Medicine and Health Sciences Commons^™

The Impact Of Tobacco-Free School Laws On Student And Staff Smoking Behavior, Rachana Bhatt, Peter Hinrichs

Upjohn Institute Working Papers

A number of U.S. states have enacted bans on tobacco use by students, staff, and visitors anywhere on the grounds of public elementary and secondary schools statewide. These laws are intended to reduce tobacco use, reduce exposure to secondhand smoke, reinforce anti-tobacco curricula taught in schools, and prevent children from viewing their teachers and fellow students using tobacco products. We examine the impact that the laws have on the smoking behavior of students, teachers, and other school staff by using stacked difference-in-differences estimators that exploit the time variation in adoption of the laws across states. The results presented in this …

Virginia Team Nutrition Training Grant Workshop Participation Increased Intention To Change In Specific Topics, Rachel A Liebe, Kathleen J Porter, Valisa Hedrick, Elena Serrano, Kelly Shomo, Sandra Curwood, Sarah Misyak

Journal of Extension

Team Nutrition is implemented nationally to improve school food environments. Yet evidence on factors impacting implementation is limited. This study aimed to evaluate the execution of the Team Nutrition Training Grant (TNTG) in Virginia elementary schools using the RE-AIM (Reach, Efficacy, Adoption, Implementation, Maintenance) framework. The TNTG grant was implemented through two train-the-trainer workshops that were conducted with school nutrition directors (SNDs). Overall, SNDs from 84% of school divisions attended at least one workshop. Intention to change increased significantly from pre- to post- for both workshops in some target areas. This evaluation could help practitioners guide the development of evaluation …

Did Statewide School Smoking Bans Reduce Smoking Rates?, Rachana Bhatt, Peter Hinrichs

Upjohn Institute Policy and Research Briefs

No abstract provided.

Demographic And Socioeconomic Factors Influence Perceived Community Needs And Risk Factors For Firearm Violence In Mississippi, Masoumeh Karimi, Matthew Morris, Xiaoshan Gordy, Matthew Kutcher, Leila Seidfaraji, Michelle Brassfield, Erin Dehon, Alyscia Severance, Rukia Lumumba, Fredrick Womack, Lei Zhang

Journal of Public Health in the Deep South

Background: The burden of firearm-related injuries and deaths is not borne equally across sociodemographic groups. The present study investigated the perceived needs and risk factors of firearm related injuries and mortality across gender, education, and income levels through a quantitative needs assessment completed by community members and firearm injury survivors living in the greater Jackson, Mississippi, metropolitan area.

Methods: A total of 93 participants including gunshot wound patients, survivors and community members who have been recruited through community organizations completed the needs assessment survey collecting data on demographic information, firearm exposure, substance use, community exposure to crime and …

Pilot Evaluation Of A Cross-Disciplinary Training Addressing Substance Use Among Mississippi Mothers, Saijun Zhang, Catherine Poehling, Xiaoshan Gordy, Chinedu P. Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

Background: Intimate partner violence (IPV) and substance use co-occurring is often managed in siloed systems. Training IPV and related service providers on substance use topics may strengthen screening, response, and referral.

Purpose: To assess whether a pilot training program on substance use disorders (SUDs) in Mississippi improved service providers’ knowledge, preparedness, and attitudes around substance use and satisfaction with the training.

Methods: Pre–post surveys were administered to healthcare and community service providers who completed the training, assessing substance use service-related knowledge, preparedness, and attitudes.  Descriptive statistics and t-tests were used to analyze the data.

Results: Fifty-nine providers completed a …

There's No Vision Like Low Vision: Living With And Serving Those With Macular Degeneration And Stargardt Macular Dystrophy, Paul B. Freeman Od

Optometric Clinical Practice

Book Review: Perski T, There's No Vision Like Low Vision: Living with and Serving Those with Macular Degeneration and Stargardt Macular Dystrophy, Inicio Press, 2025. 306 pages, Paperback, $14.99, ISBN 978-1-998315-48-2, Kindle $9.99 ISBN 978–1– 998315– 49–9

The Other Visual Acuity, Paul B. Freeman Od

Optometric Clinical Practice

Editorial

Bemotrizinol And The Modernization Of Us Sunscreen Regulation, Umayr R. Shaikh, Christopher G. Richter, Leela K. Raj, Afrin Mirza, Harold William Higgins, Jane M. Grant-Kels

SKMC Student Presentations and Publications

No abstract provided.

