Medicine and Health Sciences Commons^™

Social Influences On Quitting E-Cigarette Use: A Mixed Method Analysis, Olivia Peterson, Page Dobbs

Health, Human Performance and Recreation Undergraduate Honors Theses

Social Influences on Quitting E-Cigarette Use: A Mixed Method Analysis

Page Dobbs, Olivia Peterson, Erin Arthur, Jessica Seymore, Jenn Veilleux, Robert Davis, Mance Buttram, Mufazzela Tabassum

Words: 250/250

Introduction. Young adult e-cigarette users report peers as a reason for using these products; however, it is unclear how social influences are associated with attempting to quit e-cigarettes. The purpose of this mixed-methods study was to examine the relationship between social factors and quitting e-cigarettes.

Methods. E-cigarette users from a large southern university were recruited to take part in an explanatory, sequential mixed-methods study. First, participants (n=423) completed a cross-sectional survey about …

Addressing Equitable Access In A Safety-Net Hospital System: An Implementation Framework, Hillary Alycon

Dissertations: Doctor of Public Health

Acute care organizations face a significant challenge in effectively implementing health equity programs, particularly in rural areas where guidance is often lacking. Despite abundant literature focusing on health outcomes, there remains a noticeable dearth of published data on implementing health equity initiatives. In response to this gap, I present a comprehensive analysis that utilizes readily available, open-sourced data to address this critical issue.

A thorough assessment of the demographic characteristics of acute care facilities within the catchment regions was conducted based on data from reputable sources such as the US Census Bureau, the American Community Survey, and the County Health …

Exploring The Lived Experience Of Self-Care In Young Adults With Type 2 Diabetes, Holly Berry-Price

Electronic Theses and Dissertations

Introduction

The prevalence of prediabetes in adults aged 18 or older was as high as 38% between 2017-2020. Youth-onset T2DM is a more aggressive phenotype than T2DM that occurs later in life. Young adults with T2DM have poorer health outcomes, lose an average of 15 years of life, all resulting in significant economic burden impacting the person. Current self-management interventions do not improve health outcomes in young adults with T2DM.

Purpose

The purpose of this research was to explore the self-care experiences of young adults living with T2DM.

Methods

Existential hermeneutic phenomenology informed the research. Inclusion criteria as follows: adults …

Examining The Relationship Between Deafness And Mental Health Status: An Analysis Of The Behavioral Risk Factor Surveillance System (Brfss) 2022, Brianna Stroud-Williams

Capstone Experience

Objective: The objective of the research is to examine the association between mental health status as measured by number of mentally healthy days in the past month and deafness and binge drinking.

Methods: The Behavioral Risk Factor Surveillance System (BRFSS) study was conducted via telephone survey in 50 states, including the District of Columbia and US territories. The sample size is 402,156 participants. Univariate, bivariate, and multivariate regressions, odds ratio, and 95% confidence interval were used to measure the data.

Results: Deaf respondents have 1.56 times the odds of having poor mental health than those who are not deaf. (95% …

Cervical Cancer Screening And Affordability Of Medical Care: A Cross-Sectional Study, Sarah M. Johnson

Capstone Experience

Objective: To determine if, among women aged 21-65, there is a positive association between avoiding healthcare due to cost and not being up to date on cervical cancer screening.

Methods: This cross-sectional study utilized the 2022 Behavioral Risk Factor Surveillance System dataset. A total of 123,275 women, aged 18-69 without a hysterectomy, were analyzed with bivariate and multivariate analyses. The outcome was length of time since last cervical cancer screening. The exposure was avoiding healthcare in the last 12 months due to cost.

Results: Women who avoided healthcare due to cost had higher odds of not being up to date …

Examining The Association Between Smoking Frequency And Long Covid: A Brfss Study, Bhavya Patel

Capstone Experience

Objectives: To examine the relationship between self-reported smoking frequency and the presence of Long COVID among individuals who tested positive for COVID-19.

Methods: A cross-sectional study was conducted using a sample of 44,738 COVID-positive participants from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) dataset. Logistic regression was utilised to compute prevalence odds ratios (pOR) and was adjusted for potential sociodemographic confounders.

