Digital Commons Network^™

Prenatal Maternal Depression In Canada: Are Current Protocols Adequate?, Britney A. Glasgow-Osment, Farah Wahib, Madeleine Zanin, Shama Kassam

Master's in Interdisciplinary Medical Sciences Graduate Program

Throughout pregnancy, maternal and fetal health are influenced by a multitude of factors. Prenatal maternal depression is one such factor. It is well documented that prenatal maternal depression causes negative pregnancy outcomes for both the mother and baby, including irregular placental function, psychological distress, and pre-term birth, among others. In Ontario, the incidence of prenatal maternal depression is alarmingly high, at 10.3%.As such, the current tools for managing prenatal maternal depression must be effective, efficient, and comprehensive. We hypothesized that the current protocols for screening and treating prenatal maternal depression in Canada are inadequate. To investigate this, a literature review …

Supporting Ontario Public Health Units To Address Adverse Childhood Experiences In Pandemic Recovery Planning: A Priority-Setting Exercise, Kimberly B Harding, Erica Di Ruggiero, Erick Gonzalez, Amanda Hicks, Daniel W Harrington, Sarah Carsley

Faculty, Staff and Student Publications

BACKGROUND: Adverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units' work towards ACEs-informed pandemic recovery plans.

METHODS: The Child Health and Nutrition Research Initiative method …

Factors Associated With Digestive System Cancer Screening In Texas., Stella Green

Walden Dissertations and Doctoral Studies

Walden University College of Health Sciences and Public Policy This is to certify that the doctoral study by Stella Green has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Shanna Barnett, Committee Chairperson, Public Health Faculty Dr. Simone Salandy, Committee Member, Public Health Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2024 The specific research problem in this study was that despite the high prevalence of digestive system cancer, screening for digestive system cancer has not been optimized, …

Factors Associated With Digestive System Cancer Screening In Texas., Stella Green

Walden Dissertations and Doctoral Studies

The specific research problem in this study was that despite the high prevalence of digestive system cancer, screening for digestive system cancer has not been optimized, thus compromising early diagnosis and treatment. Early detection and treatment of digestive system cancer can generate better patient outcomes and enhance quality of life. The purpose of this quantitative correlation study guided by the social ecological model was to examine whether demographic factors (age, sex, race/ethnicity, marital status), socioeconomic status (education level, employment status, income level), and health behaviors (physical activity, tobacco use, healthcare coverage) are associated with receiving digestive cancer screening in Texas. …

The Inflammatory Exposome Of Major Depressive Disorder In An Egyptian Sample, Reem Deif

Theses and Dissertations

Major depressive disorder (MDD) has been recognized as a global public health concern affect-ing the lives of 264 million people with increasing prevalence worldwide. Inspired by the expo-somic research, this study aims to investigate the dynamic and complex interplay between dif-ferent demographic, lifestyle, environmental factors and bimolecular factors that are potentially involved in the pathology of MDD in a sample of Egyptian adults living in Cairo. This is in an attempt to acknowledge the biological underpinnings of MDD without underestimating the role of environmental influences. The context of Egypt provides richness to the current study given the national transition from …

Predictors Of Complementary Alternative Medicine Usage Among Diabetic Adults In The United States, Erlina Kearse-Lewis

Walden Dissertations and Doctoral Studies

Available data for the last two decades have shown that the use of complementary and alternative medicine (CAM) is increasing, with users including adult diabetics around the world. There is not a strong consensus concerning the influence of socioeconomic factors on the use of CAM by adult diabetics. The purpose of this retrospective cross-sectional study was to examine the use of CAM among U.S. adults 21 years and older diagnosed with diabetes and whether income influences the use of CAM among adult diabetics after adjusting for age, gender, and location. Cross-sectional data from the 2017 National Health Interview Survey represented …

Predictors Of Complementary Alternative Medicine Usage Among Diabetic Adults In The United States, Erlina Kearse-Lewis

