Medicine and Health Sciences Commons^™

Cognitive And Economic Development, John Luke Gallup

OHSU-PSU School of Public Health Annual Conference

A burgeoning literature finds that early childhood risk factors have large causal effects on individuals' cognitive development, education and earnings, but has not assessed the impact on the economy as a whole.

Cognitive ability is the foundation of human capital and the capacity to learn. The risk factors for poor cognitive development are very high in many countries. Each risk factor also causes child mortality, making child survival a viable proxy for good cognitive development conditions. The cognitive development of current workers happened decades earlier when they were children, providing a predetermined correlate. Controlling for country characteristics, income levels and …

Knowledge Of Medicaid Expansion To Recent And Undocumented Immigrants Among Oregon Mexican-Origin Latinos: (Work In Progress), Nancy Ledezma, Grace Parra, Alejandra Nunez, Dr. Blair Darney

OHSU-PSU School of Public Health Annual Conference

Background

Recent and undocumented immigrants are explicitly excluded from federal Medicaid and state insurance exchanges. The first phase of Healthier Oregon was implemented in July 2022 and expanded Medicaid (OHP) benefits to undocumented immigrants ages 19-25 or 55 and older. The second phase was implemented in July 2023 and extended benefits to everyone regardless of age. We assessed understanding of Healthier Oregon among Mexican-origin Latinos. We hypothesize that many potentially eligible people may not know about the program, if they qualify, or how to apply.

Methods

This is a cross-sectional study in collaboration with the General Consulate of Mexico. Our …

Understanding Variation In Provider Referral Rates To Early Intervention For Children With Developmental Delays, Gabriella Tangkilisan, Zoe Kilmer, Michelle Owens, Benjamin Sanders, Katharine Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background:

Early detection and treatment of developmental disabilities (DD), including Autism Spectrum Disorder (ASD), improves language, IQ, and adaptive outcomes. Guidelines recommend immediate referral to Early Intervention (public developmental therapy services) upon positive ASD/DD screening in infant/toddler well child checks. However, children screening positive for ASD/DD are not always referred for Early Intervention services. This project aimed to understand why pediatricians do and do not refer children with positive DD/ASD screens to early intervention.

Methods:

We conducted qualitative interviews with pediatricians who participated in a randomized trial investigating family navigation for children with autism risk. We determined pediatrician referral rates …

A Window Of Opportunity: Describing Participants Engaged In A Comprehensive Perinatal Care Model To Treat Substance Use Disorder During Pregnancy, Christina Jäderholm

OHSU-PSU School of Public Health Annual Conference

In 2019, 12% of pregnant persons were estimated to use psychoactive substances, the highest rate in US history. Substance use disorder (SUD) is a chronic, relapsing condition, and while pregnancy presents a unique opportunity for SUD intervention, research on pregnant and postpartum SUD patient experiences is vital for informing perinatal systems of care. The purpose of this presentation is to describe a sample from SUN, a comprehensive perinatal care program for pregnant persons with SUD in North Carolina.

Methods

We abstracted medical records (n=29), surveyed participants (n=29), and conducted two focus groups (n=7). Medical records provided participant demographics; medical, social, …

Gender Affirming Surgery And Pain In Adolescents: Teen And Parent Experiences, Corrin Murphy, Eleanor Battison, University Of Rhode Island, Anna Wilson Phd

OHSU-PSU School of Public Health Annual Conference

Background: Adolescents seeking gender affirming medical care face unique biopsychosocial challenges, including experiences of discrimination and stigma. Transgender and gender diverse (TGD) adolescents often undergo gender affirming surgery (GAS). While there is an increase in GAS for TGD adolescents in the U.S., little is known about the pain experiences in the post-surgical period among these youth. There have been no studies to our knowledge that examine the psychological functioning of parents and their ability to handle their child's distress, which may be affected by their child's post-GAS pain experiences. Parental responses to their children’s pain and distress may, in turn, …

Employer Voices: Insights On Bolstering Career Development For Graduate Students, Alexandria J. Ashraf Mph, Josh Hodsden Mba, Justin Howe Ba, Danielle Ross Ba, Dalton Wesemann Ba, Lisa K. Marriott Phd

OHSU-PSU School of Public Health Annual Conference

Title: Employer voices: Insights on Bolstering Career Development for Graduate Students

Alexandria J. Ashraf, MPH; Josh Hodsden, MBA, CPH; Justin Howe, BA; Danielle Ross, BA, CPH; Dalton Wesemann, BA; Lisa K. Marriott, PhD

Background: The development of the public health workforce has become increasingly vital as our world faces current and future challenges. The workforce has gained considerable insight into job skills that enhance responses to emergent needs. Building the foundation for a larger scale study on public health workforce needs, this project established processes for engaging with professionals who have hired recent public health graduates.