Hidden Patterns: Revealing The Noise Exposure Habits Of College Musicians Throughout The Year, Maya Vallejo

Holster Scholar Projects

College musicians face elevated risk for noise-induced hearing loss (NIHL) due to extensive rehearsal, headphone use, and performance activity, yet most objective sound-exposure studies rely on personal dosimeters that capture only brief windows (1–3 weeks) during the academic year, and overlook headphone-specific exposure. This study leveraged historical Apple Watch and AirPods sound data from participants in the ongoing AMI study (Skoe lab, University of Connecticut) to compare environmental and headphone noise exposure between academic-year and academic-break periods in college-age lifelong, former, and non-musicians. Sound levels (dBA) were calculated using duration-weighted, log-power averaging to account for the logarithmic nature of decibels. …

Improving Assessment And Documentation Adherence In An Age-Friendly Health System With A Focus On "What Matters", Thelma I. Arzu

Doctor of Nursing Practice Final Project Abstract

Purpose

To improve adherence in assessing and documenting “What Matters” (WM) using a standardized assessment and documentation process.

Background

The project was implemented within a large Age-Friendly Health System (AFHS) in Houston, Texas, comprised of a geriatric outpatient clinic and a House Call program. Although the 4Ms of AFHS were regularly documented in the outpatient setting, there was limited documentation in the House Call Program.

Methodology

A standardized process was established with clinician stakeholders to assess and document WM using simplified assessment criteria, the electronic medical record (EMR) 4Ms documentation phrase, and a designated location for the 4Ms phrase in …

Holding Hope: Maternal Experiences Of Kangaroo Mother Care Within Sociocultural Contexts In Ethiopia., Miraj Fuad Alemar, Betelehem B. Kassa, Mahlet Abayneh, Hanan N. Mohammed, Stephanie Kukora

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Kangaroo mother care (KMC) is a crucial method for improving the health outcomes of preterm and low birth weight (LBW) infants, particularly in resource-limited settings. However, barriers hinder mothers from effectively practicing KMC. This study aims to explore mothers' perceptions, hopes, and buy-in regarding KMC in a tertiary care center in Ethiopia.

METHODS: A semistructured interview guide was developed on the basis of a literature review. In-depth interviews were conducted with a purposive sample of mothers who had practiced KMC within the past two years at Saint Paul's Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia. The interviews, which …

Pooled Proportion And Associated Factors Of Postoperative Pain During The Recovery Time Among Adult Surgical Patients In An Ethiopian Setting With Limited Resources: A Systematic Review And Meta-Analysis, Sintayehu Samuel Lorato, Mitiku Desalegn, Kelemu Abebe Gelaw, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Tiruye Menshaw Tiruneh, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Natnael Atnafu Gebeyehu, Tewodros Shitemaw Tekoye, Genanew Kassie Getahun, Kedir Seid, Abel Tibebu Goshu

Research outputs 2022 to 2026

No abstract provided.

Pharmacy Access Is Out Of Reach For One In Six South Carolinians, Bryan L. Love Pharm.D., Tessa J. Hastings Phd, Abby Davies

CORE Research Briefs

A cross-sectional geospatial analysis mapped active South Carolina community pharmacies and used 2020 Census tract data to estimate the population residing within and beyond five-mile pharmacy service areas. About one in six South Carolinians lives more than five miles from an active community pharmacy, with limited access disproportionately affecting rural communities.

Smart Moves™ Family Healthy Weight Program Cross-Cohort Evaluation Report 2025-2026, Camille Velarde, Theresa H. Cruz

Reports & Documents

This report presents findings from a mixed-methods evaluation of three implementations of the Smart Moves™ Family Healthy Weight Program conducted in Bernalillo County, New Mexico, between 2025 and 2026. Smart Moves™ is a family-centered wellness program that integrates nutrition education, physical activity, social-emotional learning, caregiver support, and family engagement.

The evaluation examined participant experiences, program adaptations, implementation challenges, and health-related outcomes across clinic- and school-based settings. Data included parent and caregiver focus groups, implementer and administrative interviews, and descriptive pre- and post-program measurements. Across the three evaluated cohorts, 51 participant records were documented, including 28 youth and 23 parents/caregivers.