Walden Dissertations and Doctoral Studies

Available data for the last two decades have shown that the use of complementary and alternative medicine (CAM) is increasing, with users including adult diabetics around the world. There is not a strong consensus concerning the influence of socioeconomic factors on the use of CAM by adult diabetics. The purpose of this retrospective cross-sectional study was to examine the use of CAM among U.S. adults 21 years and older diagnosed with diabetes and whether income influences the use of CAM among adult diabetics after adjusting for age, gender, and location. Cross-sectional data from the 2017 National Health Interview Survey represented …

Pediatric Obesity In The United States: Age–Period–Cohort Analysis, Ashley W. Kranjac, Dinko Kranjac, Roxanne I. Aguilera

Sociology Faculty Articles and Research

The rates of obesity among American children aged 2–5 years has reached a historic high. It is crucial to identify the putative sources of population-level increases in obesity prevalence among preschool-aged children because early childhood is a critical window for obesity prevention and thus reduction of future incidence. We used the National Health and Nutrition Examination Survey data and hierarchical age–period–cohort analysis to examine lifecycle (i.e., age), historical (i.e., period), and generational (i.e., cohort) distribution of age- and sex-specific body mass index z-scores (zBMI) among 2–5-year-olds in the U.S. from 1999 to 2018. Our current findings indicate that period effects, …

Client Perspectives On The Development Of A Rapid Prep Initiative At A Sexual Health Center In New Orleans, Louisiana, Aish Lovett, Rose Luder, Rebecca Lillis, Isolde Butler, Julia Siren, Samuel Gomez, Kevin Kamis, Oluyomi Obafemi, Sarah E. Rowan, Stefan Baral, Meredith E. Clement

School of Medicine Faculty Publications

Uptake of PrEP remains suboptimal, especially in the Southern United States. Same-day or “Rapid PrEP Initiatives” (RPIs) in sexual health centers (SHCs) could facilitate access and overcome barriers to PrEP. We studied the adaptation of an RPI from Denver, Colorado to an SHC in New Orleans, Louisiana. Through focus group discussions (FGDs) with local SHC staff and PrEP providers, we developed a preliminary RPI model. In 5 FGDs with SHC clients referred for or taking PrEP, we gathered adaptation recommendations and feedback on model acceptability, feasibility, and utility. Providers and clients voiced unanimous support for the RPI. Clients favored the …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

Impact Of Telehealth On Type 2 Diabetes Self-Management During The Covid-19 Pandemic, Nancy Olivo Marshall

Walden Dissertations and Doctoral Studies

The incidence of Type 2 diabetes mellitus (T2DM) is on the rise, particularly among adults aged 18 years and older. Glycosylated hemoglobin (HbA1c) levels are commonly used by healthcare professionals to assess glucose variability; fluctuations are associated with an increased risk of adverse effects. The COVID-19 pandemic highlighted the importance of self-directed management of HbA1c levels through telehealth. The purpose of this retrospective quantitative study was to investigate the effectiveness of self-directed management of HbA1c levels using telehealth among T2DM diagnosed adults at a community health service organization in the northeastern U.S. from December 2018 to 2022. Using multivariate regression …

Exploring Associations Between Poverty, Race/Ethnicity, Gender, And Childhood Obesity In Cherokee County, South Carolina, Lillie Mae Hall

Walden Dissertations and Doctoral Studies

Childhood obesity (CHO) rates have increased significantly worldwide over the last decade. The magnitude of CHO extends beyond physical health to include economic stability, social connections, and access to daily living resources. CHO is complex and requires a multifaceted approach that may differ from traditional prevention approaches and treatment. Over the years, interventions have focused on maintaining a balance of healthy eating and active living to reduce weight and promote lifelong behavior change. Body mass index (BMI) surveillance studies have been conducted in Cherokee County, South Carolina since 2012 to assess and inform CHO interventions. However, the data have not …