Methods: Open-ended questions assessed …

The Association Between Acculturation & C-Reactive Protein In U.S. Immigrants: A Cross-Sectional Study, Jessica Kilinski Bs, Rosol Mikail Bs, Kelly M. Reavis Phd, Mph, Deborah Karasek Phd, Mph

OHSU-PSU School of Public Health Annual Conference

Purpose: Immigrants undergo acculturation as they assimilate to a different culture, potentially leading to immense stress. Our objective was to examine the association between acculturation and C-reactive protein (CRP), a marker of stress-induced inflammation. We hypothesized that U.S. foreign-born adults 20 years and older with higher degrees of acculturation would have higher CRP levels compared to those with lower acculturation.

Method: We used 2017-2018 National Health and Nutrition Examination Survey (NHANES) data from 1526 participants to conduct a cross-sectional analysis. We measured acculturation as language spoken at home (categorized as low, moderate, and high) and examined its association with CRP …

The Cost Of Healthy Eating, Diana Prychyna, Miriam R. Elman, Joy Kim, Karen F. Miller, Deonni P. Stolldorf, Sean P. Collins, Bory Kea

OHSU-PSU School of Public Health Annual Conference

Abstract

Background

Each year in the United States, 15-20% of 1 million visits to the Emergency Department for Acute Heart Failure result in home discharge, with patients often experiencing adverse health outcomes within 30 days. The study, Get With the Guidelines in Emergency Department Patients With Heart Failure (GUIDED-HF), utilized ‘Self-Care Coaches’ who meet participants via telehealth calls to discuss self-care maintenance after discharge as a strategy to mitigate adverse health outcomes; and offer provisions of resources, including a cookbook by the American Association for Heart Failure Nurses (AAHFN).

During the calls, we observed gaps in self-care for retired older …

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of Us Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

Impact Of Two Shift Schedules On Post-Shift Blood Pressure In Firefighters, Ayeisha H. Haswarey

OHSU-PSU School of Public Health Annual Conference

Background: Firefighters have an increased risk of cardiometabolic disease compared to the general population. Blunted blood pressure (BP) dipping during nocturnal sleep is associated with increased cardiometabolic disease morbidity/mortality. Shift work can alter diurnal BP oscillation, but the extent of alteration by different schedules remains debated. No study to date has examined firefighting shift schedules, necessitating a longitudinal evaluation to begin to understand their implications for cardiometabolic health. Thus, this preliminary analysis compares how two common schedules (24/48 hours on/off vs. 1/3/2/3 days on/off) impact post-shift BP and dipping in 20 firefighters.

Methods: 20 participants (10% female; 25-54 years of …

Transgender And Non-Binary Health In Oregon Under A Single-Payer Health System, Amy (Mick) L. Mcveety (They/She)

OHSU-PSU School of Public Health Annual Conference

As the state with the highest percentage of population who identifies as LGBTQ+, Oregon has a duty to provide adequate health protections and services to its transgender and nonbinary (TGNB) residents, particularly given the disparities TGNB individuals face in housing, employment, education, and health. Following recommendations from the Oregon Joint Task Force on Universal Health Care, Oregon should implement a single-payer health care system, with particular attention to:

1. Protecting patient privacy in EHR and other systems, particularly for youth TGNB patients;
2. Expanding the covered gender-affirming services and removing barriers such as cost-sharing and prior authorization, and;
3. Recruiting TGNB providers and …

Exploring Decolonial And Indigenous Mental Health Framework And Practice To Address Complex Trauma Among Palestinian Youth Living Under Violence Of Settler-Colonialism, Vivian L. Duong, Corrin Murphy

