Medicine and Health Sciences Commons^™

Food Insecurity And Risky Sexual Behaviors Among College Students During The Covid-19 Pandemic, Bertille Assoumou, Jennifer Pharr, Courtney Coughenour

Environmental & Occupational Health Faculty Publications

Background

Sexually transmitted infections (STIs) and food insecurity are public health concerns in the United States (US) due to their growing prevalence and incidence among young people, and particularly in college students. Studies have reported that college students are at higher risk of STIs due to the high rates of risky sexual behavior (RSB). Most studies report a food insecurity prevalence of more than 30% among college students, which was more than twice the overall national food insecurity rate of 10.5% in 2020. This study aims to assess the relationship between food insecurity and RSB among college students during the …

Assessing The Testability Of The Multi-Theory Model (Mtm) In Predicting Vaping Quitting Behavior Among Young Adults In The United States: A Cross-Sectional Survey, Manoj Sharma, Kavita Batra, Ravi Batra, Chia-Liang Dai, Traci Hayes, Melinda J. Ickes, Tejinder Pal Singh

Social & Behavioral Health Faculty Publications

Purpose: Given the increased exposure to e-cigarettes and nicotine among young adults, difficulty in quitting vaping is likely, which supports the need for effective behavioral interventions. Therefore, this cross-sectional study aims to assess the testability of the contemporary multi-theory model of health behavior change in predicting the vaping quitting behavior among young adults in the United States. Methods: A nationally representative sample of 619 young adults engaged in vaping behavior and aged 18–24 years was recruited to complete a 49-item web-based survey. A structural equation model was used to test relationships between MTM constructs. Hierarchical multiple regression was utilized to …

Assessing Covid-19 Booster Hesitancy And Its Correlates: An Early Evidence From India, Geetanjali C. Achrekar, Kavita Batra, Yashashri Urankar, Ravi Batra, Naved Iqbal, Sabiha A. Choudhury, Deepti Hooda, Roohi Khan, Suraj Arora, Aditi Singh, Francesco Chirico, Manoj Sharma

School of Medicine Faculty Publications

The emergence of SARS-CoV-2 mutants, waning immunity, and breakthrough infections prompted the use of booster doses of the COVID-19 vaccine to fight against the pandemic. India started booster doses in January 2022 and it is critical to determine the intention of booster dose uptake and its correlates. Therefore, the current cross-sectional study aimed to investigate booster dose acceptability and associated predictors among the Indian population. A convenience sampling technique was utilized to recruit a sample of 687 Indian residents. A 55-item psychometric validated survey tool was used to assess booster dose acceptability, vaccine literacy and vaccine confidence. Univariate, bivariate, and …

Covid-19 Booster Vaccination Hesitancy In The United States: A Multi-Theory-Model (Mtm) Based National Assessment, Kavita Batra, Manoj Sharma, Chia-Liang Dai, Jagdish Khubchandani

School of Medicine Faculty Publications

Background: Despite the availability of COVID-19 vaccines and the proven benefits of vaccinations outweighing the potential risks, hesitancy to accept vaccines and additional doses remains a persistent problem. Therefore, the purpose of the study was to investigate hesitancy, confidence, literacy, and the role of the multi-theory model (MTM) constructs in COVID-19 booster uptake. Methods: This cross-sectional study utilized a 52-item psychometric valid web-based survey conducted during the month of October 2021 to recruit a nationally representative sample of U.S. adults. Univariate, bivariate, and multivariate statistical tests were used to analyze the data. Results: Among the booster hesitant group (n = …

Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen

School of Medicine Faculty Publications

Aims There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. Methods Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. …

Knowledge Or Awareness Of Non-Communicable Diseases And Their Associated Risk Factors Among University Students In Fiji: A Cross-Sectional Study, Awadhesh Kumar Shirotriya, Kavita Batra

School of Medicine Faculty Publications

Introduction: Chronic diseases (aka Non-communicable diseases, NCDs) contribute to the global burden of morbidity and mortality, with a significant share of premature deaths among low-and middle-income countries (LMICs), including Fiji. The early exposure to the risk factors of NCDs affects the entire life course; knowledge or awareness of adolescents towards NCDs and associated risk factors is critical for health promotion. This study aims to investigate the knowledge or awareness level of chronic conditions and their risk factors among Fijian students. Methods: In this cross-sectional study, a sample of 338 university students was recruited using the paper as well as web-based …