Perception Of Pre-Existing Dm2 Management Among Pregnant Asian Indian Immigrants During Covid-19, Sanya Bedi Grewal

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a chronic disease that exerts a significant burden among communities by increasing healthcare costs, reducing productivity, higher rates for premature mortality, and tangible socioeconomic burden, which overall reduces the quality of life. The purpose of the study was to explore the perception of pregnant Asian Indian immigrants regarding diabetes self-management strategies during the COVID-19 pandemic. Five women were recruited via purposive sampling from Facebook groups. Data were collected via individual interviews using Facebook groups. The health belief model was used to help understand and interpret the findings. Clarke and Braun’s thematic analysis method was used to …

Exploring Associations Between Poverty, Race/Ethnicity, Gender, And Childhood Obesity In Cherokee County, South Carolina, Lillie Mae Hall

Walden Dissertations and Doctoral Studies

Childhood obesity (CHO) rates have increased significantly worldwide over the last decade. The magnitude of CHO extends beyond physical health to include economic stability, social connections, and access to daily living resources. CHO is complex and requires a multifaceted approach that may differ from traditional prevention approaches and treatment. Over the years, interventions have focused on maintaining a balance of healthy eating and active living to reduce weight and promote lifelong behavior change. Body mass index (BMI) surveillance studies have been conducted in Cherokee County, South Carolina since 2012 to assess and inform CHO interventions. However, the data have not …

Building Trust: The Role Of Place-Based Consciousness In Vaccine Hesitancy, Ramsey W. Ash

Quantitative Social Science Undergraduate Senior Theses

Vaccine hesitancy poses a threat to public health initiatives of the 21st century. Following a stark divide in the rural/urban COVID-19 vaccine uptake and harsh disparities between these areas in COVID-19 moralities and morbidities, further understanding of the drivers of vaccine hesitancy are needed. This study makes use of the framework of place-based consciousness (PBC), pioneered by scholars of rural political science, such as Katherine Cramer, to explore this phenomenon as a mechanism by which to understand vaccine hesitancy. To examine this, an experimental survey was distributed to 300 Americans (150 rural and 150 urban) that inquired about their PBC, …

Enhancing Foot Care Education And Support Strategies In Adults With Type 2 Diabetes, Hsiao-Hui Ju, Madelene Ottosen, Jeffery Alford, Jed Jularbal, Constance Johnson

Faculty, Staff and Student Publications

BACKGROUND: People with diabetes are susceptible to serious and disabling foot complications, which increase their morbidity and mortality rates. Examining the perspectives of people with diabetes on their foot care routines could help elucidate their beliefs and offer practical ways to prevent foot problems.

PURPOSE: We explored the perspectives of adults with diabetes on their foot care practices to identify and enhance foot care education and support strategies.

METHODOLOGY: Using the Zoom platform, 29 adults with diabetes completed a 3-month telehealth educational program, during which interviews were conducted. This article reports the results of thematic content analysis of the qualitative …

Polarization, The Pandemic, And Public Trust In Health System Actors, Alessandro Del Ponte, Alan S. Gerber, Eric M. Patashnik

Political Science Faculty Articles and Research

Context: Public opinion on the performance of health system actors is polarized today, but it remains unclear which actors enjoy the most or the least trust among Democrats and Republicans, whether the COVID-19 pandemic has influenced how people view their own physicians, and whether doctors have retained the ability to influence public beliefs about policy issues.

Methods: The authors conducted two national surveys in 2022 and 2023 to examine these questions.

Findings: Democrats rated the performance of medical research scientists and public health experts during the pandemic more highly than did Republicans and independents. About three in ten Republicans said …

Associations Between Disordered Eating Behaviour And Sexual Behaviour Amongst Emerging Adults Attending A Tertiary Education Institution In Coastal Kenya, Stevenson Chea, Adama Kazienga, Eunice Oyugi, Isaac Menza, Carophine Nasambu, Fauz Ibrahim, Osman Abdullahi, Amin Hassan, Amina Abubakar, Kristien Michielsen

Institute for Human Development, East Africa

Background Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.

