Digital Commons Network^™

Navigating The Nexus Of Food Insecurity, Anxiety, And Depression In The Face Of Climate Change: A Longitudinal Study In Rural Kenya, Michael Goodman, Lauren Raimer-Goodman, Heidi M Hagen Mcpherson, Dawit Woldu, Shreela Sharma, Ryan Ramphul, Fridah Mukiri, Agnes Maigallo

Faculty, Staff and Student Publications

Objective: This study aims to address critical gaps in understanding the bidirectional relationships between food insecurity, anxiety, and depression in Meru County, Kenya. By employing a cross-lagged panel analysis, we seek to clarify these temporal dynamics, contributing to the design of targeted interventions that integrate food security and mental health in the context of climate change.

Methods: A cross-lagged panel analysis was conducted using data from 362 adult participants in a community-based empowerment program (2023) in Meru County, Kenya. Participants completed self-report measures of food insecurity, anxiety, and depression at two time points, 11 weeks apart.

Results: Food insecurity (T1) …

Prediction Of Preterm Birth Among Infants With Orofacial Cleft Defects, Katherine L Ludorf, Renata H Benjamin, Mark A Canfield, Michael D Swartz, A J Agopian

Faculty, Staff and Student Publications

Objective: To develop risk prediction models for preterm birth among infants with orofacial clefts.

Design: Data from the Texas Birth Defects Registry for infants with orofacial clefts born between 1999-2014 were used to develop preterm birth predictive models. Logistic regression was used to consider maternal and infant characteristics, and internal validation of the final model was performed using bootstrapping methods. The area under the curve (AUC) statistic was generated to assess model performance, and separate predictive models were built and validated for infants with cleft lip and cleft palate alone. Several secondary analyses were conducted among subgroups of interest.

Setting: …

Perspectives On Smoking Cessation In The Oncology Environment: Insights From Brazilian Patients And Healthcare Providers, Raquel Descie Veraldi Leite, Ricardo Ribeiro Gama, Fabiana De Lima Vazquez, Gabriela Beltrami Massarão, Raiany Carvalho, Renan De Jesus Teixeira, Vinicius De Lima Vazquez, Irene Tami-Maury

Faculty, Staff and Student Publications

Objective: The aim of this study was to identify barriers and facilitators to smoking cessation among Brazilian cancer patients, considering the perspectives of both patients and healthcare professionals at a leading oncology center in the country.

Methods: A cross-sectional study was conducted, collecting smoking-related data from two groups: cancer patients and healthcare professionals at the Barretos Cancer Hospital (BCH) between 2019 and 2021. The questionnaire for healthcare professionals was adapted from the 2012 International Association for the Study of Lung Cancer and the Global Adult Tobacco Survey. For the cancer patient group, sociodemographic and clinical data were collected, along with …

Optimizing Community-Based Hepatitis B And C Care For Engaging Housing-Insecure Individuals, Vanessa Schick, Abigail Grace, F Tiffany Quan, Cathy Troisi, Jack Tsai

Faculty, Staff and Student Publications

Introduction

Hepatitis B and C (HBV/HCV) are bloodborne infections, with individuals who have histories of substance use and homelessness bearing a disproportionate risk. Long-standing difficulties in engaging these populations have made testing and treatment challenging. This retrospective observational study describes a community-based approach to HBV/HCV prevention and treatment, comparing the effectiveness of different engagement site types in reaching and engaging this high-need population.

Methods

GRASSROOTS HEALTH was launched in 2018 to improve HBV/HCV care by providing on-site testing, HBV vaccination, treatment navigation, and adherence support across various housing and drop-in centers. Outcomes were tracked through REDCap and analyzed by engagement …

Protective Effects Of Psychiatric Medications Against Covid-19 Mortality Before Vaccines, Rodrigo Machado-Vieira, Trudy M Krause, Gregory Jones, Antonio L Teixeira, Lokesh R Shahani, Scott D Lane, Jair C Soares, Chau N Truong

