Community Health Commons^™

Opioid Lifeline Community Service Project, Ekrem Cetinkaya, Cam'ron Klotz, Harvy Patel

Rowan-Virtua Research Day

The opioid epidemic has claimed the lives of thousands of people over the last decade due to overprescribing, synthetic opioids, and lack of treatment options. Project Opioid Lifeline was created as a mission to combat this issue by equipping the Camden County, NJ population with the necessary information to advocate for themselves and others. This project aims to find and centralize available resources for residents of Camden County by including addiction treatment centers, Narcan training and distribution, and unused medication drop off locations. Over the last nine months, partnerships were formed with community leaders and organizations, such as the Neuromusculoskeletal …

A Call To Action: Preventing Opioid And Substance Abuse In South Florida Youth, Julie A. Jacko, Katherine P. Cohen, Cathaerina Appadoo, Arkene S. Levy, Timothy F. Page, Michael J. Parker, Solina Pierre-Gilles, Francois Sainfort

HCA Healthcare Journal of Medicine

The opioid crisis poses a substantial threat to youth throughout the nation. This crisis has been exacerbated by the COVID-19 pandemic, reversing some of the positive national trends in the fight against the opioid epidemic. Some risk factors for youth opioid use have been identified nationally. The South Florida tri-county region of Miami-Dade, Broward and Palm Beach is a culturally distinct region which may not follow national trends and likely has unique risk and protective factors. To address the concerning spike in youth opioid use in South Florida, a community coalition was formed to identify factors unique to South Florida …

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …

Moving Past The Binary: Transgender And Gender Non-Conforming Students’ Experiences Of And Perspectives On College Campus Fitness Centers, Rachel E. Petterson

Honors Projects

Transgender and gender non-conforming (TGNC) people face various mental and physical health disparities. Despite this, spaces related to health and wellness are not always inclusive. Similarly, college campuses are often not as inclusive or accommodating as they should be. This study looks at the experiences of TGNC students at campus fitness centers. Through both quantitative and qualitative data gathered through an online survey, it aims to better understand the following: the presence of inclusive facilities; the perceived importance of facility variables; use of campus fitness facilities by TGNC students; what improvements they would like to see; and how any of …

Predictive Modeling Of Fmol Health System Utilization Using Machine Learning Algorithms And Retrospective Study Of Covid Tested Patients, Ramyakrishna Tummala

LSU Master's Theses

Overutilization of Emergency Departments (ED) is a major problem among the health care providers in the United States. In this research, a machine learning-based predictive model for predicting ED high utilizers will be designed based on a set of existing and proposed facilities and the population and social determinant of health (SDOH) factors influencing utilization. The purpose of the model will be to alert the healthcare systems and government organizations by identifying the reasons for overutilization of the medical services among the people in a particular community. Also, the novel coronavirus disease 2019 (COVID-19) developed in Whunan city, China has …

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

Health Policy & 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 …

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

Health Policy & 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 …

Hiv Clinical Stage Progression Of Patients At 241 Outpatient Clinics In Democratic Republic Of Congo: Disparities By Gender, Tb Status And Rurality, Gina D. Etheredge, Raimi Ewetola, Gulzar H. Shah, L. Maluantesa, Kristie C. Waterfield, A. Mulenga, A. Kilundu

Health Policy & Community Health: Faculty Publications

Background: HIV clinical care programs are increasingly cognizant of the importance of customizing services according to patients’ clinical stage progression (WHO's four-tiered staging) and other risk assessments. Understanding factors associated with Persons Living with HIV (PLHIV) patients’ progression through the treatment cascade and clinical stages is essential for programs to provide patient-centered, evidence-based services.

Methods and materials: To analyze patient characteristics associated with disease progression stages for PLHIV on antiretroviral therapy (ART), this quantitative study used data, from January 2014–June 2019, from 49,460 PLHIV on ART from 241 HIV/AIDS outpatient clinics in 23 health zones in Haut-Katanga and …

Retention And Predictors Of Attrition Among Children Living With Hiv On Antiretroviral Therapy (Art) In Côte D’Ivoire Between 2012 And 2016, F. Traore-Toure, Gina D. Etheredge, Gulzar H. Shah, C. Brennan

Health Policy & Community Health: Faculty Publications

Background: In Côte d’Ivoire a retrospective national-level cohort study conducted in 2009 indicated that 77%, 72% and 75% of children living with HIV (CLHIV) remained in care at 12, 36, and 48 months after starting ART, respectively. The CDC-sponsored Improving HIV Surveillance and Program Evaluation in Côte d’Ivoire project assessed retention progress since that study.

