Medicine and Health Sciences Commons^™

Navigating New Normals: Student Perceptions, Experiences, And Mental Health Service Utilization In Post-Pandemic Academia, Hadiza Galadima, Anne Dumadag, Cara Tonn

Community & Environmental Health Faculty Publications

This study explores the profound impacts of the COVID-19 pandemic on higher education, focusing on shifts in learning experiences and students’ intentions to utilize mental health services post-pandemic. Utilizing Andersen’s Behavioral Model of Health Services Use, this study assesses perceptions from a stratified random sample of college students on post-pandemic learning experiences and mental health service utilization intentions. Findings reveal a positive reception to university initiatives and a preference for ongoing virtual classes. There is an evident increase in, and varying intentions for, using mental health services, shaped by demographics, employment, and prior service utilization. Younger and female students showed …

Potential Chemical Risks From Tattoos And Their Relevance To Military Health Policy In The United States, James D. Blando, Blas A. Guigni

Community & Environmental Health Faculty Publications

We summarize and consolidate disparate sources of information about the practice of tattooing and its potential implications for military population health and policy. Each branch of the United States military has policies about tattoos for service members, but these have varied over time and do not cover health protection. The number of veterans receiving disability payments and the cost of those payments has been rising over time; the broad category of skin conditions accounts for 11% of disability claims. Any additional factor, such as tattoos that may increase the occurrence of adverse skin reactions, can substantially impact veteran benefit expenses …

Protecting Low-Income Consumers In The Era Of Digital Grocery Shopping: Implications For Wic Online Ordering, Qi Zhang, Priyanka Patel, Caitlin M. Lowery

Community & Environmental Health Faculty Publications

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is now expected to allow participants to redeem their food benefits online, i.e., via online ordering, rather than only in-store. However, it is unclear how this new benefit redemption model may impact participants’ welfare since vendors may have an asymmetric information advantage compared with WIC customers. The WIC online ordering environment may also change the landscape for WIC vendors, which will eventually affect WIC participants. To protect WIC consumers’ rights in the new online ordering model, policymakers need an appropriate legal and regulatory framework. This narrative review provides that …

Unraveling Controversies Over Civic Honesty Measurement: An Extended Field Replication In China, Qian Yang, Weiwei Zhang, Shiyong Liu, Wenjin Gong, Youli Han, Jun Lu, Donghong Jiang, Jingchun Nie, Xiaokang Lyu, Rugang Liu, Mingli Jiao, Chen Qu, Mingji Zhang, Yacheng Sun, Xinyue Zhou, Qi Zhang

Community & Environmental Health Faculty Publications

Cohn et al. (2019) conducted a wallet drop experiment in 40 countries to measure "civic honesty around the globe," which has received worldwide attention but also sparked controversies over using the email response rate as the sole metric of civic honesty. Relying on the lone measurement may overlook cultural differences in behaviors that demonstrate civic honesty. To investigate this issue, we conducted an extended replication study in China, utilizing email response and wallet recovery to assess civic honesty. We found a significantly higher level of civic honesty in China, as measured by the wallet recovery rate, than reported in the …

Reply To Tannenbaum Et Al.: Constructive Dialogue Advancing Research On Civic Honesty, Weiwei Zhang, Yacheng Sun, Shiyong Liu, Xinyue Zhou, Qian Yang, Qi Zhang

Community & Environmental Health Faculty Publications

No abstract provided.

Evaluation Of Wic Online Ordering During The Covid-19 Pandemic: Evidence From An Oklahoma Grocery Store Chain, Qi Zhang, Junzhou Zhang, Kayoung Park, Chuanyi Tang

Community & Environmental Health Faculty Publications

The COVID-19 pandemic is worsening the disparities in food access in the United States. As consumers have been increasingly using grocery online ordering services to limit their exposure to the COVID-19 virus, participants of federal nutrition assistance programs lack the online benefit redemption option. With the support of the US Department of Agriculture (USDA), retailers are pilot-testing online food benefit ordering in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). By combining the Oklahoma WIC administrative data, the online ordering data from a grocery store chain in Oklahoma, and the COVID-19 data in Oklahoma, this study examines …

