Digital Commons Network^™

Racialized Masculinities In The Sexual Field: A Latent Profile Analysis Of Gay Community Stressors, Okoduwa Aboiralor

Public Health Theses

While intra-group discrimination is commonly experienced among men in the LGBT community, little is known about the intersection of multiple forms of discrimination. This study used a latent class analysis (LCA) to visualize the intersections of different forms of perceived discrimination and to evaluate to what degree LCA membership is associated with depression, anxiety, and somatization among a sample of racially and ethnically diverse men who have sex with men (MSM). The data was sourced from the Gay Community Stress Scale (GCSS) wherein participants were asked to what degree their perception of the mainstream gay community’s racism, racial objectification, masculinity …

Experiences And Beliefs About Violence And Sexual Health: A Qualitative Analysis Of The Experiences Of Female Migrant Lao Workers At The Border Of Thailand And Laos, Rachel Michele Brase

Public Health Theses

Background: It is estimated that 10% of Thailand’s total labor force is estimated to be made up of migrant workers. While the exact number of migrant workers from nearby countries is unknown, border towns and provinces are acknowledged to utilize a large population of undocumented and documented migrant workers. A majority of undocumented and a nearly half of documented migrants were reported to be female. While previous research has explored the health needs of female migrant workers in specific industries, such as the sex work industry and manufacturing industry, few studies have examined the health needs and beliefs of female …

Self-Directed Behavioral Interventions For Health Promotion Among Graduate Students, Chelsea Brett

Public Health Theses

Background: Graduate school environments are recognized for contributing to elevated stress levels among student populations, particularly when compared to their non-academic peers. Graduate school settings can subsequently foster maladaptive coping strategies among students, including self-isolation, poor nutrition choices, engaging with less physical exercise, and substance misuse. Self-stigma related to mental health care may additionally discourage students from seeking mental health treatment. The objective of this study was to explore whether self-directed behavioral interventions, delivered in the context of a course on behavior change, are effective in promoting health among this population. Prior studies have shown that self-directed behavioral interventions can …

Associations Between Campus Bathroom Use And Mental Health Among Gender Minority And Cisgender Students, Antonia Caba

Public Health Theses

Introduction: Gender minority individuals, including university students, experience worse mental health compared with cisgender individuals. Although there are many factors that may shape these mental health disparities, inequitable bathroom access is one known factor. Therefore, the purpose of this thesis is to explore how campus bathroom use influences the mental health of gender minority students compared with cisgender students. Specifically, this study examines how discordance in bathroom preference and bathroom use is associated with mental health.

Method: This was a cross-sectional online study administered across three universities in the United States. Participants (N=120) completed an online survey. Respondents answered questions …

The Health Action For Psychiatric Problems In Nigeria Including Epilepsy And Substances (Happiness) Project: A Preliminary Mixed-Method Evaluation, Casey Jia-Chyi Chu

Public Health Theses

Background: The Health Action for Psychiatric Problems in Nigeria Including Epilepsy and Substances (HAPPINESS) Project is a mental health capacity building intervention based in Imo State, Nigeria that incorporates the World Health Organization’s Mental Health Gap Action Programme (mhGAP). So far, the HAPPINESS Project has trained 36 primary care workers (doctors, nurses, and community health extension workers) in one initial training (covering 5 local government areas) and one refresher training. The goal of this project is to leverage Imo State’s widespread primary care network, to address gaps in access to mental health care.

Objective: To evaluate the impact of the …

Personalized Multimedia Videos As Reminiscence Therapy For Persons With Dementia, Julia Rose Donald

Public Health Theses

Reminiscence therapies are an effective intervention in increasing self-esteem, well-being, sense of personhood and even reducing distress and confusion in persons with dementia. There is even evidence that reminiscence therapies can slightly slow the progression of dementia, by enabling a cohesive narrative and sense of identity. This paper will consider relevant literature and explore the potential of using modern technological advances, such as a wealth of digital media and the ability to scan old photos, to create personalized and engaging life narratives. In addition to this paper, this special project will include a concrete example of this type of video …

Association Between Maternal Depressive Symptoms And Hypertension Among African American Mothers In The Intergen Study, Xiaosong Gao

Public Health Theses

Purpose: The purpose of this paper is to examine the association between maternal depressive symptoms and hypertension among African American mothers from the InterGEN study.

