Community Health Commons^™

“Community Members Have More Impact On Their Neighbors Than Celebrities”: Leveraging Community Partnerships To Build Covid-19 Vaccine Confidence, Maria Tjilos Mph, Autumn L. Tamlyn, Elizabeth J. Ragan Mph, Sabrina A. Assoumou Md, Mph, Katherine Gergen Barnett Md, Petrina Martin Mba, Rebecca Perkins Md, Msc, Benjamin P. Linas Md, Mph, Mari-Lynn Drainoni Phd, Med

Medical Student Research Symposium

Vaccines are a strong public health tool to protect against severe disease, hospitalization, and death from COVID-19. Still, inequities in COVID-19 vaccination rates and health outcomes continue to exist among Black and Latino populations. Boston Medical Center (BMC) has played a significant role in vaccinating medically underserved populations, and organized a series of community-engaged conversations to better understand community concerns regarding the COVID-19 vaccine. We accessed and analyzed nine publicly available recordings of the community-engaged conversations which were held between Mar 2021-Sep 2021 (n=8-122 attendees). We employed a Consolidated Framework for Implementation Research-driven codebook to code our data and utilized …

Editorial: Assessing And Addressing Health Inequities And Disparities: The Role Of Health Informatics, Gulzar H. Shah, Anjum Khurshid, Joanne Chopak-Foss

Health Policy & Community Health: Faculty Publications

No abstract provided.

Syndemics And Social Factors: Infectious Disease Patterns Within The Population Of People Experiencing Homelessness In The United States, Kathleen Berzonsky

Honors Program: Senior Projects (Public)

Individuals experiencing homelessness are at increased risk of suffering from infectious diseases. This is due to a number of social factors and healthcare disparities, as well as the idea of syndemics, by which diseases cluster together to worsen disease burden. Current intervention strategies approach treatment from a post-infection perspective, but reducing transmission rates of infectious diseases within the population of people experiencing homelessness will require a shift in the healthcare framework. The issue of people experiencing homelessness must be viewed through a biosocial lens, focusing on preventative care and treatment. I provide an overview of the social factors governing infectious …

A Nationwide Study Of The “July Effect” Concerning Postpartum Hemorrhage And Its Risk Factors At Teaching Hospitals Across The United States, Zahra Shahin, Gulzar H. Shah, Bettye Apenteng, Kristie Cason Waterfield, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

Objective To assess the “July effect” and the risk of postpartum hemorrhage (PPH) and its risk factors across the U.S. teaching hospitals. Method This study used the 2018 Nationwide Inpatient Sample (NIS) and included 2,056,359 of 2,879,924 single live-birth hospitalizations with low-risk pregnancies across the U.S. teaching hospitals. The International Classification of Diseases, Tenth Revision (ICD-10) from the American Academy of Professional Coders (AAPC) medical coding was used to identify PPH and other study variables. Multivariable logistic regression models were used to compare the adjusted odds of PPH risk in the first and second quarters of the academic year vs. …

Determinants Of Child Stunting, Wasting, And Underweight: Evidence From 2017 To 2018 Pakistan Demographic And Health Survey, Maryam Siddiqa, Gulzar H. Shah, Tilicia Mayo-Gamble, Amber Zubair

Health Policy & Community Health: Faculty Publications

Child malnutrition persists in low-resource countries such as Pakistan, indicating an urgent need for interventions and policies aimed to address this critical population health issue. The World Health Organization Global Target 2025 includes the reduction of malnourishment in the form of stunting, wasting, and low weight. This study aims to examine the prevalence of factors associated with three measures of child malnutrition, i.e., stunting, wasting, and low weight in Pakistan. This study uses a secondary data analysis design based on data from Pakistan Demographic and Health Survey (2017-18) that used a two-stage cluster sampling approach. National level data covering urban …

Covid-19 Induced Environments, Health-Related Quality Of Life Outcomes And Problematic Behaviors: Evidence From Children With Syndromic Autism Spectrum Disorders, Corneliu Bolbocean, Kayla B Rhidenour, Maria Mccormack, Bernhard Suter, J Lloyd Holder