Methods and materials: A retrospective review of medical records was conducted using 2-stage cluster sampling. HIV care and treatment centers (CTC) were sampled based on patient caseload, then records of patients under 15 years of age who initiated ART between 2012–2016 were randomly …

Tb/Hiv Coinfection And Patient Outcomes: Evidence From 241 Clinics In The Democratic Republic Of Congo, Gulzar H. Shah, Raimi Ewetola, Gina D. Etheredge, L. Maluantesa, Kristie C. Waterfield, L.-K. Lukusa

Health Policy & Community Health: Faculty Publications

Background: To provide efficient, equitable, patient-centered, and evidence-based services to people living with HIV/AIDS (PLWH), it is critical for the intervention programs to understand the nature of barriers to effective treatment and additional risks faced by PLWH with tuberculosis (TB) coinfection. This study analyzes two aspects of TB coinfection in PLWH: (a) variation in TB/HIV coinfection by demographic and clinical characteristics of patients; and (b) risks of negative outcomes such as death, loss to follow up, and higher viral load among PLWH with TB coinfection compared to those without such coinfection.

Methods and materials: This quantitative study used …

The Silence Of Food Insecurity: Disconnections Between Primary Care And Community Organizations, Nicole K. Runkle, David A. Nelson

Journal of Patient-Centered Research and Reviews

Purpose: Food insecurity is a prominent issue in the United States, and it is well established that food insecurity is linked to health and chronic illnesses. Studies show that screening for food insecurity is not yet part of standardized practice among all primary care physicians, nor are care providers comfortable with how to proceed with a patient who presents with this issue. Food insecurity is often handled by community-based organizations (CBOs) such as food pantries. Family medicine and pediatric clinics (FMPC) and CBOs hold unique relationships with their clients and can benefit from partnerships with each other to improve health …

Protecting Youth Mental Health: The U.S. Surgeon General's Advisory

United States Natonal Institutes of Health: Materials

Conclusion

As we learn the lessons of the COVID-19 pandemic, and start recovering and rebuilding, we have an opportunity to offer a more comprehensive, more fulfilling, and more inclusive vision of what constitutes public health. And for a generation of children facing unprecedented pressures and stresses, day in and day out, change can’t come soon enough.

It won’t come overnight. Many of the recommendations offered in this Advisory require structural buy-in and change.

But everyone has a role to play in combating this mental health pandemic. Without individual engagement, no amount of energy or resources can overcome the biggest barrier …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Strategic Implications Of Covid-19: Considerations For Georgia’S Rural Health Providers, Bettye A. Apenteng, Linda Kimsey, Charles Owens, Samuel T. Opoku, Angela Peden, William Mase

Health Policy & Community Health: Faculty Publications

Whether rural hospitals and providers have seen a surge in COVID-19 cases or a reduction in patients seeking care since the pandemic began, their financial condition has been negatively impacted. Many providers have now received some emergency funding through the Coronavirus Aid, Relief, and Economic Security Act and the Payroll Protection Program but these are likely only short-term fixes. For many, the crisis has exacerbated already existing problems. Notable among these problems are volume declines, supply chain disruptions, and workforce concerns. While these problems require immediate action, two longer-term systemic changes to rural healthcare delivery are needed to address them. …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

More Than A Myth: The Benefits Of Incorporating Holistic Healing Methods From Native American And Mexican Cultures To Approach Opioid Use Disorder (Oud) Treatment, Juliana Favela

CMC Senior Theses

Opioid Use Disorder (OUD) is a substance use disorder that characterizes a dependence on and an addiction to opioids. Opioids attack the prefrontal cortex, the dopaminergic reward system, and the hypothalamic-pituitary-adrenal (HPA) axis which is responsible for the body’s stress response. Opioids constantly shift one’s “set point” to the point where normal actions that cause joy and excitement no longer cause those feelings, resulting in craving and dependence. The opioid epidemic is currently ravaging the United States and has disproportionately affected Native American populations specifically in the rural areas (Tipps, et.al, 2018). The current methods for addressing OUD include medicine …

