Digital Commons Network^™

A History Of Cioms (Council For International Organizations Of Medical Sciences) And The Creation Of Multinational Consensus For Human Subjects Research Ethics, Abigail Belle Cheung

Public Health Theses

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The Roads Less Traveled: A Metaresearch Analysis Of Local Histories In Racial Health Equity Research, Devin Trévion Brown

Public Health Theses

While it is important that racial health equity research receive growing attention in theUnited States, doing so must involve a thorough recognition and interrogation of the role that structural racism plays in creating different outcomes for Black communities. History aids in making clear the process through which race can become biology as structural racism is embodied by members of Black communities. Guided by Táíwò’s conceptualization of “resource distribution and accumulation” as well as Carter’s discussion of “racialized local biologies”, this cross-sectional meta-research analysis sought to investigate when and how racial health equity research after 2020 utilized local history to understand …

Exploring The Associations Between Stereotypes Of Aging And Dementia And Self-Reported Health In Parent-Adult Child Dyads, Yunke Gu

Public Health Theses

Stereotypes and stigma about Alzheimer’s Disease continue to emerge, as the number of populations affected by the disease in society is escalating. The sociocultural context sets the stage for the significant impact that Alzheimer’s has on family dynamics, especially for the adult children who provide over half of informal caregiving. Our study aims to adopt a dyadic approach, examining the interrelated experiences of adult child caregivers and their parents with ADRD. 126 dyads were included in this secondary data analysis. Measures included depressive symptoms and self-reported physical and mental health, stereotypes of aging and of person with memory loss. Results …

Prep-Aring For Prevention: Mental Health, Internalizations, And Contextual Factors As Barriers To Prep Uptake Among Sexual Minority Men And Nonbinary Individuals, Amanda Glatter

Public Health Theses

Pre-exposure prophylaxis (PrEP) has revolutionized HIV prevention in the last ten years, as it is highly effective at preventing infection. PrEP is a strong preventive option for those at risk of HIV, but only 30% of those who could benefit from it were prescribed PrEP in the United States in 2021.2 The purpose of this study is to investigate how mental health, internalizations, and greater contextual factors unique to sexual minority men and nonbinary individuals (SMMNI) impact PrEP knowledge, uptake, and adherence. Survey data from the #MVMNT (Men’s Voices on Mapping, Networks, and Technology) project was utilized to examine the …

Measuring The Differential Effect Of Internalized Homonegativity On Hiv Prevention Outcomes By Sexual Orientation Disclosure Status Among Ymsm Across Two Us Cities, Liv Gotte

Public Health Theses

Human Immunodeficiency Virus (HIV) is highly preventable with the right resources. Nonetheless, young men who have sex with men (YMSM) face disproportionately high rates of HIV acquisition, indicating barriers to effective implementation of prevention strategies. To better understand these implementation barriers, this research explores the relationship between internalized homonegativity and HIV prevention outcomes with a focus on the mediating effect of sexual orientation disclosure to healthcare professionals among YMSM. The data used in this research were collected in a previous prospective cross-sectional study that enrolled YMSM seeking HIV prevention care in two U.S. cities ( Nashville, TN and Buffalo, NY) …

Evaluation Of One Health Education Materials: A Scoping Review And Quality Assessment, Sydney Jones

Public Health Theses

The increasing risk of zoonotic spillover, driven by climate change and evolving human behaviors, requires a systematic shift in pandemic prevention strategies towards a One Health approach. Central to this approach is effective health communication intended to translate knowledge into actionable recommendations for the most vulnerable populations. This thesis aims to systematically evaluate the quantity and quality of existing One Health communication materials through a scoping review and two distinct methods of quality evaluation: the CDC Clear Communication Index and content analysis. Among 82 communication materials identified in the scoping review, the median overall CDC Clear Communication Index score was …

Real-World Rollout Of Injectable Antiretrovirals For Hiv Prevention And Treatment: Understanding Predictors Of Early Adoption, Liza Koshy

