Medicine and Health Sciences Commons^™

Exploring The Potential Of Hearing Screening Smartphone Applications To Enhance Access To Hearing Healthcare: A Literature Review, Adam Sulaiman

Dissertations, Theses, and Capstone Projects

In 2016, the National Academies of Sciences (NAS) published a landmark consensus report with several recommendations to enhance the availability and affordability of hearing healthcare in the United States. Among the most notable of the recommendations was the creation of a new category of FDA-approved Over-the-Counter (OTC) hearing aids. Unlike the traditional hearing aid model, which requires a comprehensive hearing test by a hearing health professional prior to purchase, OTC hearing aids would be directly available for sale to any American adult with a self-perceived mild-to-moderate degree of hearing loss. This proposal has now become reality with the passage of …

Sit Less, Move More: A National Study Of Physical-Activity Behavior And Cancer, Stella O. Nwogugu

Dissertations, Theses, and Capstone Projects

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts.

Methods: Using the …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

Screening For Hearing Loss: Physician Attitudes And Practice, Theresa N. Vitale

Dissertations, Theses, and Capstone Projects

Age related hearing loss (ARHL) is considered a public health hazard in large part due to the negative health outcomes with which it is associated, such as, cognitive decline, increased risk of falling, social isolation and depression. Despite the health-related costs of ARHL, physician’s rarely screen older adults for ARHL. Some of the reasons previously cited include a lack of time and resources in medical offices, a lack of reimbursement for such measures, or lack of knowledge of risk factors associated with hearing loss. The latter is problematic as improved communication among physicians and their patients is an important correlate …

Perceptions Of Fidelity And Adaptation In Evidence-Informed Interventions By Women Of Color Sexuality Health Educators, Sara C. Flowers

Dissertations, Theses, and Capstone Projects

Sexuality health educators (SHEs) adapt interventions to the participants’ needs in the dissemination and implementation of comprehensive sexuality education (CSE) programming. However, there is a lack of understanding of how, why and when SHEs make such adaptations. Success or failure of the transfer of prevention technology to practitioners occurs by determining community capacities and preparedness to adopt/adapt high-impact interventions to effectively manage implementation. Experts argue for evidence-informed interventions (EII), as opposed to evidence-based interventions (EBI), as the best way to incorporate research in applied settings. EBIs are solely guided by recommendations from current evidence, whereas EIIs recognize and incorporate the …

Ethnicity Matters: Implications For Understanding And Acting Upon Disparities In Health Affecting Black Men In The United States, Helen V. S. Cole

Dissertations, Theses, and Capstone Projects

Compared to non-Hispanic whites, non-Hispanic blacks have higher rates of mortality from heart disease, cancer, cardiovascular disease, and HIV/AIDS. Black men have a life expectancy approximately 4.7 years than the life expectancy of non-Hispanic white men, due in part to higher prevalence of chronic disease among black men. Many factors are hypothesized to contribute to disparities in health between races, including differences in socioeconomic status; culturally-linked behaviors such as diet, substance use, and physical activity; access to quality healthcare and other resources; and experiences of racism, both institutional and interpersonal. However, in public health research, race is usually treated as …

Development Of A Patient-Centered Health Literacy Toolkit For Audiology And Hearing Loss (The 'Hh Lit Kit'), Jennifer L. Gilligan

Dissertations, Theses, and Capstone Projects

The Patient-Centered Health Literacy Toolkit for Audiology & Hearing Loss (‘HH Lit Kit’) represents four years of inquiry into health literacy and Patient-Centered Care (PCC) in audiology. While awareness of health literacy continues to gain momentum in medicine and public health, there is a paucity of information on PCC and health literacy in audiology.

Low health literacy is linked to poorer health and poorer quality of life. Patients with hearing loss are at high risk for low health literacy. This presents a major concern because hearing loss affects the way information is processed, retained, and applied. Gaps have been identified …

Target Zero: Why States Choose To Eradicate Infectious Diseases And How They Succeed, Gifty Abraham

Dissertations, Theses, and Capstone Projects

Realism has remained the dominant paradigm within international relations for most of the modern era, emphasizing the competitive nature of the international arena and the unlikeliness of states to within it to cooperate. The attempts and further still, successes, by states to eradicate infectious diseases--which remain among the most cooperative enterprises--present a number of challenges to realism's assumptions, particularly with respect to the unlikely world historical-times during which the eradication campaigns took place. As such, a two-part puzzle arises. First, why would states, which are natural competitors, cooperate to eradicate infectious diseases given structural and situational incentives not to do …

Risk Factors And Costs Influencing Hospitalizations Due To Heat-Related Illnesses: Patterns Of Hospitalization, Michael T. Schmeltz