Testing Multi-Theory Model (Mtm) In Explaining Sunscreen Use Among Florida Residents: An Integrative Approach For Sun Protection, Manoj Sharma, Matthew Asare, Erin Largo-Wight, Julie Merten, Mike Binder, Ram Lakhan, Kavita Batra

Environmental & Occupational Health Faculty Publications

Florida residents have the second highest incidence of skin cancer in the nation. Sunscreen usage was found to be the one of the most effective integrative health approaches for reducing risk of skin cancer. Given the limited information on the likelihood of adopting and continuing sunscreen usage behavior, this cross-sectional study aimed to examine the correlates of initiating and sustaining sunscreen usage behavior among Florida dwellers, using the fourth-generation, multi-theory model (MTM) of behavior change. A web-based survey containing 51 questions was emailed to Florida residents aged 18 years or above, who were randomly selected from the state voter file. …

Protective Factors That Foster Resilience To Hiv/Aids: Insights And Lived Experiences Of Older Gay, Bisexual, And Other Men Who Have Sex With Men, Renato M. Liboro, Tammy C. Yates, Sherry Bell, Brandon Ranuschio, George Da Silva, Charles Fehr, Francisco Ibañez-Carrasco, Paul A. Shuper

Psychology Faculty Research

Since the beginning of the HIV/AIDS epidemic, gay, bisexual, and other men who have sex with men (gbMSM) have been disproportionately impacted by HIV/AIDS health disparities. Research showed that resilience to HIV/AIDS is associated with increased use of relevant health services, lower sexual health risks, and improved mental health outcomes among racially and ethnically diverse gbMSM. As the subpopulation that has historically been impacted by HIV/AIDS the longest, older gbMSM living with HIV/AIDS have inarguably exhibited resilience to HIV/AIDS the most. The qualitative study described in this paper sought to identify and examine protective factors that fostered resilience to HIV/AIDS …

Postsecondary Educational Attainment And Health Among Younger U.S. Adults In The “College-For-All” Era, Anna Zajacova, Elizabeth Lawrence

Sociology Faculty Research

Population-health research has neglected differentiation within postsecondary educational attainments. This gap is critical to understanding health inequality because college experience with no degree, vocational/technical certificates, and associate degrees may affect health differently. We examine health across detailed postsecondary attainment levels. We analyze data on 14,750 respondents in Waves I and IV of the nationally representative Add Health panel spanning adolescence to ages 26 to 34. Multivariate regression and counterfactual approaches to minimize the impact of confounders estimate multiple health outcomes across postsecondary attainment levels. Compared to high school diplomas, we find significant returns to bachelor’s degrees for most health outcomes …

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Presentations

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …

Conceptualization Of College Students' Covid-19 Related Mask-Wearing Behaviors Using The Multi-Theory Model Of Health Behavior Change, Robert E. Davis, Manoj Sharma, Kayla E. Simon, Amanda H. Wilkerson

Environmental & Occupational Health Faculty Publications

Background: Recommendations and policies, regarding the use of face coverings, have been instituted to control transmission of coronavirus disease 2019 (COVID-19). Understanding of psychosocial factors related to the use of face coverings within the context of COVID-19 is needed. This study aimed to conceptualize mask-wearing behavior among students using the Multi-theory Model (MTM) of behavior change. Methods: In October 2020, students (n = 595) enrolled in a large public southeastern US university were recruited to participate in a cross-sectional survey, using a valid and reliable instrument. Univariate, bivariate, and multivariate techniques described mask-wearing behavior and differentiated theoretical drivers of mask-wearing …

Risk Factors Associated With Cardiovascular Disease Among Adult Nevadans, Dieu My T. Tran, Nirmala Lekhak, Karen Gutierrez, Sheniz Moonie

Nursing Faculty Publications

© 2021 Tran et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Objective Cardiovascular disease (CVD) remains the number one cause of death in the US and Nevada is ranked 11th highest for CVD mortality. The study sought to examine the association between self-reported risk factors and CVD presence among adult Nevadans, between years 2011 and 2017. Methods This is a cross-sectional, population-based study that utilized the 2011 and 2017 Nevada Behavioral Risk …

