Digital Commons Network^™

Association Between Socioeconomic Status And Mental Health Among China’S Migrant Workers: A Moderated Mediation Model, Yubo Shao, Huang Ying, Xiaoming Li Ph.D., Lian Tong

Faculty Publications

Mental health problems are prevalent among China’s internal migrant workers. However, research on the relationship between socioeconomic status (SES) and mental health is insufficient. Therefore, this study, utilizing the China’s National Dynamic Monitoring Survey data from a sample of 15,997 migrant workers aged 15–59 years to explore differences in the relationship between migrants’ objective and subjective SES and mental health status in 2015. Both the mediating effect of perceived interpersonal discrimination and the moderating effect of age were examined through structural equation modeling. The results indicated that subjective SES has a stronger direct relationship with mental health than objective SES. …

Where Have All The Flowers Gone? A Multicenter Investigation Of Frequent Users Of Midwest Emergency Department Services During The Covid-19 Stay-At-Home Orders., Howard W Levitin, Bruce G Jones, Marie M Lockhart, Christopher M Lloyd, Meenal D Sharkey, Paul A Willette, Andrew F Kalnow

Ambulatory and Primary Care Articles

INTRODUCTION: In this study we aimed to determine the impact of the mandatory coronavirus disease 2019 (COVID-19) pandemic stay-at-home order on the proportional makeup of emergency department (ED) visits by frequent users and super users.

METHODS: We conducted a secondary analysis of existing data using a multisite review of the medical records of 280,053 patients to measure the impact of the COVID-19 pandemic stay-at-home order on ED visits. The primary outcomes included analysis before and during the lockdown in determining ED use and unique characteristics of non-frequent, frequent, and super users of emergency services.

RESULTS: During the mandatory COVID-19 stay-at-home …

Geographic Proximity To Primary Care Providers As A Risk-Assessment Criterion For Quality Performance Measures, Nathaniel Bell, Ana Lopez-De Fede Ph.D., Bo Cai Ph.D., John Brooks Ph.D.

Publications

Importance Previous studies have found a mixed association between Patient-Centered Medical Home (PCMH) designation and improvements in primary care quality indicators, including avoidable pediatric emergency department (ED) encounters. Whether these associations persist after accounting for the geographic locations of providers relative to where patients reside is unknown. Objective To examine the association between geographic proximity to primary care providers versus hospitals and risk of avoidable and potentially avoidable ED visits among children with pre-existing diagnosis of attention-deficit/hyperactivity disorder or asthma. Methods Retrospective cohort study of a panel of pediatric Medicaid claims data from the South Carolina from 2016–2018 for 2,959 …

Two Mental Models Of Integrated Care For Advanced Liver Disease: Qualitative Study Of Multidisciplinary Health Professionals, Jennifer Arney, Caroline Gray, Anne M Walling, Jack A Clark, Donna Smith, Jennifer Melcher, Steven Asch, Fasiha Kanwal, Aanand D Naik

Faculty, Staff and Student Publications

OBJECTIVES: The purpose of this paper is to present two divergent mental models of integrated advanced liver disease (AdvLD) care among 26 providers who treat patients with AdvLD.

SETTING: 3 geographically dispersed United States Veterans Health Administration health systems.

PARTICIPANTS: 26 professionals (20 women and 6 men) participated, including 9 (34.6%) gastroenterology, hepatology, and transplant physicians, 2 (7.7%) physician assistants, 7 (27%) nurses and nurse practitioners, 3 (11.5%) social workers and psychologists, 4 (15.4%) palliative care providers and 1 (3.8%) pharmacist.

MAIN OUTCOME MEASURES: We conducted qualitative in-depth interviews of providers caring for patients with AdvLD. We used framework analysis …

Attitudes Toward Influenza, Pertussis, And Covid-19 Vaccines Among Economically Underserved Black Women/Birthing People: A Mixed-Methods Approach, Jasmine Cooper, Hanna Lebuhn, James D. Campbell, Stacey Stephens, Wendy G. Lane, Keerthana Kumar, Kathleen M. Neuzil

Journal of Health Disparities Research and Practice

Vaccination during pregnancy is critical to the health of birthing persons and infants. Yet, persistent racial disparities in vaccination threaten health outcomes in the U.S. (Lu et al., 2015). Vaccination coverage remains low among non-Hispanic Blacks and other racial minorities – a situation magnified by the COVID-19 pandemic (Freimuth, Jamison, An, Hancock, & Quinn, 2017; Stokes et al., 2020). Consequently, understanding vaccine attitudes for systemically disadvantaged groups is paramount to promoting public health. Illuminating barriers to vaccine uptake creates space for new strategies to reduce hesitancy.