Faculty, Staff and Students Publications

Between July 2020 and January 2021, 230 principal caregivers completed a questionnaire to measure proxy-assessed health-related quality of life outcomes (HRQoL), behavioral outcomes in children with syndromic autism spectrum disorders and COVID-19 induced changes to lifestyle and environments. HRQoL and behavioral outcomes reported earlier during the pandemic were generally worse compared to those reported later. COVID-19 induced reduction to a caregiver's mental health appointments, and hours spent watching TV were associated with decreases in HRQoL and increased the likelihood of problematic behaviors. Increasing time outdoors and time away from digital devices were positively associated with HRQoL and behaviors and might …

Implementation Of A Novel Social-Emotional Learning Program To Advance Integration Of Wellness In Education Practice, Kit Knier, Gauri Sood, Will Ruffin Ii, Jennifer Arroyo, Ankit Sabharwal, Michael Bostwick, Chris Pierret

The Journal of Advancing Education Practice

Social-emotional learning (SEL) programs aim to enhance emotional intelligence by teaching problem solving, self-awareness, self-management, social awareness, and relationship building skills. SEL interventions have been shown to improve quality of life and wellbeing, increasingly important outcomes in the wake of the staggering effects of the COVID-19 crisis on mental health. HappiGenius is a novel SEL program with the addition of mindful attention and self-compassion. We hypothesized HappiGenius would improve positive emotions, self-compassion, attention, mindful self-awareness, and social skills in a group of students. This observational cohort study took place at a diverse elementary school in a midsize midwestern city and …

The Silent Suffering Of Survivors: The Covid-19 Pandemic's Impact On Domestic Violence Resources, Osoniya I. Wodi

XULAneXUS

Increased reports of domestic violence has coincided with the eruptions and growth of the COVID-19 pandemic. Previous research has shown a positive correlation between domestic violence and the occurrence of humanitarian crises. Recently published research about domestic violence police reports in the COVID-19 pandemic has also supported this correlation. We used data from the National Network To End Domestic Violence (NNEDV) to analyze the number of survivors served by domestic violence programs in the United States, type of resources available, and unmet request from 2019-2021, one year pre-pandemic and the first two years of the pandemic. Findings from this study …

A Focused Review Of Multidimensional Well-Being Assessments, Samantha Schonhardt, Stephanie Sullivan, Rebecca Shisler Marshall

Journal of Wellness

Introduction: Interest in the topic of well-being continues to grow and has resulted in the creation of a variety of well-being assessments. However, each assessment often brings its own terminology, theories, definitions, and dimensions. This creates a muddled research base that produces inconsistencies in the field of well-being. Therefore, the aim of this review was to identify assessments that measure multiple dimensions of well-being, catalogue and group the dimensions into categories, and develop definitions for the categories based on the conceptualizations in the literature. In doing so, the dimensionality of well-being portrayed in the literature can be better understood. …

Effectiveness Of Telemedicine In Diabetes Management: A Retrospective Study In An Urban Medically Underserved Population Area (Umupa), Lisa Ariellah Ward, Gulzar H. Shah, Jeffery A. Jones, Linda Kimsey, Hani M. Samawi

Health Policy & Community Health: Faculty Publications

This paper examines the efficacy of telemedicine (TM) technology compared to traditional face-to-face (F2F) visits as an alternative healthcare delivery service for managing diabetes in populations residing in urban medically underserved areas (UMUPAs). Retrospective electronic patient health records (ePHR) with type 2 diabetes mellitus (T2DM) were examined from 1 January 2019 to 30 June 2021. Multiple linear regression models indicated that T2DM patients with uncontrolled diabetes utilizing TM were similar to traditional visits in lowering hemoglobin (HbA1c) levels. The healthcare service type significantly predicted HbA1c % values, as the regression coefficient for TM (vs. F2F) showed a significant negative association …

Centering Culture In The Treatment Of Opioid Use Disorder With American Indian And Alaska Native Communities: Contributions From A National Collaborative Board, Katherine A. Hirchack, Melanie Nadeau, Angel Vasquez, Alexandra Hernandez-Vallant, Kyle Smith, Cuong Pham, Karen Anderson Oliver, Paulette Baukol, Karen Lizzy, Raquel Shaffer, Jalene Herron, Aimee M. C. Campbell, Kamilla L. Venner