Results: Individuals who smoked daily were found to have a greater likelihood of reporting Long COVID in comparison with nonsmokers (Crude pOR=1.22; CI= [1.10-1.35]). However, in the adjusted regression model, daily smoking was no longer significant (Adjusted pOR=1.04; …

Heartache Beyond The Physical: Unraveling The Nexus Between Myocardial Infarction History And Depressive Disorders In Us Adults, Sonika Khanal

Capstone Experience

Objective: To estimate the prevalence of depressive disorders among US adults and explore the association between a history of Myocardial Infarction (MI) and depressive disorders, considering potential risk factors and demographic variables.

Methods: A cross-sectional study was conducted from 2022 Behavioral Risk Factor Surveillance System data, including 390,429 US adults. Logistic regression was used to estimate the association between the history of MI and depressive disorders, adjusting for age, gender, race, smoking status, health insurance, education level, and BMI. Effect modification by age was assessed.

Results: The prevalence of depressive disorders was 21.19%, with 4.46% reporting a …

A Cross-Sectional Analysis Of Self-Reported Long Covid And Binge Drinking Amongst Covid-Positive Individuals Using The Behavioral Risk Factor Surveillance System (Brfss), 2022, Maire Kirley

Capstone Experience

Objective: Identify an association between Long COVID (exposure) and binge drinking (outcome) amongst COVID-positive individuals.

Methods: COVID-positive respondents (n=116,120) were sampled from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Univariate analysis assessed distribution of Long COVID, binge drinking, and covariates sex, age, race/ethnicity, education, income, rural/urban residency, veteran status and BMI. Bivariate analysis determined crude prevalence odds ratios (POR) between exposure, outcome, and covariates. Multivariate logistic regression determined adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI) for exposure, outcome and covariates.

Results: No association found between Long COVID and binge drinking (aPOR: 0.94 (95% CI: 0.87, …

Association Between Depression And Coronary Heart Disease: A Cross-Sectional Study Using Behavioral Risk Factor Surveillance System (Brfss), 2022, Juliana Monono

Capstone Experience

Objectives: To examine the association of depression and coronary heart disease in U.S. adults.

Methods: This cross-sectional study uses the Behavioral Risk Factor Surveillance System (BRFSS), 2022 data for non-institutionalized U.S adults aged 18 and older. The exposure variable is depression, the outcome is coronary heart disease (CHD), and covariates are age, race, education, and physical activity. Performed univariate, bivariate, and multivariate analyses to assess the association between depression and CHD.

Results: The analytical sample size consisted of 427,217 individuals. A total of 88,841(20.7%) of the population reported having coronary heart disease, while 338,376(70.3%) reported having no …

Association Between Long Covid-19 And Insurance Status Using The Behavioral Risk Factor Surveillance System (2022), Elizabeth E. Osbourn

Capstone Experience

Objective. To determine if insurance status can directly predict self-diagnosed Long COVID and what sociodemographic factors are significantly associated with a self-diagnosis of Long COVID among those who tested positive for COVID-19.

Methods. This cross-sectional study uses data from the 2022 Behavioral Risk Factor Surveillance System to conduct a multivariate logistic regression model analysis. Out of 445,132 participants, 110,402 participants were identified to be used in this study.

Results. After testing positive for COVID-19, 21.7% of individuals were self-diagnosed with Long COVID. After controlling for confounders, insurance status wasn't significant (p-value: 0.8458). However, in crude analysis, individuals with Medicaid (cPOR:1.44; …

The Impact Of Household Income On The Development Of Long-Covid After Covid-19 Infection, Clayton Mowrer

Capstone Experience

Objective

Long-COVID can occur following coronavirus-19 infection and can have debilitating consequences. It is unclear how household income (a social determinant of health) might impact the development of long-COVID. This study aims to characterize and compare the prevalence of long-COVID in persons who have been diagnosed with COVID-19, according to household income.

Methods

Using data from the 2022 Behavioral Risk Factor Surveillance System Questionnaire, 124,313 respondents who reported a diagnosis of COVID-19 infection were analyzed for the development of long-COVID (outcome) and compared across annual household income (exposure). Other demographic and socioeconomic factors were similarly analyzed.

