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The Importance Of Framing The Context Of Black/African Americans' Livelihood To Enhance Health Outcomes And Mitigate Health Inequalities, Elvis Gyan

Theses, Dissertations and Culminating Projects

This study investigates the portrayal of Black/African Americans in Health Marriage and Relationship Education (HMRE) programs, which predominantly follow Eurocentric models while examining how social and structural determinants (e.g., community context) influence stress levels, general health, and relationship satisfaction through two main objectives. Firstly, it aims to scrutinize the acknowledgment of biases towards non-Eurocentric communities in published Administration of Children and Families HMRE programs, analyzing 39 research studies. Secondly, it examines the interplay between perceived community context, stress as a mediator, general health, and relationship satisfaction among Black/African Americans across three distinct articles by testing hypothesized process models. Results for …

Healthcare Providers’ Screening And Counseling For Tobacco Use Among Youth In The United States: Prevalence, Practices, And Providers’ Perspectives, Adeola Omolade Ayo

Electronic Theses and Dissertations

Youth tobacco use is a public health concern in the United States (U.S.) with about 2.8 million middle and high school youth reporting current tobacco use in 2023. Healthcare providers (HCPs) can play a crucial role in addressing youth tobacco use through screening and counseling, yet rates of these interventions are suboptimal. Tennessee has a high prevalence of youth tobacco use and not much is known about these interventions in Northeast Tennessee. This study has several objectives: 1) conduct a scoping review of available evidence on screening and counseling for youth tobacco use and identify related gaps; 2) assess youth …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

The Association Between Prenatal Care And Postpartum Depression: Current State And Future Directions, Esther Adebayo-Abikoye

Electronic Theses and Dissertations

Background

Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.

Methods

A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used …

Perceptions Of Metabolic Syndrome Management Utilization In Relation With Patient Characteristics And Health-Related Quality Of Life, Olajide Adekunle

Pharmaceutical Sciences (PhD) Dissertations

Challenges in managing MetS include untreated risk factors and ineffective management, resulting in poor health-related quality of life (HRQoL). A significant factor contributing to these challenges is the underutilization of management services, possibly due to patients' perceptions of disease management resource utilization (PMU). Therefore, understanding patients' PMU is crucial for improving health outcomes. The study investigated PMU, explored PMU predictors, and investigated the impact of PMU and patients’ demographics on HRQoL. Using a cross-sectional design, data on perceptions of healthcare, medication, and pharmacy service utilization, prior experience with pharmacy services, demographics, and HRQoL were collected from adult individuals with obesity …

The Moderating Effect Of Socioeconomic Status And Walkability On The Efficacy Of Physical Activity Interventions, Analisa Vavoso, Vincent Berardi, Marc A. Adams

Student Scholar Symposium Abstracts and Posters

To enable physical activity (PA) interventions to better tailor procedures to participant characteristics, we investigated the role of neighborhood socioeconomic status (SES) and walkability on the differential effectiveness of adaptive versus static activity goals (AG vs. SG) and immediate versus delayed (IR vs. DR) reinforcement in a PA trial.

Data was collected as a part of the WalkIT Arizona study, where healthy, inactive adults (n = 512) were instructed to wear an accelerometer daily for one year and were provided with daily goals for moderate-to-vigorous PA (MVPA). The intersection of goal types (adaptive and static) as well as reinforcement types …

Comparative Analysis Of Acceptance And Commitment Therapy’S Effectiveness In An Intensive Outpatient Program Setting, Efrain Frank Ellin Iii

Electronic Theses and Dissertations

This thesis presents a comparative analysis of acceptance and commitment therapy (ACT) and treatment as usual (TAU) within an intensive outpatient program setting, evaluating their effectiveness in enhancing various dimensions of psychological well-being. Guided by two main research questions, the study investigates whether ACT demonstrates greater or equal effectiveness compared to TAU and if it provides more immediate effects on psychological well-being within three weeks. Utilizing a quasi-experimental design, the research incorporates a comprehensive array of measurement tools to assess outcomes related to anxiety, depression, stress, psychological flexibility, cognitive flexibility, emotion regulation, mindfulness self-efficacy, and life satisfaction among participants. The …