Indigenous Health Faculty Publications

American Indian/Alaska Native (AI/AN) communities are disproportionally impacted by the opioid overdose epidemic. There remains a dearth of research evaluating methods for effectively implementing treatments for opioid use disorder (OUD) within these communities. We describe proceedings from a 2-day Collaborative Board (CB) meeting tasked with developing an implementation intervention for AI/AN clinical programs to improve the delivery of medications to treat OUD (MOUD). The CB was comprised of Elders, cultural leaders, providers, individuals with lived experience with OUD, and researchers from over 25 communities, organizations, and academic institutions. Conversations were audio-recorded, transcribed, and coded by two academic researchers with interpretation …

Identification Of Cancer Related Risk And Protective Factors For American Indian Youth: A Mixed Studies Review, Melanie Nadeau, Kathryn Wise, Vianca Farfan Cuela, Devon Olson, Karan Saravana

Indigenous Health Faculty Publications

Introduction: Many causes of cancer related morbidity and mortality can be traced back to childhood behaviors. The culmination of cancer related risk and protective factors impacting the health and wellbeing of American Indian youth is unknown. The aim of this Mixed Studies Review was to identify cancer related risk and protective factors among American Indian youth. Results will be shared with Tribal communities to inform surveillance efforts.

Methods: A Mixed Studies Review process was deemed most appropriate for the search process and data collection. 7 databases were included in the search along with 3 databases that were hand searched. Google …

Implementation Of A Smoking Cessation Program In A Multidisciplinary Clinic, Lori Prewitt Moore, Shannon Harris

DNP Manuscripts

Tobacco use remains the solitary, most preventable cause of death and secondary disease among patients in the United States (US). Health-related smoking costs are in an excess of $300 billion yearly (CDC, 2018). Addressing this global, public health concern is vital in order to attempt to reduce unnecessary smoking-related comorbid conditions and death. This project is important to scholarly nursing practice in order to reduce smoking-related Chronic Obstructive Pulmonary Disease (COPD) exacerbations, reduce carbon monoxide (CO) levels, and reduce dyspnea on exertion (DOE) among current primary care smokers. The expectations of this project are for the doctoral of nursing practice …

Addressing Breast Health Disparities Among Recent, Established African-Born Immigrant Women And Second-Generation Americans In Prince George County, Maryland, Omolola Okunromade

College of Graduate Studies: Theses & Dissertations

Background: Breast health disparities and underutilization of screening methods are major concerns in the United States (US), particularly affecting Black women who experience lower survival rates and advanced diagnoses. Despite the rapid growth of the African-born immigrant population, breast health among this group in the US is notably under-examined. This study aims to investigate the breast health knowledge and practices of first-generation African-born immigrants and second-generation immigrant women of African descent, aiming to understand the distinctive attributes of this group and the impact of acculturation on this public health issue.

Methods: Interviews were conducted among First Generation African immigrants and …

Health Behavior And Outlooks In An Altered Microbial Diversity: Changes In Parental Attitudes On ‘Building Immunity’ Throughout The Covid-19 Pandemic, Jennifer Vidal

Pitzer Senior Theses

The Covid-19 Pandemic in a short amount of time put into action disease control measures. Current literature has sought to address the long-term effects of sanitization efforts and social isolation on the diversity of the microbiome and the future of infectious diseases. Microbes – microorganisms such as bacteria, protozoa, algae, fungi, and viruses – inhabit the natural environment and human microbiome with our immune system, playing an essential role in immune regulation. The interplay between humans and microbes forms early immune development that has impacted parents’ attitudes toward microbes shown through their participation in Covid-19 preventative health practices. Using the …

Covid-19, Health Inequities, And Behavioral Health Issues Facing Children, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

No abstract provided.

Evaluating The Impact Of Mental Health Needs And Services Disruption: Covid-19 & Wisconsin Children’S Welfare Services, Gavin Rienne

Theses and Dissertations--Epidemiology and Biostatistics

Children’s traumatic experiences have lifelong impacts on their mental health and quality of life, therefore mental health services are a critical part of necessary community resources. The increased frequency and severity of natural disasters such as hurricanes, tornadoes, and pandemics reinforces the need to examine and understand the importance of mental health and child services in response to disaster events. This research assesses the relationship between disasters and subsequent health service utilization amongst children and adolescents. We investigated current research on the relationship between children’s mental health and community mental health resource efficacy and accessibility after a major disaster by …