Data Source: The Intergenerational Blood Pressure (InterGEN) Study was a longitudinal study which enrolled 250 African American mother-child dyads based in Southwest and Central Connecticut.

Methods: We used logistic regression models to examine the association between depressive symptoms and hypertension, and adjusted for educational level, employment in the past 6 months, and Race-Related Events Score (RRES). We used growth curve modeling to examine the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) …

“Malicious Medicine”: A Qualitative Study Of Medical Mistrust And Prep Perceptions For African American And Hispanic Men And Women In New Haven, Ct, Alexandra Lee Grimaldi

Public Health Theses

Objective: To understand how medical mistrust impacts perceptions of PrEP and willingness to use PrEP for African American and Hispanic men and women in New Haven, Connecticut.

Methods: This qualitative study utilized semi-structured interviews to examine medical mistrust, PrEP awareness, and willingness to use PrEP amongst African American and Hispanic men and women in New Haven, Connecticut.

Results: The majority of participants did not know about PrEP before their first interview of this study and the majority of participants did not decide to use PrEP over the course of this study. For those who are not interested in using PrEP, …

Evaluation Of Pilot Methadone Treatment Programs For Inmates With Opioid Use Disorder In Connecticut Jails, 2014-2018, Alissa Haas

Public Health Theses

Background and Aims. Methadone treatment is underutilized in correctional facilities, despite high prevalence of opioid use disorder in criminal justice settings. In 2013 and 2014, two pilot programs were established by the Connecticut Department of Corrections in the New Haven and Bridgeport Correctional Centers to provide methadone for inmates who had been in medication-based treatment prior to incarceration. We sought to assess post-release outcomes (non-fatal overdose, fatal overdose, recidivism, and resumption of methadone in the community) associated with implementation of methadone treatment in these correctional centers.

Methods. This was a retrospective observational cohort study, linking datasets from the Connecticut Department …

Management Of Opioid Tapering With A Mobile App Among Veterans, Jennifer Villegas Ibarra

Public Health Theses

Objective: The goal of this project is to better understand the Veterans’ perspective on the facilitators and barriers of using a mobile app for opioid tapering.

Methods: Semi-structured interviews were conducted with nine Veteran patients who have experienced opioid tapering at the VA Connecticut Healthcare System in West Haven, CT. Interviews were conducted in-person at the VA Opioid Renewal Clinic (ORC). Each interview lasted approximately 55-70 minutes and participants were compensated with $25. Data analysis was conducted using Grounded Theory to generate findings for this research project.

Results: Findings identified a total of 11 codes, which were categorized as facilitators …

Measuring Tb Stigma In Kampala, Uganda, Amber James

Public Health Theses

Tuberculosis (TB) is one of the leading causes of death worldwide and adversely affects persons living with HIV. TB is a highly stigmatizing disease and has been shown to interfere in household TB contact investigation. The objective of this study was to investigate the severity and characteristics of TB stigma through a multiple methods approach. Quantitative methods involved distributing Van Rie Stigma Scales validated in Southeast to household contacts of Index TB patients during routine household TB contact investigation. Qualitative methods involved interviewing household contacts about their attitudes towards household contact investigation, knowledge of TB transmission and treatment, and perceptions …

Impact Of A 6-Month Exercise Intervention On Cognitive Function Among Ovarian Cancer Survivors: The Women’S Activity And Lifestyle Study In Connecticut (Walc), Jonica Yu Kao

Public Health Theses

Purpose: Cancer survivors often exhibit symptoms of impaired cognitive abilities after chemotherapy treatment. Physical activity has been shown to be promising in improving cognitive function among survivors for various types of cancer. However, very few studies have addressed this concern among the ovarian cancer patient population specifically.