Using Adult Learning Characteristics And The Humanities To Teach Undergraduate Healthcare Students About Social Determinants Of Health, Elizabeth A. Brown, Hannah Kinder, Garrett Stang, Wendy Shumpert

Community & Environmental Health Faculty Publications

Authors used an andragogy framework to help undergraduate allied health students better understand social determinants of health (SDOH) using a photo essay assignment. The study examined students’ perceptions of SDOH in various communities, description of health outcomes associated with their chosen SDOH, and lessons learned and suggestions to improve the assignment for future cohorts. Data were extracted from photo essays from 2019–2021 and entered in Microsoft Excel and Word for data analysis after course completion. Conventional qualitative content analysis was used to analyze student evaluation data from open-ended questions. Data were extracted from 53 student essays from 2019 to 2021. …

Vaccination Inequities Among Children 12-23 Months In India: An Analysis Of Inter-State Differences, Octavia K. Goodman, Abram L. Wagner, Dakota Riopelle, Joseph L. Mathew, Matthew L. Boulton

Community & Environmental Health Faculty Publications

Background

Previous research has shown that socioeconomic and demographic risk factors in children are additive and lead to increasingly negative impacts on vaccination coverage. The goal of this study is to examine if different combinations of four risk factors (infant sex, birth order, maternal education level, and family wealth status) vary by state among children 12-23 months in India and to determine the impact of ≥ 1 risk factor on differences in state vaccination rates.

Methods

Using data from the National Family Health Survey (NFHS) conducted in India between 2005 and 2006 (NFHS-3) and 2015-2016 (NFHS-4), full vaccination of children …

Experiences With Covid-19 Stress Among Hispanic/Latino Farmworkers, Brenda Berumen-Flucker, Hadiza Galadima, Sylvia Shangani, Michele Kekeh, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: Hispanics/Latinos, particularly those that identify as foreign-born, are overrepresented in the agricultural sector in the U.S. Over the course of the COVID-19 pandemic, this subpopulation of farmworkers was recognized as an invaluable group of essential workers unable to implement COVID-19 protections.

METHODS: Previously validated COVID-19 stress scale measures were identified, adapted, and translated to collect COVID-19 stress data from Hispanic/Latino agricultural workers in two heavily agricultural counties in northeastern North Carolina. Participants were recruited using purposive convenience sampling. Data collection took place from June to November of 2021.

RESULTS: The majority of Hispanic/Latino agricultural workers surveyed reported experiencing worries …

Effect Of Living Arrangements On Cognitive Function In Chinese Elders: A Longitudinal Observational Study, Yanwei Lin, Qi Zhang, Tingxian Wang, Zhirong Zeng

Community & Environmental Health Faculty Publications

Objective To examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.

Setting and participants Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.

Outcome measures Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement …

Compassion, Discrimination, And Prosocial Behaviors: Young Diasporic Chinese During The Covid-19 Pandemic, Youli Chen, Zicong Wang, Qi Zhang, Weizhen Dong, Jia Huei, Chen Xu, Sizhe Ji Wu, Xiangyang Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The coronavirus disease 2019 (COVID-19) pandemic has fueled anti-Asian, especially anti-Chinese sentiments worldwide, which may negatively impact diasporic Chinese youths' adjustment and prosocial development. This study examined the association between compassion, discrimination and prosocial behaviors in diasporic Chinese youths during the COVID-19 pandemic. 360 participants participated and completed the multi-country, cross-sectional, web-based survey between April 22 and May 9, 2020, the escalating stage of the pandemic. This study found compassion as prosocial behaviors' proximal predictor, while discrimination independently predicted participation in volunteering, and could potentially enhance the association between compassion and charitable giving. These findings suggest that prosociality among young …

The Prevalence Of And Factors Associated With Anxiety And Depression Among Working-Age Adults In Mainland China At The Early Remission Stage Of The Coronavirus 2019 Pandemic, Haixia Xie, Xiaowei Huang, Qi Zhang, Yan Wei, Xuheng Zeng, Fengshui Chang, Shuyin Wu

Community & Environmental Health Faculty Publications

Background: The Coronavirus 2019 (COVID-19) outbreak has led to a considerable proportion of adverse psychological symptoms in different subpopulations. This study aimed to investigate the status of anxiety and depression and their associated factors in the adult, working-age population in Mainland China at the early remission stage of the COVID-19 pandemic.

