Medicine and Health Sciences Commons^™

Social And Structural Determinants Of Health As Predictors Of Covid-19 Vaccine Hesitancy Among Older Adults In The United States, Kingsley Kalu

Electronic Theses and Dissertations

Background: Although vaccination is one of the greatest accomplishments in public health, some people, especially older adults, are reluctant to take vaccines. This study examined the association between the social and structural determinants of health and COVID-19 vaccine hesitancy among older adults in the United States.

Methods: Secondary data from the Health and Retirement Study (HRS) was used. The HRS participants were 65 years and older, and the sample size was 2311. Multinomial multivariable logistic regression models were conducted for this study.

Results: The study shows that social determinants of health (marital status, educational level) and structural determinants of health …

Assessment Of The Utilization Of Healthcare Services Specific To Pregnancy-Related Complications In Rural And Medically Underserved Georgia, Diana L. Aguirre

Electronic Theses and Dissertations

Maternal mortality is a continuing issue, with rates for the state of Georgia (3.7 per 100,000 live births) are higher than that of the US rates (2.9 per 100,000 per live births) (Centers for Disease Control and Prevention, National Center for Health Statistics, n.d., 2023). However, maternal mortality may not account for health disparity factors, apart from access to quality care and physiological issues, which is a factor in pregnancy-related deaths, Pregnancy-related death, as defined by the US Centers for Disease and Control (CDC), is a death of a woman that occurs during or within one year of pregnancy that …

Factors Associated With Physical Activity Intent Among Adults With Multiple Sclerosis, Biebele Okpeahior

Electronic Theses and Dissertations

Introduction. Although research has highlighted the benefits of physical activity in people with Multiple Sclerosis (MS), they are still more likely to live an inactive lifestyle. There are limited studies that examine the relationship between physical activity and the Theory of Planned Behavior (TPB) among the MS population. This study aimed to explore the factors that associate with physical activity intent of adults with MS utilizing the constructs of the TPB. Methods. This study utilized a cross-sectional online survey done via a social media platform. There were 326 respondents to the survey and ultimately 249 surveys that met the criteria …

Factors Associated With Patient Portal Utilization, Preventive Services Utilization, And Health Promoting Behaviors Among Adults In The United States, Elizabeth Ayangunna

Electronic Theses and Dissertations

Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults …

What Could Go Wrong? Patient And Hospital Characteristics Associated With Pediatric Quality Of Inpatient Care And Pediatric Adverse Events, Michael H. Samawi

Electronic Theses and Dissertations

This study aims to analyze associations between hospital and patient characteristics with pediatric adverse events (PAE) in the inpatient hospital setting, utilizing the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ) indicators. Three PDIs were identified and utilized for this purpose: NQI 03 Neonatal Blood Stream Infection, PDI 09 Postoperative Respiratory Failure, and PDI 10 Postoperative Sepsis. The data used for the study is based on an analysis of discharge data from the Healthcare Cost and Utilization Project (HCUP) Kid’s Inpatient Databases (KID) for the year 2019. The findings contribute to the growing …

Using The Cipp Model Of Evaluation On A Health Disparities Curriculum Delivered To Medical Residents In 12 Residency Programs, Gauri K. Shevatekar

Electronic Theses and Dissertations

Background: Although the Accreditation Council for Graduate Medical Education (ACGME) has provided educational directives on health disparities education during residency program for the medical residents, there is paucity of curricula focused on disparities education within the graduate medical education.

Objective: The purpose of this study was to evaluate a Health Disparities Curriculum (HDC) that was delivered to twelve residency programs at a College of Medicine.

Methodology: The study employed a cross-sectional study design. Stufflebeam’s Context-Input-Process-Product (CIPP) model was utilized as theoretical framework to assess whether the curriculum achieved its stated goals and objectives, the teaching and learning processes, and the …

Bridging The Gaps: Exploring Factors Associated With Goal Achievement Within An Accountable Care Organization Care Coordination Program, Jessica L. Polk

Electronic Theses and Dissertations

Background: Healthcare cost in the U.S. has been increasing at an unsustainable rate due to the growing population diagnosed with multiple chronic conditions and a fragmented healthcare system. The high-risk patient population includes persons who over utilize the healthcare system with frequent avoidable hospitalizations, emergency room visits, and exacerbations of their chronic conditions. This high-risk population makes up five percent of the U.S. but accounts for over fifty percent of all healthcare spending. Care coordination models have emerged to focus proactive health interventions for the highest-risk patient populations to reduce overutilization and empower patients to improve long-term health. Evidence has …

United States Nursing Homes And Health Equity During The Covid-19 Pandemic, Carla Cooper

Electronic Theses and Dissertations

Objective: The COVID-19 pandemic disproportionately affected older populations, with nursing homes impacted early on by the disease. The contribution of race/ethnicity of nursing home residents and facility characteristics on COVID-19 were unknown. The Donabedian model framework was used to study the relationship between the racial/ethnic characteristics of nursing home residents and COVID-19 outcomes and to examine if this relationship was moderated by the racial/ethnic composition of the county of nursing home location.

