Community Health Commons^™

Identifying Critical Aging Care Challenges And Opportunities In High-Income Countries: A Cross-Country Comparison Of Denmark, Germany, And The United States, Cassandra Martin

Capstone Collection

Despite the rapid growth in the aging population in the United States, insufficient resources and attention are invested in improving the support systems this population relies on. This discussion explored the question of how the United States as a high-income country fails to operate an aging care support infrastructure that has comparable comprehensiveness, availability, affordability, and overall quality to other high-income countries. Comparing financing structures, long-term care models, and various aging care supports is important for answering this question. This paper approached exploring this question by analyzing specified indicators from publicly available data across the United States, Germany, and Denmark. …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

The Influence Of Recreation Engagement On Adolescent Health-Risk Behaviors, Krista Thomas

All Dissertations

The number of adolescents who engage in suicidality is staggering. Adolescence is a unique developmental period where engagement in health-risk behaviors is prominent. Factors influencing engagement in suicidality are vast and occur both internally and externally in the adolescent. Substance use during adolescence has shown an association with increased suicidality. Similarly, bullying, both cyberbullying and in-person bullying, have contributed to adolescent suicidality. Alternatively, recreation engagement has yielded benefits in both psychosocial and physical health for adolescents. However, limited research has identified that engaging in recreation can minimize suicidality. Therefore, the purpose of this study was to explore how substance use, …

The Protective Effects Of Influenza Vaccination In Elderly Patients With Breast Cancer In Taiwan: A Real-World Evidence-Based Study, Szu-Yuan Wu, Ho-Jui Tung, Kuang-Hua Huang, Chiachi Bonnie Lee Lee, Tung-Han Tsai, Yu-Chia Chang

Health Policy & Community Health: Faculty Publications

In elderly patients with newly diagnosed breast cancer, clarity is lacking regarding the effects of influenza vaccines, particularly on clinical outcomes. This study conducted two nationwide, population-based, and propensity score-matched cohorts to estimate and compare the protective effects of influenza vaccine in elderly women and elderly patients with breast cancer. Data were derived from the National Health Insurance Research Database and Cancer Registry Database. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. Adjusted odds ratios (aORs) were used to estimate the relative risks, and stratified analyses in the breast cancer cohort were performed …

Adaptation Of Diabetes Prevention Program For Chinese Americans – A Qualitative Study, Ming-Chin Yeh, Wincy Lau, Siqian Chen, Ada Wong, Grace X. Ma, Judith Wylie-Rosett

Health Policy & Community Health: Faculty Publications

Background: Studies have demonstrated that a culturally and linguistically tailored Diabetes Prevention Program (DPP) can be effective in reducing diabetes risk in Chinese Americans. The purpose of this study was to explore the cultural and linguistic acceptability of the Centers for Disease Control and Prevention’s Prevent T2 curriculum in an online format in the Chinese American community in New York City (NYC). Methods: Three focus groups among a total of 24 Chinese Americans with prediabetes and one community advisory board (CAB) meeting with 10 key stakeholders with expertise in diabetes care and lifestyle interventions were conducted. Each focus group lasted …

Care Alert Program In Chronic Recurrent Ed Utilizing Patients, Kaitlyn Phelps, Jonathan Bryan, Jonathan Leggett, Erica Gibbons, Brian Griggs

HCA Healthcare Journal of Medicine

The Care Alert program is designed to help navigate encounters with patient populations that are high utilizers of emergency department (ED) resources. These populations often have chronic medical conditions, have a poor understanding of their conditions, are unfamiliar with the EDs’ role in the management of these conditions, and commonly lack outpatient resources. The Care Alert program intends to address the needs of this challenging patient population by designing individualized care plans that are approved through a multidisciplinary committee. Data from this study showed a 37% decrease in ED visits and a 47% decrease in hospitalizations during the initial 8 …

Phq-2 Scores In Broward County’S Homeless: Prevalence, Barriers, And Proposed Solutions To Mental Health Disparities, Jeena A. Kar, Reeja Raj, Ariba Hashmi, Tahia Hossain, Joshua Berko, Joseph S. Degaetano, Patrick Hardigan

Cooper Rowan Medical Journal

Introduction: Florida ranks 9th in states with highest prevalence of mental illness among homeless individuals. The state also ranks 43rd of 52 states in providing adequate access for mental health concerns in homeless individuals. This study surveyed people experiencing homelessness in Broward County to investigate utilization of healthcare and mental health resources and accessibility of the target population to adequate care.. Aims included a collection of demographics concerning homelessness such as age and gender, prevalence of mental illness, history of substance use and emergency department, and then correlating these with scores from a standardized depression rating scale (PHQ-2). Methods: The …

