2020 National Health and Nutrition Examination Survey including a sample size of 1,417 noninstitutionalized male and …

Sociodemographic And Psychosocial Characteristics Of E-Cigarette Ever-Use: U.S. Hints 6 Survey, Lilianna Phan, Kuang-Yi Wen, Hee Jun Kim, Julie A. Barta, Hee-Soon Juon

Department of Medical Oncology Faculty Papers

Objective

Methods

Results

Guidelines For The Creation And Implementation Of A School-Based Vision Program For The Greater Seattle Area, Suzanna P. Gill

Honors Projects

Proper vision care contributes to a child’s ability to perform academically as well as their overall health and wellbeing. Pediatric vision care begins with vision screening, which occurs in public schools in Washington state. These vision screenings allow for possible vision issues to be identified in children. They are not, however, a replacement for eye examinations that help determine what is causing the problem and provide treatment. A substantial proportion of children that are recommended to receive the exams will not, partially because Washington does not require parents to take their children to eye care professionals. These children are more …

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …

Emergency Medicine Residency Website Wellness Pages: A Content Analysis, Alexandra Sappington, Brian Milman

School of Medicine Faculty Publications

Introduction: The COVID-19 pandemic impacted the way medical students seek residency positions. In 2020, the Accreditation Council for Graduate Medical Education advocated for virtual interviews. Most emergency medicine (EM) interviews in 2023 remained virtual, and this format will persist for the foreseeable future. Since students are not evaluating programs in person in most cases, residency websites are crucial for prospective residents. Resident wellness is critical for resident training and important to prospective residents; it follows that programs must be transparent about resident wellness on websites. In this study we aimed to quantify the number of EM programs with wellness pages …

Assessing One-Year Health Impacts From Wildfires In Rural Communities: Roles For Extension In Promoting Wildfire Preparedness And Recovery, Marc T. Braverman, Sandi Cleveland Phibbs, Emily Jane Davis, Amanda Rau, Elijah Penner

Journal of Extension

Wildfires can produce health impacts that persist for years in affected communities. This article describes an Extension-led study of health impacts in rural Oregon communities one year after a destructive wildfire. Data collection included key informant interviews (n=36), an online survey (n=80), and three focus group interviews with survivors (n=23). Mental health, exposure to contaminants, physical stress, food insecurity, and other issues were frequently identified health concerns. Survivors’ difficulties in dealing with housing displacement significantly exacerbated health challenges. We describe potential roles for Extension in addressing wildfire risk and mitigating health impacts, including a description of the Oregon Fire Program.

Framing The Future: A Community Health Analysis Of The Pee Dee Region, Stephen Borders, Jean Anton, Rian Fontaine, Donielle Phillips, Treyton Ringer, Jessica Robinson, Caitlin Thompkins

Public Health

This report presents a comprehensive, data-driven analysis of community health across South Carolina’s Pee Dee region, encompassing Florence, Darlington, Chesterfield, Marlboro, Marion, and Dillon Counties. Using tract-level data from CDC PLACES, the U.S. Census, and the National Provider Identifier registry, it assesses chronic health conditions, health behaviors, and social determinants of health. The analysis incorporates the South Carolina Healthy Communities Index (SCHCI) and a Suitability Analysis to identify the region’s most disadvantaged communities. The findings highlight persistent disparities, particularly in rural counties, where high rates of poverty, chronic disease, and unmet basic needs intersect with limited access to care. Despite …

Enhancing Intimate Partner Violence Screening: Implementing Standardized Ehr Protocols And Staff Education In A Community Health Center Serving The Latinx Community, Gabriela Alejandra Davila Barajas

Master's Projects and Capstones

Intimate Partner Violence (IPV) is a public health issue that disproportionately impacts Latinx populations, who often face barriers such as cultural stigma, language barriers, fear of legal consequences, and limited access to culturally competent care. Community Health Centers (CHCs) are well-positioned to identify and address IPV. This project aims to increase IPV screening rates in a CHC serving a predominantly Latinx population by implementing standardized EHR protocols and culturally responsive staff education. The project’s goal is to raise IPV screening rates to 25% by April 15, 2025. The intervention includes two key components: integrating the Hurt, Insulted, Threatened, and Screamed …

Community Health Workers’ Lived Experience Of Using Videoconferencing With Community Members, Valdora Lejune Avery

Walden Dissertations and Doctoral Studies

Community health workers in the United States faced significant challenges in conducting in-person community practice during the COVID-19 pandemic, which adversely affected their communication, training, and service delivery outcomes. Videoconferencing enabled workers to connect with underserved populations for individual and community crisis response. The purpose of this study was to describe the lived experiences of community health workers in the Rural Community Health Worker Network (RCHWN) regarding the use of videoconferencing among community members in practice and how members in RCHWN perceive the availability of videoconferencing devices to communicate in the community. Transcendental phenomenology provided the conceptual framework and research …