Mental and Social Health Commons^™

Hiv Viral Suppression Among People Living With Hiv On Antiretroviral Therapy In Haut-Katanga And Kinshasa Provinces Of Democratic Republic Of Congo, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Osaremhen Ikhile, Roger Beni, Elodie Engetele, Astrid Mulenga

Department of Health Policy and Community Health Faculty Publications

Human immunodeficiency virus (HIV) infections and less-than-optimal care of people living with HIV (PLHIV) continue to challenge public health and clinical care organizations in the communities that are most impacted by HIV. In the era of evidence-based public health, it is imperative to monitor viral load (VL) in PLHIV according to global and national guidelines and assess the factors associated with variation in VL levels. Purpose: This study had two objectives—(a) to describe the levels of HIV VL in persons on antiretroviral therapy (ART), and (b) to analyze the significance of variation in VL by patients’ demographic and clinical characteristics, …

Social Media Usage And Transitioning Into Online Classes During Covid-19- A Survey Of Undergraduate Students In Georgia, United States, Sylvia Ofori, Janet Choongo, Mario Kekop, Gulzar H. Shah, Haresh Rochani, Joseph Telfair

Department of Health Policy and Community Health Faculty Publications

Previous studies on the use of social media (SM) during the COVID-19 pandemic have focused on the use in sustaining academic communication. This study aimed to assess the association between SM and the ease of transitioning to online classes during the COVID-19 pandemic using survey data from 872 undergraduate students. The findings showed that Snapchat and Instagram were the most preferred social media sites among participants. Compared to students who use SM for <2 hours a day, use for > 5 hours (AOR= 2.44; 95% CI, 1.13 – 5.25) or 3 to 5 hours a day (AOR = 2.01, 95% CI 1.06-3.81) increased the odds of easily …

Low Acceptance Of Helmet-Use And Injuries From Motorcycle Accidents In Rawalpindi And Abbottabad, Pakistan, Maryam Siddiqa, Gulzar H. Shah, A. Munam

Department of Health Policy and Community Health Faculty Publications

Background: Motorcycle accidents are a major cause of head injuries and the current study evaluated the beneficial impact and effectiveness of helmet usage among injured Motorcycle users. This study has been performed to observe the Motorcycle collisions within 6 months in Rawalpindi and Abbottabad cities of Pakistan

Objectives: Implications of helmet usage were assessed and the risk factors for severe injury during motorcycle accidents were identified.

Results: The multivariate analysis indicated that riders without a helmet were more likely to experience severe (AOR, 2.216; 95% CI, 2.02 to 10.5) or moderate injury (AOR, 1.215; 95% CI, 0.84 …

Determining The Optimal Healthcare System For America: Comparing The Current American And Universal Healthcare Systems, Tejas Kandharkar

University Honors Program

U.S. citizens ranked healthcare as the most important issue when it comes to voting (Zieff, 2020). The healthcare system’s importance is evident which is why it is important to determine what healthcare system is optimal for America. I used core indicators to compare the current American healthcare system and universal healthcare system and evaluated them for four key parameters. Based on my analysis, I conclusively determined that the universal healthcare system (Score: 8.23/10) is more optimal than the current American healthcare system (Score: 5.10/10). The American system had a somewhat better quality of care but the universal healthcare system was …

Covid-19 Investigated In Terms Of Disparities: An Analysis Of The Past, Present, And Future Of Public Health In Illinois, Hannah Deblock

University Honors Program

As a relatively new topic, previous literature fails to address the relation of social determinants of health to COVID-19. By combining existing knowledge on previous epidemics, information on the role of social determinants of health, and data on COVID-19, conclusions can be made about the path going forward. Historically, nonpharmacologic interventions such as quarantine periods, face coverings, and social distancing have been used in epidemics such as the Spanish Influenza of 1918-19. In terms of social determinants of health, geographical location, educational level, and income level all play a part in the health of an individual. Rather than emphasizing personal …

Support For Me: Substance Use Disorder Prevalence And Treatment Capacity Assessment, Rachel T. Gallo Mph, Katharine Knight Mph, Mary Lindsey Smith Phd

Substance Use Research & Evaluation

The aim of this report was to understand the sociodemographic and geographic distribution of substance use disorder (SUD) prevalence in Maine, through a claims-based analysis which assessed current statewide capacity to address SUD by examining current SUD treatment and recovery infrastructure, service utilization patterns, and geographic distribution of services and usage throughout the state to identify any gaps in treatment and recovery capacity.

