Medicine and Health Sciences Commons^™

Cultural And Religious Belief Approaches Of A Tuberculosis Program For Hard-To-Reach Populations In Mentawai And Solok West Sumatera, Indonesia, Rizanda Machmud, Irvan Medison, Finny Fitry Yani

Kesmas

Tuberculosis (TB) is a leading public health concern in Indonesia. It ranks second on the list of high-burden TB countries. In West Sumatra, 47% of TB cases are undetected, late diagnosed, and received incomplete treatment because of low-level awareness and knowledge and stigma, especially among the hardest to reach populations. The study aims to identify the best communication channel to reach those who live in vulnerable and remote areas. This study was a qualitative study applying in-depth interviews to the informal leaders, health officers, cultural artists, and religious leaders across districts in Mentawai and Solok Districts, which are remote and …

A Pain Control Optimization Pathway To Reduce Acute Postoperative Pain And Opioid Consumption Postoperatively: An Approach To Battling The Opioid Epidemic, Holly Franson

Student Scholarly Projects

Practice Problem: Healthcare providers worldwide are working to battle the opioid epidemic and reduce opioid-related harm to patients. Utilizing evidence-based acute pain management methods to reduce opioid consumption is critical to combat the problem.

PICOT: The PICOT question that guided this project was: In opioid-naïve adult patients undergoing general anesthesia for out-patient, minimally invasive abdominal wall hernia surgery, how does the implementation of an evidence-based, preventative Pain Control Optimization Pathway (POP) using a multimodal, opioid-sparing acute pain management technique and standardized procedure-specific opioid prescribing, compared to standard treatment, affect postoperative pain scores and opioid consumption, upon discharge from the …

Covid-19: Best Practices And The Way Forward, Juliana Nwauwa

Student Scholarly Projects

COVID-19 is a global health emergency that originated in Wuhan, China, in December 2019. It was declared a pandemic on March 11, 2020, and since then has affected more than 53,507,282 individuals and claimed the lives of more than 1,305,164 around the globe. It is a respiratory virus transmitted from person to person through airborne aerosols and droplets from infected individuals and direct contact with infected surfaces.

Numerous factors, such as socioeconomic status, population density, pre-existing health conditions, and lack of health insurance, have contributed to the disproportionate impact of COVID-19 among certain demographic groups. The COVID-19 impact ranges from …

The Early Impact Of The Affordable Care Act Upon Colorectal Cancer Screening Utilization In Florida, Aldenise P. Ewing, Laura Baum, Rosalyn Roker, Marlene Joannie Bewa, Tali Schneider, Claudia F. Parvanta, Clement K. Gwede, Cathy D. Meade, Dinorah Martinez Tyson

Journal of Health Disparities Research and Practice

Background: Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Although preventable and curable through screening, early detection and treatment, a lack of health insurance is a major obstacle to receiving colorectal cancer screening (CRCS). Despite the Affordable Care Act (ACA) increasing access to health insurance by mandating coverage of CRCS, disparities in utilization rates continue. Therefore, researchers sought to better understand ACA related facilitators and impediments that affect the utilization of CRCS and collect specific recommendations from healthcare professionals to increase screening utilization rates in Florida.

Methods: Researchers conducted in-depth interviews with …

Employing Position Generators To Assess Social Capital And Health: A Scoping Review Of The Literature And Recommendations For Measurement In Future Population-Based Surveillance, Steven Meanley, Candice Biernesser, Teagen O'Malley, Todd Bear, Jeanette Trauth

Journal of Health Disparities Research and Practice

Beneficial social connections are critical to individual-level health because they can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of health surveillance studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities. Our review yielded 39 articles conducted across 14 predominantly high-income countries. Most studies (77%) with composite measures for beneficial social connections exhibited health-protective associations. Of the remaining articles, …

Sex Education In The United States: Implications For Sexual Health And Health Policy, Eliana R. Johnson

The Corinthian

There is much disagreement over what constitutes effective sex education in the United States. There are several reasons why America’s sex education system is outdated and problematic. First, it often advocates only for abstinence, which leaves people unprepared and unable to protect themselves if/when they choose to have sex, leading to higher rates of unintended pregnancies, abortions, and sexually transmitted infections in the U.S. than in any other developed nation in the world. In addition, the culture of fear surrounding sex education leads to negative attitudes among young people about sex. This can not only cause sexual dysfunction and strife …