To investigate Black women’s/birthing people attitudes toward influenza and pertussis vaccination during pregnancy, we …

Inspire Yourself: Volunteer!, Judith Sullivan

Journal of Transformative Touch

Doing volunteer short Zero Balancing sessions once a month for 13 years for staff, volunteers and sometimes "guests" at The Haven, a a multi-resource day shelter in downtown Charlottesville, Virginia supports the community in many ways.

Evaluation Of The Control Of Water Sanitation And Hygiene Related Disease Through Community Hygiene Club Intervention In Rwanda, Amans Ntakarutimana, Elias Nyandwi, Nadine Rujeni, Chantal Marie Ingabire Dr, Kato Jonas Njunwa, Théoneste Ntakirutimana, Gaspard Rwanyiziri, Joseph Tuyishimire, Schaddrack Ngabonziza

Journal of Social, Behavioral, and Health Sciences

This article consists of a review article reporting the results of previous evaluations of the control of water, sanitation, and hygiene (WASH) related disease through the Community Hygiene Club (CHC) intervention from 2010 to 2020. CHC constitutes the main intervention for the control of WASH-related disease in Rwanda and is implemented countrywide. The study objective was to evaluate if the CHC intervention significantly reduced the prevalence of WASH-related disease after 10 years of its implementation in Rwanda. The study utilized online existing policy documents, research reports, and experiences on the CHC intervention in Rwanda published between 2010 and 2020. We …

Are Women With Disabilities Less Likely To Utilize Essential Maternal And Reproductive Health Services?-A Secondary Analysis Of Pakistan Demographic Health Survey, Shafaq Mahmood, Waqas Hameed, Sameen Siddiqi

Community Health Sciences

Background: People with disabilities deal with widespread exclusion from healthcare services, including sexual and reproductive health (SRH) rights. Studies analyzing the relationship between disability and key SRH utilization outcomes have often reported mixed findings. In Pakistan, very little to no literature is available on this topic, therefore we aim to determine inequalities in the utilization of essential maternal and reproductive health services between women with and without disabilities in Pakistan.
Methods: This was a secondary analysis of Pakistan Demographic Health Survey 2017-18 performed on a weighted sample of 6,711 women aged 15-49 years with a live birth in the 5 …

The Need For Sexual Health Clinics, Their Future Role, And Contribution To Public Health, Meena S. Ramchandani, Christopher Bourne, Lindley A. Barbee, Elske Hoornenborg, Preeti Pathela, Stephanie N. Taylor, Henry De Vries

School of Medicine Faculty Publications

Specialised sexual health clinics (SHCs) play an important role in addressing the staggering rates of STIs seen in many high-income nations. Despite increasing healthcare coverage in the US and nationalised health care in some countries, there is a continued need for SHCs to meet the needs of patients and the community, especially for high-priority populations: those at high risk of STI acquisition and/or groups historically marginalised and underserved in the traditional healthcare system. We need to mobilise resources to support a stronger clinical infrastructure in specialised SHCs. This review describes the importance of SHCs, their future role, and some of …

Trauma Exposures Across The Life Course For Individuals Who Experience Incarceration, Maria Morrison

Brown School Graduate Student Theses and Dissertations

The U.S. incarcerates more people than any other country in the world, with 2.2 million people currently behind bars, 60% of whom are people of color. At the same time, there is an unprecedented political consensus to develop strategies for reducing the incarcerated population and safely returning the majority of incarcerated individuals to society. While there has been a substantial research focus on the potential of this population to commit acts of violence post-release, this tells only half the story. This dissertation hopes to provide a more complete picture of the role of violence in the lives of individuals released …

The Cost Of Child Support: Policy Design And Father Identity, Lara Markovitz

Brown School Graduate Student Theses and Dissertations

Child support policy is one of the key forces in the lives of families in the U.S., where 1 in 4 children and half of African American children live apart from their fathers (Carlson et al., 2017; Grall, 2020; U.S. Census Bureau, 2014). Most unmarried fathers of newborns express a strong desire and commitment to their children (Carlson & McLanahan, 2002; England & Edin, 2007). However, by the time their children turn five, fathers'; involvement (caregiving and time, provision of child support) diminishes greatly (Turner & Waller, 2017). This decrease in father involvement among low-income NRFs is thought to be …