Factors Associated With Prep And Pep Uptake Among The Latinx Population, Santiago Gudiño-Rosales, Melva Thompson-Robinson, Johanna Andrews

Calvert Undergraduate Research Awards

Advanced Undergraduate Winner

Uptake of PrEP and PEP amongst LatinX population has been low, despite being a population disproportionately affected by HIV. Systemic barriers and cultural factors affect general LatinX approaches to healthcare and may impact uptake of these medications. The purpose of this study is to assess the factors that are associated with the likelihood to take PrEP and PEP in the LatinX population. In this cross-sectional study, survey data was collected from 169 LatinXs from January - March 2020. Using the Sexual Health Model as the theoretical framework, the survey examined the following four constructs to identify factors …

If I Get Sick With Coronavirus, Can Donald Trump Make Me Stay Home?, Brian Labus

Environmental & Occupational Health Faculty Publications

President Donald Trump recently appointed Vice President Mike Pence to lead the government’s response to the COVID-19 outbreak and control public statements by government health officials about the crisis. In the days since, health departments throughout the country have investigated potential cases, announced new cases and declared public health emergencies, all without the approval of the vice president. So who really is in charge of the outbreak response? As with most things in American government, the answer is complicated.

Love In The Time Of The Coronavirus: Do You Turn Your Back When Someone Offers You A Hand, A Kiss Or A Hug?, Brian Labus

Environmental & Occupational Health Faculty Publications

We are exposed to numerous viruses from our day-to-day interactions with other people all the time. However, our risk of being infected by a simple greeting usually isn’t in the forefront of our minds. The spread of COVID-19 has changed that. Conferences have banned handshakes, churches have changed their worship services, and even politicians have changed the way they greet each other. But what’s the risk in a simple hug or a handshake?

What Really Works To Keep Coronavirus Away? 4 Questions Answered By A Public Health Professional, Brian Labus

Environmental & Occupational Health Faculty Publications

Editor’s note: The World Health Organization has declared that COVID-19, the disease caused by the new coronavirus, has a higher fatality rate than the flu. As of March 4, 2020, nine deaths have been reported in the U.S. Brian Labus, a professor of public health, provides essential safety information for you, from disinfectants to storing food and supplies.

A State Of Uncertainty: An Analysis Of Recent State Legislative Proposals To Regulate Preventive Services In The United States, Maxim Gakh, Cody Cris, Prescott Cheong, Courtney Coughenour

Public Health Faculty Publications

This policy brief examines preventive services state legislation trends in the United States during uncertainty regarding the Affordable Care Act (ACA), which requires certain coverage of 4 evidence-based preventive services categories without additional patient costs under §2713. We used a legal mapping approach to search for and analyze state legislation related to preventive services proposed or enacted over a 25-month period of ACA uncertainty. We screened 1231 bills and coded the 76 screened-in bills. Next, we determined their characteristics and examined trends. Bills originated in 28 states, and 69.7% were not enacted. Only 3.9% contained requirements contingent on ACA modifications. …

Racial Variations Of The Injection Route Of Administration Among Injection Drug Users In The United States: A Comparative Trend Analysis, Philip Danquah

Graduate & Professional Student Association Research Forum

The objective of this research is to address the variations in the injection route of administration among racial groups who are injection drug users in the United States and how that contributes to their vulnerability to HIV/AIDS behaviors and hospital admissions.

The Life She Deserves: Medical Marijuana In The United States, John Hudak, George Burroughs, Maritza Bermudez

Brookings Scholar Lecture Series

Brookings Mountain West offered an event titled, "The Life She Deserves: Medical Marijuana in the United States on Monday, November 5, 2018. This event featured a viewing of the film, and was followed by a panel discussion with John Hudak, George Burroughs, and Maritza Bermudez. “The Life She Deserves” is an intimate portrait of Jennifer Collins and her family’s struggle to find a treatment to control her debilitating epilepsy. Because her legal pharmaceutical treatments cause severe side effects, Jennifer and her mother move across the country to access medical marijuana. The therapy provides Jennifer and her family with the relief …