Opioid Use Disorder: The Timeline For Medication Assisted Therapy, Alexander Cristofori

Capstone Showcase

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached …

Neuropsychiatric Presentation Of Covid-19: A Case Report Of Disinhibition In An Acute Sars-Cov-2 Infection, I. Jack Abramson, Kristy A. Fisher, Clara V. Alvarez, Jacqueline Horan Fisher

HCA Healthcare Journal of Medicine

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system; therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician with a history of stable Bipolar Disorder for decades, hospitalized for persistent COVID-19 symptoms with documented positive serology, who presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate the viral infection. We postulate neuroinvasion as the putative origin of the patient’s psychiatric instability. Further investigation is needed to expand upon our understanding of the …

Employing Position Generators To Assess Social Capital And Health: A Scoping Review Of The Literature And Recommendations For Measurement In Future Population-Based Surveillance, Steven Meanley, Candice Biernesser, Teagen O'Malley, Todd Bear, Jeanette Trauth

Journal of Health Disparities Research and Practice

Beneficial social connections are critical to individual-level health because they can be used to avoid or minimize the risks and consequences associated with diseases. How to best measure beneficial social connections to inform social network-level health interventions remains poorly understood. A scoping review of health surveillance studies was conducted to highlight the utility of employing position generators to assess how access to beneficial social connections was associated with population health and disparities. Our review yielded 39 articles conducted across 14 predominantly high-income countries. Most studies (77%) with composite measures for beneficial social connections exhibited health-protective associations. Of the remaining articles, …

Discordance In Perceptions Of Barriers To Breast Cancer Treatment Between Hispanic Women And Their Providers, Swapna Reddy, Mary Saxon, Nina Patel, Matthew Speer, Tiffany Ziegler, Nirali Patel, Madison Ziegler, Stephany Esquivel, Andrea Daniella Mata, Asha Devineni, Pooja Paode, Nitika Thawani, Subhakar Mutyala

Journal of Patient-Centered Research and Reviews

Despite comparable screening and incidence rates that are 26% below that of non-Hispanic Whites, Hispanic women present with breast cancer at more advanced stages of disease, representing a continuing and troubling health disparity for this population. Reducing these disparities warrant more innovative research approaches to better understand perspectives of Hispanic patients regarding barriers to treatment and how these perspectives compare to those of their providers. A pilot qualitative study was conducted at a major urban cancer center in Arizona that measured both patient and provider perspectives regarding barriers to treatment. Through a multimethod qualitative analysis, researchers surveyed patients and providers …

Public Health Implications Of Early Marriage, Prachi Joshi, Tilicia Mayo-Gamble

Health Policy & Community Health: Faculty Publications

Work published by Georgia Southern University Press.

Perinatal Anxiety And Depression During The Covid 19 Pandemic, Helen Xumin Chen, Nancy Selix, Marcianna Nosek

DNP Qualifying Manuscripts

Abstract

The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. Measures include increased screening, non-pharmacologic and/or pharmacologic interventions and the use of telehealth for care delivery.

Keywords: perinatal anxiety, perinatal depression, COVID-19, SARS CoV-2, maternal …

Blood Transfusion: Knowledge, Perspectives, And Experiences Of Individuals With Sickle Cell Disease, Raymona H. Lawrence, Ashley Singleton, Jane Branscomb

Health Policy & Community Health: Faculty Publications

Patient voice and perspective were needed to inform effective, comprehensive strategies for reducing preventable transfusion-associated complications. This report presents the results of interviews with sickle cell disease (SCD) patients and implications for strategies to reduce transfusion complications in this population. Twenty-two participants were recruited from 2 comprehensive SCD treatment centers in Georgia and interviewed regarding knowledge about transfusions and potential complications, attitudes about data storage and sharing, and the transfusion experience. Participants had general knowledge of physiology, blood products, and blood transfusions, including knowing the risk of complications, but varied in comprehension of complex health information and level of misinformation. …

Hs-4100 - Global Health Issues, Jose Nanin

Open Educational Resources

This syllabus includes OER materials and college policies for a fully online course that takes a comprehensive look at global health issues. In this course, the assessment of health issues are analyzed from various perspectives including geographic, ethnic, religious, human rights, socioeconomic, social, cultural, and political influences. Students learn about global environmental causes and consequences of infectious diseases, major diseases, mental illness, natural disasters, malnutrition, drug and alcohol addiction, violence and injuries.