Vision And Hearing Loss Associated With Lifetime Drug Use: Nhanes 2013–2018, Amanda M. Hinson-Enslin, Ramzi W. Nahhas, Heather F. Mcclintock

Population and Public Health Sciences Faculty Publications

Background: One in four American adults has a disability. Individuals with disabilities are more likely to have mental health issues and use substances and are less likely to attend substance use rehabilitation compared to individuals without disabilities. However, most research about substance use and substance use rehabilitation does not focus specifically on sensory disabilities. Objective: The purpose was to test the association between vision and/or hearing loss, lifetime drug use, and lifetime drug rehabilitation. Methods: Data files from National Health and Nutrition Examination Survey cycles (2013–2014, 2015–2016, 2017–2018) were combined. Ordinal logistic regression was used to test the association between …

Factors Associated With The Nutritional Status Of Infants And Young Children From Rural Honduras, Ana M. Palacios, Mario Keko, Aishat Adewoye, Haresh Rochani, Asli Aslan, Dziyana Nazaruk, Ana Gisela Ramos, Weston L. Oliver, Laura Manship

Health Policy & Community Health: Faculty Publications

Objectives

Malnutrition is a major public health problem in children. Undernutrition and excessive weight at young ages are associated with life-long consequences. The main objective of this study was to characterize the sociodemographic and food insecurity factors associated with the nutritional status of rural children ages 6 to 24 months living in 27 rural communities in Intibucá, Honduras.

Methods

This secondary analysis of baseline data included a total of 402 children ages 6 to 24 months who were recruited to participate in a cluster-non-randomized trial of a community-based nutrition intervention. Data were collected in January 2021 through a survey that …

The Need For Depression And Anxiety Screenings At A Student-Run Clinic, Shayna Peterzell, Sahil Parikh, Alicia Podwojniak, Vibha Chauhan, Riya Tandra, Emily Forester, Saumil Parikh, Jessica-Sophie Horoschak, Patrick Pearce, Roma Padalkar, Sobiah Khan, Tara Pellegrino

Rowan-Virtua Research Day

General anxiety and major depressive disorder are common and treatable mental health disorders. The US Preventive Services Task Force provides strong evidence that early screening helps identify depression in primary care settings, promotes intervention and facilitates treatment. Many medical offices use validated screening tools, GAD-7 and PHQ-9, to measure symptom severities and further help guide treatment modalities for patients with anxiety and depression, respectively. The Rowan Community Health Clinic (RCHC) in Lindenwold, NJ is a student-run free clinic that serves patients regardless of patient gender, race, income, or insurance status. This study aims to determine if there is a need …

Income And Its Effects On Health Literacy: A Study Between A Student-Run Free Clinic And A Family Medicine Office, Shayna Peterzell, Sahil Parikh, Thomas Ruta, Rabiye Ayaz, Srujan Dadi, Emily Forester, Olivia Choi, Rachel Fletcher-Slater, Melodi Harfouche, John Cruz, Roma Padalkar, Sobiah Khan, Rebecca Moore

Rowan-Virtua Research Day

More than 1/3 of people nationwide (80+ million) have limited health literacy, which contributes to poor health outcomes and lifestyle choices. Health literacy is defined as the understanding and application of words, numbers & documents (i.e., medication labels, medical forms). The Rowan Community Health Center (RCHC), located in Lindenwold NJ, is a student-run clinic that wanted to assess the health literacy of our patients in order to further provide better care. RCHC provides cost-free primary care services regardless of income, insurance, or legal status. To assess health literacy, RCHC used the New Vital Signs (NVS) literacy assessment tool to investigate …

Associations Of Lifestyle And Sociodemographic Factors With Dietary Supplement Use In College Students, Sydney Chratian

Senior Honors Projects

Background: Dietary supplement use has been shown to be significantly prevalent in the United States, especially among the young adult population. Studies have reported increasing use of dietary supplements among college students in the US. However, little research has investigated the sociodemographic and behavioral characteristics associated with dietary supplement use in this population.

Objectives: The aim of this study was to examine the prevalence of dietary supplement use and sociodemographic and behavioral characteristics associated with dietary supplement use in college students and examine the attitudes and beliefs of college students on dietary supplements.