Results

The prevalence of …

Physician Burnout In The United States: A Systematic Review Of Organizational And Systemic Approaches And Their Efficacies, 2014-2024, Nicole Butler

Capstone Experience

Physician burnout represents a critical public and clinical health concern in the United States. It compromises patient care and physician safety. Approaches to solve the issue are pervasive, with limited indication of effectiveness. Due to the essential job functions of physicians, the practice of medicine is inherently stressful. However, the introduction of new, more complex stressors, including those exacerbated by the COVID-19 pandemic, and the increase in chronic healthcare conditions have made burnout an unfortunate staple of physician life, with an estimated prevalence of up to 60%. Burnout involves three factors: emotional stress, depersonalization, and reduced job satisfaction. The consequences …

Identifying Barriers To Healthcare Access And Utilization Experienced By Lgbtq+ Adults With Chronic Diseases Through The Lens Of The Social Ecological Model, Devin Mottier

Capstone Experience

The purpose of this literature review is to comprehensively examine and synthesize existing research on present barriers to health access and utilization that contribute to the disparities in chronic disease prevalence within the adult LGBTQ+ population. In the context of this review, the social-ecological model (SEM) was used to describe the nuanced and multifaceted nature of healthcare access and utilization. This literature review was based upon the following question: ‘Using the social-ecological model, what are the barriers to health access and utilization that contribute to high rates of chronic disease in LGBTQ+ adults?’ Outcome measures of interest included the following …

Examining The Impact Of Racial And Ethnic Disparities In Colorectal Cancer Screening Compliance In The United States And The Potential Of Targeted Interventions., Jessica Ware

Capstone Experience

Objectives:

Examine Colorectal cancer (CRC) screening compliance among racial and ethnic groups in the United States (US) based on the US Preventive Services Task Force (USPSTF) recommendations.

Identify targeted interventions to promote screening compliance, early diagnosis, and CRC survivorship.

Methods: This cross-sectional study utilized 165,878 selected participant responses from the 2022 Behavioral Risk Factor Surveillance System. We modeled and investigated CRC screening compliance based on the USPSTF recommendations as inclusion criteria between racial/ethnic groups in the US while adjusting for covariates using a weighted stepwise logistic regression.

Results: With covariates adjustment, Hispanics (POR 1.16 95%CI 1.04-1.29), Asian …

Optimizing Malaria Control In Nigeria: A Comprehensive Review Of Llin Effectiveness And Policy Frameworks, Jash Mehta

Capstone Experience

This comprehensive literature review examines the effectiveness of Long-Lasting Insecticidal Nets (LLINs) and the policy frameworks governing their use in Nigeria, with the goal of optimizing malaria control strategies in the country. The review explores the scientific underpinnings of LLINs, evaluates their effect on malaria incidence, and examines the operational, sociocultural, and economic aspects that affect their use. It also examines Nigeria's policy environment, assessing the creation, application, and efficacy of policies pertaining to LLIN. The summary of research results from several studies emphasizes the importance of LLINs in preventing malaria and the challenges associated with implementing policies in different …

Development Of A National Core Indicators Dashboard Of Long-Term Services And Supports Outcomes For Individuals With Intellectual And Developmental Disabilities, Rhonda Haitz

Capstone Experience

The National Core Indicators (NCI) surveys are conducted annually across the United States, including Nebraska. Individuals with intellectual and developmental disabilities and/or their guardians are surveyed to learn more about their experiences and the quality of their services and lives (National Core Indicators- IDD, 2023). However, the data is only useful when understood and applied to make informed decisions to improve the lives of those with intellectual and developmental disabilities (McDonald et al., 2013). This project designed and developed two data dashboards for the state of Nebraska that publicly track, analyze and display the NCI survey results. The In-Person Survey …

Hiv Testing Among High-Risk Individuals In The Us: 2022 Brfss, Alissa Lorchick

Capstone Experience

Objective

Human Immunodeficiency Virus (HIV) infection is a global epidemic, and public health efforts are moderately effective to date. This cross-sectional study aimed to determine association between high-risk behavior (intravenous drug use, risky sexual behaviors) and odds of testing for HIV utilizing 2022 Behavioral Risk Factor Surveillance System (N= 445,132).

Methods

Using SAS 3.82, the age-stratified logistic regression model for exposure (high-risk behavior) and outcome (HIV testing) included covariates gender, race, income, mental health and checkup frequency.