OHSU-PSU School of Public Health Annual Conference

The growing settler colonial project of Israel forced indigenous Palestinians to flee from their homeland to further the Zionist movement of establishing a Jewish-majority state. The forced dispossession and displacement of Palestinians at this time was referred to as the Nakba, or catastrophe (Masalha, 2002). From 1947 and 1949, approximately 750,000 Palestinians from a population of 1.9 million were made refugees (Al Jazeera, 2017). Also referred to as the ethnic cleansing of Palestine, Zionists forcibly took over 78 percent of Palestine, destroyed about 530 villages and cities, and killed around 15,000 Palestinians including more than 70 massacres (Al Jazeera, 2017). …

Strong Hearts Program: The Results Of A Novel Primary-Care Based Diagnostic And Referral Program For Chagas Disease In East Boston, Ma, Usa, Javier J. Huerta

OHSU-PSU School of Public Health Annual Conference

Purpose: Chagas disease (CD), a neglected parasitic infection, affects ~300,000 people in the US. Untreated, CD leads to irreversible cardiac morbidity and death in 20-30% of cases, yet

Methods: After provider and community sessions, 14,354 patients were screened at EBNHC from March 2017 - May 2023, following a prespecified protocol. Confirmed Chagas patients were referred to Boston Medical Center for further evaluation. Using chi-squared tests, we analyze diagnostic uptake and prevalence stratified by demographics. Additionally, we abstracted care continuum barriers from Chagas patients' records.

Results: Per quarter, a median of 572 patients were screened (IQR: 393 – 712). …

The Use Of Extreme Risk Protection Orders Intended To Prevent Mass Violence In Oregon: A Descriptive Study, Rosol Mikail, Rebecca Valek, Shauna Rakshe, Rebecca Teichman, Susan Defrancesco, Kathleen Carlson

OHSU-PSU School of Public Health Annual Conference

Purpose: Firearm violence is a critical public health issue in the United States. Extreme Risk Protection Order (ERPO) laws are an intervention method that have been enacted in many states to prevent firearm violence including mass violence threats. This study examined the characteristics of ERPO petitions filed in Oregon for a 6-year period that involved mass violence threats.

Method: ERPO petitions included in court records obtained through the Oregon Judicial Case Information Network, from January 1, 2018, to December 31, 2023 were abstracted; a 20% random sample of records was double-coded to ensure interrater reliability. An epidemiologic analysis of cases …

“Sense Of Belonging”: Partnering With Central Oregon's Communities To Promote Health And Social Inclusion, Christina Jäderholm

OHSU-PSU School of Public Health Annual Conference

Abstract:

Community-engaged research can increase local research capacity and create momentum for social change. From research planning to dissemination, partnering with organizations and engaging with community members requires dedicated work and time. Using the Belonging project in Central Oregon as an example, we outline the ‘nuts and bolts’ of a community-engaged research process and highlight how we validated our findings through co-interpretation sessions.

Project

The Belonging project is a collaboration between Oregon Health & Science University (OHSU), Oregon State University - Cascades, the Central Oregon Health Council, and the Central Oregon communities. The project began [early] 2022 and concluded Feb …

Self-Reported Follow-Up Care Needs Can Be Met In Both Facility And Self-Managed Abortion: Evidence From Low- And Middle-Income Countries, Laura E. Jacobson Mph

OHSU-PSU School of Public Health Annual Conference

Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.

Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.

Results: A total of n=67 …

Using Systems Thinking Tools To Inform The Implementation Of A Cysticercosis Control Program In Rural Peru, Lisset M. Dumet Poma Mba, Angela Spencer Phd, Ruth Atto Bsc, Vanessa Cruz Bsc, Percy Vilchez Mph, Seth O'Neal Md, Mph For The Cysticercosis Working Group In Peru

OHSU-PSU School of Public Health Annual Conference

Cysticercosis is an infectious disease responsible for 30-40% of acquired epilepsy in endemic areas such as rural Peru. Ring Treatment (RT) is a community-engaged cysticercosis control strategy, shown to be efficacious when delivered by research teams. We applied the Consolidated Framework for Implementation Research with additional constructs compatible with low-resource contexts in the formative evaluation to develop a protocol for implementing RT.