Public Health Theses

Background: Data is limited on implementation of long-acting injectable (LAI) HIV treatment (ART) and prevention (PrEP). We sought to characterize “early adopters” of LAI ART and PrEP in terms of social determinants of health, using a health equity lens. Methods: A retrospective cohort included patients prescribed ART or PrEP through a large Northeast urban health system (January 2021-September 2023). Separate analyses used electronic health record data for: 1) prevention (LAI vs. oral PrEP) and 2) treatment (LAI vs. oral ART). Group differences were examined using ANOVA, chi-square tests or Fisher’s exact tests. Bivariate logistic regression modeled associations between LAI ART …

Diagnostic Evaluation For Abnormal Uterine Bleeding At Emergence Departments In The United States, Wanyi Huang

Public Health Theses

Objectives: To examine the pattern of diagnostic evaluation for abnormal uterine bleeding (AUB) in a national sample of women seeking care at emergency departments (ED) and to identify potential influencing factors with a focus on race and ethnicity.

Methods: We identified 1,049 (unweighted, or 7,900,653 weighted) women without previous cancer diagnosis who visited ED for non-pregnancy related AUB from the National Hospital Ambulatory Medical Care Survey during 2014-2021. The primary outcomes were whether an ultrasound was provided/ordered and whether a referral/return for follow-up consultation was recommended. Multivariable logistic regressions were conducted to assess the association of race and ethnicity with …

Exploring The Use Of Mobile Health Application To Promote Self-Managment Of Cardiovascular Disease: A Study Of Age-Related Differences And Technology Adoption Among Chinese Patients, Yunan Mei

Public Health Theses

Background: Cardiovascular diseases (CVD) are the leading cause of mortality globally, particularly in China's aging population. Mobile health (mHealth) technologies offer a promising avenue to address healthcare disparities and enhance CVD management among the elderly. This study aims to explore the acceptance of mHealth in improving self-management of CVD among older adults in China, focusing on its potential to mitigate accessibility and treatment challenges.

Methods: This cross-sectional study was conducted at the Xinhua Hospital of Shanghai Jiao Tong University. Data were collected using an online Qualtrics questionnaire from 225 participants who met inclusion criteria including being Chinese speakers, diagnosed with …

Exploring The Connections Between The Arts And Mental Health In The Face Of Climate Change, Marla Joy Minkoff

Public Health Theses

Objective: This study aims to explore how engagement with art may shape emotions related to the climate crisis and expand the conception of art as a mechanism of public health practice.Background: Climate change impacts human health not only physically but also psychologically, manifesting in symptoms of climate emotions (e.g., ecological grief, eco-anxiety, eco-paralysis) that arise as a result of changes to the earth and our relationship to the natural world. These symptoms are among the pressing mental health effects of climate change. Methods: A qualitative approach utilizing the Rapid Assessment Process (RAP) was employed to conduct semi-structured interviews (N=10) with …

Exploring The Association Between The Supplemental Nutrition Program For Woman, Infants And Children (Wic) And Gestational Weight Gain, Oyinlola Obatolu

Public Health Theses

Background: The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) has been an impactful federal public assistance program that has provided nutrition education and support to millions of low income women and children around the country. Despite its positive impact on perinatal and birth outcomes, the precise mechanisms between WIC and these outcomes remain unclear. Past studies have looked at the relationship between WIC and gestational weight gain (GWG), a potential mediator of the effect of WIC on birth outcomes, but they have mainly focused on city or state level data or Medicaid enrollees. This study aims to …

“Their Body, Their Choice. Your Body, Your Choice. Your Baby, Your Choice.”: A Reflexive Thematic Analysis Of Vaccine Access And Acceptance Among U.S. Pregnant People On Reddit, Sydney Marie Perlotto

Public Health Theses

Compared to the general population, pregnant people and newborns are at a higher risk of contracting infectious diseases and experiencing worse adverse outcomes. Vaccines delivered during pregnancy, known as prenatal vaccines, represent a critical yet underused form of preventive care for these populations in the United States. Increasing successful prenatal vaccination uptake requires a focus on both access and acceptance, which pregnant people may experience differently than non-pregnant people due to their unique physiological and social state. Given the evolution of vaccine hesitancy following the COVID-19 pandemic, coupled with the recent expansion of the U.S. prenatal immunization schedule, this study …