Provider Perspectives On Demand Creation For Maternal Vaccines In Kenya, Irina Bergenfeld, Stacy W. Nganga, Courtni A. Andrews, Vincent L. Fenimore, Nancy A. Otieno, Sandra S. Chaves, Jennifer R. Verani, Marc-Alain Widdowson, Winnie N. Wairimu, Susan N. Wandera, Raphael O. Atito, Maxwell O. Adero, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Background. Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods. Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview …

Nonlinear Associations Between Working Hours And Overwork-Related Cerebrovascular And Cardiovascular Diseases (Ccvd), Ro-Ting Lin, Lung-Chang Chien, Ichiro Kawachi

Public Health Faculty Publications

Long working hours are recognized as a risk factor for cerebrovascular and cardiovascular diseases (CCVD). We investigated the relationship between working hours and different CCVD severity outcomes—death, disability, and illness—across industries in Taiwan from 2006 to 2016. We applied a generalized additive mixed model to estimate the association between working hours and the rate of each severity outcome, adjusted for salary, unemployment rate, time, and a random intercept. Industry-average working hours were significantly associated with each outcome level of overwork-related CCVD, especially when monthly working hours increased from 169 (relative risk [RR] = 1.46, 95% confidence interval [CI] 1.002–2.12) to …

Pediatric To Adult Healthcare Transitioning For Adolescents Living With Hiv In Nigeria: A National Survey, Okikiolu A. Badejo, William A. Menson, Nadia A. Sam-Agudu, Jennifer Pharr, Salome Erekaha, Tamara Bruno, Gift Nwanne, Olabanjo Ogunsola, Jude Ilozumba, Olusegun Busari, Echezona E. Ezeanolue

Public Health Faculty Publications

Introduction The period of transition from pediatric to adult care has been associated with poor health outcomes among 10–19 year old adolescents living with HIV (ALHIV). This has prompted a focus on the quality of transition services, especially in high ALHIV-burden countries. Due to lack of guidelines, there are no healthcare transition standards for Nigeria’s estimated 240,000 ALHIV. We conducted a nationwide survey to characterize routine transition procedures for Nigerian ALHIV. Materials and methods This cross-sectional survey was conducted at public healthcare facilities supported by five local HIV service implementing partners. Comprehensive HIV treatment facilities with ≥1 year of HIV …

Factors Associated With Immunization Opinion Leadership Among Men Who Have Sex With Men In Los Angeles, California, Ian W. Holloway, Robert Bednarczyk, Vincent L. Fenimore, Cameron Goldbeck, Elizabeth Wu, Rebecca Himmelstein, Diane Tan, Laura Randall, Chelsea S. Lutz, Paula M. Frew

Environmental & Occupational Health Faculty Publications

We sought to identify the characteristics of men who have sex with men (MSM) who are opinion leaders on immunization issues and to identify potential opportunities to leverage their influence for vaccine promotion within MSM communities. Using venue-based sampling, we recruited and enrolled MSM living in Los Angeles (N = 520) from December 2016 to February 2017 and evaluated characteristic differences in sociodemographic characteristics, health behaviors, and technology use among those classified as opinion leaders versus those who were not. We also asked respondents about their past receipt of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal B …

Jail, An Unappreciated Medical Home: Assessing The Feasibility Of A Strengths-Based Case Management Intervention To Improve The Care Retention Of Hiv-Infected Persons Once Released From Jail, Anne C. Spaulding, Ana Drobeniuc, Paula M. Frew, Tiffany L. Lemon, Emeli J. Anderson, Colin Cerwonka, Chava Bowden, John Freshley, Carlos Del Rio

Environmental & Occupational Health Faculty Publications

Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection …

Secondary Data Analysis: A Non-Pharmacology Treatment For Individuals Living With Hiv/Aids, Joseph Jean, Carolee Dodge-Francis Ed.D

McNair Poster Presentations

At the end of 2015, 36.7 million people were living with HIV/AIDS world wide (WHO, 2017). Living with this disease puts individuals at increased risk for mental and physical health complications. Opportunistic infections and increased serious mental health conductions are common (NIH, 2016). Advances in antiretroviral therapies have been made to increase life expectancy but often times can adversely affect the individuals quality of life. Complementary and alternative medicine (CAM) is one way to help improve quality of life. One form of CAM, massage therapy may offer benefits to PLWHA in terms of ability to cope with stress.

