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Integrating Health Equity Into Implementation Science To Advance Chronic Disease Prevention And Control, Callie Walsh-Bailey

Brown School Graduate Student Theses and Dissertations

Marginalized populations are inequitably burdened by chronic diseases such as diabetes, heart disease, obesity, and cancer. The goal of health equity work is to ensure all people have a fair and just opportunity to achieve optimal health. Implementation science has made health equity a greater focus and priority in recent years. There has been a proliferation of guidance on what implementation science needs to do to advance equity. However, the field currently lacks specific, actionable guidance on how to integrate equity. The overarching goal of this dissertation is to synthesize conceptual and theoretical underpinnings regarding health equity and bring them …

Risk For Diagnosis Or Treatment Of Mood Or Anxiety Disorders In Adults After Sars-Cov-2 Infection, 2020–2022, Christina X. Wang, Rhea Kohli, Veronica R. Olaker, Pauline Terebuh, Rong Xu, David C. Kaelber, Pamela B. Davis

Faculty Scholarship

COVID-19 is associated with increased risks for mood or anxiety disorders, but it remains uncertain how the association evolves over time or which patient groups are most affected. We conducted a retrospective cohort study using a nationwide database of electronic health records to determine the risk of depressive or anxiety disorder diagnoses after SARS-CoV-2 infection by 3-month blocks from January 2020 to April 2022. The study population comprised 822,756 patients (51.8% female; mean age 42.8 years) with COVID-19 and 2,034,353 patients with other respiratory tract infections (RTIs) (53.5% female, mean age 30.6 years). First time diagnoses of depressive or anxiety …

Self-Efficacy, Grit, And Rural Career Aspirations Among Early Career Nurses: A Repeated Cross-Sectional Study, Daniel Terry, Blake Peck, Ed Baker, David Schmitz

Public and Population Health Faculty Publications and Presentations

Background Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession.

Methods As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18–24 months after graduating, and 32 participants (response …

The Hiv/Aids Epidemic In Miami: Perspectives Of Stakeholders And Frontline Providers, Tracy Pugh, Carrigan L. Parish, Pedro C. Castellon, Allan Rodriguez, Michael A. Kolber, Lisa R. Metsch

Florida Public Health Review

Background: Miami, Florida persists as an epicenter of HIV/AIDS nationally and has been more delayed than other areas with high HIV burden in implementing public health measures that mitigate transmission risk. These issues among other social and structural-level determinants have complicated progress in addressing HIV/AIDS in Miami.

Purpose: The stagnated progress in improving HIV outcomes in Miami necessitated a more comprehensive understanding of the experiences and insights of stakeholders within the system. We used a stakeholder analysis approach to understand the complexity of driving factors and key challenges facing this HIV epidemic.

Methods: A stakeholder analysis was conducted …

Treatment Strategies For Metabolic Associated Fatty Liver Disease (Mafld) In Childhood: A Systematic Review, Anthony Alanis, Alisha Valdez, Hector Rivera-Marrero, Joshua Membreno, Isabel Omaña-Guzman, Marisol Rosas-Diaz, Yoscelina Estrella Martínez-López, Esperanza Milagros Garcia-Oropesa, Nayely Garibay-Nieto, Alejandra Bustamante, Octelina Castillo-Ruiz, Beatriz Tapia, Leonel Vela, Kathleen V. Carter, Juan Carlos Lopez-Alvarenga

Research Symposium

Introduction: Obesity is associated with various metabolic conditions, but the impact differs between children and adults. Our previous research has demonstrated that children may exhibit reversibility in biochemical features, while experiencing less response in terms of anatomical damage. Metabolic Associated Fatty Liver Disease (MAFLD) is a condition that necessitates urgent treatment during childhood to mitigate future complications, such as worsening chronic inflammation and increased predisposition to diabetes, hypertension, or endothelial damage. In this study, we aim to evaluate the main clinical interventions (including drugs, behavioral treatments, nutrition programs, and traditional medicine) that effectively reduce MAFLD in children with obesity. …

Self-Efficacy Of Urban African Americans In Response To Covid-19 Health Information, Katrina Volbrecht

Walden Dissertations and Doctoral Studies

No abstract provided.