End-Of-Life Patient Communication: Exploring Comfort, Communication And Education Of Healthcare Professionals For End-Of-Life Care, Madison Gremillion

Undergraduate Honors Theses

Historically, the medical field has viewed death and dying as incurable ‘medical failures,’ and as a result, many healthcare professionals have difficulties when facing a patient who is dying or at the end of their life. These individuals will use avoidant behavior to avoid end-of-life (EOL) patients or can have difficulty providing essential aspects of care including communication, that contribute to building a strong relationship between the healthcare provider and patient. For the healthcare professional (HCP), this can stem from anxiety related to thoughts of death and a lack of educational support or experience. The study of death is where …

Substantial Increases In Healthcare Students’ State Empathy Scores Owing To Participation In A Single Improvisation Session, Brian D. Schwartz, Shane L. Rogers, Nicole Michels, Lon J. Van Winkle

Research outputs 2022 to 2026

Purpose: To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. Methods: Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants’ self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. Results: The exploratory factor analysis …

The Role Of Psychogenic Factors In The Etiopathogenesis Of Autoimmune Disorders In The Oral Cavity, Nadya T. Avramova, Boyko K. Bonev

Journal of Mind and Medical Sciences

Autoimmune disorders (AD) represent a heterogeneous group of multifactorial chronic conditions, which are triggered secondary to the loss of self-antigen tolerance. Their etiology involves genetic, epigenetic, and environmental factors; however, AD cannot be explained by these factors alone. Recent studies have shown increasing stress levels in industrialized countries and also increasing trends in the prevalence of autoimmune diseases. The oral mucosa is extremely responsive to emotional influences such as stress, anxiety and depression. Therefore, oral diseases can appear as a direct expression of emotions or indirectly, due to various psychological mechanisms. The aim of this study is to find and …

Ensuring Equitable Application Of Interventions To Vulnerable Subpopulations In The Kentucky Consortium For Accountable Health Communities (Kc-Ahc), Jing Li, Jessica M. Clouser, Akosua Adu, Aiko Weverka, Nikita Vundi, Terry D. Stratton, Mark V. Williams

Journal of Appalachian Health

Introduction: The Centers for Medicare and Medicaid Services (CMS) has funded the Accountable Health Communities (AHC) model to test whether systematically identifying and addressing the health-related social needs (HRSNs) of individuals would impact healthcare utilization and total cost of care for Medicare and Medicaid beneficiaries. Toward this effort, AHCs implement screening, referral, and community navigation services in their local areas. There are 28 CMS-funded AHCs nationwide, including the Kentucky Consortium for Accountable Health Communities (KC-AHC).

Purpsoe: This study aims to assess the equity of KC-AHC model activities in three vulnerable sub-populations: dual enrollees, disabled individuals, and women.

Methods: Twenty-eight primary …

Healthcare Provider Engagement And Its Effects On Patient Rereferral: Insights From Indonesia, Felicia Setiawan

Makara Journal of Health Research

Background: In the highly competitive landscape of healthcare, nurturing strong relationships between referring healthcare providers and healthcare facilities is essential for maintaining patient loyalty. This study explores the factors influencing referring health care provider engagement and its subsequent impact on the willingness to rerefer to healthcare facilities.

Methods: A cross-sectional quantitative survey was conducted with 181 healthcare providers who regularly refer patients to a private hospital in Jakarta. Data were collected through an online structured questionnaire consisting of 29 questions. The following dimensions were covered: specialist characteristics, practice characteristics, healthcare provider–specialist interaction, patient–specialist interaction, returning referral, training opportunity, …

Trilogies: Lessons From 50 Years Facilitating Community-Based Health Assessments And Planning In Appalachia, Bruce Behringer

Journal of Appalachian Health

Involvement of community and organizational groups is fundamental to most public ventures. Most social, health, economic, and educational improvements in Appalachia have been characterized by successfully integrating community input and finding ways to encourage organizational change and collaboration.