We included small, medium, and large municipal districts from northern Peru representing different rural primary health delivery settings. We collected 169 semi-structured and 341 network interviews. We applied Social-Network-Analysis to identify key players, roles, and collaborations to inform …

Trauma Informed Approaches To Researcher-Participant Relationships: Examples From A Housing And Health Study, Cristina Flores, Jade Garza, Judith R. Solomon, Marisa Westbrook

OHSU-PSU School of Public Health Annual Conference

In qualitative research, the aim of researcher-participant relationships is to allow for vulnerability and authenticity while maintaining professional boundaries. Trauma-informed care (TIC) in mental health services and social work considers the impact of violence and victimization in the lives of clients, while emphasizing trauma as causation (SAMHSA, 2014; Butler, 2011). Applying a trauma-informed approach to qualitative research processes may assist in building rapport with research participants, minimizing re-traumatization, appropriately interpreting results, and uncovering cultural significance. Research suggests that trauma-informed approaches avoid excluding underrepresented voices and allows researchers to engage through a social justice and health equity lens (Roche, 2020). For …

Beyond The Bmi: Expanding Quantitative Methods To Study Health For All Bodies, Kieran Chase, Daniel Oron

OHSU-PSU School of Public Health Annual Conference

The public health field is beginning to reckon with its role in perpetuating and reinforcing systemic anti-fatness. Emerging evidence for the devastating health impacts of stigma call into question decades of research and policy that labels the size of people’s bodies as diseased. However, even as we acknowledge the harmful effects of stigma, the field is materially and institutionally invested in a health paradigm that centers weight loss and size-related proxies for health, such as the BMI. Public health scholars interested in questions related to nutrition, chronic disease, and exercise must begin to expand their research focus to imagine non-stigmatizing …

Serotonin And Migraine, Sophia A. Kogan

OHSU-PSU School of Public Health Annual Conference

Migraine, experienced by more than 1 billion people, is the second leading cause of disability worldwide. It is a physiologically complex disorder with nervous, vascular, and inflammatory components, and is associated with genetic factors and environmental influences. Migraine triggers are poorly understood, and sufferers have little control in preventing migraines from occurring. The aim of this review is to bridge the physiological migraine processes with lifestyle behaviors that can be modified by individuals, focusing on serotonin.

Migraines can be initiated when an external event triggers the release of vasodilators such as calcitonin gene-related peptide (CGRP), leading to cranial vasodilation, headache, …

(Un)Weighted Assumptions: Anti-Fatness & Health, Kieran Chase, Nell Carpenter, Madysen Schreiber

OHSU-PSU School of Public Health Annual Conference

This lecture/discussion session aims to expand and add nuance to public health students’, professors’, and practitioners’ understanding of the interplay between body size and health. We will begin by naming and challenging common assumptions about the relationship between bodyweight and health outcomes. We will then argue for the consideration of weight-related stigma as a Fundamental Cause of Disease as defined by Phelan and Link, and for institutionally embedded anti-fat bias at the policy level (e.g., insurance policy, medical equipment) as a cause of population health inequity as defined in Whitehead’s Health Equity Framework. We offer these frameworks in contrast to, …

Does Sph Curricula Promote ‘Health Equity’, Reproduce Injustice, Or Both?, Jesse Yarnold

OHSU-PSU School of Public Health Annual Conference

Does SPH Curricula Promote ‘Health Equity’, Reproduce Injustice, or both?

The social justice movements of recent years (preceded by [generations of] insurmountable suffering) have facilitated a collective recognition of the systemic effects of racism and epistemic violence. Despite the ambitious and well-intentioned vision of “health equity” as defined by epidemiologic scholarship - progress is slow and injustices prevail.

Students, scholars, and researchers of ‘Public Health’ are uniquely positioned to imagine and create innovative ways of understanding and addressing the harmful inequities and injustices perpetuated by white settler colonialism. I argue that Academic institutions delivering Public Health education are uniquely positioned …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investing In Family Planning, Education, And Empowering Of Women And Girls To Mitigate The Impact Of Climate Change: An Exemplary Case Of Rwanda., Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Countries where population growth is high are often highly impacted by the climate crisis despite not being a significant contributor to historical greenhouse gas emissions. This has created a global inequality in that countries with poorly developed infrastructure are 15 times more likely to have deaths due to climate related disasters such as floods, droughts, and storms compared to wealthy countries that can better protect against similar events. While the climate crisis impacts everyone, women and girls are at a higher risk because of their unique health needs and roles in the community. The effects of climate change can be …

Impact Of Industrial Disasters On The Mental Health Of Vietnamese Americans On The Gulf Coast, Vivian L. Duong