Dissertations, Theses, and Capstone Projects

The objective of this dissertation was to identify individual and environmental risk factors, investigate outcomes and hospital resource use, including costs, and document the pattern of heat-related illness hospitalizations in the United States. The main data source for the study population was the 2001-2010 Nationwide Inpatient Sample (NIS). The study population for heat-related illnesses (HRIs) consists of patients in the NIS with at least one diagnosis of a heat-related illness (ICD-9 codes 992.0 - 992.9) from 2001 to 2010. Outcome analysis included a study population of patients who had primary or secondary diagnoses of diabetes, cardiovascular diseases, respiratory illnesses, nephritic …

An Examination Of The Effect Of Vision-Related Factors And Availability Of Health Care Resources On Depression, Functional Status, And Falls Among New York City Senior Center Attendees, Lauren Evans

Dissertations, Theses, and Capstone Projects

There is substantial variability across different geographic regions and demographic groups in health outcomes and health resource availability. This dissertation examines the relationship between self-reported ocular disease and depression, functional status, and falls in a diverse sample of senior center attendees in New York City. Further, these analyses explored whether the availability of health care resources at the area level affects the observed relationship between ocular disease and these other adverse outcomes.

This dissertation project addresses two main gaps in the current research, specifically, the need to better understand elders' experiences with these conditions in different geographic regions and demographic …

A Meta-Analysis Of The Prediction Of Violence Among Adults With Mental Disorders, Hing Po Lam

Dissertations, Theses, and Capstone Projects

The study of the risk for violence among persons with mental disorders has received substantial scientific attention over the past few decades; however, many uncertainties and controversies remain due to the wide disparities in the reported results. Using the state-of-the-art perspective of public health, a meta-analysis was conducted to clarify the ambiguities by synthesizing quantitative findings from 85 research reports (completed between January 1970 and May 2010) on violence risk assessment among mentally disordered adults. Results of this meta-analytic study revealed that the estimates of the prevalence of violence among the psychiatric population varied considerably from 1.1% to 78.4% with …

Access To Healthcare For Vulnerable Asian Subgroup Populations In The United States, Deborah Kim-Lu

Dissertations, Theses, and Capstone Projects

Objectives: This dissertation examines the barriers for access to healthcare for the top four most uninsured Asian American subgroups (Bangladeshi, Cambodian, Korean, and Pakistani communities). Methods: Combining quantitative and qualitative approaches, this study consisted of: (1) an in-depth review of the Health Services Research literature; (2) qualitative interviews with 24 national health experts and advocates on Asian American health; (3) a survey of a non-probability sample of 107 Koreans in the tri-state region (Connecticut, New Jersey, and New York) using the Access to Healthcare Survey for Koreans in the U.S. instrument, which includes a Likert scale with 21 barrier questions …

Hot And Bothered: The Role Of Arousal And Rejection Sensitivity In Dual Process Sexual Decision Making For Gay And Bisexual Men, H Jonathon Rendina

Dissertations, Theses, and Capstone Projects

Dual process theories of decision making acknowledge the functioning of two distinct yet simultaneous processes termed System 1 and System 2. While System 1 relies more heavily on automatic and affective processing, System 2 relies more heavily on effortful and cognitive processing. Over the past several decades, many lines of research have shown the importance of System 1 in decision making and several prominent social psychological theories of interpersonal behavior, such as rejection sensitivity, rely on this dual distinction between affective and cognitive processing. Despite the prominence of dual process theories in many areas of psychology, the role of System …

Post-Treatment Drug Use, Recidivism, Analogous Behaviors, And Perceptions Of Fairness: Examining Whether Parolees With Low Self-Control Will Benefit From The Collaborative Behavioral Management Intervention, Sriram Chintakrindi

Dissertations, Theses, and Capstone Projects

This dissertation tested Gottfredson and Hirschi's (1990) low self-control theory and its relationship with post-treatment outcomes by conducting a secondary-data analysis of a randomized controlled trial on parolees (n=569) called the Step'n Out study (2005). The Step'n Out study (2005) compared the results of a control group (standard parole) with an experimental treatment for parolees called the Collaborative Behavioral Management (CBM) intervention which was designed to improve substance-use treatment outcomes, reduce drug use, and reduce recidivism for parolees participating in the study.

Low self-control theory states that individuals with character traits that are impulsive, risk-seeking, self-centered, and display volatile temper …

Does End Of Life Terminology Influence Decisional Conflict In Surrogate Decision Makers?, Dawn Fairlie

Dissertations, Theses, and Capstone Projects

This study investigated the relationship between end of life terminologies and decisional conflict in surrogate decision makers using a convenience sample of 234 adults age 50 and older at active adult communities, and senior centers in New Jersey. Participants were randomized into two groups, and each received a vignette that was personalized. The vignettes varied only in the use of the words "Do Not Resuscitate (DNR)" and "Allow Natural Death (AND)". The Decisional Conflict Scale (DCS) was administered.

There was no difference in total DCS score based on AND and DNR versions. However, AND respondents perceived their decision as a …