Qualitative …

Analysis Of The Deborah Sampson Act Of 2020: Improving Women Veterans’ Care, Jessica N. Shipp

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Women Veterans are one of the fastest-growing populations served by the Veterans Health Administration (VHA), yet gaps persist in access to gender-responsive, trauma-informed care. Despite requirements established by the Deborah Sampson Act (DSA) of 2020, implementation remains inconsistent in Women's Health Primary Care Provider (WH-PCP) access, women's mental health (MH) services, military sexual trauma (MST) care, workforce capacity, care coordination, and accountability.

Aim of the Project: The aim was to evaluate the effectiveness, feasibility, equity, and implementation fidelity of the DSA using the Centers for Disease Control and Prevention (CDC) Policy Analytical Framework (POLARIS) and identify evidence-based recommendations to …

Improving Screening And Referral Of Adolescent Depression In Pediatric Primary Care, Eleanor Shaw

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: A practice gap existed in a rural primary care clinic where adolescents aged 12–18 years were not routinely screened for depression during annual well-child visits. A retrospective review of 22 adolescent charts identified no routine PHQ-9 screenings during well-child visits, establishing a baseline routine screening rate of 0%.

Aim of the Project: The aim was to implement a standardized Patient Health Questionnaire-9 (PHQ-9) screening process and increase routine depression screening to at least 90% of eligible adolescents while achieving documented follow-up within 14 days for at least 85% of adolescents with positive screens.

Review of the Evidence: Evidence supports …

Program Evaluation: Effectiveness Of Case Management Carehub For Skilled Nursing Facility Transitions, Rachel Choudhury

All Doctor of Nursing Practice (DNP) Scholarly Projects

Background: Ineffective communication during transitions from acute care hospitals to skilled nursing facilities (SNFs) contributes to avoidable bed days (ABDs), prolonged length of stay (LOS), and discharge delays. Although evidence-based tools such as InterQual and Milliman Care Guidelines supported clinical decision-making, a standardized communication process among case managers, social workers, payers, and SNF partners was lacking. This program evaluation examined the effectiveness of a standardized CareHub communication workflow designed to improve discharge coordination and transitions to SNFs.

Methods: Guided by the Centers for Disease Control and Prevention Program Evaluation Framework, a 90-day program evaluation (February-April 2026) was conducted in a …

Implementation Of The Tailored Interventions For Patient Safety (Tips) Program To Reduce Falls, Jeremy Zobell

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Inpatient falls on a 48-bed orthopedic medical-surgical unit exceeded the organizational benchmark. Before implementation, the unit fall rate was 5.34 falls per 1,000 patient-days, compared with the benchmark of 2.45. Variation in bedside communication, documentation, and patient understanding created an evidence-to-practice gap.

Aim of the Project: The project aimed to reduce inpatient falls by implementing the Fall TIPS program to improve the reliability of individualized fall-prevention planning and integration of evidence-based strategies into daily nursing workflows.

Review of the Evidence: Evidence supports multifactorial fall-prevention strategies that combine individualized risk assessment, patient education, visual cues, and shared decision-making. Fall TIPS …

Social Distancing Under Strategic Uncertainty: The Role Of Strategic Sophistication In The Covid-19 Pandemic, Mimi Jeon, Seonghoon Kim, Kanghyock Koh, Euncheol Shin

Research Collection School Of Economics

This study examines how individuals’ strategic sophistication shapes social distancing during the early stages of the COVID-19 pandemic, when distancing was a costly protective decision under two sources of risk: the private risk of infection and strategic uncertainty about whether others would comply. We develop a weakest-link public goods game with private costs of social distancing, in which agents differ in their level-k depth of reasoning about others. The model predicts that the probability of distancing rises with the level-k type when baseline compliance is low. We test this prediction using large-scale, nationally representative survey data that include incentivized experiments …

Exploring The Risk Factors Associated With Poor Maternal Health And Mortality In Bangladesh, Sheikh Sarahzin Ahmed

Graduate Research - Health Sciences

Background

Poor maternal health and mortality remain a major public health concern in Bangladesh. Being a lower-middle-income country, Bangladesh is struggling to decrease maternal mortality ratio (MMR). 115 women die per 100,000 live births in 2023 due to pregnancy-related causes in Bangladesh. (World Bank Group, 2025). It is found that 73% of maternal deaths occur during postnatal period and 56% die within 24 hours of delivery, indicating the importance of early postnatal care (PNC) to reduce maternal mortality. (Bangladesh National Strategy for Maternal Health (2019–2030). Besides this, food insecurity, maternal nutrition, child marriage, patriarchal influence, decision making role, limited access …

