Medicine and Health Sciences Commons^™

Social Norms, Misperceptions, And Mosquito Net Use: A Population‑Based, Cross‑Sectional Study In Rural Uganda, Jessica M. Perkins, Paul J. Krezanoski, Sae Takada, Bernard Kakuhikire, Vincent Batwala, Alexander Tsai, Nicholas A. Christakis, David R. Bangsberg

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Mosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Furthermore, perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours.

Methods: Population-based data were collected from 1669 adults across eight villages in one rural parish in southwestern Uganda. Individuals’ perception about whether …

E-Cigarettes And Conventional Cigarettes: Perceived Risks And Benefits Among College Students, Evi Addoh

Electronic Theses and Dissertations

ABSTRACT Background: Accompanying the decline in cigarette smoking rates has been a rise in prevalence of electronic cigarette (e-cigarette) use. The ongoing investigations on the health impact of e-cigarettes have been accompanied by mixed messages and a lack of consensus which may lead college students to rely on their own perceptions of risk and benefits in deciding whether to use e-cigarettes. Conclusion: Considering the significant association of perceived risks and benefits with e-cigarette and cigarette use this study yields some findings that show the importance of appropriately addressing perceptions. It is paramount to keep the public updated on pertinent research …

Improving Access To Antenatal Care In Ngara, Tanzania Through Implementation Of The Lady Health Worker Programme, Alison L. Bailey

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal mortality is one of the greatest health disparities facing the world today. A disproportionate number of women who die from pregnancy-related complications live in developing countries: the average maternal mortality in developed nations is 12/100,000, compared to 239/100,000 in developing nations; this rate is even higher in several sub-Saharan African nations. Reasons for this disparity include a lack of providers, inaccessibility to care, and poor quality of treatment in developing nations. Women living in the sub-Saharan country of Tanzania face many of these barriers, and as a result the country’s maternal mortality rate is 398/100,000. Antenatal care is an …

Association Between Education And Health Outcomes Among Adults With Disabilities: Evidence From Shanghai, China, Tong Ge, Qi Zhang, Jun Lu, Gang Chen, Mei Sun, Xiaohong Li

Community & Environmental Health Faculty Publications

Background

Adults with disabilities often have worse health outcomes than do their peers without disabilities. While education is a key determinant of health, there is little research available on the health disparities across education levels among adults with disabilities in developing countries. We therefore examined the association between health outcomes and education among adults with disabilities in Shanghai, China.

Methods

We used the health examination records of 42,715 adults with disabilities in Shanghai in 2014. Five health outcomes, including two diseases (fatty liver and hemorrhoids) and three risk factors (overweight [body mass index ≥ 24]), high blood glucose, and high …

Geospatial-Temporal, Demographic, And Programmatic Adoption Characteristics Of A Large-Scale Water Filter And Improved Cookstove Intervention In Western Province, Rwanda, Katie Fankhauser, Corey L. Nagel, Christina Barstow, Miles Kirby, Evan A. Thomas

OHSU-PSU School of Public Health Faculty Publications and Presentations

Lowering the global disease burden of preventable disease has been addressed in part by the distribution of health products and behavior change campaigns in low-income countries. Realizing a health impact requires adoption by participants, and the topic of program uptake and sustained adoption has been studied extensively, although an ecological context is largely missing from existing work. This study characterizes self-reported and observed adoption of improved cookstoves and point-of-use water filters among nearly 80,000 households in Rwanda using demographic and programmatic variables from implementer surveys and integration of geospatial and temporal data based on differentiated recipient location. The odds of …

Associations Between Cannabis Use, Medication Status And Panic-Anxiety Disorder Symptoms Among Us Adults, Diane Tran Ma

Public Health Theses

The existing body of literature focuses on the onset of panic disorders or other side effects as an association with cannabis use, but does little to address how possible concomitant cannabis use affects symptom presentation in already-diagnosed patients. The present project aims to take a closer look at adults with a lifetime history of DSM-5 diagnosed anxiety disorders, their prescribed (non-cannabis) medication use, cannabis use frequency, and associated symptom severity.