The authors would like to note that this report was completed during the planning phase of the SUPPORT for ME project, which was funded by the Centers for Medicare & Medicaid Services (CMS) via the SUPPORT Act …

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

A Hidden Emergency: Transgenerational Inheritance In The Next Generation Of Rwandans, Neila Gross

Independent Study Project (ISP) Collection

Cases of physiological and psychological health disorders in the generation succeeding generation of the 1994 genocide are rising at an alarming pace. The presented work herein details a qualitative and quantitative approach to understanding the transmission of trauma from the surviving population of the 1994 Genocide Against Tutsi in their offspring using the APA PTSD System Scale-Interview (PSS-I). Several variables including age, gender and background were employed in this study. The results indicate that offspring born of targeted survivors of the 1994 Genocide Against Tutsi show increased trends of experiencing PTSD symptoms with children born in 1994 exhibiting the greatest …

Support For Me: Provider Focus Group Summary, Mary Lindsey Smith Phd, Katie Rosingana Ba, Evelyn Ali Bs, Tyler Egeland Ba, Karen Pearson Mlis, Ma, Mark Richards Bs

Substance Use Research & Evaluation

This summary highlights feedback from focus groups with providers across Maine who currently address the needs of persons with substance use disorder (SUD). These providers represent individuals working in the following organizations: Health Systems, Behavioral Health Agencies, Residential Treatment, Community Recovery Programs, Opioid Treatment Programs (OTP), Emergency Medical Services (EMS), First Responders (EMT, fire, police), and law enforcement (e.g., Sheriff’s Office, Corrections). This summary report is designed to provide feedback to the Office of MaineCare Services to help inform their strategic planning process to increase statewide capacity for SUD treatment and recovery service capacity to better meet the needs of …

Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell

Independent Study Project (ISP) Collection

Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …

Representation And Recommendations: Participation Of People Who Use Drugs In Un-Level Policy-Making, Lily Knudsen

Independent Study Project (ISP) Collection

Although participation in health policy-making is a popular topic in the literature and a stated priority of the United Nations, very little research has been published examining the full spectrum of participation by people who use drugs (PWUD) at the UN level. This study aims to describe and evaluate this participation through a combination of a literature review that looks at academic sources, UN publications, and publications by organizations of PWUD, and a series of interviews with representatives of organizations of PWUD who have participated in UN level policy-making.

Data collected demonstrates that there is no comprehensive system for the …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Opening Pandora’S Box From Readmissions To Transitional Care Patient-Centered Outcome Measures, Mathew J. Reeves, Michele C. Fritz, Ifeyinwa Osunkwo, Corita R. Grudzen, Lewis L. Hsu, Jing Li, Raymona H. Lawrence, Janet Prvu Bettger

Department of Health Policy and Community Health Faculty Publications

Background:

Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice.

Methods and Results:

This …

Implementation Of Complex Interventions Lessons Learned From The Patient-Centered Outcomes Research Institute Transitional Care Portfolio, Sabina B. Gesell, Janet Prvu Bettger, Raymona H. Lawrence, Jing Li, Jeanne Hoffman, Barbara J. Lutz, Corita R. Grudzen, Anna M. Johnson, Jerry A. Krishnan, Lewis Hsu, Dorien Zwart, Mark V. Williams, Jeffrey L. Schnipper

Department of Health Policy and Community Health Faculty Publications

Background:

Despite the well-documented risks to patient safety associated with transitions from one care setting to another, health care organizations struggle to identify which interventions to implement. Multiple strategies are often needed, and studying the effectiveness of these complex interventions is challenging.

Objective:

The objective of this study was to present lessons learned in implementing and evaluating complex transitional care interventions in routine clinical care.

Research Design:

Nine transitional care study teams share important common lessons in designing complex interventions with stakeholder engagement, implementation, and evaluation under pragmatic conditions (ie, using only existing resources), and disseminating findings in outlets that …

Assessment Of The Financial Health Of Rural Hospitals After Implementation Of The Georgia Rural Hospital Tax Credit Program, Bettye A. Apenteng, Samuel T. Opoku, Charles Owens, Emmanuel Akowuah, Linda Kimsey, Angela Peden

Department of Health Policy and Community Health Faculty Publications

Importance In 2016, Georgia implemented the Rural Hospital Tax Credit Program, which allows taxpayers to receive a tax credit for contributions to qualifying rural hospitals in the state. Empirical evidence of the program’s association with the viability of the state’s rural hospitals is needed.

Objective To examine the association of the tax credit program with the financial health of participating rural hospitals.