Knowledge, Attitudes, And Subjective Norms Associated With Covid-19 Vaccination Among Pregnant Women In Kenya: An Online Cross-Sectional Pilot Study Using Whatsapp, Sylvia Ayieko, Walter Jaoko, Rose Okoyo Opiyo, Elkanah Omenge Orang'o, Sarah E Messiah, Kimberly Baker, Christine Markham

Faculty, Staff and Student Publications

COVID-19 vaccination during pregnancy has been recommended, but the perceptions related to uptake remain unexplored. This pilot study aimed to explore how perceptions influence COVID-19 vaccine uptake among a sample of 115 pregnant women in Kenya, recruited via WhatsApp. Data were collected using an adapted online questionnaire between May and October 2022. Logistic analyses assessed the relationship between COVID-19 vaccination uptake and the Theory of Reasoned Action (TRA) constructs: attitudes and subjective norms. COVID-19 vaccination coverage was 73%, with vaccine hesitancy estimated at 41.4% among the unvaccinated group. Most participants had completed college education and had good knowledge of COVID-19 …

Covid-19 And Burnout Among Community Pharmacists In The West Bank – Palestine, Amjad H. Bazzari, Firas H. Bazzari

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

The coronavirus disease 2019 (COVID-19) pandemic had a strong impact on the physical and mental well-being of healthcare workers. However, the focus has been directed towards nurses and physicians compared to pharmacists. Here, the researchers investigated the prevalence of burnout among community pharmacists in the West Bank – Palestine during the pandemic and the associated COVID-19 factors. The study was conducted using a written questionnaire and the sample included a total of 70 pharmacists. The results showed a burnout prevalence of 45.7% with work-related burnout having the highest impact on both males (50%) and females (54.8%). The level of burnout …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

Antibiotic Use, Obesity, And Preterm Birth Among Women In The United States, Mya Thuzar Win

Walden Dissertations and Doctoral Studies

No abstract provided.

Pastoral Leaders’ Perception Of Obesity And Their Role Within Faith-Based Organizations, Darren D. Moore, Clinton E. Cooper, Charles Williams

The Qualitative Report

The purpose of this study was to explore the perspectives of pastoral leaders regarding obesity and health within faith-based organizations (FBOs). In this study, the authors focused on gaining additional insight regarding how pastoral leaders conceptualize and make sense of their roles in terms of health promotion within FBOs. Utilizing a qualitative research methodological approach, specifically Qualitative Description, authors administered a qualitative survey to 12 participants which yielded three emerging themes: (1) perceived scope, (2) understanding and use of resources, and (3) defining obesity through pastoral leaders’ perspectives. In the study, investigators discuss clinical implications and provide recommendations.

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Determining The Feasibility Of A Codesigned And Personalised Intervention (Veg4me) To Improve Vegetable Intake In Young Adults Living In Rural Australian Communities: Protocol For A Randomised Controlled Trial, Katherine M. Livingstone, Jonathan C. Rawstorn, Stephanie R. Partridge, Yuxin Zhang, Eric O, Stephanie L. Godrich, Sarah A. Mcnaughton, Gilly A. Hendrie, Kate Dullaghan, Gavin Abbott, Lauren C. Blekkenhorst, Ralph Maddison, Scott Barnett, John C. Mathers, Laura Alston

Research outputs 2022 to 2026

Introduction:

Diets low in vegetables are a main contributor to the health burden experienced by young adults in rural communities. Digital health interventions provide an accessible delivery model that can be personalised to meet the diverse preferences of young adults. A personalisable digital vegetable intake intervention (Veg4Me) was codesigned to meet the needs of young adults living in rural communities. This study will determine the feasibility of delivering a personalised Veg4Me programme and compare preliminary effects with a non-personalised Veg4Me (control).

Methods and Analysis:

A 12-week assessor-blinded, two-arm, parallel randomised controlled trial will be undertaken from August 2023 until April …

Proceedings Of The 23rd International Conference Of Public Health Sciences

Journal of Health Research

Chulalongkorn University aims to be a prominent national institution with global recognition. Its primary focus is on producing knowledge and innovation that are crucial for the creative and sustainable development of Thai society. To achieve this vision, the university consistently provides support to all of its faculties, institutes, colleges, and other entities in carrying out a range of academic activities, including in-class teaching, research, and conferences, such as the one we are gathered for today. With a primary focus on graduate-level teaching in the field of public health and public health sciences, the College of Public Health Sciences is a …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Association Of Depression With Myocardial Infarction With Non-Obstructive Coronary Arteries: A Systematic Review, Sarim Rashid, Khawaja Usama Maqbool, Umer Hassan, Subhan Ahmed, Hamayle Saeed, Fnu Avanteeka, Syed Muhammad Jawad Zaidi, Jahanzeb Malik, Amin Mehmoodi

Journal of Community Hospital Internal Medicine Perspectives

This systematic review examined the association between depression and myocardial infarction with non-obstructive coronary arteries (MINOCA). A comprehensive literature search was conducted using electronic databases, resulting in the inclusion of six small case-control and cohort studies reported from Spain, Australia, China, and Pakistan. The studies included various study designs, such as cohort studies, case-control studies, and prospective cohort studies. The results of the systematic review indicate a significant association between depression and MINOCA. Several studies reported a higher prevalence of depression among MINOCA patients compared to those with obstructive coronary artery disease. Additionally, depression was found to be associated with …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Challenges And Promising Solutions To Engaging Patients In Healthcare Implementation In The United States: An Environmental Scan, Eva N. Woodward, Andrea Isabel Castillo, Gala True, Cathleen Willging, Joann E. Kirchner