Methods: A cross sectional study was conducted …

The Effect Of A Health Educational Program On Sleep Related Health Outcomes, Swetha Sirigineedi

Biological Sciences Undergraduate Honors Theses

Sleep quality has effects on both physical and mental health. Because of this, sleep hygiene is an important health goal. Participation in health programs promoting healthy behaviors has helped people reach their health goals and elicited positive behavior change. Because of this, it was of interest to determine if participation in a virtual, multi-media health education program improved health and wellbeing outcomes of Arkansans. The main objective of this study was to determine the effect of a 20-week behavior and health educational program on the ability of participants to achieve their health goals and improve their health behaviors related to …

Caregiver-Child Conversations About Sex In African American Women, Hannah King

Electronic Theses and Dissertations

Using grounded theory methods, this study examines the experience of African American women during their caregiver-child conversations about sex and the impacts of the conversations on their sexual attitudes. The process of these conversations begins with an unplanned topic and progresses further to identify six essential themes of these conversations: gender differences, race and religion, protective/emphasis on protection, lack of knowledge, withholding knowledge, and sex negativity/shame. African American women’s description of the process included feelings of shame and negativity towards their sexuality. Caregivers promoted positive messages about sex by having open conversations that advocated for equality between the genders, empower …

Characterization Of Folic Acid, 5-Methyltetrahydrofolate And Synthetic Folinic Acid In The High-Affinity Folate Transporters: Impact On Pregnancy And Development, Ana M. Palacios, Rachel A. Feiner, Robert M. Cabrera

Health Policy & Community Health: Faculty Publications

Objectives:

Folates are B vitamins that are essential for several molecular, cellular, and biological processes, including nucleotide synthesis, methylation, and methionine cycling. The physiological impacts of these processes on health also extend to cell proliferation, folate deficiency anemia, and reduction of the risk of birth defects during pregnancy. The primary objective of this study was to characterize the binding affinities of different folate forms, folic acid (FA), 5-methyltetrahydrofolate (5MTHF), and folinic acid, to the folate receptors α and β, and to the bovine milk folate binding protein. These three dietary forms of folate are found in enriched grains (FA), various …

Eat Well, Be Well: Basic Needs Initiative's Online Hub For Nutrition Education, Misha Moseley

Capstone Projects and Master's Theses

Basic Needs Initiative at California State University, Monterey Bay is a department that provides students with food, housing, and wellness resources. Over half of the university's students experience food insecurity, and over 85% use non-academic resources to learn about nutrition. This project adds a dietary health section to the department’s website to increase students’ access to nutrition education. It addresses the micro-level agency problem that too few students eat a healthy, balanced diet. Unhealthy eating is a risk factor for food insecurity, so the project indirectly addresses the macro-level health problem that too many college students in California experience food …

The Effects Of Alcohol Intoxication And Threats To Masculinity On Engagement In Sexual Aggression: Results From A Web-Based Survey Design And Alcohol Administration Study, Tiffany Lynn Marcantonio

Graduate Theses and Dissertations

Background: Research examining the combined effects of men’s alcohol consumption and perceptions of their masculinity as precarious (e.g., viewing masculinity as easily threatened) on sexual aggression (SA) is lacking. The goal of this dissertation study was to assess if alcohol consumption and precarious masculinity are related to men’s SA via a web-administered survey (Study 1) and an in-person alcohol administration experiment (Study 2).

Methodology: In Study 1, two samples of young adult men (aged 18-30) were collected, 1) a community sample of 492 men and 2) a college sample of 478 men, to complete a 20-minute survey; participants answered questions …

Dnp Final Report: Adolescent Support For Healthy Living, Kristin S. Hudson

DNP Final Reports

Adolescents often make decisions that negatively impact their health and wellness. They do this for many reasons including impulsivity, underdeveloped communication and coping skills, feelings of invincibility, and a perceived lack of support. In adolescents, how does education and training related to risky behaviors compared to no education affect knowledge, skills, and understanding (KSU) of high-risk behaviors three months after instruction? Thirteen peer- reviewed articles were utilized in the body of evidence. A curriculum-based intervention was implemented. Outcomes include an overall increase in KSU in six key concepts including contraception, substances abuse, sexually transmitted diseases/infections, teen pregnancy, peer pressure, and …

Boarding Barriers For Psychiatric Patients In Emergency Departments, Emmeline B. Martin Bsn, Rn, Alison Rossano Bsn, Rn, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Objective To identify past or current literature about emergency department holds and psychiatric patients consisting of the evaluation of patient outcomes, satisfaction and equity of care. It is already known that shorter boarding times from the emergency department to a psychiatric unit have positive patient outcomes such as a decrease in readmissions, increase in patient satisfaction and efficiency in appropriate treatment.