Managing group process and related facilitation skills are fundamental competencies for public health professionals and others guiding change efforts. Groups from communities and organizations can get stalled in their deliberations; a facilitator frequently must think quickly to diagnose the situation and propose alternative approaches. Creative and flexible approaches, learned through practice experiences, can blend with theories and frameworks learned in academic preparation …

Self-Reported Determinants Of Covid-19 Vaccine Acceptance Among Persons With And Without Autoimmune Disease, Jenny D. Gong, Maya Mattar, Donald D. Anthony, Adam T. Perzynski, Nora G. Singer

Faculty Scholarship

Objective: Patients with autoimmune disease (AD) are at increased risk for complications from COVID-19 infection, so, optimizing vaccine utilization in this population is of particular importance. We compared COVID-19 vaccination perspectives among persons with and without AD. Methods: 471 patients in the MetroHealth System and Cleveland Veteran Affairs Medical Center completed a 38-item questionnaire between August 2021 and February 2022. This survey containing questions regarding COVID-19 vaccine perceptions and demographics was administered both to unvaccinated individuals and individuals who delayed vaccination for at least 2 months. Multivariable ordinary least squares regression models were created to assess factors associated with vaccination …

Modeling The Transmission Dynamics Of Tuberculosis In Humans, Farida Kisinda, Joshua A. Mwasunda, Mbwiga S. Aloni

Tanzania Journal of Science

Tuberculosis (TB) is a major threat to human health particularly in most of developing countries. In this article, we formulate and analyze a deterministic model for the transmission dynamics of pulmonary and extra-pulmonary tuberculosis. The next generation method is employed to find the basic reproduction number which helps to determine whether TB clears or persists in the human population. Global stability of model equilibria is done through Lyapunov functions whereas the normalized forward sensitivity index method is adopted to determine parameters that drive tuberculosis. Analysis shows that both TB free and endemic equilibria exist. The TB free equilibrium is globally …

Relationship Of Stress And Other Factors With Emotional Eating Among Adolescents In Depok, Muthia Syifa Rahmadina, Asih Setiarini

Indonesian Journal of Public Health Nutrition (IJPHN)

Emotional eating is an overeating behavior as a coping mechanism for negative emotions that emerges in adolescence. Emotional eating causes obesity, eating disorders, and non-communicable diseases. This study aims to determine the relationship between stress, body image, peer influence, parental rearing styles, social media use, sex, sleep quality, and emotion regulation with emotional eating among adolescents at senior high school in Depok. This cross-sectional quantitative study was conducted online in March 2022. The samples were grade X and XI students from senior high school in Depok who were chosen by using purposive sampling techniques (n=174). Chi X2 test and Mann …

Covid-19 Vaccine Perception And Hesitancy Among Uninsured Free Clinic Patients, Samin Panahi, Brenda Spearman, Justine Sundrud, Mason Lunceford, Akiko Kamimura

Patient Experience Journal

There are many complexities regarding the acceptance of COVID-19 vaccines, mainly because the COVID-19 vaccine had a fast track of development compared to vaccines developed in the past years. The purpose of this study is to understand COVID-19 vaccine perception and hesitancy among uninsured free clinic patients using the theory of planned behavior. This study had seven focus groups with 37 total participants, including 19 Spanish speakers. Free clinic adult patients (over the age of 18) participated in four focus groups during Summer of 2021. The average age of the participants was 44.7, and the majority of the participants self-identified …

The Evolution Of Patient Experience: From Holistic Care To Human Experience, Corey Adams, Reema Harrison, Jason A. Wolf

Patient Experience Journal

Patient experience has evolved as a critical concept and outcome in health systems internationally. Evolving from consumer-led movements, coupled with shifts in the positioning of patients among clinical professions, the global focus on patient experience is now evident in nationally mandated measurement tools, the creation of dedicated institutional leadership roles, and outlets such as the Patient Experience Journal. By critically analysing the pivotal factors and milestones that have shaped its evolution throughout healthcare history, this review provides an in-depth exploration of the evolution of patient experience. In doing so, the review provides a critical analysis of the application of patient …

