Medicine and Health Sciences Commons^™

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

Capstone Experience

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

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

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

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

Capstone Experience

Objectives

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

Methods

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

Results

There was a significant association between income and …

Readmission Rates Of Mothers Experiencing Preeclampsia Or Complications After Delivery In Underserved Populations, Sadia Robinson

MUSC Theses and Dissertations

Hospital readmissions during pregnancy nationwide impacts maternal health outcomes elevating the risk of maternal deaths after discharge. The accessibility and affordability of necessary prenatal care is integral to the field of health across the lifespan. Socioeconomic barriers within rural locations place expecting mothers at an adverse risk of developing conditions including preeclampsia and other complications that may result in hospital readmission. Economic barriers including hospital closures, shortages of specialty healthcare providers, unstable internet access and, ease of care access on further contribute to this disparity among rural women.

A retrospective analysis was conducted using data from Health Care Cost and …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Impact Of Covid-19 On Latinx And Black Communities, Carolina Zuluaga

Dissertations

This critical literature review project explored the impact of COVID-19 on Latinx and Black communities. According to the Centers for Disease Control and Prevention, as of September 28, 2022, around 16% of COVID-19 cases in the United States were among Latinx people, and 14% of cases were among Black people (Centers for Disease Control and Prevention, 2022). Since COVID-19 began, clinicians have become more conscious of the effects of health disparities within racial and ethnic minorities, which has warranted increased advocacy by educating health and mental health providers and creating and providing resources to these communities and clinicians. The review …

Our Story, Our Song: Assessing And Addressing Black Women's Healthcare Experiences., Jason Deakings

Electronic Theses and Dissertations

Despite advancements in medicine and health sciences, health disparities and declining life expectancy persists among Black women in the United States. Researchers and non-traditional healthcare providers suggest alternative healing (e.g., music and Sister Circles) and research methodologies to achieve a culturally conscious, traumainformed, quality, and holistic care and practice. The intersecting identities and cultural responsibility of Black women highly influences the barriers and facilitators on the uptake of healthcare services. Utilizing a community engaged research approach, this qualitative study assessed the healthcare experiences, as well as the role of music in the lived and retold experiences of Black women navigating …

“They’Re Still Trying To Wrap Their Head Around Forever”: An Anatomy Of Hope For Spinal Cord Injury Patients, William A. Lucas

USF Tampa Graduate Theses and Dissertations

This dissertation draws on ethnographic data to investigate the nature of spinal cord injury (SCI) rehabilitation in Central Florida, using participant observation and interview data to understand how people with SCI (pwSCI) conceptualize their own disabilities after experiencing such radical alterations in their subjectivities. Using case studies and ethnographic vignettes, it argues that the extreme double binds in which pwSCI find themselves (where they are personally ordinarily disabled and socially extraordinarily novel; and where they are enabled resources to pursue “hopeful” therapy modalities while being designated as hopelessly disabled) is further polarized by the various legislative regimes of truth in …

Leveraging Digital Technologies For Management Of Peripartum Depression To Mitigate Health Disparities, Alexandra Zingg

Dissertations & Theses (Open Access)

Health disparities are adverse, preventable differences in health outcomes that affect disadvantaged populations. Examples of health disparities can be seen in the condition of peripartum depression (PPD), a mood disorder affecting approximately 10-15% of peripartum women. For example, Hispanic and African-American women are less likely to start or continue PPD treatment. Digital health technologies have emerged as practical solutions for PPD care and self-management. However, existing digital solutions lack an incorporation of behavior theory and distinctive information needs based on women’s personal, social, and clinical profiles. Bridging this gap, I adapt Digilego, an integrative digital health development framework consisting of: …

Comparative Medicaid Policy Analysis Related To Maternal And Infant Birth Outcomes In South Carolina, Cassidy L. Lena

Senior Theses

The United States despite being one of the most industrialized and wealthiest nations in the world, has the worst maternal and child health outcomes of any industrialized nation. The rates of maternal morbidity, mortality, and infant mortality have been increasing within the past decade, when many causes of death for this population are preventable. This study conducted a literature review on Medicaid policies and associated programs between three states (South Carolina, North Carolina, and California) in order to gain background information. Secondly, a comparative Medicaid policy analysis was completed using the Centers for Disease Control and Prevention [CDC] framework, which …

Modifiable Health Disparities And Cardiovascular Disease Risk Factors In Latino Migrant Seasonal Farmworkers: A Meta-Analysis, Cindy Mendez