Methods We applied a cross-sectional design nested in a young adults’ cohort study. Eligibility included sexually active emerging adults aged 18–24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed …

Impact Of Prenatal Maternal Depression On Gestational Length Post Hoc Analysis Of A Randomized Clinical Trial, Elysia Poggi Davis, Catherine H. Demers, Lillybelle Deer, Robert Gallop, M. Camille Hoffman, Nancy Grote, Benjamin L. Hankin

Mathematics Faculty Publications

Background Shortened gestation is a leading cause of childhood morbidity and mortality with lifelong consequences for health. There is a need for public health initiatives on increasing gestational age at birth. Prenatal maternal depression is a pervasive health problem robustly linked via correlational and epidemiological studies to shortened gestational length. This proof-of-concept study tests the impact of reducing prenatal maternal depression on gestational length with analysis of a randomized clinical trial (RCT).

Methods Participants included 226 pregnant individuals enrolled into an RCT and assigned to receive either interpersonal psychotherapy (IPT) or enhanced usual care (EUC). Recruitment began in July 2017 …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

The Relationship Between Healthcare Access And Change In Health-Related Quality-Of-Life Among The General Population Of Five Countries During The Covid-19 Pandemic, Nadja Alexandrov, Emily Stella Scott, Mathieu F. Janssen, Erica I. Lubetkin, John N. Yfantopoulos, Gouke J. Bonsel, Juanita A. Haagsma

Publications and Research

Purpose To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries.

Methods An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and …

Postpartum Recovery After Severe Maternal Morbidity In Kilifi, Kenya: A Grounded Theory Of Recovery Trajectories Beyond 42 Days, Ursula Gazeley, Marvine Ochieng, Onesmus Wanje, Angela Koech, Grace Mwashigadi, Nathan Barreh, Alice Kombo, Mwanajuma Bakari, Grace Maitha, Marleen Temmerman

Centre of Excellence in Women and Child Health

Introduction The burden of severe maternal morbidity is highest in sub-Saharan Africa, and its relative contribution to maternal (ill) health may increase as maternal mortality continues to fall. Women’s perspective of their long-term recovery following severe morbidity beyond the standard 42-day postpartum period remains largely unexplored.

Methods This woman-centred, grounded theory study was nested within the Pregnancy Care Integrating Translational Science Everywhere (PRECISE) study in Kilifi, Kenya. Purposive and theoretical sampling was used to recruit 20 women who experienced either a maternal near-miss event (n=11), potentially life-threatening condition (n=6) or no severe morbidity (n=3). Women were purposively selected between 6 …

Early Detection Of Alcohol Related Dementia Across The Lifespan: An Integrative Literature Review For Primary Care Providers, Kaylee A. Chapman

University Honors Theses

Introduction: Alcohol related dementia (ARD) is a long-term, heterogeneous cognitive impairment that can develop in the course of excessive and prolonged use of alcohol. This integrative literature review evaluated the relevant research, preventative measures, and early detection of brain changes leading to memory impairment as a result of the chronic consumption of alcohol. Widespread prevention and detection of ARD can be achieved through the support of healthcare professiona ls in understanding, observing, and catching behavioral patterns ahead of time to properly direct treatment. The risk factors associated with an early diagnosis of dementia include, but are not limited to, abnormal …

A Dual-Angle Exploration Towards Understanding Lapses In Covid-19 Social Responsibility, Sean T. H. Lee, Jerome J. X. Mah, Angela K. Y. Leung

Research Collection School of Social Sciences

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health-risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self-perceived infection should provide an impetus to engage in …

Life-Space Mobility, Transportation, And The Companionship Network Of Members Of A Hispanic Senior Center, Rebecca L Mauldin, Rupal Parekh, John P Connolly, Stephen P Mattingly, Aiman Mushtaq, Kayo Fujimoto

Faculty, Staff and Student Publications

Objectives: Companions (i.e., friends who spend time together) are important for the well-being of older adults. Senior centers in the United States are places for older adults to participate in group activities and form and maintain companionships. However, differences in mobility and transportation may affect the ability of older adults to leverage senior center activities into actual companionships.