Results

High-risk individuals had greater odds of testing compared to low-risk individuals (crude POR 2.98 [2.81 – 3.17]), with greatest odds observed among …

Disparities In Seasonal Influenza Immunization Between Hispanic And Non-Hispanic White Populations Within The United States: Findings From The 2022 Behavioral Risk Factor Surveillance System, Susanna Stageberg

Capstone Experience

Objective: To determine if inequities in influenza immunization exist between Hispanic and non-Hispanic White populations living in the United States.

Methods: Statistical analyses were executed to study the association between ethnicity and influenza immunization. Logistic regression was performed to determine probabilities related to vaccination. Data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) was utilized.

Results: Hispanic respondents had higher odds of not being vaccinated against the flu when compared to non-Hispanic White respondents (COR = 1.82, 95% CI [1.73, 1.91]). Ethnicity, household income, education, insurance status, age, sex, preferred language, and primary care provider status …

Assessing The Association Between Income And Breast Cancer Screening Practices, Hannah M. Zantow

Capstone Experience

Objectives

To determine how breast cancer screening practices differ between high- and low-income women aged 40-74. To determine the effects of sociodemographic factors on the relationship between income and breast cancer screening practices.

Methods

This was a cross sectional study. Survey data was obtained from women aged 40-74 who completed the Behavioral Risk Factor Surveillance Survey (BRFSS). The exposure was income. The outcome was if a woman ever received a mammogram. The final sample size was 171,111 participants. Regression models were used to assess the association between income and screening practices.

Results

There was a significant association between income and …

Perinatal Buprenorphine Effects On Offspring Growth, Opioid Withdrawal, And Brain Morphology In Rats, Parker Barnes

Electronic Theses and Dissertations

Opioid use disorder (OUD) impacts 5.6 million people in the US. Buprenorphine (BUP) is a commonly prescribed opioid medication used to treat OUD, including in pregnant women. However, opioid use during pregnancy is associated with poorer infant outcomes including reduced fetal growth, neurodevelopmental deficits, and neonatal opioid withdrawal syndrome (NOWS). Recent clinical data suggests that providing mothers with a lower dose of BUP may result in fewer negative outcomes in infants. Here, a preclinical rodent model of low-dose perinatal BUP exposure was used to study offspring health outcomes in the neonate, juvenile, and adolescent offspring. Dams were given clinically relevant …

Factors Affecting The Use Of Food Pantries By California State University Students, Beyza Aktepe

Electronic Theses, Projects, and Dissertations

Food insecurity is one of the major public health issues world-wide including the United States. A significant proportion of students within the California State University (CSU) system, approximately 41.6%, experience food insecurity. The purposes of this study was 1) to determine the factors and barriers that affect the use of campus food pantries by university students on seven CSU campuses, 2) to determine the improvements that can be implemented in the on-campus food pantries, 3) to evaluate the effectiveness of the management of food pantries, and 4) to evaluate the effectiveness and utilization of nutrition education services provided in conjunction …

Human Papillomavirus Vaccination: Barriers, Disparities, And Potential Solutions, Gracie Margaret Chiampas

Chancellor’s Honors Program Projects

No abstract provided.

Differences In Mental Health Disorders: The Importance Of Mental Health Literacy, Hannah More

Honors Theses

This study was conducted to see college-aged students' mental health literacy with specific disorders. The disorders studied were anxiety, depression, PTSD, and substance use disorder. I predicted that certain disorders such as anxiety and depression would have a higher mental health literacy than PTSD and substance use disorder.

Exploring The Quality Performance Of Ethno-Specific And Mainstream Not-For-Profit Long-Term Care Homes In Ontario, Lanei Amein

Electronic Thesis and Dissertation Repository

The purpose of this retrospective study was to determine how ethno-specific not-for-profit long-term care (LTC) homes in Ontario perform in comparison to mainstream not-for-profit LTC homes using nine RAI-MDS 2.0 quality indicators. Publicly available data from three sources: the Canadian Institute for Health Information "Your Health System: In Depth" database from the Continuing Care Reporting System, data on Ontario ethno-specific not-for-profit LTC homes from the Home and Community Care Support Services, and data on home and ownership records from the Ministry of Long-Term Care “Public Reporting” website, between 2017-2022, were retrieved and analyzed. Descriptive analysis suggests that for all quality …