Methods: The study randomized 111 physically-inactive ovarian cancer survivors into a 6-month exercise intervention (n=59) or an attention-control group (n=52). The FACT-Cog scale was self-reported to understand survivor perceptions of cognitive abilities at baseline and at 6 months. Generalized linear models (GLMs) were executed to examine the effect of the intervention versus attention-control …

The Hiv Care Continuum And Barriers To Viral Suppression Among Men Who Have Sex With Men In Greater Kuala Lumpur, Malaysia., Lauren Haerin Kim

Public Health Theses

Background: Men who have sex with men (MSM) now account for nearly half of all new HIV cases in Malaysia. There has been little research, however, characterizing the HIV care continuum among MSM living with HIV in Malaysia. This study describes the HIV care continuum and examines factors associated with HIV viral non-suppression among newly diagnosed MSM living with HIV in Kuala Lumpur, Malaysia.

Methods: We enrolled 163 MSM living with HIV who were in care at a major university hospital in Kuala Lumpur, Malaysia. Participants completed a self-administered questionnaire. Electronic medical chart review also provided data on engagement in …

A Qualitative Analysis On The Transitions Of Afghan Refugee Families To The U.S. And Their Parenting Experiences, Jessica Kung Leung

Public Health Theses

Introduction: Refugee families can face particularly multifaceted challenges during their transition to the U.S. There is currently little research on the experience of parenting during Afghan refugees’ transitions to the U.S. This study seeks to better understand these individuals’ experiences of parenting and their descriptions of their children’s transitions to the U.S. in the context of the greater New Haven area.

Methods: We conducted a secondary analysis on interview data with 19 recently-arrived Afghan refugee parents based in the greater New Haven area; 10 fathers and 9 mothers were interviewed from August 2019 to January 2020. We used thematic analysis …

Review Of Neurotechnological Interventions: A Need For A Recommended Public Health Response, Joel Lugones

Public Health Theses

After preliminary review of relevant research articles, the thesis was able to gain a deeper understanding of neurotechnological interventions (e.g. deep brain stimulation, and other neurostimulators), specifically in regards to their use in treatment of motor conditions (e.g. Parkinson’s, Epilepsy, etc.) and for some psychological disorders (e.g. depression, other mood disorders, etc.). A scoping review was conducted on a specific class of treatments used for particular conditions: invasive neurotechnological treatments for mood disorders. The reasoning behind this specified approach was due to the lack standardized policies and regulations in place for invasive neurotechnological interventions used for treatment of mood disorders …

Acknowledgment Of Sexual Violence And Mental Health Among College Students, Francesca Maviglia

Public Health Theses

A significant number of individuals who experience a form of sexual violence that could be classifiable as rape or sexual assault do not label their experience as such. Studies found that rape acknowledgement status can impact a survivor’s postassault experiences and recovery process. This study examined how a sample of 236 college students who experienced some form of sexual violence labeled their experience. The association between different degrees of acknowledgement and posttraumatic stress and depression symptoms was tested. 162 (68.6%) of respondents did not label their experience as unwanted; the remaining 74 (31.4%) varied in their labeling of the experience …

A Review Of Mental Health Screening Tools Used In Disaster Research, Ashley Rose Moore

Public Health Theses

Introduction: The effects of disasters are widespread and heavily studied. While attention to disasters’ impacts on mental health is growing, knowledge about these effects is fragmented due to the wide variety of assessment tools used in post-disaster settings. The purpose of this study is to review mental health assessment tools and their use in populations affected by disasters.

Methods: A systematic search was conducted in PubMed, PsycINFO, and Google Scholar for commonly-used tools that assess PTSD, anxiety, depression, substance use disorder, and general mental health in disaster settings. Next, a search for scientific studies that used the selected tools in …

“You’Re Not Gonna Get Any Help, No Matter How Hard You Try” A Qualitative Analysis Of “Severity” As A Barrier To Mental Health Care, Krishna Naik

Public Health Theses

Abstract

Objectives: This qualitative analysis explores how severity of need influences how patients perceive, experience and navigate mental health care.

Methods: Participants are English-speaking adults aged 18-64 with private insurance who have severe mental illness (SMI). After gauging interest in participating in telephone interviews, the principle investigators sampled those that used an out-of-network mental health provider (n=8), in-network mental health provider (n=8) and oversampled those that tried to use a mental health provider but ultimately didn’t (n=14). The 30 participants were interviewed for ~30 minutes each using semi-structured interview guides. All coding took place within Dedoose version 8.2.32.