Design, Setting, and Participants This longitudinal cross-sectional study used hospital financial data from the Centers for Medicare & Medicaid Services for 2015 to 2019. A difference-in-differences analytic approach was used to examine the association of the tax credit …

Personal Mastery And All-Cause Mortality Among Older Americans Living With Diabetes, Ho-Jui Tung, Ming-Chin Yeh, Randall Ford, Gulzar H. Shah

Department of Health Policy and Community Health Faculty Publications

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time.
Methods: A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.
Results: A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery …

Perceived Benefits Matter The Most In Covid-19 Preventive Behaviors: Empirical Evidence From Okara District, Pakistan, Gulzar H. Shah, Ansar Ali Faraz, Hina Khan, Kristie Cason Waterfield

Department of Health Policy and Community Health Faculty Publications

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a faceto- face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara …

Pregnant Women With Substance Use Disorders Deserve Plans Of Safe Care, Alexandra E. Punch, Monika Taylor

Population Health Research Brief Series

Substance use among women who are pregnant is a growing U.S public health issue. Approximately 340,000 infants are affected by prenatal exposure to illicit drugs annually, leading to an increase in Neonatal Abstinence Syndrome (NAS), and Child Protective Services involvement. This issue brief describes the current state of prenatal substance use and provides guidance on the use of federally mandated Plans of Safe Care to help mothers prepare for the arrival of their baby while navigating their substance use disorder.

The Use Of Mobile Apps To Increase Physical Activity Level: A Systematic Review, Dziyana Nazaruk, Kelli Rouser

Department of Health Policy and Community Health Faculty Publications

Background: About 82% of the U.S. adult population owns a smartphone. More than half of that population downloaded a fitness or health app to increase the physical activity level. The current review included studies that have utilized mobile apps in conjunction with other intervention strategies to increase physical activity levels. Methods: The search was conducted in five electronic databases. Studies were included if they were randomized controlled trials, utilized mobile apps, physical activity was the primary outcome, written in English, and conducted between the years of 2007 and 2019. Results: Thirteen studies were included in the final review. Results indicated …

Disparities In Hiv Clinical Stages Progression Of Patients At Outpatient Clinics In Democratic Republic Of Congo, Raimi Ewetola, Gulzar H. Shah, Lievain Maluantesa, Gina D. Etheredge, Kristie C. Waterfield, Astrid Mulenga, Apolinaire Kilundu

Department of Health Policy and Community Health Faculty Publications

Context: In this era of patient-centered care, it is increasingly important for HIV/AIDS care and treatment programs to customize their services according to patients’ clinical stage progression and other risk assessments. To enable such customization of HIV care and treatment delivery, the research evidence explaining factors associated with patients’ clinical stages is needed. Objectives: The primary objective of this study was to produce such scientific evidence by analyzing the most recent data for patients at outpatient clinics in the provinces of Kinshasa and Haut-Katanga and to examine the patient characteristics associated with WHO stages of disease progression. Methods: Using a …

Risk Factors For Tb/Hiv Coinfection And Consequences For Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Cong, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, Lievain Maluantesa, Kristie C. Waterfield, Elodie Engetele, Apolinaire Kilundu

Department of Health Policy and Community Health Faculty Publications

(1) Background: In resource-limited countries, patients with tuberculosis (TB)/HIV coinfection commonly face economic, sociocultural, and behavioral barriers to effective treatment. These barriers manifest from low treatment literacy, poverty, gender inequality, malnutrition, societal stigmas regarding HIV, and an absence of available care. It is critical for intervention programs to understand and assist in overcoming these barriers and any additional risks encountered by patients with TB/HIV coinfection. This study analyzes variation in TB/HIV coinfection and risks of negative outcomes among patients with TB/HIV coinfection compared to those without coinfection. (2) Methods: This quantitative study used data from 49,460 patients receiving ART from …

Support For Me: Key Stakeholder Interview Summary, Katie Rosingana Ba, Mary Lindsey Smith Phd, Karen Pearson Mlis, Ma, Evelyn Ali Bs, Tyler Egeland Ba, Mark Richards Bs

Substance Use Research & Evaluation

This summary feedback report is organized to inform the Office of MaineCare Services goal of addressing barriers and finding new and/or improved ways to increase capacity in Maine for people who seek treatment and recovery services for substance use disorder. Interview protocols were designed to assess critical domains of interest for the state, which include: current and potential provider capacity, access to care & service delivery provider willingness, and financial/ administrative policies.

Key Highlights from the stakeholder interviews indicated that:

• While there have been improvements in the integration of care for persons with behavioral health (BH) diagnoses, this integration has …

The Opioid Crisis Meets Covid-19 Pandemic, Hannah M. Westerman

English Department: Research for Change - Wicked Problems in Our World

Abstract: How have the COVID-19 pandemic and the Opioid Crisis have collided to create a negative effect on those who abuse drugs and other substances? These two wicked problems are now collectively making it more difficult for those to recover and overcome substance and drug abuse worsening the Opioid Epidemic. With no clear answer in sight can vaccines and more accessible rehab help to progress these wicked problems?