Barriers To Outdoor Recreation For Marginalized Groups At The University Of Montana, Sabine R. Englert, Beatrix Frissell, Adrienne Liebert, Sophia Rodriquez, Margaret Jensen, Rachana Harris, Abby Doss

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Exclusion from outdoor recreation reflects legacies of oppression of marginalized communities and makes access to the outdoors not equally available. In the United States, approximately 38% of Black Americans and 48% of Hispanic Americans participated in outdoor recreation in 2020. This is compared to 55% participation among Caucasian Americans. Many other intersecting identities are actively excluded, including people with disabilities, fat populations, and members of the LGBTQIA2S+ community; furthermore, class-based hierarchies are shown through the restricted outdoor access of low-income populations.

While numerous studies show a lack of diversity in outdoor recreation, little to no research has been conducted on …

Coh 1700: Health Care Coordination Syllabus, Sasha Harry

Open Educational Resources

This is the syllabus for a Health Care Coordination course.

The goal of health care coordination is to improve patient outcomes with better health care services. Care coordinators play a critical role in improving patient care. Students will learn how to effectively advocate for patients and interact with members of the healthcare team in finding solutions to provide high quality, value-based, and efficient care. Effective communication styles, assessing patient’s needs and goals, and helping with patients’ transitions of care are among many topics covered in this course. Upon course completion, students will have acquired basic knowledge and skills to educate, …

Risk Of Depression In A Suburban Primary Care Setting Before And During The Covid-19 Pandemic, Carman H Whiting, Pouran Yousefi, Jude K A Des Bordes, Nahid J Rianon

Faculty, Staff and Student Publications

INTRODUCTION: Major depression is a common disorder affecting millions of adults each year. Many population-based surveys showed an increase in the number people with symptoms of depression at the onset of the COVID-19 pandemic. Our aim was to determine and compare the prevalence of depression risk in a primary care setting before and during the COVID-19 pandemic.

METHODS: We conducted a cross-sectional study based on retrospective review of medical records from a large suburban primary care clinic. Records of adults 18 years and older, seen between January 1, 2019 and December 31, 2020 and who had also been screened for …

Development Of A Web-Based Diabetes Prevention Program (Dpp) For Chinese Americans: A Formative Evaluation Approach, Ming-Chin Yeh, Wincy Lau, Zoey Gong, Margrethe Horlyck-Romanovsky, Ho-Jui Tung, Lin Zhu, Grace X. Ma, Judith Wylie-Rosett

Health Policy & Community Health: Faculty Publications

Increasing evidence demonstrates that an online Diabetes Prevention Program (DPP) can delay the onset of type 2 diabetes. However, little has been done for Chinese Americans. This study, using Community-Based Participatory Research and Intervention Mapping approaches, describes a formative research process in the development of a culturally and linguistically tailored online DPP program among Chinese Americans with prediabetes living in New York City. Using a triangulation approach, data were collected to inform the development of an online DPP curriculum through (1) a literature review, (2) three focus groups (n = 24), and (3) a community advisory board meeting among 10 …

History Of Falls, Mild Cognitive Impairment, And The Presence Of Home Environmental Hazards Among Community-Dwelling Older Persons In District V, Manila, Marilou J. Raval, Donald S. Lipardo

Philippine Journal of Physical Therapy

Introduction: It is important to investigate factors that may increase the fall risk in the geriatric population. This study aimed to determine the relationship between: 1) mild cognitive impairments (MCI) and history of falls; 2) home environmental hazards (HEH) and history of falls; and 3) MCI and HEHs among older adults.

Methods: Community-dwelling older persons of District V, Manila were random sampled to participate in this cross-sectional correlational study. The Home Falls and Accidents Screening Tool for Health Professionals (HOMEFAST-HP) and Fall History Questionnaire were used to collect information on the presence of HEH and history of falls, respectively. Chi-Square …

The Clinical Healthcare Provided To Homeless Communities Across The United States: A Literature Review, Saylor Sisemore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Homelessness has become a global public health concern as it results in poorer physical and mental health than age-matched people living in permanent housing (Ortiz & Roser, 2017). The area that comprises Northwest Arkansas (NWA), like other areas of the United States experiencing rapid growth, has seen a marked increase in the number of people experiencing homelessness in recent years. The homeless population is one of the most vulnerable and underserved groups of individuals in NWA and beyond. Public health nursing as a discipline is dedicated to providing compassionate care and exceptional service for all members of communities, with special …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience: Master of Public Health

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Prevalent Multimorbidity Combinations Among Middle-Aged And Older Adults Seen In Community Health Centers, Ana R Quiñones, Steele H Valenzuela, Nathalie Huguet, Maria Ukhanova, Miguel Marino, Jennifer A Lucas, Jean O'Malley, Teresa D Schmidt, Robert Voss, Katherine Peak, Nathaniel T Warren, John Heintzman

Faculty, Staff and Student Publications

BACKGROUND: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).