The Vulnerability Of A Poor Urban Neighborhood To Extreme Weather Disasters And The Role Of Ecosocial Work: The Case Of Tongja-Dong Jjokbang-Chon In Seoul, South Korea, Joonmo Kang

Brown School Graduate Student Theses and Dissertations

his study is an inquiry into the vulnerability of poor older adults living in the Tongja-dong jjokbang-chon, one of the last remaining informal settlements in Seoul, South Korea, to climate change-related disasters, particularly heat waves and cold waves; climate change’s impact on their livelihoods; and the role of social work in responding to these challenges. Even though the harsh living conditions and the sufferings of those living in jjokbang-chon residents during extreme weather is constantly highlighted in the media, there is a dearth of empirical research focusing on the vulnerabilities of marginalized communities living in jjokbang-chon to extreme weather and …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …

Moving Towards Justice: Reducing Encounters Of Preeclampsia In Adolescent Maternal Health, Shaunesse' Jacobs Plaisimond, George Hodulik, Molly Wilde

Journal of Health Disparities Research and Practice

Using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), several relationships were explored between nutrition and diet, likely attributed to education, culture, training, and habits around food. While these factors remain relevant and worth pursuing, data analysis implied that the most significant issue remaining is access to healthcare. Across race, age, and nutrition consumption, if pregnant people make higher incomes—inferring better access to healthcare and higher-quality nutrients, then their risk of preeclampsia is reduced. Accordingly, this paper performs an extensive literature review of the intersection of extreme maternal age and nutrient intake as a significant factor for preeclampsia. …

Community Based Rehabilitation Programs For Resettled Muslim Women Refugees, Lori Maria Walton Phd, Dpt, Mscpt, Mph(S), Renee Hakim, Phd, Pt, Ncs, Veena Raigangar, Phd(C), Mscpt, M.Ed., Jennifer Schwartz, Dpt, Ncs, Sjm Ummul Ambia, Mscpt, Najah Zaaeed, Drph, Lmsw, Bassima Schbley

Journal of Health Ethics

According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a …

“…You Can't Unknow It, It's A New Reality": A Case Study Exploring A Social Justice Public Health Intervention's Impact On Critical Consciousness Development In Youth., Monique Williams

Electronic Theses and Dissertations

Even though public health purports to be rooted in social justice, it is not clear how social justice frameworks are integrated in public health research and intervention. The discipline focuses on groups/populations on the margins, without integrating the social and political factors that cause marginalization into the intervention. Seeing communities, and individuals, as assets and experts in their own experiences is key to population-level health improvement. Particularly for public health youth intervention, how youth are labeled and engaged in social change is critical to their healthy development. While public health lags in practically applying asset-based approaches to youth intervention, research …

Estimating The Health Effects Of Adding Bicycle And Pedestrian Paths At The Census Tract Level: Multiple Model Comparison, Ross J. Gore, Christopher Lynch, Craig Jordan, Andrew Collins, R. Michael Robinson, Gabrielle Fuller, Pearson Ames, Prateek Keerthi, Yash Kandukuri

VMASC Publications

Background: Adding additional bicycle and pedestrian paths to an area can lead to improved health outcomes for residents over time. However, quantitatively determining which areas benefit more from bicycle and pedestrian paths, how many miles of bicycle and pedestrian paths are needed, and the health outcomes that may be most improved remain open questions.

Objective: Our work provides and evaluates a methodology that offers actionable insight for city-level planners, public health officials, and decision makers tasked with the question “To what extent will adding specified bicycle and pedestrian path mileage to a census tract improve residents’ health outcomes over time?” …

The Role Of Community Factors In Predicting Depressive Symptoms Among Chinese Workforce: A Longitudinal Study In Rural And Urban Settings, Wanlian Li, Guanghan Gao, Fei Sun, Lin Jiang

School of Social Work Faculty Publications

Background: The dual urban-rural division system in China has led to distinguishes in economic development, medical services, and education as well as in mental health disparities. This study examined whether community factors (community cohesion, supportive network size, foreseeable community threat, and medical insurance coverage) predict the depressive symptoms of Chinese workers and how community factors may work differently in rural and urban settings.