OHSU-PSU School of Public Health Annual Conference

An explosion on the Deepwater Horizon oil rig caused 200 million gallons of crude oil to spill on the Gulf Coast over a five-month span. About 16,000 miles of coastline, ecosystem and marine life along Alabama, Florida, Louisiana, Mississippi, and Texas were contaminated. This disaster and the recovery process caused social, financial, and ecological shocks, resulting in adverse psychosocial and physical health outcomes, health disparities, and socioeconomic inequality. Among the oil spill's most affected and vulnerable populations are the Vietnamese American communities that settled on the Gulf Coast after the end of the Vietnam War in 1975. The plight of …

Housing Quality In Philadelphia, Pa: An Urban Health Equity Indicators Approach, Jennifer Piacentini

OHSU-PSU School of Public Health Annual Conference

Philadelphia is also the poorest large city in the country, and many residents live in substandard housing. Poor housing quality is associated with poor physical health outcomes as well as mental health issues (Schilling et al., 2022). Many homes in Philadelphia are of poor quality partially due to the median house age being 93 years, and the fact that 75% of homes are more than 50 years old (Jay, 2017). It has also been found that Black households are disproportionately impacted by housing quality issues. The Habitat for Humanity Philadelphia’s Home Repair programs are invaluable, and work with homeowners to …

Map The System: Presence And Impact Of Ppcps In Water, Emma Vandermeulen, Ruby Mitchell

OHSU-PSU School of Public Health Annual Conference

In a changing climate, there is growing emphasis on protecting our water sources and developing systems for conserving and reusing water. While many contaminants of concern are monitored and addressed by water treatment systems, pharmaceuticals and personal care products (PPCPs) are generally not accounted for. PPCPs in water systems have been an increasing concern as detection of these products has increased over the last few decades. Studies have been exploring the impact of antibiotics, antidepressants, contraceptives, and other anthropogenic products on our water system and how these substances interact with local ecosystems. Our main research questions are to understand what …

The Prevalence Of Osteoporosis And Low Femoral Neck Bone Density Among Never-Smoking U.S. Adults With Exposure To Secondhand Smoke: A Cross-Sectional Study Using The National Health And Nutrition Examination Survey (Nhanes), Felicia Zhou, Mikaela Haglund

OHSU-PSU School of Public Health Annual Conference

Objective

Epidemiologic studies have observed an association between exposure to secondhand smoke (SHS) and low bone mineral density (BMD) among current and past smokers. However, there is a knowledge gap in elucidating this association among never-smoking adults. The objective of this study is to examine the association between SHS exposure, measured by serum cotinine levels, and BMD for never-smoking U.S. adults.

Methods

This cross-sectional analysis included 3,224 never-smoking U.S. adults aged 50 years and older from the National Health and Nutrition Examination Survey cycles 2007-2008, 2009-2010, and 2013-2014. Serum cotinine, a biomarker for tobacco exposure, was the exposure variable while …

Qualitative Evaluation Of Medical Student Perceptions Of Chronic Disease, Mallory A. Decampos-Stairiker, Viviane Cahen, Sarah Dzubay, Saffron Evergreen, Rachel Shore

OHSU-PSU School of Public Health Annual Conference

Background:
Chronic disease is becoming increasingly common around the world. Students in different US medical training programs are exposed to varying amounts of chronic disease education and are taught unique ways of approaching chronic disease management. The purpose of this study is to investigate allopathic and naturopathic medical students’ attitudes, understandings, and perceptions of chronic diseases and their management.

Methods:
This study was conducted as a class project for UNI 504: Qualitative Methods for Health Professionals. We conducted virtual interviews during February 2023 with five allopathic and five naturopathic medical students from around the United States. Demographic information on …

History Of Hypertension And Urinary Incontinence Among Adults Aged 40 And Older: A Cross-Sectional Study From The National Health And Nutrition Examination Survey, Puthyda Keath, Karla Cordova Nicolas

OHSU-PSU School of Public Health Annual Conference

Introduction: Urinary incontinence (UI) impacts over 200 million individuals world-wide, though little is known about the causes of this condition. The aim of this cross-sectional study was to examine prevalence of UI and the association between a history of hypertension and UI in older adults. A secondary aim was to determine if sex modified the association between history of hypertension and UI.

Methods: This study utilized data from the U.S. National Health and Nutrition Examination Survey (NHANES) 2011-2016 cycles. We included 9,717 U.S adults (≥40 years) with complete information on history of hypertension, UI and other independent variables. Participants with …