Sexual Health Education Scope And Sequence, Sara Wadsworth

Honors Projects

Based on a significant amount of prior research, comprehensive sexuality education (CSE) has been identified to be the most effective method of teaching sexual health education (SHAPE America, 2021; World Health Organization, 2023). Comprehensive sexual health education improves healthy behaviors and outcomes, provides useful information, and is positively perceived by students (Gardner, 2015; Kirby, 2002; Robinson et al., 2022). However, the United States’ current sexual health education has not implemented this ideal method, which is shown through state laws, students’ experiences, underdeveloped skills and flawed understanding of concepts, and – most importantly – a lack of resources for teachers (Foley, …

The King Hygiene Project: Addressing Hygiene Poverty In College Students, Krislynn King

Honors Projects

For my Honors Project, I seek to shine a light on the topic of hygiene insecurity and investigate how it impacts the modern-day college student. In addition, I have taken physical action through a hygiene drive, marketing, and volunteering to better the lives of those who struggle with this issue regardless of whether they are a student at Bowling Green State University.

Playing It Sun Safe: A Quality Improvement Project, Sarah P. Tarr, Kathryn K. Dambrino, R. David Phillippi, Ashley Karpinos

DNP Scholarly Projects

Background: Athletes who play outdoor sports have multiple risk factors for the development of skin cancer. Literature highlights the need for the use of evidence-based strategies to improve the knowledge and utilization of sun protection practices in this high-risk population. Methods: Playing it Sun Safe was a multifaceted skin cancer prevention initiative implemented in a population of collegiate soccer athletes in collaboration with a university athletic department and campus health clinic. Evidence-based interventions were designed through application of the Health Belief Model (HBM) and were implemented using the Institute for Healthcare Improvement (IHI) quality improvement framework. Purpose: The two-fold aim …

Implementation Of A Standardized Suicide Screening Process In A University Student Health Clinic: A Quality Improvement Project, Addie Grace Strong, Kathryn Dambrino, R. David Phillippi, Linda Wofford

DNP Scholarly Projects

Background: Suicide is a leading cause of death among college age students, prompting the need for evidence-based screening tools like the Columbia Suicide Severity Rating Scale (C-SSRS) to enable early detection and timely intervention. Inconsistencies in suicide screening may pose a risk of missed intervention opportunities. This Doctor of Nursing Practice project specifically aimed to improve the quality and consistency of suicide screening in a university student health clinic by implementing the C-SSRS tool into the clinic workflow during mental health appointments. Methods: Employing a quality improvement framework, this scholarly project followed the Institute for Healthcare Improvement Model for Improvement …

Childhood Cancer Survivorship: Navigating A New Normal In Middle Tennessee, Karli M. Beaumont

OTD Capstone Projects

Monroe Carell Jr. Children’s Hospital at Vanderbilt in partnership with Vanderbilt-Ingram Cancer Center offers REACH for Cancer Survivorship, a pediatric cancer survivorship clinic. REACH provides a full range of follow-up care designed to meet the physical, emotional, and practical needs of survivors and continuous surveillance of deleterious effects of cancer and its treatments. The purpose of this project was to meet population and agency needs through research of long- and late-term sequela while advocating for occupational therapy’s role in the oncology population through the proactive therapy and prospective surveillance models. The process of creating this project included synthesizing the literature, …

Post-Modeling Adjustments And Delivered Dose Verification Of The 6fff Beam Model Commissioned For The Monaco Treatment Planning System, Grant C. Debevec

LSU Master's Theses

External beam radiation therapy has been shown to be an effective treatment method for tumors and abnormalities of the spine and vertebral region. Treating the spine using a stereotactic body radiation therapy (SBRT) technique can reduce toxicity to the spinal cord. The 6 MV flattening filter free (6FFF) beam model is currently used to plan and calculate dose for SBRT treatment plans, and the treatment plans are delivered using a linear accelerator (LINAC).

The commissioned beam model represents an invariant component of a LINAC. For volumetric modulated arc therapy (VMAT) treatment plans, the multileaf collimator (MLC) positions are changing throughout …