Greening And Mental Distress: Effect Modification By Housing Tenure, Saira Prasanth

Public Health Theses

Access to high-quality residential greenspace is associated with improved long-term health, particularly mental health. However, many interventions to promote “greening” or increased greenspace in urban areas have been shown through numerous qualitative studies to exacerbate environmental and health inequities, primarily through green gentrification. Our objective was to quantify the association between greenspace and mental distress in the U.S. as well as evaluate whether the association between greenspace and mental distress is modified by housing tenure. We hypothesized that increased greenspace was associated with reduced mental distress, and that this effect was more protective among homeowners than non-homeowners. Mental distress and …

Prevalence Of Perinatal Depression In Us Residents: Analysis Based On Nhanes 2017-2020 Pre-Pandemic, Yian Wu

Public Health Theses

Objective:Perinatal depression, affecting over 10% of pregnant and postpartum women globally, is a significant but often underrecognized mental health issue. Untreated symptoms can persist for years, highlighting the need for early intervention. This study, using the most recent National Health and Nutrition Examination Survey (NHANES) data available, aims to assess trends in perinatal depression prevalence and mental health care utilization in US. Methods: NHANES data from 2017 to March 2020 were analyzed, focusing on pregnant and postpartum women who had given birth within the last 24 months as the target population. The Patient Health Questionnaire (PHQ-9) was used to assess …

The Influence Of Social Convoy On The Improvement Of Depressive Symptoms In A 3-Year Longitudinal Study: The Potential Role Of Urban-Rural Division, Qianyi Xu

Public Health Theses

Objective: This longitudinal study aims to delve into the complicated relationship between social convoy and the improvement of depressive symptomatology, while also investigating the potential mediating role of household registry status.Methods: The study utilized data from 2,511 participants from the China Health and Retirement Longitudinal Study (CHARLS), specifically from the 2015 survey (Wave 3) and the 2018 survey (Wave 4). The selected sample comprised Chinese adults aged 45 and older who exhibited depressive symptoms in 2015 and for whom comprehensive data on various social convoy components and sociodemographic variables were available. Logistic regression models were applied to assess the associations …

Randomized Trial Of Exercise Vs. Usual Care On Inflammatory And Metabolic Biomarkers In Women With Breast Cancer Taking Aromatase Inhibitors, Lingxiao Zhang

Public Health Theses

ABSTRACT

Background: The Hormones and Physical Exercise (HOPE) study demonstrated efficacy of exercise in reducing AI-associated arthralgia in breast cancer survivors. Yet, the underlying mechanism for this relationship remains unclear. Prior research among breast cancer survivors highlights improvements in metabolic and inflammatory biomarkers related to exercise. This secondary analysis of HOPE examined the potential role of metabolic and inflammatory biomarkers in mediating the effect of exercise vs. usual care on AI-associated arthralgia.

Methods: Our analysis included 80 participants (42 exercise arm, 38 usual care) enrolled in the HOPE study. The intervention was a year-long exercise program that included both supervised …

Resilience In Self-Perception Of Aging Among Chinese Older Adults Under The One-Child Policy, Minyang Zhang

Public Health Theses

This study examines the resilience of self-perception of aging (SPA) among older Chinese adults affected by the One-Child Policy (OCP), based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Implemented in 1979, the OCP reshaped family dynamics. It potentially influences aging perceptions among the elderly. Utilizing the stereotype embodiment theory, this research assesses if deep-rooted cultural attitudes towards aging could mitigate the psychological effects of these demographic changes. Results suggest that despite significant societal shifts, the SPA among Chinese elderly remains stable. That indicates a minimal direct impact of the OCP on aging perceptions. The finding underscores …

Do Rental Assistance Programs Relieve Overcrowding In U.S. Children?, Frank Zhu

Public Health Theses

Introduction: Crowded living conditions are associated with many negative health outcomes, with significant implications for children, as they are particularly shaped by their home environment and more likely to live in crowded conditions, given their larger household size. How rental assistance programs may shape and improve household crowding has not been previously explored. Methods: This study leveraged data from NHANES linked with HUD administrative rental assistance records. We examined changes in crowding measures in U.S. children using linear and logistic regression models stratified by different rental assistance program types. Results: There was a statistically significant 40 percentage point reduction in …