Faculty, Staff and Student Publications

The coronavirus disease pandemic caused by the coronavirus SARS-CoV-2, which emerged in the United States in late 2019 to early 2020 and quickly escalated into a national public health crisis. Research has identified psychiatric conditions as possible risk factors associated with COVID-19 infection and symptom severity. This study aims to determine whether specific classes of psychiatric medications could reduce the likelihood of infection and alleviate the severity of the disease. The objective of this study is to investigate the relationship between neuropsychiatric medication usage and COVID-19 outcomes before the widespread utilization of COVID-19 vaccines. This cross-sectional study used Optum's de-identified …

Cardiovascular Risk Factors And Genetic Risk In Transthyretin V142i Carriers, Naman S Shetty, Mokshad Gaonkar, Akhil Pampana, Nirav Patel, Alanna C Morrison, Alexander P Reiner, April P Carson, Bing Yu, Bruce M Psaty, Charles Kooperberg, Diane Fatkin, Eric Boerwinkle, Jerome I Rotter, Kent D Taylor, Lifang Hou, Marguerite R Irvin, Michael E Hall, Mathew Maurer, Myriam Fornage, Nicole D Armstrong, Nicole Bart, Parag Goyal, Stephen S Rich, Ramachandran S Vasan, Peng Li, Garima Arora, Pankaj Arora

Faculty, Staff and Student Publications

Background: Nearly 3% to 4% of Black individuals in the United States carry the transthyretin V142I variant, which increases their risk of heart failure. However, the role of cardiovascular (CV) risk factors (RFs) in influencing the risk of clinical outcomes among V142I variant carriers is unknown.

Objectives: This study aimed to assess the impact of CV RFs on the risk of heart failure in V142I carriers.

Methods: This study included self-identified Black individuals without prevalent heart failure from 6 TOPMed (Trans-Omics for Precision Medicine) cohorts, the REGARDS (Reasons for Geographic And Racial Differences in Stroke) study, and the All of …

Heat Stress Prevention And Management In The Construction Industry: A Gap Analysis, Muinat Abolore Idris, Kristina D Mena, Christine Markham, William B Perkison

Faculty, Staff and Student Publications

Background: Despite decades of efforts to prevent heat stress, it remains a major health risk to workers in the construction industry. This health risk has been exacerbated by the rising ambient temperatures from climate change, as well as the increased susceptibility to heat stress in an aging workforce.

Objective: To develop a tailored occupational safety management framework for heat stress prevention in construction, advancing workers’ health, safety, and well-being.

Methods: We built on the findings of a systematic review and analyzed a large industrial company’s current heat stress prevention program through stakeholder engagement, evidence-based practices, and gap analysis. We reviewed …

Recovery Housing And On-The-Ground Research Priorities: A Scoping Study Through The Lens Of Community Based Participatory Research, Patrick F Hibbard, Cameron W Tice, Jodie M Dewey, Kathryn R Gallardo, James Tompkins, Justin S Bell, Jasleen Sandhu, Michelle A Cruz, Kathryn Babbitt, Amy A Mericle, Ashli J Sheidow

Faculty, Staff and Student Publications

Introduction: Though communities have featured recovery housing (RH) for several decades, the base of evidence for best practices continues to grow - especially evidence needed by, and known to, those who operate and receive these services. The Initiative for Justice and Emerging Adult Populations (JEAP) engaged with three community boards (CBs) - consisting of young adults with experience in recovery from substance use issues, people who have a history of criminal legal system involvement and recovery, and payers and provider of substance use services and harm reduction - to understand on-the-ground priorities for research into recovery support services.

Methods: JEAP …

Community-Involved Economic Evaluation And Development Of A Cost-Effectiveness Calculator For Two Peer-Driven Substance Use Interventions, Sierra Castedo De Martell, Margaret B Moore, Hannah Wang, Lori Holleran Steiker, J Michael Wilkerson, Sheryl A Mccurdy, Nalini Ranjit, H Shelton Brown

Faculty, Staff and Student Publications

Introduction: While peer-driven substance use interventions have proliferated across the U.S., economic evaluations of these interventions have lagged behind. A key characteristic of these interventions is the centrality of the "nothing about us without us" ethos, which should extend into economic evaluation research. To that end, this study sought to take a community-based participatory research (CBPR) approach to conducting a cost-effectiveness analysis (CEA) of peer recovery support services (PRSS) and turning that CEA and a CEA of bystander naloxone distribution (BND) into components of a free, web-based calculator for use by recovery community centers (RCCs).