In general, we find that cannabis use is associated with higher panic-anxiety symptom severity across panic disorder without agoraphobia, generalized anxiety disorder, and people with combined anxious-distress diagnoses, after controlling …

Exploring The Development Of Three Law-Based Competency Models For Public Health Practitioners, Montrece Mcneill Ransom, Brianne Yassine

Journal of Social, Behavioral, and Health Sciences

As public health promotion and protection become increasingly complex and integrated into various fields, public health law is emerging as an important tool for public health professionals. To ensure that public health professionals are adequately trained public health law, public health law-related competencies should to be integrated into educational and other programming. This article provides three competency models developed by the Public Health Law Program at the Centers for Disease Control and Prevention: (a) the public health emergency law competency model, (b) the public health law competency model, and (c) the legal epidemiology competency model. These competency models provide a …

Public Education/Public Health Perspectives On Collaboration-Influence On High School Completion, Claudette Virginia Campbell

Walden Dissertations and Doctoral Studies

The research problem focused on the use of collaboration by managers, supervisors, consultants, and professional staff in a department of public education and health to address disparities in on-time high school completion rates. The purpose of the study was to examine the perspectives of individuals in these public sectors on the use of collaboration as a means to improve on-time high school completion rates for African American and Hispanic students. The theoretical foundation and conceptual framework for the study were John Rawls's theory of justice and Amartya Sen's capability approach. The key research question involved how individuals in the public …

Strategies Hospital Administrators Utilize To Optimize Patient Services, Vicente Njoku

Walden Dissertations and Doctoral Studies

Hospital administrators face challenges that arise from environmental factors or psychosocial factors, and lack resources to deliver valuable medical services to stakeholders, including patients and employees. A multicase study served to explore experiences and gain a broader perspective of hospital administrators' use of strategies to optimize patient services. Ten hospital administrators from acute care hospitals in Nevada and California were purposefully selected from the population of hospital managers with a minimum of 2 years of documented experience in successfully implementing management strategies to improve patient services. The conceptual framework was Drucker's management theory. Data were collected from semistructured interviews with …

Serological Proteomic Screening And Evaluation Of A Recombinant Egg Antigen For The Diagnosis Of Low-Intensity Schistosoma Mansoni Infections In Endemic Area In Brazil, Vanessa Silva-Moraes, Lisa Marie Shollenberger, William Castro-Borges, Ana Lucia Teles Rabello, Donald A. Harn, Lia Carolina Soares Medeiros, Wander De Jesus Jeremias, Liliane Maria Vidal Siqueira, Caroline Stephane Salviano Pereira, Maria Luysa Camargos Pedrosa, Nathalie Bonatti Franco Almeida, Aureo Almeida, Jose Roberto Lambertucci, Nidia Francisca De Figueiredo Carneiro, Paulo Marcos Zech Coelho, Refaella Fortini Queiroz Grenfell

Biological Sciences Faculty Publications

Background

Despite decades of use of control programs, schistosomiasis remains a global public health problem. To further reduce prevalence and intensity of infection, or to achieve the goal of elimination in low-endemic areas, there needs to be better diagnostic tools to detect low-intensity infections in low-endemic areas in Brazil. The rationale for development of new diagnostic tools is that the current standard test Kato-Katz (KK) is not sensitive enough to detect low-intensity infections in low-endemic areas. In order to develop new diagnostic tools, we employed a proteomics approach to identify biomarkers associated with schistosome-specific immune responses in hopes of developing …

'Links2healthierbubs' Cohort Study: Protocol For A Record Linkage Study On The Safety, Uptake And Effectiveness Of Influenza And Pertussis Vaccines Among Pregnant Australian Women, Mohinder Sarna, Ross M. Andrews, Hannah C. Moore, Michael J. Binks, Lisa Mchugh, Gavin F. Pereira, Christopher C. Blyth, Paul Van Buynder, Karin Lust, Paul Effler, Stephen B. Lambert, Saad B. Omer, Donna Mak, Thomas Snelling, Heather A. D'Antoine, Peter Mcintyre, Nicholas De Klerk, Damien Foo, Annette K. Regan

Medical Papers and Journal Articles

Introduction: Pregnant women and infants are at risk of severe influenza and pertussis infection. Inactivated influenza vaccine (IIV) and diphtheria-tetanus-acellular pertussis vaccine (dTpa) are recommended during pregnancy to protect both mothers and infants. In Australia, uptake is not routinely monitored but coverage appears sub-optimal. Evidence on the safety of combined antenatal IIV and dTpa is fragmented or deficient, and there remain knowledge gaps of population-level vaccine effectiveness. We aim to establish a large, population-based, multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions. This is a first …

A Brief History Of Nutritional Rickets, Benjamin J. Wheeler, Anne Marie E. Snoddy, Craig Munns, Peter Simm, Aris Siafarikas, Craig Jefferies