OBJECTIVE: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.

DESIGN: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic …

Hiv Viral Load Suppression Before And After Covid-19 In Kinshasa And Haut Katanga, Democratic Republic Of The Congo, Gulzar H. Shah, Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky

Health Policy & Community Health: Faculty Publications

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates …

Socioeconomic Status And Other Factors Associated With Hiv Status Among Ovc In Democratic Republic Of Congo (Drc), Gulzar H. Shah, Gina D. Etheredge, Lievain Maluantesa, Kristie Cason Waterfield, Osaremhen Ikhile, Elodie Engetele, Astrid Mulenga, Alice Tabala, Bernard Bossiky

Health Policy & Community Health: Faculty Publications

Background: Orphans and vulnerable children (OVC) are a high-risk group for HIV infection, particularly in Sub-Saharan Africa.

Purpose: This study aims to portray the socioeconomic profile of OVC and examine the association of household and parent/guardian characteristics with the HIV status of OVC.

Methods: For this quantitative retrospective study, we obtained data from ICAP/DRC for a total of 1,624 OVC from households enrolled for social, financial, and clinical services between January 2017 and April 2020 in two provinces of the Democratic Republic of Congo, Haut-Katanga and Kinshasa. We computed descriptive statistics for OVC and their parents' or guardians' characteristics. We …

Correlates Of Caffeinated Energy Drinks, Substance Use, And Behavior Among Adolescents, Lauren N. Maziarz, Lauren A. Dial, Bradley Fevrier, William Ivoska

Internet Journal of Allied Health Sciences and Practice

Background: Caffeinated energy drinks (CCEDs) are frequently consumed by adolescents aged 10-19, yet the effects of consumption on adolescent behavior are not well understood. Previous research has identified positive associations between CCED use and other substances such as alcohol and marijuana but studies among adolescents are lacking. Methods: We conducted a secondary analysis using data collected from the 2019 Alcohol, Drug Addition, and Mental Health Services (ADAMHS) Board/Wood County Educational Service Center’s youth survey. Ten public schools in Wood County, Ohio participated (n=6,152). Results: CCED use was common among our sample (43.4% overall). Reported consumption increased with age and was …

Air Quality And Cancer Prevalence Trends Across The Sub-Saharan African Regions During 2005–2020, Omolola Okunromade, Jingjing Yin, Clara Ray, Atin Adhikari

Health Policy & Community Health: Faculty Publications

Poor air quality and environmental pollution remain some of the main etiological factors leading to cancers and cancer-related deaths worldwide. As a result of human activities, deleterious airborne chemicals can be dispersed not only in the environment but also released in occupational environments and industrial areas. Air pollutants and cancer links are now established through various oxidative stress-related mechanisms and related DNA damages. Generally, ambient and indoor air pollutants have been understudied in sub-Saharan Africa (SSA) compared to other regions in the world. Our study not only highlights the deleterious effects of air pollutants in these developing countries, but it …

Emergency Care For Youth Who Experience Suicidality And Identify As Lesbian Gay Bisexual Transgender Queer/Questioning (Lgbtq+): An Interpretive Phenomenology, Theresa Schultz

Electronic Theses and Dissertations

Purpose: Suicide is a leading cause of death in children; youth who identify as LGBTQ+ are at an exponentially higher risk of suicide. The purpose of this study was to explore the lived experiences of young adults who identify as LGBTQ+ and sought emergency care for suicidality when they were adolescents.

Methods: Heideggerian hermeneutics phenomenology is the research method used in this study. Youth, ages 18-25 years, who identify as LGBTQ+ and sought emergency treatment for suicidality when they were adolescents (13-17 years) were recruited to participate;fifteen youth enrolled. Individuals ranged in age from 20 to 25 years. Participants described …