Methods: An online study was conducted among 1,863 participants in 29 provinces in Mainland China from March 23 to 31, 2020. Their mental health was evaluated by the generalized anxiety disorder scale (GAD-7) and the patient health questionnaire (PHQ-9). Descriptive analysis, Chi-square, and multiple logistic regressions were applied.

Results: …

Effectiveness Of Wechat-Group-Based Parental Health Education In Preventing Unintentional Injuries Among Children Aged 0-3: Randomized Controlled Trial In Shanghai, Yuheng Feng, Xueqi Ma, Qi Zhang, Ruo Jiang, Jun Lu, Kaiyue Chen, Huiping Wang, Qinghua Xia, Jicui Zheng, Jingwei Xia, Xiaohong Li

Community & Environmental Health Faculty Publications

BACKGROUND: Unintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0-3.

METHODS: We recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for …

Influence Of The Inherent Safety Principles On Quantitative Risk In Process Industry: Application Of Genetic Algorithm Process Optimization (Gapo), Mehdi Jahangiri, Abolfazl Moghadasi, Mojtaba Kamalinia, Farid Sadeghianjahromi, Sean Banaee

Community & Environmental Health Faculty Publications

Inherent safety (IS) refers to a set of measures that enhance the safety level of processes and equipment, rendering additional equipment and/or add-ons. The early design phase of processes is suited best for implementation of IS strategies as some of such strategies either are impossible to be implemented at the operation phase or substantially increase costs. The purpose of this study is to present a new approach called genetic algorithm process optimization (GAPO), by which processes can be made inherently safer even at the operation phase. This study simulates the IS principle, assessing its impact on quantitative risk and the …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Assessment Of Cooking Matters Facebook Platform To Promote Healthy Eating Behaviors Among Low-Income Caregivers Of Young Children In The United States: A Pilot Study, Qi Zhang, Jill Panichelli, Leigh Ann Hall

Community & Environmental Health Faculty Publications

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes …

Status And Factors Associated With Healthcare Choices Among Older Adults And Children In An Urbanized County: A Cross-Sectional Study In Kunshan, China, Yuxi Zhao, Linqi Mao, Jun Lu, Qi Zhang, Gang Chen, Mei Sun, Fengshui Chang, Xiaohong Li

Community & Environmental Health Faculty Publications

As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service resources and to provide support for resource allocation. A cross-sectional study was conducted in Kunshan, a highly urbanized county in China, in 2016, among older adults aged 60 or over and children aged 0–6. Multinomial logistics models were used to identify the factors associated with healthcare choices. In this study, we found that income, distance of the …

Occupational Stressors Among Firefighters: Application Of Multi-Criteria Decision Making (Mcdm)Techniques, Fazel Rajabi, Hossein Molaeifar, Mehdi Jahangiri, Shekofeh Taheri, Sean Banaee, Payam Farhadi

Community & Environmental Health Faculty Publications

Background: Firefighters are exposed to a wide range of occupational stressors due to the nature of their job. Multicriteria decision-making technique (MCDM) is a method for identifying, evaluating, and preventing occupational stressors among firefighters. The purpose of this study was to identify and prioritize the occupational stressors among firefighters using the fuzzy delphi method (FDM) and fuzzy analytical hierarchy process (FAHP).

Methods: This qualitative-descriptive study was carried out in two stages. First, the most important occupational stressors of firefighters were identified and screened using a systematic review of scientific references and expert opinions based on the FDM. Then, all of …

Innovative Framework For Academic And Public Health Departments' Partnership On Preparing Future Practitioners- Preliminary Data, Michele Kekeh, Muge Akpinar-Elci, Myngoc Nguyen, Nancy Welch

Community & Environmental Health Faculty Publications

This article presents a model to respond to current public health challenges and transform knowledge into preventive strategies. It also presents an innovative way for academic institutes and public health departments to focus on public health workforce development. Academic institutes partnership with public health departments have started fostering service-learning opportunities to engage students in public health with an emphasis on the specific public health outcomes. However, the benefit of service–learning projects on the health departments and the populations served is largely unknown. Recently, these service-learning opportunities are becoming less sustainable due to the inability of preceptors to provide the necessary …