Methods: We engaged staff and …

Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Infection Control Module Program 200 Series, Kayla E Ruch, Anabel Rodríguez, Janelle Rios

Faculty, Staff and Student Publications

Background: The Texas Epidemic Public Health Institute (TEPHI) aims to safeguard public health and the Texas economy by preparing for infectious disease outbreaks. The Infection Prevention and Control (IPC) Webinar series was created to offer free educational resources and continuing education for public health and healthcare personnel responsible for IPC programs in rural regions of Texas. The IPC 200 Series succeeds the founding IPC 100 Series established by the TEPHI Small Rural Healthcare Preparedness.

Methods: IPC registration and attendance data were collected through WebEx® and Microsoft Teams®, which also served as the platforms for module delivery. Learning assessments and post-module …

What We Know About The Peer Workforce And Economic Evaluation For Peer Recovery Support Services: A Systematic Review, Sierra Castedo De Martell, J Michael Wilkerson, Nalini Ranjit, Lori Holleran Steiker, Sheryl A Mccurdy, H Shelton Brown

Faculty, Staff and Student Publications

Background: Peer recovery support services (PRSS) for substance use disorder (SUD) have expanded in the past 2 decades to be formally certified and reimbursed under Medicaid in almost every US state. This rapid expansion has been followed by a growth in research, but 2 persistent gaps remain: a lack of research on the peer workforce, and a lack of economic evaluation research. This systematic review examines the current literature on PRSS to summarize what is currently known about the SUD peer workforce and collect potential PRSS economic evaluation parameters, and clearly identify the current gaps in each category.

Methods: PRISMA …

Diversity In United States Dementia Prevention Trials: An Updated Systematic Review Of Eligibility Criteria And Recruitment Strategies, Najoua Lazaar, Sabine E Van Beek, Awaale F Rirash, Janne M Papma, Jaime Perales-Puchalt, Ashley R Shaw, Eric D Vidoni, Sanne Franzen

Faculty, Staff and Student Publications

Introduction: Given the elevated dementia risk in underrepresented demographic groups in the USA - particularly in Latino and Non-Latino Black individuals compared to Non-Latino White individuals - it is vital that these groups are well-represented in dementia prevention research. Eligibility criteria and recruitment strategies may play a key role in promoting participant diversity. The aim of this review was to examine eligibility criteria and recruitment strategies in US dementia prevention trials in light of participant diversity.

Methods: A systematic review was conducted using Medline (including PubMed), Embase, Cochrane Library, and CINAHL. We explored the percent White participants for trials using …

Use Of Digital Health Interventions For Cancer Prevention Among People Living With Disabilities In The United States: A Scoping Review, Chinenye Lynette Ejezie, Lea Sacca, Sylvia Ayieko, Sara Burgoa, Yasmine Zerrouki, Diana Lobaina, Goodness Okwaraji, Christine Markham

Faculty, Staff and Student Publications

BACKGROUND: The use of digital health strategies for cancer care increased dramatically in the United States over the past 4 years. However, a dearth of knowledge remains about the use of digital health for cancer prevention for some populations with heath disparities. Therefore, the purpose of the present scoping review was to identify digital health interventions for cancer prevention designed for people with disabilities.

METHODS: This scoping review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews and the Arksey and O'Malley methodological framework. The Embase, PubMed, Ovid MEDLINE, and CINAHL/EBSCO databases were …

Magnetization Transfer Ratio In The Typically Developing Pediatric Spinal Cord: Normative Data And Age Correlation, Sara Naghizadeh Kashani, Iswarya Vel, Zahra Sadeghi Adl, Shiva Shahrampour, Devon Middleton, Mahdi Alizadeh, Laura Krisa, Scott Faro, Slimane Tounekti, Julien Cohen-Adad, Feroze Mohamed

Department of Radiology Faculty Papers

BACKGROUND AND PURPOSE: This study presents automated atlas-based magnetization transfer (MT) measurements of the typically developing pediatric cervical spinal cord (SC). We report normative MT ratio (MTR) values from the whole cervical cord white matter (WM) and WM tracts, examining variations with age, sex, height, and weight.