An Examination Of Hiv Risk, Testing And Prevention Intervention Participation Among Vulnerable Youth, Bianca V. Lopez

Dissertations and Theses

Background: Young gay, bisexual and other men who have sex with men (YGBM) of color are disproportionately affected by HIV and bear the burden of the disease in the United States. Gay and bisexual men – referred to in surveillance systems as men who have sex with men (MSM) – continue to be the risk group most severely affected by HIV in the United States. The dissertation study explored factors related on HIV prevention intervention participation, HIV testing and sexual risk behaviors among YGBM ages 13-29 in the Bronx. Additionally, this dissertation endeavored to study the concept of “intervention fatigue”, …

Publication Of Data Collection Forms From Nhlbi Funded Sickle Cell Disease Implementation Consortium (Scdic) Registry, Jeffrey Glassberg, Elizabeth A. Linton, Katrina Burson, Tabitha Hendershot, Joseph Telfair, Julie Kanter, Victor R. Gordeuk, Allison A. King, Cathy L. Melvin, Nirmish Shah, Jane S. Hankins, Axel Yannick Epié, Lynne D. Richardson

Health Policy & Community Health: Faculty Publications

Background: Sickle cell disease (SCD) is an autosomal recessive blood disorder affecting approximately 100,000 Americans and 3.1 million people globally. The scarcity of relevant knowledge and experience with rare diseases creates a unique need for cooperation and infrastructure to overcome challenges in translating basic research advances into clinical advances. Despite registry initiatives in SCD, the unavailability of descriptions of the selection process and copies of final data collection tools, coupled with incomplete representation of the SCD population hampers further research progress. This manuscript describes the SCDIC (Sickle Cell Disease Implementation Consortium) Registry development and makes the SCDIC Registry baseline …

Geriatrics In Clinical Practice And Beyond: Brain Health, The Sixth Vital Sign?, Nannette Hoffman

HCA Healthcare Journal of Medicine

Brain health in middle age and geriatric patients will take on greater importance for health care practitioners in our aging society. This article discusses various approaches clinicians can use for their patients to promote and improve brain health. These are generally the same lifestyle adoptions for cerebrovascular disease and cardiovascular disease prevention: weight management, exercise, and blood pressure and cholesterol lowering. Social stimulation and cognitive activities may also be important for the elderly.

Formative Research To Design A Culturally-Appropriate Cancer Clinical Trial Education Program To Increase Participation Of African American And Latino Communities, Jennifer Cunningham-Erves, Claudia Barajas, Tilicia Mayo-Gamble, Caree R. Mcafee, Pamela Hull, Maureen Sanderson, Juan Canedo, Katina Beard, Consuelo H. Wilkins

Health Policy & Community Health: Faculty Publications

Background: Addressing knowledge deficiencies about cancer clinical trials and biospecimen donation can potentially improve participation among racial and ethnic minorities. This paper describes the formative research process used to design a culturally-appropriate cancer clinical trials education program for African American and Latino communities. We characterized community member feedback and its integration into the program.

Methods: We incorporated three engagement approaches into the formative research process to iteratively develop the program: including community-based organization (CBO) leaders as research team members, conducting focus groups and cognitive interviews with community members as reviewers/consultants, and interacting with two community advisory groups. An …

Engagement Of Community Stakeholders To Develop A Framework To Guide Research Dissemination To Communities, Jennifer Cunningham-Erves, Tilicia Mayo-Gamble, Yolanda Vaughn, Jim Hawk, Mike Helms, Claudia Barajas, Yvonne Joosten

Health Policy & Community Health: Faculty Publications

Background: Dissemination of research findings to past study participants and the community-at-large is important. Yet, a standardized process for research dissemination is needed to report results to the community. Objective: We developed a framework and strategies to guide community-academic partnerships in community-targeted, dissemination efforts.

Methods: From 2017 to 2019, a community-academic partnership was formed in Nashville, Tennessee, and iteratively developed a framework and strategies for research dissemination using cognitive interviews. A deductive, constant comparative analysis was conducted on interview responses to examine framework and strategy content. Feedback was used to finalize the framework and strategies for the evaluation. …