Effect Of An Intervention To Improve Smoking Cessation Treatment In A Federally Qualified Healthcare Clinic, Shirley A. Camp

The Corinthian

Abstract

Significant progress has been made in the reduction of tobacco use in the United States, but the smoking prevalence among the socially and economically disadvantaged populations (i.e. individuals who are homeless, uninsured, LGBT, and living with HIV) is significantly higher than the general population (CDC, 2018b). As a result, these vulnerable populations carry a disproportionate burden of tobacco-related mortality and morbidity (CDC, 2018b). There is a cost-effective and evidence-based treatment for tobacco use dependence (Fiore et al, 2008), but the delivery by primary care providers to this population is inconsistent (Tyman, Bonevski, Paul, & Bryant, 2014). This study focused …

Epidemiology And Pathophysiology Of Common Skin Diseases In West Africa: An Immunodermatological Framework, Osazomon Imarenezor

All HCAS Student Capstones, Theses, and Dissertations

This capstone reviews the common skin diseases on a global scale. With these dermatoses being further funneled into Africa and then magnified into common West African dermatoses, the meta-analyses of literature available paints a clear picture of the epidemiological & pathological factors and their contribution to the skin disease. Each article analysed in this analysis was taken from a 20-year span of January 2000 to December 2019. The selection of articles was fine-tuned by identifying the distribution of skin disease, revealing the populations affected (age, gender, ethnicity, etc), the main causes, country of origin, the prognosis of disease, and the …

The Role Of Mental Health On The Relationship Between Food Insecurity And Immunologic Outcome Among People Living With Hiv In Guangxi, China, Cheng Chen, Xueying Yang, Chengbo Zeng, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou

Faculty Publications

BACKGROUND

Previous studies showed that food insecurity could adversely affect clinical outcomes of people living with HIV (PLWH). The mental health pathways of such effects are suggested in existing literature, but empirical data are limited in resource-limited settings.

METHODS

This cross-sectional study aims to explore the role of depressive symptoms and anxiety on the association between food insecurity and CD4 counts among a sample of 2,987 PLWH in Guangxi, China. Path analysis was used to examine a hypothetical model and delta ztest was used to assess the indirect effects of food insecurity on CD4 counts through depressive symptoms and …

Open For Business: Offering Physical Library Spaces In The Covid Era, Katie Sparks, Hannah Rogers

Southern Chapter/Medical Library Association Annual Conference

Objective: Our goal was to safely reopen physical library spaces at the Woodruff Health Sciences Center Library for use by various Emory University user groups including students, faculty, and staff during the COVID pandemic of 2020. Because our university brought a subset of students back to campus, we felt it was important to offer safe, socially distanced seating and workstations in the library.

Methods: In collaboration with Emory University’s environmental and safety health officers, we made determinations of the number of seats that could safely be offered. Seating was removed or cordoned off or otherwise signposted. We implemented a reservations …

The Life-Saving Drug That No One Knows About: Naloxone Education And The Health Belief Model, Sarah Tilford

Undergraduate Honors Theses

Naloxone hydrochloride, popularly known by the brand name Narcan, is an emergency treatment used to reverse an overdose on opioid drugs. The CDC reports upwards of 26,000 individuals saved by naloxone between 1996 and 2014 (Centers for Disease Control and Prevention, 2015). Despite this success rate, those outside of the medical field largely remain unaware of what naloxone is or how they can use it in an emergency, leading to needless loss of life. Many studies focusing on naloxone access and education have been unable to offer findings meant to increase the use and ownership of the drug by lay …

Qualitative Analysis Of Maternal Barriers And Perceptions To Participation In A Federal Supplemental Nutrition Program In Rural Appalachian North Carolina, Sydeena E. Isaacs, Lenka H. Shriver, Lauren Haldeman

Journal of Appalachian Health

Background: Little is known about barriers to and perceptions of participation in the in Women, Infants, and Children (WIC) program in rural Appalachia.