METHODS: MT scans of 33 healthy females (mean age = 12.8) and 22 males (mean age = 13.09) were acquired from the cervical SC (C2-C7) using a 3.0 T MRI. Data were processed using the SC Toolbox, segmented, and registered to the PAM50 template. Affine and non-rigid transformations co-registered the PAM50 WM atlas …

Effectiveness And Implementation Of A Multi-Faceted Intervention To Facilitate Adoption Of Asthma Self-Management Practices In Peruvian Children And Adolescents: A Hybrid Type 2 Individually Randomized Controlled Trial, Alejandro Zevallos-Morales, Elisa Romani-Huacani, Kevin J Psoter, Oscar Flores-Flores, David Reif, Trishul Siddharthan, Mariona Portell, Maria Teresa Anguera, Lindsay J Underhill, Suzanne L Pollard

2020-Current year OA Pubs

BACKGROUND: Peru has one of the highest burdens of asthma in the world, as well as large gaps in access to evidence-based treatments. Studies often overlook the ways in which the research context and data collection activities interact and influence the experience of a research participant, their perception of an intervention, and, by extension, study outcomes.

METHODS: We conducted an individually randomized type 2 hybrid-implementation trial to evaluate the implementation and effectiveness of a locally adapted, multi-faceted intervention package to improve adherence to self-management practices. We enrolled 110 children with physician-diagnosed asthma living in nine urban districts Lima, Peru, and …

Evolution And Recent Radiation Therapy Advancement In Uganda: A Precedent On How To Increase Access To Quality Radiotherapy Services In Low- And Middle-Income Countries, Awusi Kavuma, Solomon Kibudde, Daniel Kanyike, Joseph Kigula-Mugambe, Tianyu Zhao, Hiram Gay, Baozhou Sun, Jackson Orem

2020-Current year OA Pubs

The evolution of radiation therapy in Uganda has been a journey marked by significant milestones and persistent challenges. Since the inception of radiotherapy services in 1988-1989, there has been a concerted effort to enhance cancer treatment services. The early years were characterized by foundational developments, such as the installation of the first teletherapy units, low-dose-rate brachytherapy units, and conventional simulators, and the recognition of radiation oncologists and medical physicist professionals laid the groundwork for radiotherapy treatment modalities. With more support from the International Atomic Energy Agency, the acquisition of dosimetry equipment, treatment planning systems, and additional professional training signaled a …

Type 2 Diabetes Polygenic Risk Score Interactions With Lifestyle Risk Factors In Black Americans, Ashley W Scadden, Aastha Kakar, Elizabeth M Litkowski, Mariah C Meyer, Nicole D Armstrong, Steven Buyske, Yanwei Cai, Iona Cheng, Burcu F Darst, Myriam Fornage, Mariaelisa Graff, Boya Guo, Christopher A Haiman, Heather M Highland, Charles Kooperberg, Loïc Le Marchand, Kari North, Ulrike Peters, Stephen S Rich, Jerome I Rotter, Vinodh Srinivasasainagendra, Hemant K Tiwari, Stephanie Waldrop, Kristin Young, Sridharan Raghavan, Ethan M Lange, Leslie A Lange, Marguerite R Irvin, Maggie A Stanislawski

The Brown Foundation: Institute of Molecular Medicine

Introduction: Prior work in predominantly European ancestry populations has explained how the risk associated with demographic, lifestyle, and health factors differs with underlying genetic susceptibility to type 2 diabetes (T2D), but less is known about these relationships in Black Americans.

Methods: We used covariate-adjusted logistic regression models of T2D to examine interactions between a published trans-ancestry derived T2D polygenic risk score (PRS) and various demographic, lifestyle, and health-related factors among 28,251 self-identified Black Americans from six cohort studies.

Results: The results are generally consistent with prior work in White populations. The PRS showed a significant interaction with body mass index, …

Mechanisms And Environmental Factors Shaping The Ecosystem Of Brain Macrophages, Silvia Penati, Simone Brioschi, Zhangying Cai, Claudia Z Han, Marco Colonna

The Brown Foundation: Institute of Molecular Medicine

Brain macrophages encompass two major populations: microglia in the parenchyma and border-associated macrophages (BAMs) in the extra-parenchymal compartments. These cells play crucial roles in maintaining brain homeostasis and immune surveillance. Microglia and BAMs are phenotypically and epigenetically distinct and exhibit highly specialized functions tailored to their environmental niches. Intriguingly, recent studies have shown that both microglia and BAMs originate from the same myeloid progenitor during yolk sac hematopoiesis, but their developmental fates diverge within the brain. Several works have partially unveiled the mechanisms orchestrating the development of microglia and BAMs in both mice and humans; however, many questions remain unanswered. …