Nursing Theses and Dissertations

BACKGROUND: Cardiovascular disease is the leading cause of death in the United States (U.S.). Existing literature concluded that Latino migrant seasonal farmworkers endure higher rates of adverse health disparities and chronic diseases than the general U.S. population. However, research on the Latino migrant seasonal farmworkers’ modifiable health disparities (i.e., alcohol use and smoking) and cardiovascular disease risk factors (i.e., high cholesterol, diabetes mellitus, hypertension, and overweight/obesity) is scarce, particularly studies comparing male and female Latino migrant seasonal farmworkers. PURPOSE: This meta-analysis had two aims. First, examine whether male or female Latino migrant seasonal farmworkers in the U.S. have …

Nursing-Related Interventions To Obstetric Violence: A Literature Review, Annaliece M. Balensiefen

Honors Undergraduate Theses

The aim of this literature search was to explore the prevalence of obstetric violence and identify nursing interventions that could potentially prevent the mistreatment of pregnant women in the United States healthcare system. Background: The topics of obstetric violence and healthcare disparities have been gaining awareness. Other countries have a larger body of research for obstetric violence compared to the U.S. Methods: CINAHL Plus with Full Text and MEDLINE databases were utilized. Global perspectives were considered in conjunction with the U.S. and specifically Florida. Healthcare disparities in obstetric care were identified, based on race, ethnicity, socioeconomic status, sexuality, disability, …

Acute Myocardial Infarction Among People Living With Hiv: Comparing Immunological And Virological Control By Hispanic Ethnicity Of The All Of Us Research Program Participants, Eugenio Reina

Honors Undergraduate Theses

In the United States, individuals of Hispanic ethnicity receive disproportionately lower-quality healthcare. These healthcare disparities exacerbate unequal access to quality healthcare services, including disparities in cardiovascular disease (CVD) and human immunodeficiency virus (HIV) care. Research on the role of ethnicity on the CVD outcomes of people living with HIV (PLWH) has been limited. We hypothesize that immunological (CD4+ cell count) and virological (HIV viral load) control may play a role in the development of acute myocardial infarction (AMI) among PLWH, and that Hispanic ethnicity may worsen these outcomes.

To verify our hypotheses, we conducted a retrospective cross-sectional study to investigate …

Epigenetic Aberrations In Systemic Sclerosis And Systemic Lupus Erythematosus, Peter C. Allen

All ETDs from UAB

Autoimmune diseases are a classification of more than eighty diseases where the immune system recognizes a self-antigen and mistakenly attacks the body’s own tissue, inducing inflammation a nd p otentially l eading t o d amage. Autoimmune diseases disproportionately affect women and develop at any age depending on the disease. The prevalence of some autoimmune diseases is increased in minority populations. Despite this, research into higher-risk populations is lacking. This highlights the need to contribute research into understanding autoimmune disease pathogenesis in diverse studies to understand why disease is more severe in these populations. We analyzed transcriptomes and methylomes of …

Social Determinants Of Health And Blood Pressure Control In Black And White Us Adults, Oluwasegun Philip Akinyelure

All ETDs from UAB

Black adults in the US have 2 to 3 times higher rates of cardiovascular disease (CVD) mortality compared to White adults. Most of the excess CVD mortality in Black adults has been attributed to their higher prevalence of hypertension and uncontrolled blood pressure (BP). In October 2020, the US Surgeon General published a Call-to-Action to improve hypertension control and identified social determinants of health (SDOH) as a major contributor to Black:White disparities in hypertension control. Prior research has showed that SDOH are associated with excess hypertension risk among Black compared with White adults, but data on their association with BP …

The Lived Experiences Of Black Women With Hysterectomy For Benign Fibroids, Clarise M. Jackson-Hall

Walden Dissertations and Doctoral Studies

Black women are more likely than women of any other race in the United States to undergo an abdominal hysterectomy instead of a less invasive and less damaging laparoscopic or robotic procedure for benign fibroids. Although Black women are the population most disparately affected by benign fibroids, as evidenced by higher morbidity and mortality rates due to complications, they are often excluded in clinical research. The purpose of this qualitative phenomenological study was to explore the lived experiences of Black women who decided to undergo an invasive abdominal hysterectomy for benign fibroids. Semistructured interviews were conducted with 14 Black women, …