Research outputs 2014 to 2021

Since first described almost a century ago, vitamin D preparations have been successfully used as a public health intervention to prevent nutritional rickets. In this manuscript, we document the periods in history when nutritional rickets was described, examine early efforts to understand its etiology and the steps taken to treat and prevent it. We will also highlight that despite the wealth of historical data and multiple preventative strategies, nutritional rickets remains a significant public health disorder. Nutritional rickets has both skeletal and extraskeletal manifestations. While the skeletal manifestations are the most recognized features, it is the extraskeletal complications, hypocalcaemic seizure …

Design And Development Of An Mph Program For Online Delivery, Steven R. Hawks, Julie A. Gast

Journal on Empowering Teaching Excellence

The Master of Public Health (MPH) degree is growing in popularity and is now delivered fully online by a large number of highly respected, fully accredited universities. This paper offers an overview of program design and development strategies that promote successful online delivery of MPH programs. Design and development challenges are discussed in terms of new accreditation standards, student demand, faculty development, user needs, course content, and plan of study. The development of an online MPH program at Utah State University with a concentration in health education and promotion is used to highlight and consider various aspects of this important …

Cannabis Caught Between Smoke And Mirrors, Laura M. Olivieri Robles

Capstones

Cannabis legalization advances across the country and social attitudes are changing. Public health experts see parallels with the tobacco industry-- and are concerned about kids exposed to cannabis advertisement.

A Mixed-Methods Refugee Community Health Needs And Assets Assessment, Eleni Florakis, Rickie Brawer, Phd, Mph, Mches, Abby Cabrera, Kaushal Desai, Saya Bery

Phase 1

Introduction:

Many factors may negatively affect the experience of refugees navigating the healthcare system in Philadelphia. These factors include, but are not limited to, lack of familiarity with the healthcare system, language and cultural barriers, limited health literacy, physical and transportation barriers, and fear and/or distrust of the healthcare system. In addition, there are a large proportion of United States refugees in Pennsylvania. According to usnews.com, Pennsylvania was ranked the top 6th state for taking in the most refugees in the year 2017.

Objective:

The primary objective is to assess the experiences of refugees within the healthcare system since resettlement …

Mental Health And Resilience In Adolescent Refugees Resettled In Philadelphia, Saya Bery, Pia Ghosh, Mph, Ellen Plumb, Md

Phase 1

Introduction: Mental health in adolescents has a large impact on physical health, academic achievement, and overall well-being; moreover, refugee youth are at an increased risk for mental health disorders. While growing evidence shows that positive youth development interventions can prevent health risk behaviors, there is need for further evaluation that shows how to tailor interventions to meet population-specific needs.

Objective: The aim is to assess how targeted interventions can enhance protective factors and reduce negative adult outcomes in vulnerable refugee adolescents. The goals are to understand the current status of mental health and access to resources among resettled adolescents in …

Normalized Healthcare Utilization Among Refugees Resettled In Philadelphia, 2007-2016, Kaushal Desai, Mph, Colleen Payton, Phd, Mph, Ches, Kevin Scott, Md, Brandon George, Phd, Ms, Marc Altshuler, Md

Phase 1

Background/Purpose: About 70,000 new refugees are resettled in the United States each year, of which approximately 600 are resettled in Philadelphia. This project seeks to better understand the patterns of healthcare utilization, including primary care, emergency, and hospitalization, among refugees resettled in Philadelphia, PA, between 2007 and 2016.

Methods: Demographic and healthcare utilization data for 1,144 refugees seen at Jefferson Family Medical Associates were compiled from the Jefferson Longitudinal Refugee Health Registry. Descriptive statistics were used to describe the demographic characteristics of the refugee population. Negative binomial count regressions were used to test for significant correlations between major demographic variables …

Medication Assisted Treatment In The Primary Care Setting: A Prospective Review, Bridget M. Smith, Lara Weinstein, Md

Phase 1

Introduction: Project HOME Health Services (PHHS) initiated a Medication Assisted Treatment program for Opioid Use Disorder in a primary care setting that is the first of its kind in the city of Philadelphia. This study assesses the MAT program by evaluating the Quality of Life (QoL) of the participants as well as their perception of the program.

Objective: The purpose of this study is to assess the QoL of the participants in the MAT program at PHHS and to evaluate the participants’ satisfaction with the program.