Intestinal Oxygen Utilisation And Cellular Adaptation During Intestinal Ischaemia-Reperfusion Injury, Paraschos Archontakis-Barakakis, Theodoros Mavridis, David-Dimitris Chlorogiannis, Georgios Barakakis, Eleni Laou, Daniel I Sessler, George Gkiokas, Athanasios Chalkias

Faculty, Staff and Student Publications

The gastrointestinal tract can be deranged by ailments including sepsis, trauma and haemorrhage. Ischaemic injury provokes a common constellation of microscopic and macroscopic changes that, together with the paradoxical exacerbation of cellular dysfunction and death following restoration of blood flow, are collectively known as ischaemia-reperfusion injury (IRI). Although much of the gastrointestinal tract is normally hypoxemic, intestinal IRI results when there is inadequate oxygen availability due to poor supply (pathological hypoxia) or abnormal tissue oxygen use and metabolism (dysoxia). Intestinal oxygen uptake usually remains constant over a wide range of blood flows and pressures, with cellular function being substantively compromised …

Rbd Amplicon Sequencing And Evolutionary Analysis Of Sars-Cov-2 Variants From Wastewater Samples, Xingwen Chen, Chunfu Zheng, Fuqing Wu

Faculty, Staff and Student Publications

The surveillance of SARS-CoV-2 is significantly limited by the presence of numerous variants with distinct behaviors driven by rapid evolution. Although the conventional clinical genome sequencing method provides comprehensive data, it has limitations in capturing the epidemiological dynamics of the variants circulating in the community. In this chapter, we describe a protocol using RBD amplicon sequencing of wastewater samples. We present the detailed experimental procedure for wastewater sample processing, robust nested-PCR-based amplification of the target RBD sequence, and library preparation. Moreover, we describe a general pipeline of sequencing data processing and interpretation, showing the epidemiological and evolutionary trends of SARS-CoV-2 …

Shifting Patterns In Primary Care Telehealth Utilization Among Medicare Beneficiaries And Providers, Yunxi Zhang, Lincy S Lal, Saurabh Chandra, John Michael Swint

Faculty, Staff and Student Publications

Introduction: The COVID-19 pandemic accelerated telehealth adoption, but disparities in its utilization persist. This study examines primary care patient sociodemographic characteristics, telehealth utilization patterns, and provider adoptions before and during the pandemic.

Methods: A retrospective cohort study analyzed data from Mississippi Medicare beneficiaries continuously enrolled in Parts A, B, and D who accessed primary care services from 2019 to 2021.

Results: Among 201 677 Medicare beneficiaries accessing primary care, 1364 used telehealth before the pandemic, compared to 73 994 during the pandemic. Telehealth utilization shifted during the pandemic to younger, female, White beneficiaries, and those enrolled in Medicare due to …

Phenotypic Variation In Disease Severity Among Hospitalized Pediatric Patients With Covid-19: Assessing The Impact Of Covid-19 In The Epico Study, María Camila Sossa-Alarcón, Mónica Paola Gutiérrez, Natalia Becerra, Luz Yessenia Ortegon, María Camila David, Melisa Naranjo Vanegas, Gabriela Friedrich, Pablo Vásquez-Hoyos, María Lucía Mesa-Rubio, Luis Miguel Navarro-Ramirez, Sergio Moreno-Lopez, Olga Lucía Baquero, Luz Marina Mejía, Juan Gabriel Piñeros, Sonia Restrepo-Gualteros, Carlos Álvarez-Moreno, Alejandro Díaz-Díaz, Iván Gutierrez-Tobar, Andrés Camilo Mesa, William Ricardo Bachiller Tuta, Clara Esperanza Galvis Diaz, Martha Africano, José Manuel Nieto, Paola Marsela Pérez Camacho, Claudia Beltrán-Arroyave, Rosalba Vivas Trochez, Irati Gastesi, Cinta Moraleda, Alfredo Tagarro García, Blanca Herrero, Lourdes Calleja, Carlos Grasa, Paula Rodriguez, Susana Melendo, Antoni Soriano-Arandes, Irene Gómez Pastrana, Sonsoles García García, Victoria Fumado, Andrea Ramírez Varela

Faculty, Staff and Student Publications

Objective: To characterize the clinical phenotypes of SARS-CoV-2 infection in hospitalized children as part of the EPICO multicenter cohort study.