A Comparative Analysis Of Agile Vs. Traditional Project Management Methodologies In Healthcare App Development, Kruti Calcuttawala

Harrisburg University Dissertations and Theses

This study examined the effectiveness of Agile and traditional project management methodologies in developing healthcare apps. While traditional approaches like the waterfall model were commonly used in healthcare IT, their inflexibility could impede app development. Agile methodologies, with their iterative approach and collaborative nature, offer a potential solution. The study assessed both methodologies by comparing their project duration, budget, user satisfaction, and success rates and provided recommendations to optimize healthcare app development processes. It also identified the strengths and weaknesses of each methodology and their suitability for different scenarios. This study used a quantitative approach to analyze data by conducting …

Feasibility And Acceptability Of A Community Health Worker Administered Behavioral Activation Intervention For Postpartum Depression: A Single Arm Pilot Study From India, Amy Szajna, Bheemsain Tekkalaki, Veereshkumar Nandagaon, Gururaj Udapi, Manjunath Sogalad, Shweta Dandagi, Uma Kole, Sushma Patil, Sudha Raddi, Vanessa Short, Patricia Kelly

College of Nursing Faculty Papers & Presentations

INTRODUCTION: Women in India experience high rates of postpartum depression (PPD), with minimal availability of screening or treatment. India has an extensive network of community health workers, known as accredited social health activists (ASHAs). While they are knowledgeable about most maternal-child health problems, they have minimal knowledge about PPD. We trained ASHAs to deliver a simple home-based intervention, behavioral activation (BA), which involves individuals in activities that are sources of positive reinforcement to counter depression. The research questions guiding this study were as follows: 1) What are the feasibility and acceptability of ASHAs screening for and delivering a brief behavioral …

Family Physicians And Menstrual Care: An Analysis Of Cera 2023, Allison Casola, Olivia Rea, Tiffany Ho

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Menstrual health is an important indicator of overall health and has large impacts on quality of life. Despite number and impact, discussion of menstruation remains largely taboo within health care. Patients and physicians are not engaging in regular, meaningful discussions on menstruation. Family physicians, as primary care providers, can facilitate these important conversations.

OBJECTIVES: We sought to understand the profile of menstrual care providing family physicians and assessed physician comfort, knowledge, training, and perceived importance regarding menstrual care.

DESIGN/METHODS: This is a cross-sectional analysis of the 2022 Council of Academic Family Medicine Educational Research Alliance survey. The survey included …

Reproductive Justice In Mississippi: A Call For Reform And Acknowledgement, Andie Udziela

Honors Theses

In this thesis, I apply the values of the Reproductive Justice Movement to reproductive healthcare resources in Mississippi to advocate for reproductive policy reform. I begin by navigating the historic racial discrimination in gynecology and how it manifested in Mississippi. Dr Sim’s abusive experimentation on Anarcha, Betsy, and Lucy depict how Anti-Black racism took root in gynecology and obstetrics and was later expanded on by the eugenic goals of white supremacy and the feminist movement through Margaret Sanger and the Mississippi Appendectomy. Then I discuss the current availability of reproductive care in Mississippi to low-income individuals to emphasize socioeconomic and …

Maternal Depression And Phone Use Around Their Children: A Phone Tracking And Daily Survey Study, Brandon T. Mcdaniel Phd, Brooklyn Coleman, Victor P. Cornet Ms, Lauren Reining, Rebecca Tegiacchi, Zachary Kaiser

Health Services and Informatics Research

Previous research has connected phone use with mood and depressive symptoms but has typically relied on self-report measures of phone use. The current study examined the potential connection between objectively tracked phone use and self-reported depressive symptoms among 42 U.S. mothers with a young child (M age = 2.34 years). Their phone use was measured continuously for 5 days via an app installed on their smartphones, and mothers also completed a nightly survey each day. Mothers spent an average of 4.73 hours on their phone each day (SD = 2.87; Range = 0.70 - 13.59), and maternal phone use occurred …

Positive Epidemiology, Revisited: The Case For Centering Human Rights And Economic Justice, Farah Qureshi, Christy Denckla, Julia K. Boehm