Findings: “Severity” …

Relationship Between Food Craving And Food Selection, Elizabeth Marie Raiff

Public Health Theses

Objective: The primary aim of this study was to determine the influence of craving on food selection.

Research Methods and Procedures: A total of 95 viable participants completed the food craving inventory

(FCI), a restaurant meal selection questionnaire, and various demographic questions. Linear regression

modeling was used to analyze the relationship between FCI craving score and various forms of caloric intake.

Logistic regression models were utilized to analyze the relationship between “high-craving” status and food

selection.

Results: No significant findings resulted from modelling the relationship between craving category FCI scores

and craved caloric intake using Pearson’s coefficient. Likewise, no significant …

How Discrimination, Social Support, And English Proficiency Impact Depression In South Asian Immigrants: The Mediators Of Atherosclerosis In South Asians Living In America Study, Shireen Roy

Public Health Theses

Objectives: Discrimination, low social support, and low English proficiency negatively impact the mental health of immigrants. More work is needed to investigate the relationship between these factors and depression in South Asian immigrants. We examined the cross-sectional associations between chronic discrimination, low social support, low English proficiency, and depression in South Asians using data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study.

Methods: We fit logistic regression models to evaluate the associations between discrimination, social support, English proficiency, and depression in a sample of 887 South Asian adults. We also explored how discrimination, social support, …

Are Food Baskets Helpful For Refugees With Chronic Illnesses In Sub-Saharan Africa?, Anthony Russell

Public Health Theses

ABSTRACT

Refugees are among some of the most vulnerable populations in our world today. Food insecurity appears to be a consistent state among many refugee populations regardless of length of refugee status and setting. The primary study aims were to: a) identify factors influencing refugees’ ability to manage their chronic illnesses; b) describe food insecurity and dietary intake among refugees with chronic illnesses; c) understand the role food baskets play for this population.

A cross-sectional mixed methods study was conducted in two phases. Phase 1 consisted of 10 in-depth interviews with older adult refugees to identify factors influencing their management …

The Effect Of Childhood Maternal Trauma Experienced Before The Age Of 18 On Young Adolescent Children Ages 8-15, Alyssa Schneider

Public Health Theses

Childhood trauma is a pervasive and prevalent issue, and one that impact the entirety of the familial unit. Furthermore, maternal childhood trauma, or childhood trauma that was experienced by individuals that are now mothers, has the potential of being passed down and having far-reaching impacts for their children. This is known as the intergenerational transmission of trauma. However, this has primarily been studied in infants and children. As such, this study aimed to elucidate the effects of maternal childhood trauma on young adolescent children using a diary study method with the children and assessing childhood trauma in the mothers. It …

Confidentiality In The Clinic: A Qualitative Analysis Of Adolescent Girls’ Experiences Of Confidentiality In Sexual And Reproductive Health Care, Karen Teekadai Singh

Public Health Theses

Purpose: Adolescents in Connecticut can legally consent to sexual and reproductive health (SRH) care themselves and their parents do not have the right to view their confidential SRH treatment records. A qualitative study capturing information about adolescent girls’ experiences when receiving SRH care was conducted to explore how confidentiality and privacy play out in the clinic from the perspective of adolescents, the facilitators and barriers to adolescents’ confidentiality and privacy in SRH care, and the influence of family members or other guardians on adolescent patients’ confidentiality and privacy.

Methods: A secondary analysis of 31 interviews with adolescent girls was conducted. …

Glycemic Variability And Indices Of Glycemic Control Among Pregnant Women With Type 1 Diabetes Based On Use Of Constant Glucose Share Technology, Julie Sklar

Public Health Theses

Pregnant women with type 1 diabetes (T1D) experience increased glycemic variability as a result of changing insulin sensitivity and resistance throughout gestation. Therefore, strategies that help pregnant women with T1D manage their glycemic control are of great interest. We examined whether remote monitoring of Continuous Glucose Monitor (CGM) data by friends and family affects glycemic variability during pregnancy compared to CGM use alone in a pilot non-randomized trial (n = 28). During preconception or the first trimester, women with T1D were placed in one of two groups based on device compatibility: (1) CGM Alone (n = 13): women without iPhone, …

Medical Student Mistreatment And Burnout: An Intersectional Approach, Bethelehem Getachew Teshome

Public Health Theses

Importance

While prior studies have described mistreatment in an undergraduate medical setting by sex, sexual orientation, and race/ethnicity, no studies have examined the degree of mistreatment and symptoms of burnout experienced by students with multiple marginalized identities with national data.