Methods: This secondary data analysis was conducted using data from the 2014 and 2016 China Labor-force Dynamics Survey (CLDS). The sample of this study includes 9,140 workers (6,157 rural labors and 2,983 urban labors) who took part …

Social Life Of Females With Persistent Covid-19 Symptoms: A Qualitative Study, Atefeh Aghaei, Ran Zhang, Slone Taylor, Cheuk-Chi Tam, Chih-Hsiang Yang, Xiaoming Li Ph.D., Shan Qiao Ph.D.

Faculty Publications

Persistent COVID-19 symptoms (long COVID) may bring challenges to long haulers' social lives. Females may endure more profound impacts given their special social roles and existing structural inequality. This study explores the effects of long COVID on the social life of female long haulers. We conducted semi-structured interviews via Zoom between April and June 2021 with 15 female long haulers in the United States, purposely recruited from Facebook and Slack groups and organization websites related to long COVID. Interviews were audio-recorded and transcribed verbatim with consent. The interview data were managed using MAXQDA and examined by thematic analysis. Long COVID …

Sars-Cov-2 (Covid-19) Vaccine Intentions In Kentucky, Kevin A. Pearce Md, Mph, Emily Messerli Dnp, Aprn, Mary E. Lacy, Brittany L. Smalls, Diane B. Francis, Sukruthi Yerramreddy, Marc Kiviniemi

Journal of Appalachian Health

Background: At the time of our writing, the COVID-19 pandemic continues to cause significant disruption to daily lives. In Kentucky, the burdens from this disease are higher, and vaccination rates for COVID-19 are lower, in comparison to the U.S. as a whole. Understanding vaccine intentions across key subpopulations is critical to increasing vaccination rates.

Purpose: This study explores COVID-19 vaccine intentions in Kentucky across demographic subpopulations and also investigates the influences on vaccine intention of attitudes and beliefs about COVID-19.

Methods: A population-based survey of 1,459 Kentucky adults was conducted between January 26 and March 20, 2021, with over-sampling of …

Congregational Leaders And Covid-19: Human Flourishing And Future Directions For Research, Isaac Voss

Essays

No abstract provided.

From Isolation To Connection: A Cross-Sectional Analysis Of Older Adults’ Social Participation Using The Cov19-Qol Scale, Kathleen Melei, Jill Linder

The Open Journal of Occupational Therapy

Background: Social isolation during COVID-19 has the capacity to impact older adults’ physical health, mental health, and quality of life. Using an occupational therapy perspective of social participation as an occupation, the current study explores (a) the extent to which social participation (habits/routines) has changed following the onset of the COVID-19 pandemic, (b) differences in perceptions of social participation in relation to the COVID-19 pandemic, and (c) differences in scores on the COVID-19 Quality of Life (COV19-QoL) scale by demographics, access to health care, and lifestyle routine.

Method: Community-dwelling adults (N = 230) 65 years of age or …

Social Determinants Of Health In Pulmonary Arterial Hypertension Patients In The United States: Clinician Perspective And Health Policy Implications, Vijay R. Nadipelli, Jean M. Elwing, Willie H. Oglesby, Karim El-Kersh

College of Population Health Faculty Papers

Social determinants of health (SDoH) can impact the vulnerable pulmonary arterial hypertension (PAH) population, especially during the COVID-19 pandemic. Providers' understanding of SDoH at the point of care and their impact is unknown. We conducted semi-structured virtual interviews with US clinicians at 17 pulmonary hypertension (PH) centers and one patient advocate from the Pulmonary Hypertension Association. We sought participants' perspective on SDoH in PAH and their impact. Transcripts were developed and analyzed for key themes to assess potential policy implications. Participants served a large PAH population and demonstrated high awareness of SDoH and its impact on treatment and outcomes. They …

Mothers’ Reflections On Cat Ownership For A Child With Autism Spectrum Disorder During Covid-19, Saskia Keville, Sophia De Vita, Amanda K. Ludlow

People and Animals: The International Journal of Research and Practice

Animal- assisted interventions are increasingly used as a complementary therapy in clinical practice to support people with autism spectrum disorder (ASD), with promising outcomes compared to traditional therapies. Less is understood about the therapeutic benefits of more accessible and affordable small pet ownership for families with a child with ASD, alongside the pets’ welfare living in these homes. This study explored the experiences of cat ownership for young people with ASD from the perspective of their mothers during a time of transition generated by COVID-19. Semi-structured interviews were conducted with six mothers and transcripts analyzed using reflexive thematic analysis. Three …

