Digital Commons Network^™

Decreasing Influenza Vaccination Disparity Rates By Utilization Of Hotspot Deployments Of A Mobile Health Vehicle, Geneveve Deasis Tejada

Student Scholarly Projects

Practice Problem: Influenza vaccination for Black/African American patients is historically lower than White patients across all healthcare organizations (Quinn, 2018). In the organization’s 2022 performance, only 13.98% of Black/African American patients ages 19 and older were vaccinated compared to 27.81% of White/Caucasian patients.

PICOT: The PICOT question that guided this project was for Black/African American patients ages 19 and older receiving care from primary care clinics in Southeast San Diego (P), what is the impact of adding access to influenza vaccinations through hotspot-driven MHV deployments (I) compared to usual vaccination delivery in the medical office building (MOB) (C) on influenza …

Sub-Saharan Africa’S Handling Of Covid-19 Pandemic: Rwanda Versus Tanzania, Luke D. Baumel

Honors Undergraduate Conference

How has the Covid-19 outbreak in early 2020 and the pandemic that followed been handled in Sub-Saharan Africa? What was done well and what was done poorly and why? What are the implications of the way it was handled? These questions and more are answered throughout this paper, using Rwanda as an example of a Sub-Saharan African country who handled it relatively well and neighboring Tanzania as an example of a Sub-Saharan African country that mishandled the outbreak and pandemic. In early 2021, most Sub-Saharan African countries had been afflicted by Covid-19 at a relatively lower rate than many Western …

More Than Just A Number: Perspectives From Black Male Participants On Community-Based Interventions And Clinical Trials To Address Cardiovascular Health Disparities., Faith E Metlock, Sarah Addison, Alicia Mckoy, Yesol Yang, Aarhea Hope, Joshua J Joseph, Jing Zhang, Amaris Williams, Darrell M Gray, John Gregory, Timiya S Nolan

Ambulatory and Primary Care Articles

BACKGROUND: Black Americans remain significantly underrepresented and understudied in research. Community-based interventions have been increasingly recognized as an effective model for reckoning with clinical trial participation challenges amongst underrepresented groups, yet a paucity of studies implement this approach. The present study sought to gain insight into Black male participants' perception of clinical trials before and after participating in a community-based team lifestyle intervention in the United States.

METHODS: Black Impact, a 24-week community-based lifestyle intervention, applied the American Heart Association's Life's Simple 7 (LS7) framework to assess changes in the cardiovascular health of seventy-four Black male participants partaking in weekly …

Cannabis Use Associated With Lower Mortality Among Hospitalized Covid-19 Patients Using The National Inpatient Sample: An Epidemiological Study, Joseph-Kevin Igwe, Ugo Alaribe

Faculty, Staff and Students Publications

BACKGROUND: Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.

METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical …

Cannabis Use Associated With Lower Mortality Among Hospitalized Covid-19 Patients Using The National Inpatient Sample: An Epidemiological Study, Joseph-Kevin Igwe, Ugo Alaribe

Faculty, Staff and Students Publications

BACKGROUND: Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.

METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical …

Unlv Mental Health Initiatives: Unifying Through Innovation And Collaboration, The Lincy Institute, Unlv Practice, Behere Nv, Unlv Department Of Psychology

Lincy Institute Events

Nevada persistently ranks at or near the bottom in the country for overall access to mental health services despite the need (Mental Health America, 2015-2023). UNLV faculty are developing initiatives to change this unacceptable situation. The Lincy Institute, in partnership with UNLV PRACTICE, BeHERE Nevada, and researchers from the Department of Psychology, offered a community forum showcasing three mental health initiatives harnessing faculty collaboration and innovation to drive overdue changes in Nevada’s mental-health landscape. Following the presentations policymakers engaged in open discussion with UNLV presenters and the audience. The three main initiatives showcased in this forum …

The Dearth Of Knowledge Of Health Insurance Literacy Within The United States, Katherine A. Conzet

Honors Thesis

This literature review and cross-comparison were conducted to combine resources that bring to light the lack of knowledge on health insurance, the impact of this low health insurance literacy (HIL), and the lack of research being done in this subject field. This thesis analyzes and compares different research that measures HIL levels and compares these findings. At the same time, this thesis presents the complex history of health insurance and how this understanding can contribute to lower population HIL and proposes different ways to accurately measure HIL. The purpose is to show the necessity for more research into the field …

Unsupervised Deep Representation Learning Enables Phenotype Discovery For Genetic Association Studies Of Brain Imaging, Khush Patel, Ziqian Xie, Hao Yuan, Sheikh Muhammad Saiful Islam, Yaochen Xie, Wei He, Wanheng Zhang, Assaf Gottlieb, Han Chen, Luca Giancardo, Alexander Knaack, Evan Fletcher, Myriam Fornage, Shuiwang Ji, Degui Zhi