Method A scoping review to analyze data by grouping articles into themes which included authors, date of publication, aims/purpose, methodology, sample, interventional details, and the key findings in each article. Excluded articles included those discussing COVID-19 and case management. …

A Scoping Review: Trauma Informed Care For Justice Involved Youth To Decrease Recidivism, Tamika Beecham, Marissa Gray, Shelby Husband, Diana Dedmon Dnp, Fnp, Bc

Doctor of Nursing Practice Projects

Purpose The purpose of this scoping review was to address trauma-informed care, juvenile justice systems, and recidivism rates. The literature review conducted identified key research and analysis of effective trauma-informed treatment methodologies, referrals, and accessibility of care for justice-involved youth, and the rate change of recidivism related to trauma-informed treatment and interventions.

Background The high rates of recidivism in the juvenile court systems matched with the increased prevalence of psychological trauma in justice-involved youth represent the need for implementing trauma informed care. The scoping review analyzed the research implementing the intervention of trauma informed care to determine if it resulted …

Reducing Immigration-Related Stress In An Immigrant Population, Stephanie Avdagic

Graduate Theses, Dissertations, and Capstones

Immigrants are a growing population in the United States and face stressors specific to immigration. Stress is associated with increased mental and physical health issues, so increased stress puts this population at risk for many health concerns. A review of literature showed that implementing community resource classes for immigrants may help decrease immigration-related stress. The purpose of this evidence-based project was to assess if implementation of community resource classes at a local day center for immigrants could help decrease immigration-related stress. The classes addressed issues such as limited English proficiency and lack of legal immigration status. The Stress of Immigration …

Covid-19 Vaccine Uptake Among College Students, Erin Hoening, Elizabeth Morse, David Phillippi, Krystal Huesmann

DNP Projects

Background: Public health strategies to improve COVID-19 vaccine uptake among college students living in residential communities varied, some universities opted to mandate COVID-19 vaccines while other universities opted to promote and influence the choice for vaccination.

Purpose: This descriptive, cross-sectional study examined the voluntary uptake of COVID-19 vaccines among residential students on a college campus in the southeastern U.S. that elected an evidence-driven health promotion strategy that included strong health promotion messaging coupled with coordinated efforts to make the vaccine accessible and appealing to students on campus.

Methods: Analysis of vaccine uptake was derived from campus electronic health records during …

Children Receiving A Nutrition And High-Quality Early Childhood Education Intervention Are Associated With Greater Math And Fluid Intelligence Scores: The Guatemala City Municipal Nurseries, Ana M. Palacios, Lisa A. Villanueva, Matthew B. Flynn, Erik Parker, Stephanie Dickinson, Helen W. Bland, Greg A. Reinhart

Health Policy & Community Health: Faculty Publications

Background: About 47% of children < 5 years of age are stunted in Guatemala. In this study, the investigators aimed to compare growth and cognitive outcomes between children in second grade that attended five Guatemala City Municipal Nurseries (GCMN) vs. same sex, grade, and age-matched children. Methods: A cross-sectional design nested in a retrospective cohort was implemented between 2015 and 2019. Children that attended the GCMN and matched controls completed a math test and validated receptive language and fluid intelligence tests. The primary caregivers completed a sociodemographic survey. General and generalized linear mixed effect models were used to compare children that attended the GCMN vs. controls. The models were adjusted by maternal education, sex, asset score, and other relevant covariates. Results: Children that attended the GCMN exhibited greater math and fluid intelligence scores relative to the controls in the adjusted models (ß = 6.48; 95% CI (2.35–10.61)) and (ß = 1.20; 95% CI (0.12–2.29)), respectively. Lower odds of stunting were significant for children who went to any early childcare institution (AOR = 0.28; 95% CI (0.09–0.89)). Conclusions: The importance of integrating nutrition and high-quality early childhood education interventions in cognitive and growth outcomes is highlighted in this study. The GCMN model may be a scalable model in similar low-resource settings.

Association Between Serum Lycopene And Lung Cancer Mortality: An 18-Year Follow-Up Study Of A National Cohort, Evans Afriyie-Gyawu, Padmini Shankar, Gulzar H. Shah, Alicia A. Brown, Shannon Cearley, Akwasi Ampofo-Yeboah, Nathaniel Abrams, Jian Zhang

Health Policy & Community Health: Faculty Publications

Background: Lycopene is a carotenoid found in some fruits and vegetables that is responsible for the red pigment in tomatoes and tomato products. While many studies have shown a link between lycopene and protection against the initiation and/or progression of lung cancer, data on its effect on lung cancer survivability is limited.