Sociodemographic Predictors Of Veterans’ Health-Related Quality Of Life, Tamala Jones Choice

Walden Dissertations and Doctoral Studies

Health-related quality of life (HRQoL) is a theoretical concept that intertwines physical, mental, emotional, and social functioning, with a focus on the impact that health status has on quality of life. Although sociodemographic factors are associated with lower HRQoL, how these factors influence HRQoL in military veterans is less understood. The study’s purpose was to examine the relationships between sociodemographic characteristics (gender, military pay grade, military branch, and geographic location) and perceived HRQoL measured by the SF-8 survey among veterans living in a metropolitan community in the Mid-Atlantic region of the United States. A cross-sectional recruitment study design yielded 90 …

Genealogy Tells: Informing Health And Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, And Experiences Of Health Inequity, Heather Davis

Doctoral Dissertations

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women …

Establishing A Sustainable Occupational Therapy Student-Led Pro Bono Clinic At The University Of Saint Augustine In Austin, Texas, Daija Chumley

Student Capstone Papers

Under-resourced and underserved communities across the United States experience significant health disparities. These communities lack access to valuable services resulting in health inequities that impinge on their health, quality of life, and engagement in meaningful occupations. There is a need for occupational therapy to provide valuable services to the under-resourced and underserved community to address the historical inequity that impacts their overall quality of life. Universities have the potential to fulfill the gaps within these communities by establishing a pro bono clinic. The purpose of this capstone project is to establish a sustainable occupational therapy pro bono clinic at the …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Beyond The Plant: Facing Systemic Barriers As A Meatpacking Community During The Covid-19 Pandemic, Shannon Barrientos

Capstone Experience

The COVID-19 pandemic has revealed and magnified health disparities and social inequities that disproportionately burden racial and ethnic minorities. These disparities are readily seen within meatpacking communities, considering a lack of protections offered by the meatpacking industry have heightened COVID-19 susceptibility. These conditions have aggravated health inequities within rural communities throughout the span of the pandemic. Despite significant advances in research investigating the effect of COVID-19 on essential workers within the meatpacking plants, this research remains isolated within the meat processing industry. Moreover, research has focused predominantly on the pandemic’s impact on rural communities and the institutional barriers that hinder …

Healthcare Disparities Among African Americans, Chantilay M. Ruffin

Graduate Dissertations and Theses

Throughout healthcare there are numerous factors that play a role in and out of the healthcare setting such as: gender, ethnicity, socioeconomic and disability status1. Having a diverse environment is an important accomplishment to strive for because it is directly related to increased patient health outcomes and quality of life2. For centuries African Americans have faced adversity with regard to the health care system. They have not been granted the same opportunities to access health information when compared to others. Kumar and West imply that racism, class inequality, financial hardship, and poverty are major contributors in the widening health care …

Screening People Experiencing Homelessness For Adverse Childhood Events (Aces), Priya Vishwanath

Doctor of Nursing Practice Final Manuscripts

The purpose of this project was to implement a screening tool identifying patients who have four or more Adverse Childhood Events (ACEs) and connecting them to resources to build protective resilience. Stress during the developmental years can lead to preventable health conditions that are costly and impede quality of life. Nine out of the ten leading causes of death are ACE related illnesses. These are caused by complications of toxic stress syndrome. During a 7-month period, 138 patients were screened; 45% had ACEs of four or more.

Improving Patient Satisfaction And Preventative Health Service Utilization For Limited English Proficiency Immigrants At Pearl Medical Centr, Chioma Holland

Graduate Theses, Dissertations, and Capstones

Background: Despite research efforts to address health disparities within immigrant communities, immigrant health continues to lack the attention from healthcare stakeholders it needs. Many immigrants already face dire health threats like extreme poverty, political unrest, and mental health concerns in their countries of origin, making them even more vulnerable to poor physical, mental, and social health outcomes upon arrival to the United States (U.S.). The purpose of this project was to improve patient satisfaction and increase immigrant use of preventative care by utilizing appropriate interpreter services. Method: The Quality improvement (QI) project involved surveying limited English proficiency (LEP) immigrants older …

Interrogating Race And Place-Based Inequities In Hiv And Covid-19, Rohan Khazanchi

MD Honors Theses

Over the last four years, I have developed a research focus examining the intersections of race, place, and health. My M.D. Honors Thesis reflects a snapshot of these efforts. In this collection of brief research reports, I leverage area-based measures to investigate structural inequities in three contexts: the HIV epidemic in our hyperlocal community, the early stages of the COVID-19 pandemic, and clinical trials for novel COVID-19 therapeutics. I apply novel social epidemiologic tools to measure and explore disparate outcomes. And, in reflecting upon my findings, I discuss concrete implications for clinicians, researchers, and policymakers alike.