Faculty, Staff and Student Publications

Understanding the genetic architecture of brain structure is challenging, partly due to difficulties in designing robust, non-biased descriptors of brain morphology. Until recently, brain measures for genome-wide association studies (GWAS) consisted of traditionally expert-defined or software-derived image-derived phenotypes (IDPs) that are often based on theoretical preconceptions or computed from limited amounts of data. Here, we present an approach to derive brain imaging phenotypes using unsupervised deep representation learning. We train a 3-D convolutional autoencoder model with reconstruction loss on 6130 UK Biobank (UKBB) participants' T1 or T2-FLAIR (T2) brain MRIs to create a 128-dimensional representation known as Unsupervised Deep learning …

Neighborhood Light At Night And Noise Levels, And Long-Term Sleep Trajectories In The Southern Community Cohort Study, Samuel H Nyarko, Qian Xiao

Faculty, Staff and Student Publications

While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal-normal …

Predictors Of Prep Uptake By Black Gay And Bisexual Men In Ohio, Ade Elisha

Walden Dissertations and Doctoral Studies

No abstract provided.

Role Of Pregnancy Intention And Substance Use In Postpartum Depression Among Black Women, Asaye Birhanu Mekonnen

Walden Dissertations and Doctoral Studies

No abstract provided.

The Theory Of X-Ray And Neutron Interferometry Using A Modulated Phase Grating, Hunter C. Meyer

LSU Master's Theses

Grating interferometry exploits wave interference to simultaneously image multiple physical properties of an object and can be performed using X-rays or neutrons. The modulated phase grating interferometer (MPGI) is a recently developed interferometry system that allows for the simultaneous acquisition of attenuation, differential-phase contrast, and dark-field images, which highlight X-ray or neutron absorption, refraction, and small angle scatter, respectively. This interferometry system uses a single grating, with a relatively high period envelope function, to produce interference fringes that can be directly resolved by standard high resolution detectors. The grating is sampled at a relatively low pitch, to meet coherence requirements …

Risk And Preventive Factors Of Asthma In Children In Texas, Yvonne A. Deen

Walden Dissertations and Doctoral Studies

No abstract provided.

Cognitive And Economic Development, John Luke Gallup

OHSU-PSU School of Public Health Annual Conference

A burgeoning literature finds that early childhood risk factors have large causal effects on individuals' cognitive development, education and earnings, but has not assessed the impact on the economy as a whole.

Cognitive ability is the foundation of human capital and the capacity to learn. The risk factors for poor cognitive development are very high in many countries. Each risk factor also causes child mortality, making child survival a viable proxy for good cognitive development conditions. The cognitive development of current workers happened decades earlier when they were children, providing a predetermined correlate. Controlling for country characteristics, income levels and …

Knowledge Of Medicaid Expansion To Recent And Undocumented Immigrants Among Oregon Mexican-Origin Latinos: (Work In Progress), Nancy Ledezma, Grace Parra, Alejandra Nunez, Dr. Blair Darney

OHSU-PSU School of Public Health Annual Conference

Background

Recent and undocumented immigrants are explicitly excluded from federal Medicaid and state insurance exchanges. The first phase of Healthier Oregon was implemented in July 2022 and expanded Medicaid (OHP) benefits to undocumented immigrants ages 19-25 or 55 and older. The second phase was implemented in July 2023 and extended benefits to everyone regardless of age. We assessed understanding of Healthier Oregon among Mexican-origin Latinos. We hypothesize that many potentially eligible people may not know about the program, if they qualify, or how to apply.

Methods

This is a cross-sectional study in collaboration with the General Consulate of Mexico. Our …

Understanding Variation In Provider Referral Rates To Early Intervention For Children With Developmental Delays, Gabriella Tangkilisan, Zoe Kilmer, Michelle Owens, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background:

Early detection and treatment of developmental disabilities (DD), including Autism Spectrum Disorder (ASD), improves language, IQ, and adaptive outcomes. Guidelines recommend immediate referral to Early Intervention (public developmental therapy services) upon positive ASD/DD screening in infant/toddler well child checks. However, children screening positive for ASD/DD are not always referred for Early Intervention services. This project aimed to understand why pediatricians do and do not refer children with positive DD/ASD screens to early intervention.

Methods:

We conducted qualitative interviews with pediatricians who participated in a randomized trial investigating family navigation for children with autism risk. We determined pediatrician referral rates …

A Window Of Opportunity: Describing Participants Engaged In A Comprehensive Perinatal Care Model To Treat Substance Use Disorder During Pregnancy, Christina Jäderholm

OHSU-PSU School of Public Health Annual Conference

In 2019, 12% of pregnant persons were estimated to use psychoactive substances, the highest rate in US history. Substance use disorder (SUD) is a chronic, relapsing condition, and while pregnancy presents a unique opportunity for SUD intervention, research on pregnant and postpartum SUD patient experiences is vital for informing perinatal systems of care. The purpose of this presentation is to describe a sample from SUN, a comprehensive perinatal care program for pregnant persons with SUD in North Carolina.