Recommendations From Health Research For Children And Adolescents Living In The Kimberley Region Of Western Australia: A Scoping Review, Lisa Cannon, Elizabeth J. Elliott, Andrew Dossetor, Tracey W. Tsang, Md Irteja Islam, Alexandra L. Martiniuk, Habiba Naanai, Tuguy Esgin, Emily Carter, Lauren J. Rice

Research outputs 2022 to 2026

Background: Aboriginal leaders in Western Australia’s Kimberley region have voiced concern that research conducted on their lands is not being adequately used to inform meaningful change. Objective: This scoping review, grounded in an Aboriginal-academic partnership, identifies the child and adolescent health-related research conducted in the region and summarises the authors’ recommendations for knowledge translation. Methods: Drawing on PRISMA-ScR guidelines, we conducted a comprehensive search of multiple databases for publications between January 1967 and June 2025, focusing on children aged ≤ 18 years. Data extraction was conducted using Covidence, and publications were categorised based on the International Classification of Diseases (11th …

Flourishing Childhood Frameworks: A Scoping Review, Jacqueline A. Davis, Zenobia Talati, Lisa Y. Gibson, Jack Kennare, Christina Bethell, Christina Hinton, Hannah Block, Tara D'Silva, Desiree Silva, Susan L. Prescott

Research outputs 2022 to 2026

Objectives: Experiences in early life impact childhood, lifelong flourishing, and overall well-being. Yet a framework to guide promoting and measuring flourishing in early childhood has not emerged. The objective of this study was to identify frameworks and measures related to promoting and assessing early-childhood flourishing (0-5 years) to build on a preexisting, community-informed framework.

Methods: A systematic search was conducted across electronic databases and the gray literature for articles published between 2014-2026. Of 13 902 total references, 8592 were eligible for screening. A machine learning-assisted tool (Research Screener) was used to streamline screening of the abstracts against the inclusion criteria. …

Women's Experiences Of Menstrual Pain And Perceptions Of Acupuncture: A Qualitative Study, Weiting Liu, Amanda Towell-Barnard, Khui Hung Lee

Research outputs 2022 to 2026

Introduction: Menstrual pain is a common reproductive health concern that can substantially disrupt physical, emotional, and social well-being, yet it is frequently normalised and insufficiently addressed within healthcare encounters. Acupuncture is increasingly used as a complementary approach for menstrual pain management; however, little qualitative research has explored how women understand, interpret, and navigate this option within their menstrual care.

Methods: A qualitative descriptive study was conducted using four online focus groups with 14 women aged 19–46 years residing in Australia who self-reported primary dysmenorrhea. Participants were purposively sampled from respondents to a previous cross-sectional survey study who had indicated willingness …

Prevalence Of Vitiligo In East Africa: Systematic Review And Meta-Analysis, Kedir Seid, Chala Getaneh Jaleta, Sintayehu Samuel Lorato, Mitiku Desalegn, Dawit Tesfaye Rundasa, Yohannes Godie Ashebir, Olyad Kuma Getahun, Gebeyehu Lakew, Mathewos Mekonnen Gemmechu, Mulualem Endeshaw Zeleke, Yibeltal Assefa Atalay, Amlaku Nigusie Yirsaw, Eyob Ketema Bogale, Abiy Hailu Tikuneh, Abas Ali Hassen, Eyasu Alem Lake, Tadesse Nigussie, Bushra Bibi, Fikiru Yigezu Y. Jaleta, Abebe Gedefaw Belete, Genanew Kassie Getahun

Research outputs 2022 to 2026

Background: Vitiligo is a chronic skin disorder characterized by the loss of melanocytes, resulting in depigmented macules and patches. No accurate estimate has been made of the prevalence of vitiligo in East Africa.

Objectives: To determine the prevalence of vitiligo in East Africa via a systematic review and meta-analysis of the literature.