Method: Cross-sectional research design merging data from five publicly available sources. Laboratory confirmed COVID-19 cases and deaths were compared by the racial composition of the county and nursing …

Thinking Ethically About Hiv Pre-Exposure Prophylaxis: Retention In Care And Sexually Transmitted Infection Testing In A Southeastern United States Local Health Department In The Time Of Covid-19, Ellie Purdy

Electronic Theses and Dissertations

Local Health Departments (LHDs) are critical providers of Human Immunodeficiency Virus (HIV) and sexually transmitted infection (STI) prevention efforts. HIV Pre-Exposure Prophylaxis (PrEP) is an evolving public health initiative and practitioners should consider PrEP interventions in context of ethical decision-making and a broad STI prevention strategy as global incidence of bacterial STIs remains high and those at-risk for HIV are generally at-risk for other STIs. An evaluation of the Thinking Ethically framework and LHD PrEP services was performed to fill a gap in the literature and support program decision-making. A retrospective review of PrEP user medical records from a LHD …

"Who's The Man?" Examining The Relationships Between Black Masculinity, Perceived Social Support, And Sexual Behavior In Black Male College Students, James Thomas

Electronic Theses and Dissertations

Introduction: Sexual health disparities in college-aged Black men remains a critical public health issue. Black men are likely to have an earlier sexual debut, acquire sexually transmitted infections (STIs) and HIV at higher rates, and enter fatherhood at earlier ages than their White counterparts. Previous research has identified masculinity and perceived social support as predictors of sexual risk behavior for men in the U.S. However, when exploring masculinity’s influence on sexual behavior, studies that are culturally sensitive to Black men’s experiences and perspectives on manhood are few. The purpose of this study was to explore the relationship between Black masculinity, …

Perceptions Of Physical Activity Engagement Among African American Emerging Adults At Georgia Southern University - Statesboro Campus, Addison Mickens

Electronic Theses and Dissertations

Introduction: Physical Activity (PA) is critical to the health and well-being of African American emerging adults, ages 18-25. Research suggests that African American (AA) college students engage in less PA than other racial/ethnic groups. Few studies have examined the relationship between the collegiate built environment (CBE) impact on PA in this population. The Social Ecological Model (SEM) and the Social Cognitive Theory (SCT) were used to show how the environment facilitates influence on the behavior through physical and social factors affecting the behavior of engaging in PA. Methods: The purpose of this cross-sectional, concurrent multi-method study was to determine barriers …

Let Me Upgrade You: Common Measures In Public Health Accreditation Action Plans, Gurleen K. Roberts

Electronic Theses and Dissertations

Objectives: The purpose of this study is to understand the success rates for health departments pursuing and achieving accreditation in version 1.0 and 1.5 of the Public Health Accreditation Board (PHAB) standards and measures. During the accreditation process, health departments that present performance gaps are asked to complete an Action Plan to specify how they plan to improve to meet the desired conformity. This study will highlight specific measures that are often included in Action Plans so that health departments pursuing accreditation can be better prepared to address these common pitfalls.

Methods: This study is a non-experimental, secondary …

Association Of Health Departments’ Completion Of A Community Health Assessment, Community Health Improvement Plan, And Strategic Plan With Better Population Health Outcomes, Kelora T. Cofer

Electronic Theses and Dissertations

Promoting health and well-being requires a strong public health infrastructure. This study examined the association of engagement of local health departments (LHDs) in accreditation and its pre-requisites with health outcomes in LHD jurisdictions such as the prevalence of premature death and tobacco use in the counties they serve. Two data sets, The 2016 National Profile of Local Health Departments and 2018 Community Health Rankings were linked using deterministic linkage approach, based on county FIPS codes as a unique identifier. Descriptive and multinomial logistic regression analyses were performed using SPSS Version 25. The results showed that having recently completed a community …

Perceptions Of Health Professionals In Ghana On The Role Of The Community In Chronic Disease Management, Jesuseme Omoruan

Electronic Theses and Dissertations

The prevalence of chronic disease has been on the rise in various developing countries. This study is an exploratory investigation of the perceptions of health professionals in Kumasi, Ghana on the role of the community in chronic disease management. Using the Chronic Care Model as a framework, the objective of the study was to examine the extent of community-healthcare system in chronic disease management and to explore the barriers to and facilitators of community involvement in chronic disease management. By exploring the availability of community resources that positively contribute to the management of these patients, the study fills an existing …

Factors Associated With Iron-Folic Acid Supplement Use Among Pregnant Women In Karu, Nasarawa State, Nigeria - A Cross Sectional Study Using Theory Of Planned Behavior, Toyin O. Akomolafe