Aberrant Epigenomic Modulation Of Glucocorticoid Receptor Gene (Nr3c1) In Early Life Stress And Major Depressive Disorder Correlation: Systematic Review And Quantitative Evidence Synthesis, Laurens Holmes Jr., Emily Shutman, Chinacherem Chinaka, Kerti Deepika, Lavisha Palaez, Kirk W. Dabney

Community & Environmental Health Faculty Publications

Early life stress (ELS) induced by psychological trauma, child maltreatment, maternal separation, and domestic violence predisposes to psycho-behavioral pathologies during adulthood, namely major depressive disorder (MDD), anxiety, and bipolar affective disorder. While environmental data are available in illustrating this association, data remain to be established on the epigenomic underpinning of the nexus between ELS and MDD predisposition. Specifically, despite the observed aberrant epigenomic modulation of the NR3C1, a glucocorticoid receptor gene, in early social adversity and social threats in animal and human models, reliable scientific data for intervention mapping in reducing social adversity and improving human health is required. We …

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

A Social-Ecological Framework Of Theory, Assessment, And Prevention Of Suicide, Robert J. Cramer, Nester D, Kapusta

Community & Environmental Health Faculty Publications

The juxtaposition of increasing suicide rates with continued calls for suicide prevention efforts begs for new approaches. Grounded in the Centers for Disease Control and Prevention (CDC) framework for tackling health issues, this personal views work integrates relevant suicide risk/protective factor, assessment, and intervention/prevention literatures. Based on these components of suicide risk, we articulate a Social-Ecological Suicide Prevention Model (SESPM) which provides an integration of general and population-specific risk and protective factors. We also use this multi-level perspective to provide a structured approach to understanding current theories and intervention/prevention efforts concerning suicide. Following similar multi-level prevention efforts in interpersonal violence …

Social Health Insurance Coverage And Financial Protection Among Rural-To-Urban Internal Migrants In China: Evidence From A Nationally Representative Cross-Sectional Study, Wen Chen, Qi Zhang, Andre M. N. Renzaho, Fangjing Zhou, Hui Zhang, Li Ling

Community & Environmental Health Faculty Publications

INTRODUCTION: Migrants are a vulnerable population and could experience various challenges and barriers to accessing health insurance. Health insurance coverage protects migrants from financial loss related to illness and death. We assessed social health insurance (SHI) coverage and its financial protection effect among rural-to-urban internal migrants (IMs) in China.

METHODS: Data from the '2014 National Internal Migrant Dynamic Monitoring Survey' were used. We categorised 170 904 rural-to-urban IMs according to their SHI status, namely uninsured by SHI, insured by the rural SHI scheme (new rural cooperative medical scheme (NCMS)) or the urban SHI schemes (urban employee-based basic medical insurance (UEBMI)/urban …

The Role Of Neighborhood Characteristics In Late Stage Melanoma Diagnosis Among Hispanic Men In California, Texas, And Florida, 1996-2012, Valerie M. Harvey, Clinton W. Enos, Jarvis T. Chen, Hadiza Galadima, Karl Eschbach

Community & Environmental Health Faculty Publications

Background. Hispanics diagnosed with cutaneous melanoma are more likely to present at advanced stages but the reasons for this are unknown. We identify census tracts at high risk for late stage melanoma diagnosis (LSMD) and examine the contextual predictors of LSMD in California, Texas, and Florida. Methods. We conducted a cross-sectional study using geocoded state cancer registry data. Using hierarchical multilevel logistic regression models we estimated ORs and 95% confidence intervals for the impact of socioeconomic, Hispanic ethnic concentration, index of dissimilarity, and health resource availability measures on LSMD. Results. We identified 12,493 cases. In California, late …

Disparities In Hospital Services Utilization Among Patients With Mental Health Issues: A Statewide Example Examining Insurance Status And Race Factors From 1999-2010, Viann N. Nguyen-Feng, Hind A. Beydoun, Michael K. Mcshane, James D. Blando

Community & Environmental Health Faculty Publications

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in …

Experiences Of Kenyan Healthcare Workers Providing Services To Men Who Have Sex With Men: Qualitative Findings From A Sensitivity Training Programme, Elise M. Van Der Elst, Evans Gichuru, Anisa Omar, Jennifer Kanungi, Zoe Duby, Miriam Midoun, Sylvia Shangani, Susan M. Graham, Adrian D. Smith, Eduard J. Sanders, Don Operario

Community & Environmental Health Faculty Publications

Introduction

Men who have sex with men (MSM) in Kenya are at high risk for HIV and may experience prejudiced treatment in health settings due to stigma. An on-line computer-facilitated MSM sensitivity programme was conducted to educate healthcare workers (HCWs) about the health issues and needs of MSM patients.