Purpose: To gain a deeper understanding of maternal barriers and perceptions related to WIC participation in rural Appalachia

Methods: Pregnant women and mothers were recruited in-person and via flyers from WIC offices in three counties in Appalachian North Carolina. Four semi-structured focus groups were conducted between May to July 2018. Each focus group was approximately 60 minutes long and included open-ended questions about the overall WIC experience in rural Appalachia. Focus groups were audio-recorded, transcribed verbatim, and …

Trust: Assessing The Efficacy Of An Intervention To Increase Hiv Self‑Testing Among Young Black Men Who Have Sex With Men (Msm) And Transwomen, Victoria Frye, Vijay Nandi, Mark Q. Paige, Jermaine Mccrossin, Debbie Lucy, Marya Gwadz, Patrick S. Sullivan, Donald R. Hoover, Leo Wilton

Publications and Research

HIV testing among young Black MSM and transwomen (YBMSM/TW) is the gateway to biomedical HIV prevention or treatment. HIV self-testing (HST) is a method that may increase consistent HIV testing. TRUST, a brief, peer-based behavioral intervention, was designed to increase uptake of consistent (every three months) HST among YBMSM/TW in New York City. To test the efficacy of the intervention, we randomized 200 friend pairs into either the intervention condition (TRUST) or a time and attention control condition. A modified intent-to-treat analysis found that self-reported HST at 3-month follow-up was statistically significantly higher (uOR 2.29; 95% CI 1.15, 4.58) and …

Management Of Frequent Ed Users By Community Paramedics Improves Patient Experiences And Reduces Ems Utilization, Oluwakemi Aiyedun Adio, Laura Ikuma, Sonja Wiley

Patient Experience Journal

This study examined a suburban emergency medical system (EMS)-led community paramedicine (CP) program in terms of adherence to protocol, patient-paramedic interactions, patient experience, and cost. Participants (n=57) are frequent emergency department (ED) users (≥ 4 ED visits/year), with a mean age of 59.8±17.6 years and have multiple chronic conditions. Of these, 36 completed a modified Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey at 3- and 6-months following program enrollment. The main outcome measures were adherence to intake goals; types, modes, and frequencies of CP interventions; CG-CAHPS patient experience scores; and cost savings. Cost savings compared …

Development Of A Comprehensive Measure Of Organizational Readiness (Motivation × Capacity) For Implementation: A Study Protocol, Timothy J. Walker, Heather M. Brandt, Abraham Wandersman, Jonathan Scaccia, Andrea Lamont, Lauren Workman, Emanuelle Dias, Pamela M. Diamond, Derek W. Craig, Maria E. Fernandez

Faculty Publications

BACKGROUND: Organizational readiness is important for the implementation of evidence-based interventions. Currently, there is a critical need for a comprehensive, valid, reliable, and pragmatic measure of organizational readiness that can be used throughout the implementation process. This study aims to develop a readiness measure that can be used to support implementation in two critical public health settings: federally qualified health centers (FQHCs) and schools. The measure is informed by the Interactive Systems Framework for Dissemination and Implementation and R = MC heuristic (readiness = motivation × innovation-specific capacity × general capacity). The study aims are to adapt and further develop …

Type 2 Diabetes Mellitus In The Pediatric Population, Lorna Santiago

DNP Qualifying Manuscripts

The incidence and prevalence of diabetes in youth in the United States is increasing. In particular, type 2 diabetes mellitus (T2DM) is becoming more common in individuals younger than 20 years. Nurse practitioners and other primary care providers that see children should be knowledgeable about the condition and confident in participating in multidisciplinary management. Screening should begin at age 10 or at puberty, whichever comes first. Providers should screen all children who are overweight or obese or of Native American, African American, Latino, Asian American, or Pacific Islander race or ethnicity. Children of these ethnicities have a greater risk for …

Impact Of Mass Distribution Of Long-Lasting Insecticidal Nets (Llins) In Mozambique, 2011 To 2025: Retrospective And Prospective Modelling Of Child Mortality And Lives Saved, Erica Wetzler, Jorge A. H. Arroz, Chulwoo Park, Marta Chande, Figueiredo Mussambala

Faculty Publications

No abstract provided.

A Community-Based School Nutrition Intervention Improves Diet Diversity And School Attendance In Palestinian Refugee Schoolchildren In Lebanon, Zeina Jamaluddine, Jowel Choufani, Amelia Reese Masterson, Reem Hoteit, Nadine R. Sahyoun, Hala Ghattas Ph.D.

Faculty Publications

Background:

School feeding programs have the potential to supply children with healthy school food, alleviate short-term hunger, and improve children's educational outcomes.

Objectives:

We linked community kitchens to a subsidized school snack intervention and assessed the impact of this intervention on nutritional (diet diversity, hemoglobin, and anthropometry) and educational (attendance and academic performance) outcomes of Palestinian refugee schoolchildren.