Objective: The primary objective of this study was to see if there was a link between lycopene levels in the blood and lung cancer mortality. A secondary goal was to see if dietary factors influence lycopene levels in the blood.

Materials and Methods: A retrospective …

Covid-19 And Social Determinants Of Health: Medicaid Managed Care Organizations’ Experiences With Addressing Member Social Needs, Samuel T. Opoku, Bettye Apenteng, Linda Kimsey, Angela H. Peden, Charles F. Owens

Health Policy & Community Health: Faculty Publications

Background

The significant adverse social and economic impact of the COVID-19 pandemic has cast broader light on the importance of addressing social determinants of health (SDOH). Medicaid Managed Care Organizations (MMCOs) have increasingly taken on a leadership role in integrating medical and social services for Medicaid members. However, the experiences of MMCOs in addressing member social needs during the pandemic has not yet been examined.

Aim

The purpose of this study was to describe MMCOs’ experiences with addressing the social needs of Medicaid members during the COVID-19 pandemic.

Methods

The study was a qualitative study using data from 28 semi-structured …

Implementation Of Community-Based Trauma-Sensitive Yoga Program For Youth With Complex Trauma, Vira Salzburn, Kierstin Graham

National Youth Advocacy & Resilience Conference

This presentation will discuss the implementation and scale-up of an evidence-based Trauma-Sensitive Yoga (TSY) program as a part of a larger community-wide safety and resilience-building effort. It will explain the effectiveness of TSY interventions for both clinical and non-clinical populations and highlight the physical, mental, emotional, and social benefits of a modified yoga practice for youth and young adults with complex trauma.

Sexual Coercion, Unintended Pregnancy, And Poor Reproductive Health Among Adolescent Girls (Aged 13 - 19) In Mexico, Arun Kumar Acharya, Maria Luisa Martinez

Dignity: A Journal of Analysis of Exploitation and Violence

In Mexico, nearly 23,000 adolescents between the ages of 12-17 years suffer sexual coercion every year. This group also has a high birth rate of 77/1,000 adolescents, which indicates that one in every five pregnant women is an adolescent. This study describes the sexual coercion of victims and their views regarding the experience based on data collected from 37 Mexican girls between the age of 13 to 19, selected purposively using the snowball method in Monterrey city, Mexico. Results indicate that sexual coercion among adolescents is a serious problem, where 70% of adolescents experienced vaginal sexual coercion, nearly 22% experienced …

African-American Lay Pastoral Care Facilitators’ Perspectives On Dementia Caregiver Education And Training, Nik M. Lampe, Nidhi Desai, Tomeka Norton-Brown, Alexandra C. H. Nowakowski, Robert L. Glueckauf

The Qualitative Report

The African-American Alzheimer’s Caregiver Training and Support Project 2 (ACTS 2) is a faith-integrated, skills-training and support program for distressed African American family caregivers of persons living with dementia across Florida. Caregivers participate in a 12-week, telephone-based, skills-building and support program led by faith community workers (i.e., lay pastoral care facilitators) who provide volunteer services to their denominations. In this case study, we examined facilitators’ perspectives and recommendations for supplementary audiovisual and written training materials to optimize group process and goal-setting skills. Utilizing a qualitative approach, we explored facilitators’ needs, experiences in using current training materials, and recommendations for supplementary …

Effects Of Nonpharmacological Interventions On Disruptive Vocalisation In Nursing Home Patients With Dementia-A Systematic Review, Saad Bilal Ahmed, Alfredo Obieta, Tamsin Santos, Saara Ahmad Muddasir, Joseph Elliot Ibrahim

Department of Biological & Biomedical Sciences

Background: Vocally disruptive behaviour is a common and difficult to treat condition in older residents with dementia. The aim of this systematic review is to evaluate the efficacy of nonpharmacological interventions in its management in persons with dementia residing in a nursing home.
Methodology: A systematic search was conducted using Ovid MEDLINE, CINAHL, and Cochrane databases and reference lists from relevant publications on various nonpharmacological approaches to manage vocally disruptive behaviour in nursing home residents. The method of appraisal was through the National Institutes of Health scoring for the Quality Assessment of controlled intervention studies. Inclusion criteria included residents of …

Four Corners: A Values Clarification Exercise, Montsine Nshom

Open Educational Resources

Four Corners is a values clarification activity that asks participants to stand/show whether they strongly agree to strongly disagree with a specific statement, and reflect on their position during and after the activity. This four corners activity is designed to help students think about and discuss topics that are pertinent to urban community health and public health.

No prior reading or coursework is required; it is a good option for the first day of class to introduce key themes that will be covered during the course as well as practice ground rules and class discussion norms.