Psychology Faculty Articles and Research

In recent years, a growing body of research in positive epidemiology has sought to expand the traditional focus of epidemiologic research beyond risk factors for disease and towards a more holistic understanding of health that includes the study of positive assets that shape well-being more broadly. While this paradigm shift holds great promise for transforming people’s lives for the better, it is also critiqued for showcasing decontextualized perspectives that could cause great harm to the public’s health if translated uncritically into population-based interventions. In this commentary, we argue for orienting positive epidemiology within a human rights and economic justice framework …

Assessing Socioeconomic Patterns Of Excessive Alcohol Consumption In Ohio: A County-Level Analysis, Tate Barney, Dev Patel

Scholarship in Medicine - All Papers

Background: Excessive alcohol consumption poses significant public health challenges, with complex socioeconomic factors influencing drinking behaviors. Understanding the relationship between socioeconomic determinants and excessive drinking patterns at the state and county levels is crucial for informing targeted interventions. Objective: To investigate the associations between excessive drinking (binge or heavy drinking) and socioeconomic factors, including median household income, mental health provider availability, health insurance coverage, educational attainment, and unemployment rates across counties in Ohio. Methods: We analyzed data from the 2023 County Health Rankings for 88 counties in Ohio. Spearman correlations were used to assess associations between excessive drinking and socioeconomic …

Aspects Of Pharmaceutical Networks, Hannah Rita Joseph, Afia L. Rahaman, Kaya Wilson

ENGL 1102 Showcase

The theme of our anthology is different drugs and processes of drug usage in the result how the various aspects of the pharmaceutical companies. We analyze the quality of health that Americans receive from certain parts of the health care industry. We have focused on informing and analyzing the increase of insulin prices, and how that affects Americans everyday lives. The delivery methods of medical cannabis, how each method is effective, and how they are administered. As well as pharmaceutical scams and how it affects elderly people, who rely on medication.

Attitude And Attitudinal Structures Toward Physical Education And Their Influences On Physical Activity Behavior, Yubing Wang, Yaogang Han, Pan Li, Binn Zhang

International Journal of Physical Activity and Health

Objectives: The purpose of this study was to examine middle and high school students’ cognitive and affective attitude and their cognitive-affective attitudinal structures toward physical education (PE). The effects of cognitive and affective attitude and attitudinal structures on physical activity (PA) in PE and outside of school were also examined. Methods: 1773 Chinese middle and high-school students participated in this study. SEM, Chi-square test, ANOVAs, and Contingency tables were adopted to address the research questions. Results: The results showed that most students (>90%) were holding positive cognitive and affective attitude toward PE. Students’ affective attitude significantly influences their PA …

Impact Of Empathic Concern On Prosocial Behavior In Gain And Loss Contexts: Evidence From Event-Related Potential, Xi Luo, Taowen Yu, Min Tan, Yiping Zhong

Faculty, Staff and Student Publications

This study employs event-related potential (ERP) to examine the impact of empathic concern on prosocial decision-making with costs in both gain and loss contexts. In this experiment, participants can choose between two types of lottery tickets and pay lottery money to help the target person gain more money or lose less money. The behavioral results showed that regardless of the context of the decision (financial loss or gain), participants tended to help individuals who had induced high empathic concern. ERP results show that compared to the low-empathic-concern condition, the high-empathic-concern condition induced greater P3 amplitude in the gain context. However, …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

Implementation Of Psychiatric Collaborative Care Management In Rural Primary Care Practices, Ryan Dean Kruis

MUSC Theses and Dissertations

Behavioral health (BH) disorders are highly prevalent in the United States and especially concerning in rural communities which disproportionately lack access to BH services. While models for integrating BH into primary care, such as psychiatric collaborative care management (CoCM), have shown promise in mitigating the BH crisis, implementation in rural communities has proved challenging.
This dissertation examines implementation of CoCM nationally and in rural settings through three distinct aims. First, a claims-based retrospective cohort study was used to determine whether commercially insured patients receiving CoCM had lower acute BH care utilization and cost as compared to similar patients not receiving …