Electronic Theses and Dissertations

Introduction: Iron-folic acid supplementation is one of the key interventions provided during antenatal care (ANC) services to reduce iron deficiency, maternal anemia, low birthweight and other pregnancy-related complications responsible for maternal and neonatal mortality. However, use of iron-folic acid supplements and adherence with recommended dosage in Nigeria is low. The purpose of this cross-sectional study was to examine factors associated with iron-folic acid supplements use among pregnant women in Karu local government area (LGA), Nasarawa, Nigeria. Methods: Questionnaires were administered in face-to-face interviews with 64 pregnant women (18 – 49 years old) and 19 healthcare providers in selected …

Exploring Psychosocial Factors And Sexual Risk Behavior Of Men Who Have Sex With Men In The United States Military: Project Minds, Erin Jordan

Electronic Theses and Dissertations

Statement of the Problem: Men who have sex with men (MSM) are at disproportionate risk for HIV infection. While many studies have examined psychosocial factors associated with HIV risk among MSM, few have focused specifically on MSM in the military. The purpose of this exploratory study is to examine ways in which specific psychosocial factors are associated with sexual risk behaviors among MSM in the military.

Methods: Data were collected from 63 MSM who were active duty military personnel or veterans in the Southeastern US. Participants were recruited from geosocial mobile applications, social media platforms, and military LGBT organizations. Logistic …

Current Concussion Education Practices In Ncaa Member Institutions: A Descriptive Study, Samuel E. Johnson Ii

Electronic Theses and Dissertations

Purpose: To investigate concussion education implementation methods in NCAA member institutions.

Methods: Of the 1,078 athletic trainers across all NCAA Divisions that were contacted, 355 were included in this study. Participants were asked to complete the Current Concussion Education Practices Questionnaire (CCEPQ). The CCEPQ consisted of four sections: demographics, concussion education questionnaire, perceived effectiveness of concussion education, and limitations/barrier to providing concussion education. Outcome frequencies were used to report survey results. Respondent division-level categorical differences across survey items were assessed with a 2X3 chi-square test of independence.

Results: Providing concussion education occurs in 98.9% of NCAA member institutions. Educating student …

Public Health Implications Associated With The Practice Of Utilizing Tires To Singe Meat In Three Major Cities Of Ghana: A Concurrent Mixed Methods Study, Tempest D. Hill

Electronic Theses and Dissertations

Utilization of automobile tires to singe meat (e.g., cows) intended for human consumption presents public health risks due to hazardous chemicals released into the environment and meat. This has become a common practice in some African countries such as Ghana. The objective of this study was to investigate the awareness and perception of the residents in three major cities of Ghana (Cape Coast, Kumasi and Accra) using the Health Belief Model and Social Ecological Model. Survey participants (n=196) and focus group discussion members (n=37) completed the study. Data collected from study participants included meat consumption, awareness of the use of …

The Determinants Of Physical Activity In Rural Women, Ages 20-44 Years, Dziyana Nazaruk

Electronic Theses and Dissertations

Despite multiple health benefits of exercise, it is reported that only 14.7% of American women engage in the recommended amount of physical activity. Whereas the potential negative consequences of not exercising are well documented, there is a scarcity of literature that investigates the determinants of physical activity in rural women. The purpose of this concurrent transformative mixed method study was to explore the determinants of physical activity in rural women ages 20-44 years. Specific quantitative research questions addressed the relationship between the determinants of physical activity on intra- and interpersonal levels, as well as the current physical activity status of …

Preventing Childhood Obesity: A Mixed Methods Study Into The Perceptions Of African Americans In A Rural Community, Dayna S. Alexander

Electronic Theses and Dissertations

Preventing childhood obesity is a global priority due to adverse health risks and financial burdens. With childhood obesity rates stabilizing it is difficult to determine which factors alone (i.e., genetic, environmental, behavioral, or demographic) increase susceptibility to childhood obesity. Parents influence childhood obesity risk factors through their parenting styles and behaviors. Social behavioral theories and public health evidence demonstrate including parents in childhood obesity efforts could assist in reducing childhood obesity rates. The objective of this study was to assess perceptions of childhood obesity among African Americans with children enrolled in a rural elementary school in the Deep South. The …

Athlete And Coach Knowledge, Attitudes, And Perceptions Of Sickle Cell Trait And National Collegiate Athletic Association Mandated Testing: Recommendations For Intervention, Raymona Holloway Lawrence

Electronic Theses and Dissertations

Individuals with Sickle Cell Trait have died suddenly after extreme exertion during military training, athletic practice or games (Kerle & Nishimura, 1996; Harrelson, Fincher & Robinson, 1995; Howe & Bowden, 2007). One of those deaths, Dale Lloyd, a football player at Rice University, prompted a change in the National Collegiate Athletic Association's (NCAA) Sports Medicine Handbook Guideline 3c: The Student Athlete with Sickle Cell Trait. Effective August 2010, the NCAA Division I Proposal No. 2009-75-B mandated sickle cell trait testing in all Division I athletes unless documented results of a prior test are provided to the institution or the student-athlete …