Chapter 1: Neighborhood-Level Deprivation …

Increasing Obesity Education In An Underserved Latino Population, Morgan Lippert, Kelsey Beard

Doctor of Nursing Practice Projects

Obesity is a rapidly growing health problem in the United States. Certain populations are at high risk for developing obesity including the Latino population and underserved communities. This Quality Improvement project aimed to develop a more patient centered approach for primary care providers use to deliver obesity education to an at-risk Latino population. The project was completed at a clinic in southern Illinois where the majority of the population is underserved and Spanish speaking. Obesity education tools in both Spanish and English were given to the patients in order to decrease the language barrier and improve patient education and understanding …

An Examination Of Historical Health Disparities Of The Black Population In America, And Their Effects On Contemporary Health Disparities In Covid-19 Vaccine Hesitancy, Sophia-Evelyne Blake Nehama

Public Health Undergraduate Program

The COVID-19 pandemic has highlighted the significant health disparities that the African American population faces in comparison to White Americans. The Tuskegee Syphilis study is often cited to support the theory that medical mistrust is responsible for these disparities despite conflicting opinions that medical distrust is not the main reason for disparities. This study examines the effects that historical health disparities in Black populations have on contemporary vaccine hesitancy. An analysis of recent sources, including peer reviewed historical analysis and news articles with accredited sources was used to make up the entirety of the literary review. For data on contemporary …

Self-Measured Blood Pressure Monitoring In Hypertension Control: The Role Of Social Determinants Of Health, Current State In The United States, And Future Directions, Adekunle Oke

Electronic Theses and Dissertations

Hypertension, a medical condition, predisposes to other cardiovascular diseases, and can be impacted by the social determinants of health (SDOH). Self-measured blood pressure monitoring (SMBP) is an evidence-based approach to hypertension control, but not much is known about the influence of SDOH on SMBP. This dissertation aims to: 1) highlight the SDOH factors whose relationship with SMBP have been explored in research studies; 2) examine the relationship between SDOH and SMBP among United States (U.S.) adults with high blood pressure; and 3) examine the current state of SMBP in the U.S., highlight policy implications from the empirical study and provide …

Lgbtq+ Health Disparities: Healthcare Intervention, Kara Steinbrecher

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community has carried the burden of countless health disparities throughout its history tied to discrimination, bias, prejudice, and stigma. LGBTQ+ individuals are disproportionately at higher risk for substance abuse, sexually transmitted diseases, cardiovascular disease, mental illness, suicide, and unequal access to healthcare, related to social stigma and bias that exists in healthcare itself. The purpose of this systematic literature review is to analyze existing health disparities among the LGBTQ+ population in the United States and the efficacy of various interventions of health care professionals to reduce them. Twenty-one articles from multiple online …

The Role Of American Domestic Medicine In The Nineteenth Century: Implications For Modern Populations With Low Access To Health Care, Savannah Allen

Senior Theses

Domestic medicine can be defined as medical treatment provided within the home or community that is administered by a member of that home or community who is not a physician, surgeon, or nurse. During the late nineteenth and early twentieth century, domestic medicine flourished as housewives began to take on the role of medical practitioner. This was an attempt to alleviate the stress of low healthcare access that plagued lower-income and rural communities. Among lower- and middle-class communities in present day, we continue to see disparities in access to quality health care. I will argue that telemedicine has transformed during …

Healthcare Safety-Net In The United States: Patient Satisfaction Across Rural And Urban Hospitals, Vivian Ho

Senior Theses

Objective. To examine rurality and other hospital characteristics associated with patient satisfaction across hospitals in the United States.

Data. Nationwide hospital data from the 2019 Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and the 2020 Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) file.

Study Design. Hospital ZIP-codes were categorized into urban, rural micropolitan, or small/isolated rural based on Rural-Urban Commuting Area (RUCA) codes. Patient satisfaction measures from the HCAHPS survey were linked to the CMS POS data for hospital characteristics, yielding 2,357 urban, 749 rural micropolitan, and 1,343 small/isolated rural hospitals. ANOVA and …