Methods:

We collected data from 1362 students (aged 5-15 y) and their parents at baseline, and at an 8-mo follow-up in 2 control and 2 intervention schools. We conducted linear, logistic, and negative binomial regression analyses to assess changes in outcomes of …

Gender And Racial Disparity For Hospital Emergency Service Usage In Usa: A Quantitative Analysis For Various Age Groups During 2010–2017., Subhendra N. Sarkar, Anthony F. Devito, Evans Lespinasse, Faisal Khosa

Publications and Research

Background: Annually emergency department (ED) services are utilized by more than 100 million Americans making ED usage trends important determinants of healthcare quality, outcomes and cost. Previous workers have demonstrated the existence of disparity in various healthcare services in USA although a comprehensive analysis has not been undertaken. Dahlgren and Whitehead rainbow model has offered insights for multiple factors of influence on an individual’s health and focuses on the relationships among these factors. The Commission on Social Determinants of Health (CSDH; WHO initiatives) suggests that the social and environmental factors are at the root of most of the inequalities responsible …

Building Capacity In Dissemination And Implementation Science: A Systematic Review Of The Academic Literature On Teaching And Training Initiatives, Rachel E. Davis, Danielle D'Lima

Faculty Publications

BACKGROUND: The field of dissemination and implementation (D&I) science has grown significantly over recent years. Alongside this, an increased demand for training in D&I from researchers and implementers has been seen. Research describing and evaluating D&I training opportunities, referred to here as 'capacity building initiatives' (CBIs), can help provide an understanding of different methods of training as well as training successes and challenges. However, to gain a more detailed understanding of the evidence-base and how D&I CBIs are being reported in publications, a field-wide examination of the academic literature is required. METHODS: Systematic review to identify the type and range …

Terminal Logic Behavior And Strategic Defection Of Governmental Officials During Presidential Transitions In Guatemala: Implications For The Sustainability Of Food And Nutrition Security Policy, Jessica L. Escobar-Alegria, Edward A. Frongillo Jr., Christine E. Blake

Faculty Publications

Background: Presidents with no possibility of re-election overvalue far-future rewards and succumb to terminal logic behavior (TLB), responding to end-of-tenure legacy concerns despite political context. Government authorities perceiving the outgoing government is losing power at the end of term behave under the logic of strategic defection (SD), dissociating from the outgoing government once it is perceived powerless. In countries where re-election is impossible and government turnover and inconstant political parties are concerns, governmental officials at all levels may show TLB and SD during transitions that affect policy sustainability. Objectives: This study aimed to understand the context during presidential transitions that …

A Prospective Study Of Patterns Of Regret In The Year After Hysterectomy, Roopina Sangha, Andrew Bossick, Wan-Ting K. Su, Chad Coleman, Neha Chavali, Ganesa Wegienka

Journal of Patient-Centered Research and Reviews

Purpose: This study sought to identify patterns of self-reported regret after hysterectomy.

Methods: Women undergoing hysterectomy for a benign indication were recruited in the 2 weeks prior to surgery. Women reported demographics and completed validated questionnaires (Decisional Regret Scale, Patient Health Questionnaire-9, Decisional Conflict Scale, and the Comprehensive Score for Financial Toxicity) up to 7 times over the first year postsurgery. Medical records were reviewed for clinical and operative details. Latent class growth mixture models were applied to the repeated regret scores to identify patterns after hysterectomy. Clinical and other participant characteristics were compared across the classes.

Results: Three latent …

Action Items For Breast Cancer Awareness Month, Deanna J. Attai

Journal of Patient-Centered Research and Reviews

This special issue introduction provides a brief history of Breast Cancer Awareness Month and focuses on patient populations often omitted from annual marketing campaigns. The importance of research is emphasized as a means to improve the outcomes of people with metastatic breast cancer and male breast cancer as well as to address health care inequities related to breast cancer diagnosis and treatment.

A History Of #Bcsm And Insights For Patient-Centered Online Interaction And Engagement, Matthew S. Katz, Alicia C. Staley, Deanna J. Attai

Journal of Patient-Centered Research and Reviews

Purpose: Participation in cancer support groups can provide a sense of community and may better prepare patients for interactions with their health care team. Online interactions may overcome some barriers to in-person support group participation. #BCSM (breast cancer social media), the first cancer support community established on Twitter, was founded in 2011 by two breast cancer survivors. The aims of this study are to describe the growth and changes in this community and to discuss future directions and lessons that may apply to other online support communities.