Methods

Seventy-four HCWs from 49 ART-providing health facilities in the Kenyan Coast were recruited through purposive sampling to undergo a two-day MSM sensitivity training. We conducted eight focus group discussions (FGDs) with programme participants prior to and three months after completing the training programme. Discussions aimed to characterize HCWs’ challenges in …

Victimization From Bullying Among School-Attending Adolescents In Grades 7 To 10 In Zambia, Seter Siziya, Emmanuel Rudatsikira, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background:

Among school- attending adolescents, victimization from bullying is associated with anxiety, depression and poor academic performance. There are limited reports on victimization from bullying in Zambia; we therefore conducted this study to determine the prevalence and correlates for victimization from bullying among adolescents in grades 7 to 10 in the country in order to add information on the body of knowledge on victimization from bullying.

Methods:

The 2004 Zambia Global School-based Health Survey (GSHS) data among adolescents in grades 7 to 10 were obtained from the World Health Organization. We estimated the prevalence of victimization from bullying. We also …

Prevalence And Socio-Demographic Correlates For Serious Injury Among Adolescents Participating In The Djibouti 2007 Global School-Based Health Survey, Adamson S. Muula, Seter Siziya, Emmanuel Rudatsikira

Community & Environmental Health Faculty Publications

Background

Mental health and injury are neglected public health issues especially in low-income nations. The objective of the study was to determine the prevalence and socio-demographic correlates for serious injury in the last 12 months.

Findings

The study used data of the 2007 Djibouti Global School-based Health Survey. Logistic regression analysis was used to establish associations. Of the 1, 777 respondents, 61.1% (63.2% males and 57.8% females) reported having sustained serious injury (SSI). Compared to participants who were not bullied, those who reported being bullied 3-9 days per month were more likely to have sustained serious injury in the last …

Prevalence Of Hypertension And Its Correlates In Lusaka Urban District Of Zambia: A Population Based Survey, Fastone M. Goma, Selestine H. Nzala, Olusegun Babaniyi, Peter Songolo, Cosmos Zyaambo, Emmanuel Rudatsikira, Seter Siziya, Adamson S. Muula

Community & Environmental Health Faculty Publications

Background

Hypertension is a leading cause for ill-health, premature mortality and disability. The objective of the study was to determine the prevalence and associated factors for hypertension in Lusaka, Zambia.

Methods

A cross sectional study was conducted. Odds ratios and their 95% confidence intervals were calculated to assess relationships between hypertension and explanatory variables.

Results

A total of 1928 individuals participated in the survey, of which 33.0% were males. About a third of the respondents had attained secondary level education (35.8%), and 20.6% of males and 48.6% of females were overweight or obese. The prevalence for hypertension was 34.8% (38.0% …

The Cost-Effectiveness Of Improving Diabetes Care In U.S. Federally Qualified Community Health Centers, Elbert S. Huang, Qi Zhang, Sydney E. S. Brown, Melinda L. Drum, David O. Meltzer, Marshall H. Chin

Community & Environmental Health Faculty Publications

Objective. To estimate the incremental cost-effectiveness of improving diabetes care with the Health Disparities Collaborative (HDC), a national collaborative quality improvement (QI) program conducted in community health centers (HCs).

Data Sources/Study Settings. Data regarding the impact of the Diabetes HDC program came from a serial cross-sectional follow-up study (1998, 2000, 2002) of the program in 17 Midwestern HCs. Data inputs for the simulation model of diabetes came from the latest clinical trials and epidemiological studies.

Study Design. We conducted a societal cost-effectiveness analysis, incorporating data from QI program evaluation into a Monte Carlo simulation model of diabetes.

Data Collections/Extraction …