Methods: The population includes patients enrolled in the MAT program at PHHS who consented …

Rethinking Emergency Response To Mass Casualty Incidents: Disaster Medicine Education And The Role Of Medical Students, Claire Zurlo, Edward Jasper, Md, Mph

Phase 1

Introduction: The threat of a mass casualty incident (MCI) is one that must be taken seriously and for which hospitals must be prepared. In the wake of a disaster, emergency departments are often taxed beyond their ability to handle the demands of incoming traumas. In response to this, Dr. Edward Jasper, an emergency physician at Thomas Jefferson Hospital, designed the Hospital Emergency Response Team (HERT) to alleviate the pressure on the ED during a MCI. The HERT is a team of nursing and medical students who are FEMA trained to respond in the event of a MCI.

Objective: The primary …

Maternal Immune Activation (Mia) In Mice: A Study To Phenotype Asd-Related Communication Behaviors And Analyze Maternal Health Outcomes In The Us, Komalpreet Gulati

Honors Scholar Theses

Core symptoms of Autism Spectrum Disorders (ASD) include deficits in social/communicative behaviors, and repetitive/stereotyped behaviors. Mouse models are a highly established paradigm used to study the phenotypic deficits that result from various inducible genotypic or environmental risk factors for ASD. Previous studies have demonstrated a link between maternal immune activation (MIA) and ASD-like behaviors in mouse models. In this model, the maternal immune system is activated during pregnancy by injecting the viral mimic poly(I:C). The resulting offspring are phenotyped and analyzed with regards to their communicative behaviors.

Previous studies have demonstrated that male pups born to dams with immune activation …

Knowledge And Awareness Of Std Risk Perception Of Msm In Philadelphia, Timothy Chou, Nancy Brisbon, Md

Phase 1

There has been a rise in incidence of sexually transmitted diseases (STDs), in particularly in men who have sex with men (MSM). MSM were 106x as likely to have primary or secondary syphilis as compared to men who exclusively had sex with women (MSW). MSM account for large portion of antimicrobial resistant gonorrhea diagnoses and saw a 151% increase in incidence while compared to a 31.7% increase in MSW. This study examines what MSM in Philadelphia know about transmission methods and outcomes of syphilis and gonorrhea to better understand MSM risk perception of these diseases. A multiple-choice test was distributed …

Clinician Perspectives On Factors Affecting Shared Decision Making About Lung Cancer Screening, Mohammad Abubaker-Sharif, Melissa Dicarlo, Mph, Ms, Ronald E. Myers, Phd, Dsw

Phase 1

Background/Objective. In 2015, the Centers for Medicare and Medicaid Services (CMS) announced coverage for annual lung cancer screening (LCS) with low dose computed tomography (LDCT) for individuals who are 55 to 77 years of age, have > 30 pack years of smoking history, and undergo shared decision making (SDM) prior to screening. Most referrals for LCS are initiated in primary care. Currently, little is known about how primary care physicians view SDM and barriers in practice to SDM about LCS. This study aimed to gather information to help fill these knowledge gaps.

Methods. I worked with senior leadership in …

Knowledge, Attitudes, And Beliefs About Sexual Health And Behavior In Huye, Rwanda, Sara Charles, Lianna Drobatz, Ryan Dorey

Phase 1

Introduction: Pregnancy and its associated complication is the leading cause of death for women aged 15-19 worldwide. Teenage pregnancy is correlated with increased health complications, death, poverty, and societal stigma. Pregnancy in Rwanda has been documented at rates of 7% among teen women.

Objective: The objectives of this research study include assessing the attitudes, knowledge, and beliefs of adolescents in the Huye District of Rwanda regarding sexual health and behavior. We hypothesize that gaps in sexual health knowledge may exist and that differing beliefs among male and female adolescents affect adolescent sexual decision making, and, therefore, teenage pregnancy prevalence.

Methods: …

Impact Of Physical Activity On Stress Levels And Methadone Maintenance Treatment Outcomes, Praneeja Matta, Robert Sterling, Phd

Phase 1

Introduction: While the opioid epidemic has continued to intensify over the last decade, unfortunately the likelihood of achieving stable long-term abstinence using methadone maintenance treatment (MMT) remains as low as 60 percent. Perceived stress has been identified as a factor predictive of premature termination and relapse, making stress reduction an important area of study in MMT. However, little research is available on the effects of active stress-coping mechanisms on MMT outcomes.

Objective: To address this gap, the current study was conducted to examine the impact of physical activity on stress reduction and treatment outcomes.