Methods

We abstracted medical records (n=29), surveyed participants (n=29), and conducted two focus groups (n=7). Medical records provided participant demographics; medical, social, …

The Use Of Extreme Risk Protection Orders Intended To Prevent Mass Violence In Oregon: A Descriptive Study, Rosol Mikail, Rebecca Valek, Shauna Rakshe, Rebecca Teichman, Susan Defrancesco, Kathleen Carlson

OHSU-PSU School of Public Health Annual Conference

Purpose: Firearm violence is a critical public health issue in the United States. Extreme Risk Protection Order (ERPO) laws are an intervention method that have been enacted in many states to prevent firearm violence including mass violence threats. This study examined the characteristics of ERPO petitions filed in Oregon for a 6-year period that involved mass violence threats.

Method: ERPO petitions included in court records obtained through the Oregon Judicial Case Information Network, from January 1, 2018, to December 31, 2023 were abstracted; a 20% random sample of records was double-coded to ensure interrater reliability. An epidemiologic analysis of cases …

Gender Affirming Surgery And Pain In Adolescents: Teen And Parent Experiences, Corrin Murphy, Eleanor Battison, University Of Rhode Island, Anna Wilson Phd

OHSU-PSU School of Public Health Annual Conference

Background: Adolescents seeking gender affirming medical care face unique biopsychosocial challenges, including experiences of discrimination and stigma. Transgender and gender diverse (TGD) adolescents often undergo gender affirming surgery (GAS). While there is an increase in GAS for TGD adolescents in the U.S., little is known about the pain experiences in the post-surgical period among these youth. There have been no studies to our knowledge that examine the psychological functioning of parents and their ability to handle their child's distress, which may be affected by their child's post-GAS pain experiences. Parental responses to their children’s pain and distress may, in turn, …

The Cost Of Healthy Eating, Diana Prychyna, Miriam R. Elman, Joy Kim, Karen F. Miller, Deonni P. Stolldorf, Sean P. Collins, Bory Kea

OHSU-PSU School of Public Health Annual Conference

Abstract

Background

Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure (GUIDED-HF), utilized ‘Self-Care Coaches’ who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During the calls, we observed gaps in self-care for retired older …

Gaza's Healthcare System In Collapse: An Exploratory Analysis Of Healthcare Attacks In Occupied Palestinian Territories (Opts) And Israel Since October 2023, Vincenzo J. Cornacchione

OHSU-PSU School of Public Health Annual Conference

Decades of apartheid practices and oppression in Occupied Palestinian Territories (OPTs), marked by mass displacement, restricted access to essential services, and countless human rights violations, have culminated in today's systematic dismantling of Gaza’s healthcare infrastructure. To investigate the systematic obstruction of healthcare access in OPT, this exploratory analysis employs an open intelligence dataset containing event data on reported healthcare attack incidents in OPT and Israel since October 2023. Specifically, this analysis seeks to elucidate the nature and extent of healthcare attacks in OPT by answering student-defined research questions, based on a priori expectations around the data. The analysis confirms that …

Impact Of Two Shift Schedules On Post-Shift Blood Pressure In Firefighters, Ayeisha H. Haswarey

OHSU-PSU School of Public Health Annual Conference

Background: Firefighters have an increased risk of cardiometabolic disease compared to the general population. Blunted blood pressure (BP) dipping during nocturnal sleep is associated with increased cardiometabolic disease morbidity/mortality. Shift work can alter diurnal BP oscillation, but the extent of alteration by different schedules remains debated. No study to date has examined firefighting shift schedules, necessitating a longitudinal evaluation to begin to understand their implications for cardiometabolic health. Thus, this preliminary analysis compares how two common schedules (24/48 hours on/off vs. 1/3/2/3 days on/off) impact post-shift BP and dipping in 20 firefighters.

Methods: 20 participants (10% female; 25-54 years of …

Transgender And Non-Binary Health In Oregon Under A Single-Payer Health System, Amy (Mick) L. Mcveety (They/She)

OHSU-PSU School of Public Health Annual Conference

As the state with the highest percentage of population who identifies as LGBTQ+, Oregon has a duty to provide adequate health protections and services to its transgender and nonbinary (TGNB) residents, particularly given the disparities TGNB individuals face in housing, employment, education, and health. Following recommendations from the Oregon Joint Task Force on Universal Health Care, Oregon should implement a single-payer health care system, with particular attention to:

1. Protecting patient privacy in EHR and other systems, particularly for youth TGNB patients;
2. Expanding the covered gender-affirming services and removing barriers such as cost-sharing and prior authorization, and;
3. Recruiting TGNB providers and …