Trauma-Informed Digital Health Interventions: A Scoping Review, Amelea Lowery

Public Health Theses

Background: Trauma exposure is a pervasive issue around the world and the impacts of trauma can be long lasting and detrimental to individual and population health outcomes. Trauma responses can influence and determine an individual or community’s approach in seeking supportive resources. Given the critical role of supportive resources and the prevalent use of technology and internet use, it is essential to understand how digital health interventions contribute to addressing trauma explicitly. This scoping review aims to explore the landscape of trauma-informed digital health interventions for adults, assess their outcomes, and identify their measurable impacts across various settings.Methods: A scoping …

Resilience In Self-Perception Of Aging Among Chinese Older Adults Under The One-Child Policy, Minyang Zhang

Public Health Theses

This study examines the resilience of self-perception of aging (SPA) among older Chinese adults affected by the One-Child Policy (OCP), based on data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Implemented in 1979, the OCP reshaped family dynamics. It potentially influences aging perceptions among the elderly. Utilizing the stereotype embodiment theory, this research assesses if deep-rooted cultural attitudes towards aging could mitigate the psychological effects of these demographic changes. Results suggest that despite significant societal shifts, the SPA among Chinese elderly remains stable. That indicates a minimal direct impact of the OCP on aging perceptions. The finding underscores …

Travel Literature. Mircea Eliade’S Occidental View In The Himalayan Journal And The Portugal Journal, Irina Armianu

Literatures and Cultural Studies Faculty Publications

This article retraces Mircea Eliade’s mystical travel through the Himalayas as shown in his Himalayan Journal and his struggle to survive as a writer under the weight of brutal historical events in his Portugal Journal. The two travel journals reveal the influence of geographical and historical elements on Eliade's mystical writing. A deeper analysis of these journals is necessary to link travel genre to mystical thought. The next pages will show (1) how these journals fit into the category of existential travel, as theorized by Erik Cohen in "The Phenomenology of Tourist Experiences" (179-201), (2) Eliade’s own transcendence of his …

Reporting On Un Security Council: Decoding Media Bias, Alessandra Loiero

Dissertations and Theses

This thesis explores Western media's representation of the United Nations (UN), focusing on the Security Council's role in global conflict resolution. It examines how UN-accredited correspondents perceive the effectiveness of the Security Council, particularly when the body faces deadlock. The study employs text analysis techniques to identify biases and perceptions in media coverage, using The New York Times' reporting on the Ukraine conflict as a case study. It illuminates framing effects in journalistic narratives, revealing how journalists subtly interject their views when reporting, often revealing unrealistic expectations and shedding light on the limitations of the UN's mandate or its inability …

Parasympathethic Nervous Activity And Social Exclusion In Borderline Personality Disorder, Rebecca E. Barnes

Dissertations and Theses

Abstract

The experience of being excluded is universally unpleasant. However, for individuals that suffer from Borderline Personality Disorder (BPD), the experience of social exclusion, or ostracism can be unbearable (Bortolla, et al., 2019). While there is a significant amount of research on physiological reactivity in BPD, no studies adequately connect the parasympathetic nervous system (PNS) responses of people with BPD to social exclusion which is critical to understand as the inability of the PNS of individuals with BPD to adapt to stressors may be a contributing factor to the elevated rate of suicide and suicide attempts in this clinical population …

Depression In African American Males And The Mental Health Stigma, Deanna Carrington

Dissertations and Theses

Depression is a common mental health disorder in the United States. In particular, African Americans have a greater risk of depression because they are predisposed to depressive symptoms as opposed to their White counterparts (Miller and Taylor, 2011). Moreover, African Americans are 20% more likely to experience psychological distress that leads to depression compared to other racial groups. While African American cultural norms focus on resilience and independence, discussion around mental health is discouraged, which leads to underreporting and delayed treatment. For males in the African American community, they can be hesitant to seek help, let alone discuss their experiences …