Methods: This was a retrospective cohort …

Peer Assessments May Predict Objective Long-Term Academic Performance, Noah Christian, Yousif Hanna, John Spandorfer, Md

Phase 1

Introduction: A common challenge in medical education is to create a curriculum that both teaches the required material but still delivers a personable physician. In this data study, 673 Sidney Kimmel Medical College (SKMC) students were given a required survey to judge their group members on personal attributes ranging from preparedness to affability. These scores were used to aid students and hopefully prevent unfortunate habits from settling. We hypothesize that peer assessments will predict academic performance.

Methods: A five-question, Likert scale, peer assessment was given to each first-year medical student at SKMC. The electronic survey was given twice during the …

Medication Assisted Treatment For Opioid Use Disorder In The Primary Care Setting In Philadelphia: A Retrospective Review, Denis Ostick, Lara Weinstein, Md, Mph

Phase 1

Introduction:

The opioid crisis continues to be a growing public health concern across the United States. Americans struggling with Opioid Use Disorder (OUD) can seek different resources to help curtail their addiction. These include abstinence -based programs such as Narcotics Anonymous and Specialty treatment facilities including methadone and suboxone clinics. It has been shown that increased availability of drugs to treat opioid use addiction, such as methadone and buprenorphine, is linked to a lower likelihood of relapse and fatal overdoses. Therefore, medication assisted treatment (MAT) is a valuable asset because it combines behavioral therapy and medications to treat opioid use …

Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use Disorders In Title X Facilities: Assessing Barriers, Change Of Provider Behavior, And Patient Outcomes, Christian Iversen, Ms, Holly Ireland, Lcsw-C, Dickie Lynn Gronseth, Mph

Phase 1

Introduction: Substance use disorders, specifically opioids, are an increasing problem in the US. Screening, brief intervention, and referral to treatment (SBIRT) is a method to identify and treat patients at risk, or currently using illicit substances. Integrating SBIRT into Title X facilities, which provide reproductive healthcare to lower income populations, may allow identification and treatment of individuals that do not seek healthcare elsewhere. Objective: We aim to assess the efficacy of a longitudinal training program in Title X facilities. The program provides a structured approach to implementing new protocols, including an educational session on SBIRT and motivational interviewing (MI).

Methods: …

Advocating For Support For Families Of Pregnant And Parenting Women Impacted By The Opioid Crisis In Pennsylvania, Caitlin Weiss, Rosemarie Halt, Rph, Mph

Phase 1

Introduction:

The perinatal period is a key opportunity for intervention for families impacted by opioid use disorder (OUD). However, in 2016 only 7.6% of treatment facilities in PA offered childcare for parents receiving treatment and only 2.8% of residential facilities offered beds for clients’ children.

Objective:

The purpose of this project was to understand the magnitude of the opioid crisis as it affects pregnant women and their children in PA as well as what avenues exist to advocate for policy changes to better support their recovery.

Methods:

1. A policy brief was prepared for the Maternity Care Coalition (MCC) using …

Quality Improvement For The Jeffmd Clinical Experience Program, Chloe Virgil, Emily Romano, Sara Goldstein, Msw, Lsw, Rhea E. Powell, Md, Mph

Phase 1

Introduction: The JeffMD curriculum at Sidney Kimmel Medical College, which completed its inaugural year in the spring of 2018, aims to prepare future physicians to “thrive in the landscape of modern healthcare.” The curriculum is based upon the knowledge that human health exists interdependently with all aspects of life, including but not limited to social, health care system, behavioral, and biological factors. The JeffMD Clinical Experience Program (CE) is a mandatory, experiential, value-added component of the curriculum. Through the CE course, which spans the 21-month preclinical period, students work with a Community Health Worker to screen patients for social …

A Longitudinal Assessment Of Change In Blood Pressure Among Participants In The Heart Smarts Program, Kathryn Haskins, Susana Suzrez, Rickie Brawer, Phd, Mph, Sandra Sherman, Edd, Michelle Abel, Msph, James Plumb, Md, Mph

Phase 1

Many low-income areas of the United States are considered food deserts because people living in those communities have limited access to fresh fruits and vegetables (FFV); lack of FFV is tied to numerous health issues, including cardiovascular disease and obesity. The Heart Smarts Program (HSP) provides increased access to FFV in food deserts, as well as providing participants with nutrition education courses and health screenings, including blood pressure. The purpose of this study is to examine HSP participants who have been with the program for differing lengths of time in order to determine if length of participation has an impact …