Methods: We included hospitalized children with confirmed SARS-CoV-2 infection from Colombian and Spanish institutions to assess disease evolution and outcomes. Cluster analysis was performed to identify clinical phenotypes.

Results: A total of 2318 patients were included (55% male, 36% infants). Five phenotype clusters emerged: Cluster 1 (26.5%): infants without comorbidities, low PICU admissions and mortality; Cluster 2 (18.5%): respiratory comorbidities, high microorganism co-detection and mortality; Cluster 3 (11.5%): fever, gastrointestinal symptoms, high PICU admissions; Cluster 4 (32%): mild unspecific symptoms, …

Factors Influencing Implementation Of A Self-Measured Blood Pressure Program In Community Health Centers: An Implementation Mapping Approach, Serena A Rodriguez, Fernanda Velasco-Huerta, Mahalia Sampson-Ansah, Ella R Garza, William B Perkison, Patenne D Mathews, Catherine Pulicken, Maria E Fernandez

Faculty, Staff and Student Publications

Objectives: Uncontrolled hypertension is a leading cause of cardiovascular disease, particularly among adults aged 45 years and older. Self-measured blood pressure (SMBP) is an evidence-based intervention that can help patients manage hypertension outside of the clinical setting. We conducted a needs and assets assessment to identify (1) health center adopters and implementers and (2) barriers and facilitators to SMBP adoption and implementation in six community health centers in Texas.

Methods: Data sources included: (1) needs and assets assessment surveys and semi-structured interviews; (2) site visits with participating health centers; and (3) detailed meeting notes and logs. Leaders and administrators from …

Adaptation Using Im Adapt Of An Evidence-Based Lifestyle Intervention To Support The Management Of Metabolic-Dysfunction Associated Steatotic Liver Disease Among Hispanic/Latino Adults, Natalia I Heredia, Sylvia A Ayieko, Serena A Rodriguez, Jessica P Hwang, Lorna H Mcneill, Maria E Fernandez

Faculty, Staff and Student Publications

The high prevalence of metabolic-dysfunction associated steatotic liver disease (MASLD), formerly non-alcoholic fatty liver disease (NAFLD), necessitates the availability of an evidence-based intervention to manage the condition among patients to prevent severe chronic liver disease and other cardiometabolic-related illnesses. IM Adapt (Intervention Mapping for Adaptation) is a systematic approach for planning modifications in interventions to improve fit and potential effectiveness. Following this stepped approach, we conducted interviews with the target population, conducted a literature review, solicited expert advice, and created a logic model describing expected program outcomes for the new population and setting. We searched for, selected, and adapted an …

Co-Creation Of Staff Training To Address Health-Related Social Needs In Emergencies, Linda Highfield, Gayla Ferguson

Faculty, Staff and Student Publications

Background: Health-related social needs (HRSN), such as housing and transportation barriers, contribute to poor health outcomes and increased healthcare costs. Patient navigators help connect patients to community resources, but workforce training gaps are a challenge. The Strengthening Peer AHC Navigation (SPAN) study aimed to enhance navigation training during the COVID-19 Public Health Emergency.

Methods: Using a stakeholder-driven peer planning approach, SPAN co-developed a quality improvement plan for patient navigation training. Training focused on housing and transportation navigation and included didactic sessions, hands-on case studies, and biweekly expert consultations. Self-efficacy surveys measured navigator confidence pre- and post-training, and changes in navigation …

A Mixed-Methods Usability Pilot Of A Value-Goal Elicitation Tool In The Inpatient Setting For Older Adults Anticipating Post-Acute Care, Kirstin M Piazza, Caroline Pascal, Syama R Patel, Caroline Sefcik, Marilyn M Schapira, Caroline Madrigal, Katherine C Ritchey, Longyi Yip, Aanand D Naik, Robert E Burke