Exploring Decolonial And Indigenous Mental Health Framework And Practice To Address Complex Trauma Among Palestinian Youth Living Under Violence Of Settler-Colonialism, Vivian L. Duong, Corrin Murphy

OHSU-PSU School of Public Health Annual Conference

The growing settler colonial project of Israel forced indigenous Palestinians to flee from their homeland to further the Zionist movement of establishing a Jewish-majority state. The forced dispossession and displacement of Palestinians at this time was referred to as the Nakba, or catastrophe (Masalha, 2002). From 1947 and 1949, approximately 750,000 Palestinians from a population of 1.9 million were made refugees (Al Jazeera, 2017). Also referred to as the ethnic cleansing of Palestine, Zionists forcibly took over 78 percent of Palestine, destroyed about 530 villages and cities, and killed around 15,000 Palestinians including more than 70 massacres (Al Jazeera, 2017). …

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of U.S. Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

Strong Hearts Program: The Results Of A Novel Primary-Care Based Diagnostic And Referral Program For Chagas Disease In East Boston, Ma, Usa, Javier J. Huerta

OHSU-PSU School of Public Health Annual Conference

Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet

Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.

Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). …

The Association Between Acculturation & C-Reactive Protein In U.S. Immigrants: A Cross-Sectional Study, Jessica Kilinski Bs, Rosol Mikail Bs, Kelly M. Reavis Phd, Mph, Deborah Karasek Phd, Mph

OHSU-PSU School of Public Health Annual Conference

Purpose: Immigrants undergo acculturation as they assimilate to a different culture, potentially leading to immense stress. Our objective was to examine the association between acculturation and C-reactive protein (CRP), a marker of stress-induced inflammation. We hypothesized that U.S. foreign-born adults 20 years and older with higher degrees of acculturation would have higher CRP levels compared to those with lower acculturation.

Method: We used 2017-2018 National Health and Nutrition Examination Survey (NHANES) data from 1526 participants to conduct a cross-sectional analysis. We measured acculturation as language spoken at home (categorized as low, moderate, and high) and examined its association with CRP …

Impact Of Medical Formula Shortage On Patients With Inborn Errors Of Metabolism (Iem) And Their Dietitians, Haemin Lee

OHSU-PSU School of Public Health Annual Conference

Since Feb. of 2022, patients with inborn errors of metabolism (IEM) suffered medical formula shortages due to an abrupt shut down of a major formula company in the US. The goal of this project was to understand the nutritional and psychosocial impacts on patients with IEM and changes in patient-dietitian relations as a result of the unexpected formula shortage.

Two survey were set up and disseminated via REDCap to patients(18 years-old or older), parent/legal gurdian of patients in the US, from Dec.2023-Jan.2024. Of those 571 records, 139(60.4%) patient surveys and 166(48.7%) caregiver surveys were retained for analysis after dropping complete …

Supporting Self-Managed Abortion Care In “Practice Not Premise”: Provider Perspectives, Roles, And Referral Pathways In India, Laura E. Jacobson Mph, Caila Brander, P. Balasubramanian, Sruthi Chandrasekaran, Blair Darney, Julia Goodman, Ruvani Jayaweera, Caitlin Gerdts

OHSU-PSU School of Public Health Annual Conference

Objective: Describe provider perspectives and roles in self-managed abortion (SMA) in India and identify referral pathways to facility- and self-managed abortion care.

Methods: We conducted a qualitative study of 33 semi-structured interviews with a range of providers (medical, community health, and pharmacy) in India. We conducted a thematic analysis and identified referral pathways including the type of provider, the abortion care modality (in-facility or SMA), and the reason.

Results: Referrals to facility-managed abortion care were common. Providers' perception of SMA safety coupled with­ liability concerns resulted in discouraging clients from seeking SMA. Nonetheless, participants acknowledged three areas where providers played …

Employer Voices: Insights On Bolstering Career Development For Graduate Students, Alexandria J. Ashraf Mph, Josh Hodsden Mba, Justin Howe Ba, Danielle Ross Ba, Dalton Wesemann Ba, Lisa K. Marriott Phd

OHSU-PSU School of Public Health Annual Conference

Title: Employer voices: Insights on Bolstering Career Development for Graduate Students

Alexandria J. Ashraf, MPH; Josh Hodsden, MBA, CPH; Justin Howe, BA; Danielle Ross, BA, CPH; Dalton Wesemann, BA; Lisa K. Marriott, PhD

Background: The development of the public health workforce has become increasingly vital as our world faces current and future challenges. The workforce has gained considerable insight into job skills that enhance responses to emergent needs. Building the foundation for a larger scale study on public health workforce needs, this project established processes for engaging with professionals who have hired recent public health graduates.

Methods: Open-ended questions assessed …