Methods: A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines. Eleven articles were retrieved from PubMed/MEDLINE, Embase, Scopus, Google Scholar, Science Direct, Web of Science and African Journals Online. Microsoft Excel was used to extract the data, which were then exported to STATA 17 …

The Effects Of Age Related Ocular Diseases On Nighttime Driving Within Geriatric Populations, Donovan J. O'Keefe

Undergraduate Research Symposium

Driving at night is a task that places large demands onto the sensory system as a whole, and in particular, the visual system. As a task that already comes with an increased risk when compared to daytime driving, various factors can contribute to how safely one can drive on a roadway. As individuals progress in age, age-related ocular diseases can develop. These ocular diseases further impair vision, which can lead to an overall decrease in road safety. Three of the most common of these diseases include Open-Angle Glaucoma, Dry Age-Related Macular Degeneration, and Cataracts. Understanding how each of these diseases …

Burden And Prioritization Of Airborne Diseases In Bogor City, 2024: A Situational Analysis, Tuti Alawiyah, Helda Helda, Menikha Maulida

Jurnal Epidemiologi Kesehatan Indonesia

Indonesia, particularly urban agglomeration areas such as Bogor, continues to face major challenges related to air quality, resulting in an increased risk of airborne disease transmission. This study aimed to assess the burden of airborne diseases and determine health problem priorities in Bogor City using surveillance data from 2022 to October 2024. A descriptive epidemiological study was conducted in Bogor City using surveillance data from 2022 to 2024. Health problem prioritization was performed using the Pan American Health Organization (PAHO)-adapted Hanlon method through structured questionnaires administered to an expert panel consisting of health office officials and heads of primary healthcare …

Covid-19 Vaccination Coverage And Associated Factors In Conflict-Affected Provinces Of The Democratic Republic Of The Congo: A Cross-Sectional Study, Anthony E. Mwakapugi

Jurnal Epidemiologi Kesehatan Indonesia

Background: This study analysed the coverage and determinant factors for COVID-19 vaccination in Ituri, North Kivu, and South Kivu provinces in the Democratic Republic of the Congo (D.R.C). These are war-affected provinces that have experienced prolonged armed conflict, potentially limiting vaccine access.

Methods: A cross-sectional analysis of 9,795 people aged at least 15 years old and older fromyears from the 2023–2024 D.R.C Demographic and Health III Survey was conducted. Weighted descriptive statistics, design-adjusted chi-square tests, and multivariable logistic regression identified determinants of vaccination uptake.

Results: Overall vaccination coverage was 14.1% (95% CI: 11.3% - 17.4%)16.6% (95% CI= 14.2–19.3), with marked …

Descriptive Epidemiology Of Tuberculosis Case With Diabetes Mellitus Identified Through Screening Activities In Indonesia, 2024, Chrisshanti Putri Pasaribu

Jurnal Epidemiologi Kesehatan Indonesia

Tuberculosis (TB) remains a major public health problem, particularly among individuals with diabetes mellitus (DM), who are at an increased risk of developing TB disease. Screening activities conducted through health facility-based screening and active case finding (ACF) provide opportunities to identify TB cases with DM comorbidity. This study aimed to describe the epidemiological characteristics of TB-DM cases identified through screening activities in Indonesia in 2024. This descriptive study used routine secondary program data obtained from the Tuberculosis Information System (SITB). The source population consisted of 615,357 individuals screened for TB in 2024, among whom 14,727 TB cases were identified. Of …

Situational Analysis Of Maternal And Child Health Problems In Dki Jakarta Province In 2024, Jennifer Irene Amorita Hadiono, Helda Helda, Tri Yunis Miko Wahyono, Inggariwati Inggariwati

Jurnal Epidemiologi Kesehatan Indonesia

Maternal and child health (MCH) is a critical indicator of national health development aligned with SDGs targets. DKI Jakarta, as a densely populated capital city, faces unique challenges in providing equitable MCH services. This study aims to analyze the situational status of MCH problems in DKI Jakarta Province in 2024 and to determine health priorities using the PAHO-adopted Hanlon method. A descriptive study using quantitative and qualitative approaches was conducted at the DKI Jakarta Provincial Health Office from October 2024 to January 2025. Primary data were collected through structured interviews, while secondary data were sourced from reports of the Nutrition …

Factors Associated With Hiv Infection Among People Who Inject Drugs In Jakarta, Igo Cahya Negara, Mondastri Korib Sudaryo, Helwiah Umniyati

Jurnal Epidemiologi Kesehatan Indonesia

HIV infection among people who inject drugs (PWID) remains a substantial public health burden, with Jakarta consistently reporting among the highest PWID-associated HIV prevalence in Indonesia. This study aimed to identify factors associated with HIV infection among PWID in Jakarta, utilizing secondary data from the 2023 Integrated Biological and Behavioral Survey (IBBS 2023). A cross-sectional study design was employed using secondary data from 261 PWID recruited in Jakarta. Bivariate associations were examined using Chi-square tests, and multivariate analysis was performed using modified Cox regression with a constant time parameter to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals. The …