School of Medicine Faculty Publications

BACKGROUND: One practice in healthcare implementation is patient engagement in quality improvement and systems redesign. Implementers in healthcare systems include clinical leadership, middle managers, quality improvement personnel, and others facilitating changes or adoption of new interventions. Patients provide input into different aspects of health research. However, there is little attention to involve patients in implementing interventions, especially in the United States (U.S.), and this might be essential to reduce inequities. Implementers need clear strategies to overcome challenges, and might be able to learn from countries outside the U.S. METHODS: We wanted to understand existing work about how patients are being …

Examining The Effects Of Manualized Suicide Intervention Training On Clinical Psychology Doctoral Trainees: A Quasi-Experimental Trial, Alexander Dorfman M.S.

Selected Full Text Dissertations, 2011-

Although most clinical psychology doctoral trainees encounter at least one suicidal client over the course of their training (Dexter-Mazza & Freeman, 2003), there is notable variability in the degree of formal suicide risk assessment and intervention training offered across clinical psychology doctoral programs (Monahan & Karver, 2021). Most suicide-related training involves passive (e.g., lectures) rather than active (e.g., role-plays, experiential exercises) training techniques, despite evidence for the effectiveness of the latter in improving clinicians’ skills (Gryglewicz et al., 2020). The Applied Suicide Intervention Skills Training (ASIST) is a manualized, evidence-based training incorporating didactics and role-plays (LivingWorks, 2013; Rodgers, 2010). The …

The Impact Of Permit Concealed Carry And Social Factors On Firearm Fatalities, Witty Kwok, Jacob Weaver

Scholarship in Medicine - All Papers

A tragic amount of gun fatalities occur in today's world. These fatalities can be from acts of aggression, negligence, or accidental, but nonetheless are taking lives at an alarming rate. There has been a call to action to make changes and begin combating these issues, with the most commonly proposed solution being firearm regulation. This study aimed to assess the effectiveness of firearm legislation, specifically of concealed carry regulations, on controlling firearm fatalities while also attempting to identify underlying causes or predictors of firearm fatalities. In an attempt to simplify the many regulations implemented differently between states, this study looked …

Practice Patterns And Medical Provider Perceptions Of Ketamine In The Treatment Of Psychiatric Disorders: A Nationwide Survey, Amna M. Aslam

Theses and Dissertations

Background: Major Depressive Disorder (MDD) significantly impacts society, with a prevalence of 8.4% in the U.S., highlighting the need for effective treatments for treatment-resistant depression (TRD). Ketamine, while not FDA-approved for TRD, shows promise in treating mental health disorders and is used in specialized clinics, though evidence of effectiveness is scarce. Objectives: This study investigates the use of off-label ketamine for TRD and other disorders, focusing on ketamine clinic operations where the drug is administered, treatment methods, patient characteristics, and ketamine's impact on psychiatric care, from providers' perspectives. Methods: The survey was distributed to over 1,000 ketamine providers across the …

Exploration Of Associations Between Asthma And Depression In Older American Adults: A Pooled Cross-Sectional Analysis Of Medicare Recipients, Brian Ring

Graduate Research Theses & Dissertations

Background

While unclear in older populations within the US, individuals with asthma are disproportionally affected by depression relative to those without asthma. This work explores the associations between asthma, depression, sociodemographic, and disease-related factors in a US population ≥ 65 years of age.

Methods

A pooled cross-sectional analysis of Medicare Current Beneficiary Survey (MCBS) data was utilized to determine the association between asthma and depression from 2018 to 2020. Depression was defined as a score of ≥ 10 from the Patient Health Questionnaire-9 (PHQ-9). Disease-related variables were recorded if the subject met Medicare claims criteria for the calendar year. Multivariable …

Addressing The Big Picture As A Community-Engaged Linguist: Community-Engaged Scholarship And Applied Learning For Systemic Change, Rachel E. Showstack

International Journal of the Linguistic Association of the Southwest

Through a narrative about the formation and advancement of Wichita State University’s community-based health equity initiative Alce su Voz (‘Speak Out’), this article presents a reflection on the author’s role as a community-engaged scholar and the multiple levels of work in which linguists can engage to support linguistic social justice. The paper begins with a discussion of the role of the applied linguist in social change and a discussion of community-engaged scholarship, including community-based learning and community-based research. Then, using Alce su Voz’s approach to improving health equity for speakers of Spanish and Indigenous languages as an example, the author …