Mental Health In Music: Why Are We Not Talking About It?, Christian Pence

English Department: Research for Change - Wicked Problems in Our World

The music business has taken many hits over the past 20 years, and we are seeing musicians slowly going extinct. There are so many factors that are hurting musicians, and workers in the music business. Back in the 80’s and 90’s, we were investing in music like no tomorrow. So many concerts were happening, and so many Broadway shows were going on. We were really supporting our musicians, and we were helping them in any way we could. But society, has not been investing in musicians, causing certain problems, like financial stability, mental health problems, and making music more of …

Physician Burnout: Stress Within The Health Care System, Aidan Hauser

English Department: Research for Change - Wicked Problems in Our World

As our nation’s healthcare system expands, more stress and responsibility are placed on our physicians and frontline healthcare workers. The pressures of the daily job often prove extremely damaging to the employee’s mental and physical health. Physician and worker burnout is a growing epidemic that is damaging our care providers more and more every day. Burnout effects not only workers, but all of those surrounding them as well. This plague is not going to be repaired by one single change, but it is clear that many adjustments must be made to reform our healthcare system.

Mental Health And Covid-19, Haley Thiel

English Department: Research for Change - Wicked Problems in Our World

The recent pandemic has taken a toll on everyone’s mental health. Transitioning to full freedom and opportunity to lockdown with no human interaction was a huge adjustment. The global pandemic especially hit home to college students and had a significant impact on universities. In this paper we discuss and analyze how the pandemic has shifted college students mental health and the negative toll it had. We will examine how anxiety, depression, and other general mental health disorders have skyrocketed in college students during the pandemic. The need for reform and attention on college campuses to preserve students mental health is …

Public Health Employees’ Perceptions About The Impact Of Emerging Public Health Trends On Their Day-To-Day Work: Effects Of Organizational Climate And Culture, Kristie Cason Waterfield, Gulzar H. Shah, Linda Kimsey, William A. Mase, Jingjing Yin

Department of Health Policy and Community Health Faculty Publications

Objective: The purpose of this research was to assess the workforce characteristics associated with public health employees’ perceived impact of emerging trends in public health on their day-to-day work. Methods: Multinomial logistic regression was performed to analyze data from the 2017 PH WINS, a cross-sectional survey utilizing a nationally representative sample of the United States public health workforce. Results: More than 55% of the public health workforce perceived that their day-to-day work was impacted by the emerging public health trends. Workplace environment was significantly associated with the perception of their day-to-day work being impacted by emerging public health trends such …

Area Agencies On Aging Provide Crucial Support For Older New Yorkers During Covid-19, Claire Pendergrast

Population Health Research Brief Series

This research brief discusses how Area Agencies on Aging are providing crucial support for older NewYorkers during COVID-19.

Consequences Of Covid-19 Crisis For Persons With Hiv: The Impact Of Social Determinants Of Health, Kristie Cason Waterfield, Gulzar H. Shah, Gina D. Etheredge, Osaremhen Ikhile

Department of Health Policy and Community Health Faculty Publications

Background

With the indiscriminate spread of COVID-19 globally, many populations are experiencing negative consequences such as job loss, food insecurity, and inability to manage existing medical conditions and maintain preventive measures such as social distancing and personal preventative equipment. Some of the most disadvantaged in the COVID-19 era are people living with HIV/AIDS and other autoimmune diseases.

Discussion

As the number of new HIV infections decrease globally, many subpopulations remain at high risk of infection due to lack of or limited access to prevention services, as well as clinical care and treatment. For persons living with HIV or at higher …

Capacity Of Rural Counties To Address An Hiv Or Hepatitis C Outbreak, Jennifer Lenardson Mhs, Jaclyn Janis Rn, Mph, Amanda Burgess Mppm, Karen Pearson Mlis, Ma, Martha Elbaum Mpa

Population Health

HIV and hepatitis C (HCV) are major public health concerns in the United States and are a focus of significant federal health policy attention. Rural counties may be potentially vulnerable to an HIV or HCV outbreak among persons who inject drugs due to greater prevalence of high-risk injection practices as well as limited public health capacity to prevent, prepare for, and respond to an HIV or HCV outbreak. This study identified states potentially at risk for an HIV or HCV outbreak and used data from the 2016 Association of State and Territorial Health Officials (ASTHO) Profile Survey, 2016 National Association …