Development Of A Digital Health Capability Framework For Allied Health Practitioners: An Australian First, Nikki Littlewood, Sharon Downie, Abbey Sawyer, Kath Feely, Dhruv Govil, Brit Gordon

Internet Journal of Allied Health Sciences and Practice

Background: The value of digital health technologies and their contribution to high-quality and safe clinical care and enhanced health patient experience and outcomes is well established. Digital health technologies are increasingly being used by Victorian allied health professionals (AHPs) in routine service delivery, the uptake of which has been significantly accelerated by the impact of the coronavirus (COVID-19) pandemic. Objectives: This case study outlines the development of a capability framework to support Victorian AHPs, health services, other employers, and university training partners to measure and expand digital health capability at individual practitioner and workforce levels. Methods: A mixed-methods approach to …

Subject Cognitive Decline In Informal Caregivers, Eunika Simons

Theses and Dissertations

Purpose. The United States is experiencing unprecedented demographic shifts as the population continues to age. More than 53 million Americans are caregivers and that number is continuing to grow. Caregiving has become a significant societal and public health issue to be addressed. This study provided a population-based national perspective regarding informal caregivers to identify differences between caregivers reporting cognitive decline and those caregivers reporting no cognitive decline. The analysis explored the relationships between the type and characteristics of informal caregivers, the nature of the caregiving relationship, caregiver unmet needs, and the general, physical, and mental health-related outcomes of the caregivers. …

Telerounding: A Scoping Review And Implications For Future Healthcare Practice, Natasha N Ludwig, Amanda E Child, Dasal Tenzin Jashar, Allison J Mostow, Ericka L Wodka

Faculty, Staff and Student Publications

A diagnosis of autism spectrum disorder (ASD) provides access to interventions that are important for fostering development and improving quality of life. Thus, the timeliness of a diagnosis should not be limited by social-distancing limitations whenever possible. Despite this, clear guidance for transitioning autism diagnostic services to a telehealth model of care in the era of the COVID-19 pandemic is lacking. At our Institute, we have adapted our approach to ASD evaluation to promote continued access to evaluation services during this unprecedented time. The purpose of this case series is to provide examples of three different approaches to ASD differential …

The Quality Of Life Of Regional And Remote Cancer Caregivers In Australia, Belinda C. Goodwin, Fiona Crawford-Williams, Michael Ireland, Sonja March, Suzanne K. Chambers, Joanne F. Aitken, Jeff Dunn

Research outputs 2022 to 2026

Objective: This study compares the well-being of rural caregivers with that of the general population and explores the potential drivers of poorer outcomes. Method: Patient–caregiver dyads (n = 241) residing in regional or remote Queensland, Australia, reported on QoL, chronic illness, caregiver burden, depression, anxiety and stress. Caregiver outcomes were compared with population norms and patient outcomes. Multiple regressions were conducted to identify factors associated with poorer caregiver outcomes. Results: Caregivers reported lower mental health-related QoL (M = 0.436, 95% CI = 0.410–0.462) in comparison with age-matched population norms (M = 0.556, 95% CI = 0.532–0.580). No differences existed between …

Universities In And Beyond A Pandemic, Lily Kong, Sovan Patra

Research Collection School of Social Sciences

The impact of the COVID pandemic, and concomitant public health interventions, on university operations and finances is unprecedented in its scope and scale. This chapter provides, firstly, a panorama of the challenges of tertiary teaching and learning in a socially distanced world as well as of the fiscal impact of the pandemic on universities. Secondly, it is an experience-informed personal reflection on the lessons that university instructors, researchers, and leaders can learn from the events of the past year to be more effective in sub-optimal environments, both as individuals and as members of the larger society. Finally, it presents an …

Unearthing Historical Trauma To Advance Health Equity For Survivors Of Human Trafficking, Sandy Woo-Cater

HCA Healthcare Journal of Medicine

In the last decade, the public health field has grown a strong interest in responding to issues related to human trafficking. This specific concentration in healthcare has made efforts to ensure this work includes culturally appropriate tools to serve patients. While curricula to guide health professionals in areas such as cultural competency, cultural responsiveness, or cultural humility exist, historical trauma is not often integrated in the understanding of health outcomes for patients experiencing human trafficking. This paper asserts that advancing health equity for these patients necessitates a deeper historical perspective.