Pediatric Vaccination Adherence: Enhancing Compliance Among First-Generation Asian American Parents, Katelyn Leong

Nursing | Senior Theses

Background: Vaccine adherence in the pediatric population refers to receiving vaccines as per the recommended schedule, which significantly reduces vaccine-preventable diseases and enhances community immunity. Vaccine hesitancy, driven by concerns such as safety, misinformation, or cultural beliefs can affect adherence. National coverage of state-mandated vaccines among kindergarteners declined from 95% to around 93% between 2019 and 2022, varying across different vaccines. Objective: This research proposal’s focus is to determine if an educational intervention targeting first-generation Asian Americans, who have adopted their immigrant parents' misinformation about vaccines, will effectively increase vaccination rates among their children. The study aims to assess the …

The Effects Of Adverse Childhood Experiences And Racism On The Risk For Poor Birth Outcomes In Women Of Color, Audrey Hermosura

Nursing | Senior Theses

Background: Adverse childhood experiences, or ACEs, are traumatic challenges experienced before the age of 18. These adversities have lifelong effects on physiologic and mental health. A relationship has been made between the number of ACEs and occurrences of poor birth outcomes. The toxic stress that accumulates from ACEs compounded by racism increases the risk for poor birth outcomes in women of color. Understanding the importance of screening for these events can mitigate the negative effects on women’s health during and after gestation. Purpose: This current paper, in addition to a literature review, proposes a research design to validate the feasibility …

Food Accessibility Struggles For College Students With Dietary Restrictions, Ella Schleuning

Mahurin Honors College Capstone Experience/Thesis Projects

College is a time when many students experience independence for the first time in their lives. This is the first time they have had to do their laundry on their own, keep their room clean, and maybe most importantly, they are responsible for figuring out where they are going to eat every day, for every meal. The focus of this study is on food accessibility struggles for college students, specifically looking at Western Kentucky University’s (WKU) food on-campus, as well as students with dietary restrictions.

Since college is the first-time students are responsible for their own meals, it can often …

The Relative Impacts Of Peer Disapproval, Parental Disapproval, And Perceptions Of Risk On Adolescent Marijuana Use, Sean P. Varano, Pamela Kelley, Laurie Becker

Justice Studies Faculty Publications

Adolescent drug use has consistently been a concern for researchers and policymakers for decades as its early onset and continued use can lead to a variety of negative life outcomes. Concerns related to marijuana use have emerged in recent years as states have begun to change laws regarding recreational cannabis use. The current study uses data from a cohort of students in Massachusetts to understand how these changes may impact marijuana use. Findings from this study suggest that nearly three years after the first recreational marijuana retail center opened, the protective features of parental norms toward marijuana use may no …

Doulas In Modern Health Care, Gabriella J. Lawrence

Soaring: A Journal of Undergraduate Research

This paper looks into whether the implementation of doulas by all hospitals would benefit mothers before, during, and after childbirth. Through previous research it is shown how traumatizing birth can be for mothers who don't feel that they have control within the labor and delivery room. High rates of augmentation, epidural anesthesia, and cesarean sections within hospitals are all causes of postpartum anxiety and depression among new mothers. By researching who a doula is and what they can do for mothers during childbirth, we can get a better understanding on how to prevent mental health disorders that are caused by …

Climate Change And Mental Health: An Interactive Educational Session, Andrea Costin, Daniel Fisher, Bethany Harper, Ramzi W. Nahhas, John Sullenbarger

Population and Public Health Sciences Faculty Publications

Introduction: Climate change is the single biggest health threat facing humanity, with direct and indirect impacts on mental health, yet health impacts of climate change remain notably absent from most medical school curricula. We describe a timely interactive educational session on climate change and mental health that was implemented and studied on a medical student clinical psychiatry rotation. Methods: We developed a 1-hour introductory session on the mental health impacts of climate change and potential solutions. The session was delivered to third-year medical students on their 4-week clinical psychiatry rotation and included pre- and postsession survey questions assessing their knowledge, …

Understanding Social Dynamics In Toxic Conversations And Public Health Intervention Acceptance On Social Media, Ana Aleksandric

Computer Science and Engineering Dissertations - Archive

Social media is now central to daily life, offering users a space to share content and opinions. However, these platforms also facilitate the spread of hate speech and misinformation, which can negatively impact public health. This dissertation develops methodologies to analyze social media data for insights that could inform health interventions. The research first examines user responses to toxic content, focusing on behavioral and emotional reactions, as well as group dynamics and bystander effects in toxic interactions. Another key focus is public opinion toward health interventions, particularly COVID-19 vaccination, using geolocated posts and analyzing factors such as race, ethnicity, and …