Methods: Symplur Signals was used to obtain all #BCSM Twitter data from January …

Three Decades Of Research: The Case For Comprehensive Sex Education, Eva Goldfarb, Lisa D. Lieberman

Department of Public Health Scholarship and Creative Works

Purpose

School-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.

Methods

Researchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving …

Weight Status Of Children Aged 2-5 Years Old, Attending A Paediatric Outpatient Clinic And Its Association With Parental Feeding Style And Parental Perceptions Of Weight Status, Aisling Lee, Helen Callaghan, Dara Gallagher Dr, Annette Lalor, Louise Rattigan, Hilary Greaney, Laura Keaver

SURE Journal: Science Undergraduate Research Experience Journal

Background: A child’s weight status can allow health care professionals to assess their developmental growth. A child having a low or high weight for height could be due to an imbalance in nutrient intake occurring. It is important to balance dietary intake and physical activity to maintain a healthy weight status. Excessive consumption of food can lead to an overweight/obese weight status which is linked to non-communicable diseases. Parental feeding style can directly impact a child’s set of eating behaviours. Therefore, parents have a strong influence over a child’s growth pattern. In addition, parental awareness of childhood obesity is reported …

An Evaluation Of The Coverage Of Theoretically Based Implementation Factors In Disseminated Classroom Physical Activity Programs., Hannah G. Calvert, Hannah G. Lane, Carolina M. Bejarano, Kelli Snow, Kate Hoppe, Nicole Alfonsin, Lindsey Turner, Jordan A. Carlson

Manuscripts, Articles, Book Chapters and Other Papers

Classroom-based physical activity (CBPA) is increasingly recommended as a method to support children's physical activity, health, and academic performance. Many adoption-ready programs exist to aid in the implementation of CBPA in schools; yet, implementation rates remain low. The purpose of this study was to evaluate the extent to which resources provided by adoption-ready CBPA programs addressed theory-based implementation contextual factors to support implementation. Existing CBPA programs (N = 37) were identified through Internet searches and all materials (e.g., implementation guides) provided by each program were coded for their inclusion of 51 implementation factors based on the Consolidated Framework for Implementation …

Child Marriage: Parents’ Lived Experience Of Decision-Making Processes And Consequential Health Effects, Hadiza Yakub, Jirina Foltysova, Jeanne Connors

Walden Faculty and Staff Publications

Child or early marriage is increasingly recognized as a public health concern that poses significant health challenges for a young bride. This qualitative research explored child marriage among Hausa-Fulani ethnolinguistic communities in Northeastern Nigeria. Qualitative interviews were conducted with parents who married off their underage children. The central research questions relied on a theoretical foundation of social values theory and interpretative phenomenological analysis. The study results provide an in-depth understanding of the child marriage phenomenon by exploring parents' lived experiences and the role of a child bride's health in the decision-making process and illustrates how social values and norms drive …

Influence Of Incentive Design And Organizational Characteristics On Wellness Participation And Health Outcomes, Jessica Grossmeier, David J. Mangen, David R. Anderson, Stefan B. Gingerich, Rebecca J. Mitchell, Mary T. Imboden, Gordon D. Kaplan, Gregg M. Gascon, Seth A. Serxner, Tony Bodak

Faculty Publications - Department of Kinesiology

Objective: To explore how changing incentive designs influence wellness participation and health outcomes.

Methods: Aggregated retrospective data were evaluated using cluster analysis to group 174 companies into incentive design types. Numerous statistical models assessed between-group differences in wellness participation, earning incentives, and over-time differences in health outcomes.

Results: Four incentive design groups based on requirements for earning incentives were identified. The groups varied in support for and participation in wellness initiatives within each company. All four design types were associated with improved low density lipoprotein (LDL)(P < 0.01), three with improved blood pressure (P < 0.001), and two with improved fasting glucose (P < 0.03). No incentive plan types were associated with improved body mass index (BMI), but designs predominantly focused on health outcomes (eg, Outcomes-Focused) exhibited a significant increase over time in BMI risk.

Conclusion: Incentive design and organizational characteristics impact population-level participation and health outcomes.

The Social Value Of Zero Balancing, David Laden

Journal of Transformative Touch

Does Zero Balancing have a social value? Does it in some way contribute to the betterment of society? Does it really have the capacity to make the world a better place? These are questions I started asking myself years ago when I was going through a period of soul searching - investigating my own feelings of powerlessness - feelings of not doing enough in the larger sphere of “making the world a better place”.