Social Determinants Of Psychosis: An Examination Of Loneliness, Stress, Discrimination, And Neighborhood Cohesion In Psychotic Disorders, Alexandria Selloni

Dissertations and Theses

This study examined social determinants in individuals diagnosed with psychotic disorders in a large, diverse, sample from the NIH-sponsored All of Us Research Program. Participants completed self-report measures of loneliness, perceived stress, everyday discrimination, and neighborhood social cohesion. Analyses showed that individuals with a diagnosis of a psychotic disorder experience significantly more feelings of loneliness, stress, everyday discrimination, and poorer neighborhood social cohesion compared to individuals without any diagnosis of a mental disorder as well as compared to individuals who may have other mental disorders other than psychosis. We further examined racial difference among individuals with psychotic disorders and found …

Exploring Spatial Operations Of Distractor Suppression In The Sense Of Touch, Nicole A. Serino

Dissertations and Theses

The ability to select sensory information in our environment is key to facilitating goal-directed actions. Sensory selection mechanisms are prevalent in all sensory modalities, and can be implemented by enhancing information at the relevant location and/or suppressing neural information outside the focus of attention (a mechanism known as distractor suppression). Although we have a decent understanding of how the brain enhances information within the focus of attention, less is known about the mechanisms that mediate suppression of distractors, especially in sensory modalities outside vision. In this study, we conducted a series of behavioral experiments to investigate the spatial flexibility of …

The Menstrual Cycle In Psychotherapy: Interventions, Therapist Engagement, And Blind Spots, Rozita Alaluf

Dissertations and Theses

There is a dearth of literature on psychotherapy and menstruation, except for the treatment and diagnosis of issues associated with premenstrual distress. This study aimed to bridge this gap by investigating the frequency and context of discussions about the menstrual cycle, the factors influencing therapists’ engagement with this topic, and the therapeutic approaches utilized to address the menstrual cycle within psychotherapy.

In phase 1, 118 psychotherapists from various theoretical backgrounds completed a survey on menstruation in clinical practice. The data was analyzed using descriptive statistics. In phase 2, semi-structured interviews were conducted with 7 psychotherapists, primarily identifying their theoretical orientation …

Motherhood In Crisis: A Qualitative Study Of First-Time Mothers Diagnosed With Breast Cancer, Tamzin M. Baker

Dissertations and Theses

The aim of this study is to explore the psychological impact of pregnancy-associated breast cancer (PABC) on a first-time mother’s identity. What effects does life-threatening illness have on the development of maternal identity and connection? This question was explored with a sample of six mothers via semi-structured interview and self-report measure with the aim to shed light on a scarcely studied phenomenon that is predicted to affect a greater number of mothers in the future. These research questions were explored through Interpretive Phenomenological Analysis (IPA) (Smith et al., 2009) resulting in group experiential themes and three theoretical constructs: (1) a …

Teach Them How To Say Goodbye: Student Therapist Termination At A Psychodynamic Training Clinic, Michael Ferrara

Dissertations and Theses

Termination is arguably one of the most important aspects of psychotherapy, however, the research into training for termination is sparse. Further, student therapists report that their training for termination provided little guidance, instruction, or acknowledgment of clinical realities around treatment endings. Using a semi-structured interview with a sample of 11 student therapists at a psychodynamic training clinic, this study explored experiences of termination and the preparation for those endings. Qualitative thematic analysis indicated that this group of student therapists did not experience shared and structured termination training but did not feel they were unprepared for the endings with their patients. …

The Shadow Of Grief: Understanding Grief Among Ethnoracially Diverse Young Adults, Rona R. Tarazi

Dissertations and Theses

Background: Complicated grief, characterized by prolonged and intense mourning, presents unique challenges for individuals grappling with loss, as it is shaped by a multitude of factors influencing the grieving and mourning processes. While the literature has identified several factors that significantly impact complicated grief, such as post-loss symptom severity, stigmatization, the quality of the relationship to the deceased, and grief-related avoidance, this two-part study aimed to expand on existing findings by shedding light on the landscape of grief among a sample of ethnoracially diverse young adults. Part 1 of the study examined whether previously identified factors remain significant in this …