Childhood Health Status And Adulthood Cardiovascular Disease Morbidity In Rural China: Are They Related?, Qing Wang, Jay Shen

Public Health Faculty Publications

Cardiovascular diseases (CVDs) are among the top health problems of the Chinese population. Although mounting evidence suggests that early childhood health status has an enduring effect on late life chronic morbidity, no study so far has analyzed the issue in China. Using nationally representative data from the 2013 China Health and Retirement Longitudinal Study (CHARLS), a Probit model and Two-Stage Residual Inclusion estimation estimator were applied to analyze the relationship between childhood health status and adulthood cardiovascular disease in rural China. Good childhood health was associated with reduced risk of adult CVDs. Given the long-term effects of childhood health on …

Impact Of Hiv Testing And Counseling (Htc) Knowledge On Hiv Prevention Practices Among Traditional Birth Attendants In Nigeria, Alice Osuji, Jennifer R. Pharr, Uche Nwokoro, Anulika Ike, Christiana Ali, Ogheneaga Ejiro, John Osuyali, Michael Obiefune, Kevin Fiscella, Echezona E. Ezeanolue

Environmental & Occupational Health Faculty Publications

Nigeria is second in the world for the number of people with HIV and has a high rate of mother-to-child transmission (MTCT). Over 60% of births in Nigeria occur outside of health care facilities, and because of this, Traditional Birth Attendants (TBAs) play a significant role in maternal and child health. It is important that TBAs be knowledgeable about HIV prevention. The purpose of this study was to determine the impact of HIV testing and counseling (HTC) knowledge on the HIV prevention practices among TBAs in Nigeria. Five hundred TBAs were surveyed. Chi-square and logistic regression were used to assess …

Delivering A “Dose Of Hope”: A Faith-Based Program To Increase Older African Americans’ Participation In Clinical Trials, Paula M. Frew, Saad B. Omer, Kimberly Parker, Marcus Bolton, Jay Schamel, Eve Shapiro, Lauren Owens, Diane Saint-Victor, Sahithi Boggavarapu, Nikia Braxton, Matthew Archibald, Ameeta S. Kalokhe, Takeia Horton, Christin M. Root, Vincent L. Fenimore, Aaron M. Anderson

Environmental & Occupational Health Faculty Publications

Background: Underrepresentation of older-age racial and ethnic minorities in clinical research is a significant barrier to health in the United States, as it impedes medical research advancement of effective preventive and therapeutic strategies. Objective: The objective of the study was to develop and test the feasibility of a community-developed faith-based intervention and evaluate its potential to increase the number of older African Americans in clinical research. Methods: Using a cluster-randomized design, we worked with six matched churches to enroll at least 210 persons. We provided those in the intervention group churches with three educational sessions on the role of clinical …

Evaluation Of An Assertive Continuing Care Program For Hispanic Adolescents, Eric Strunz, Joanna Jungerman, Juliet Kinyua, Paula M. Frew

Environmental & Occupational Health Faculty Publications

PURPOSE: This study evaluated an Adolescent Community Reinforcement Approach (A-CRA) and Assertive Continuing Care (ACC) program targeting Hispanic adolescents at risk for substance abuse.

Culture, Caregiving, And Health: Exploring The Influence Of Culture On Family Caregiver Experiences, Jennifer Pharr, Carolee Dodge Francis, Christine Terry, Michele Clark

Public Health Faculty Publications

Ethnic minorities are expected to experience a greater demand for family caregiving than non-Latino Whites due to their projected population growth. Although the consensus of researchers on caregiving and culture finds that the caregiving experience differs significantly among cultural/ethnic groups, the question remains as to how cultural values and norms influence the caregiver experiences. We conducted an interpretative, phenomenological qualitative analysis of focus group transcripts from four groups (African American, Asian American, Hispanic American, and European American) for cultural influences on caregiving. Data were collected in Nevada between December 7, 2009, and August 20, 2010. Thirty-five caregivers participated in this …