Methods: This social network analysis was conducted to characterize the companionship network among members of a senior center in relation to their life-space mobility and transportation resources. An exponential random graph model was estimated to identify mobility- and transportation-related correlates of the …

Patient Location And Disparities In Access To Fertility Preservation For Women With Gynecologic Or Breast Cancer, Alexa Kanbergs, Kirsten Jorgensen, Nuria Agusti, David Viveros-Carreño, Chi-Fang Wu, Roni Nitecki, John A Harris, Terri Woodard, Ryan Ramphul, Jose Alejandro Rauh-Hain

Faculty, Staff and Student Publications

Objective: To assess the effect of geographic factors on fertility-sparing treatment or assisted reproductive technology (ART) utilization among women with gynecologic or breast cancers.

Methods: We conducted a cohort study of reproductive-aged patients (18-45 years) with early-stage cervical, endometrial, or ovarian cancer or stage I-III breast cancer diagnosed between January 2000 and December 2015 using linked data from the California Cancer Registry, the California Office of Statewide Health Planning and Development, and the Society for Assisted Reproductive Technology. Generalized linear mixed models were used to evaluate associations between distance from fertility and gynecologic oncology clinics, as well as California Healthy …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

I See You! Play: A Therapeutic Playgroup For Caregivers And Their Intensive Care Group Infants, Mariana Cerqueira Aokalani

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper articulates a new therapeutic playgroup for caregivers of Intensive Care Unit (ICU) infants, named I See You! Play. This intervention is an adaptation of WePlay! (Gross et al., 2021), a cooperative learning and therapeutic playgroup for caregivers and their children from 6 to 36 months old. Dr, Tracy Vozar developed this program inspired by Saleem Penny’s program with the same name in Chicago. Parents of ICU infants face several challenges that can affect their experience of parenthood, their parenting skills, caregivers' sensitivity, their mental health, and their relationship with their premature infant. This in turn affects infant’s attachment …

A Mixed-Method Analysis Of The Contribution Of Informal Sport To Public Health In Australia, Ruth Jeanes, Justen O'Connor, Dawn Penney, Ramon Spaaij, Jonathan Magee, Eibhlish O' Hara, Lisa Lymbery

Research outputs 2022 to 2026

Informal sport is a growth area of sport participation but there has been limited examination of how informal and unstructured forms of participation may contribute to health outcomes that are important for public health. This article aims to address the current lack of data examining the health outcomes associated with informal sport participation and consider the potential role of informal sport within efforts to promote healthier communities through sport. The article seeks to broaden understanding of how informal sport participation can contribute to health outcomes, particularly with regard to increasing physical activity and enhancing mental health and social connection. The …

Examining The Association Of Type 2 Diabetes Mellitus Risk Factors Between African Immigrants Living In The United States And African Americans Born In The United States, Philip Effiong

Walden Dissertations and Doctoral Studies

The purpose of the study was to investigate the risk factors for Type 2 diabetes mellitus (T2DM) among African immigrants and African Americans born in the United States to identify differences and similarities in their impact and prevalence. Variables considered as potential differentiators included alcohol consumption, income, educational levels, and smoking habits, age, and gender. The health belief model served as the theoretical framework. Utilizing data from the National Health and Nutrition Examination Survey 2015-2016, logistic regression analyses were used to test for significant factors affecting T2DM prevalence in these groups. Results indicated that country of origin did not predict …