Objective

To describe the association between mistreatment, burnout, and having multiple marginalized identities during undergraduate medical education.

Design

This cohort study utilized data from the Graduate Questionnaire administered annually by the Association of American Medical Colleges.

Setting

This study utilized student responses from the 140 U.S. medical schools accredited by the Association of American Medical Colleges’ Liaison Committee on Medical …

Major Depression Among Immigrants: Findings From The Nis-2003, Trang Tran

Public Health Theses

Lawful permanent residents (LPRs) are immigrants who come to the US through a variety of countries and circumstances. Most studies focus on subsets of immigrant populations, however, this study utilized data from the 2003 New Immigrant Survey, a nationally representative, cross-sectional survey of LPRs (n = 8,573). Participants were grouped into three main visa categories (i.e. Refugees/Asylees/Parolees, Legalization, Family/Employment/Diversity) and the objective was to examine the association between visa status and depression outcomes among adult survey respondents. We used bivariate analyses to measure the relationship between sociodemographic variables and visa status. Approximately 98% of the Legalization category originated from Latin …

Solid Fuel-Related Indoor Air Pollution And Poor Sleep Quality In Adults Aged 45 Years And Older; A National Longitudinal Study In China, Haiqing Yu

Public Health Theses

Background: Sleep disorders are a common public health issue in an aging society. Outdoor air pollution has been linked to poor sleep quality, but few studies have investigated the relationship between indoor air pollution derived from solid fuel combustion and sleep quality in elderly.

Objective: To evaluate the association between indoor air pollution due to cooking solid fuels and sleep quality among adults aged 45 years and elderly in China.

Methods: We analyzed data from the China Health and Retirement Survey (CHARLS), a national survey of ~17,000 residents aged over 45 from 150 counties/districts in China. Participants were restricted to …

The Impact Of Cognitive Decline On Decision-Making Among Older Persons In China, Quan Yuan

Public Health Theses

Decision-making among the older population is of importance as older persons make critically consequential decisions on daily errands, household financials, and care-seeking that affect the remainder of their lives. Despite the increasing prevalence rate of cognitive impairment in developing countries, many questions surrounding the impact of cognitive impairment on decision-making among older persons remain unexplored. Therefore, using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), this study helps bridge the gap in the existing literature by examining the effect of cognitive decline on decision-making among the older population in China. We first investigate the association between an individual's cognitive …

Intimate Partner Violence, Colorism, And Stress Coping In Barbados, Nkandu Yumbe

Public Health Theses

Persons who experience intimate partner violence (IPV) have higher rates of chronic disease. This is thought to be due, in part, to the adoption of health risk coping behaviors, as well as the detrimental biological response to chronic stress associated with violence. The role of colorism (perceived skin tone discrimination) in the experiences of victims of IPV, their stress and stress coping behaviors has not previously been examined. The objective of this study was to explore the intersecting experience of black skin, coping strategies and stress among women with IPV histories in Barbados. Women above the age of 18, who …

Taking A Joke Seriously: When Does Humor Affect Responses To The Slurring Of People With Intellectual Disabilities?, Jennifer Katz, Dimitri Wing-Paul

Psychology

The use of humor may affect how bystanders respond to slurs. Undergraduates (N = 192) completed a measure of prejudice towards people with intellectual disabilities and were randomly assigned to read a scenario in which a peer uses a slur either as part of a joke (humor condition) or a statement (control condition). Participants responded to measures of intent to assertively respond and their evaluation of the speaker. Humor inhibited intent to nonverbally disagree and to verbally confront. Bystanders’ own prejudicial attitudes moderated the effects of humor on intent to verbally confront and negative evaluation. In the humor condition, compared …