Faculty, Staff and Student Publications

Age-Friendly Health Systems (AFHS) emphasize aligning care with "What Matters" most to older adults. Hospitalization represents a critical period where value-based goals could shape key decisions about post-acute care transitions. However, few tools designed for eliciting such goals have been adapted for use in the inpatient setting, where the acute nature of care poses unique challenges. This mixed-methods study evaluates the usability of the Health Priorities Primer Tool (HPPT) in older hospitalized adults who anticipate needing post-acute care, aiming to identify necessary adaptations for the inpatient setting. We conducted interviews, observations, and surveys with older hospitalized patients to understand their …

A Directed Content Analysis For Greatest Problems Among People With And Without Traumatic Brain Injury, Emily Dudek, Michael W Williams, Chung Lin Novelle Kew, Annalyn Demello, Brittany Wright, Alexandra B Holland, Alyssa Day-Gorman, Alexa S Gonzalez, Luis Leon Novelo, Xiangyi Liu, Shannon B Juengst

Faculty, Staff and Student Publications

Objective: To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.

Design: A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.

Setting: Community.

Participants: A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls).

Interventions: Not applicable.

Main outcome …

A Systematic Review And Narrative Synthesis Of Factors Affecting Pre-Exposure Prophylaxis Willingness Among Black Women For Hiv Prevention, Alexis Sims Haynes, Christine Markham, Vanessa Schick, Robert Suchting, Nivedhitha Parthasarathy, Sumaita Choudhury, Mandy J Hill

Faculty, Staff and Student Publications

Pre-exposure prophylaxis (PrEP) can significantly reduce human immunodeficiency virus (HIV) transmission among Black women in the United States (U.S.), a group disproportionately affected by HIV. However, PrEP uptake in this HIV-vulnerable population is low. This review analyzes the factors influencing Black women's PrEP willingness using the Behavioral Model for Vulnerable Populations (BMVP). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the Population, Intervention, Comparison, Outcome, Study Design (PICOS) framework, we conducted a systematic literature search and selected 24 peer-reviewed studies on PrEP willingness. Narrative synthesis revealed a heterogeneous landscape of the determinants affecting PrEP willingness …

Association Between Trust In The Incumbent President And Covid-19 Preventive Behaviors During The Pandemic In Four Latin American Countries, Juliana Mejía-Grueso, Gloria Isabel Niño-Cruz, Javiera Alarcón-Aguilar, Pablo Roa-Urrutia, Sergio Mauricio Moreno-López, Adriano Akira Ferreira Hino, Alexandre Augusto De Paula Da Silva, Fernando López, Deborah Salvo, Rodrigo Siqueira Reis, Guillermo Rosas, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

The COVID-19 pandemic revealed disparities in policy responses in Latin America. We examined the association between trust in the president and COVID-19 preventive behaviors in Brazil, Chile, Colombia, and Mexico. We used data from the Collaborative COVID-19 Response Survey by the McDonnell Academy at Washington University in St. Louis (United States), from September 2020 to March 2021. Nonprobabilistic sampling included adult citizens from the four countries. Multivariate negative binomial regression models were applied. The study included 8,125 participants, with Brazil showing the lowest adherence to preventive behaviors (65.5%). Increased adoption of preventive behaviors was linked with ages 18-26 (aIRR = …

A Comparison Of Floating Catchment Area Parameters With Applications To A Dataset Of Clinics Enrolled In A Statewide Child And Adolescent Psychiatric Consultation Program, Jocelyn Hunyadi, Lara S Savas, Kehe Zhang, Jeanette E Deason, Ryan Ramphul, Melissa F Peskin, Erica L Frost, Cici Bauer

Faculty, Staff and Student Publications

INTRODUCTION: Healthcare resources are often crucial but limited, requiring careful consideration and informed allocation based on population needs and potential healthcare access. In resource allocation settings, availability and accessibility of resources should be examined simultaneously. The two-step floating catchment area (2SFCA) method has been previously used to evaluate spatial accessibility to healthcare resources and services, and to address health-related disparities. The 2SFCA methods have regained significant popularity during the COVID-19 pandemic, as their application proved crucial in addressing priority public health data analysis, modeling, and accessibility challenges. However, comprehensive comparisons of the 2SFCA method input parameters in the context of …