Community Health Commons^™

Behavioural Support And Nicotine Replacement Therapy For Smokeless Tobacco Cessation: Protocol For A Pilot Randomised-Controlled Multi-Country Trial, Faraz Siddiqui, Linda Bauld, Ray Croucher, Cath Jackson, Ian Kellar, Mona Kanaan, Subhash Pokhrel, Rumana Huque, Romaina Iqbal, Javaid Ahmed Khan

Community Health Sciences

Background: Smokeless tobacco (ST) is consumed globally by more than 350 million people, with approximately 85% of all users based in South and Southeast Asia. In this region, ST products are cheap and easily accessible. Evidence-based interventions to people quit ST use are lacking. This study aims to test the feasibility of conducting a future definitive trial of ST cessation, using a culturally adapted behavioural intervention, and/or nicotine replacement therapy (NRT) in three South Asian countries.
Methods: We will conduct a factorial design, randomised-controlled pilot trial in Bangladesh, India and Pakistan. Daily ST users will be recruited from primary health …

Nutritional Cooking Program With Girls Inc., Taunton, Ma, Chantel Almanzar

Honors Program Theses and Projects

As a member of the Institutional Review Board-approved research team comprised of Dr. Maura Rosenthal, Dr. Angela Bailey, and Christina Elderbee, I led a six-week community-based health program that included cooking lessons for girls aged 10 to 13. I taught girls how to prepare healthful foods that they may cook with their family and friends at home. The larger project, Building Equity Through Collaboration with Girl's Inc., aims to study the outcomes of girls’ participation in after school and summer camp programs in 2021 and 2022. One part of this research, which intends to learn more about girls' current and …

Enhancing Elementary School Educators And Staffs Behavioral Classroom Management Strategies To Support Children Affected By Trauma Through Utilization Of Trauma-Informed Care (Tic) And Social-Emotional Learning (Sel) Modalities: A Quality Improvement Project, Kerstin Burt

Doctor of Nursing Practice (DNP) Manuscripts

Abstract

Background: The fundamental ACE study asked more than 17,000 adults about their childhood trauma exposure and how it has impacted their health as an adult. The study found a link between ACE exposure and a higher likelihood of experiencing adverse emotional and physical outcomes (Felitti et al., 1998).

Problem: Educators and staff encounter children affected by trauma and are untrained in trauma-informed care approaches, known as the “Four R’s” (SAMHSA, 2014b).

Purpose: This quality improvement (Q.I.) project aimed to respond to the trauma-informed care (TIC) and social-emotional learning (SEL) gaps among educators and staff at a private elementary school …

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 …

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 …

Native American Mental Health: Adding Culture To The Conversation, Margaret Rose

Population Health Research Brief Series

American Indians/Alaska Natives (AI/ANs) experience higher rates of depression, suicide, and psychological distress compared to other communities in the United States. Despite this, they are less likely to receive mental health services due to barriers such as lack of resources, limited mental health service access, stigma, and mistrust of providers. This issue brief describes the influence of colonialism on AI/AN mental health and discusses how barriers to mental health treatment can be addressed by integrating AI/AN culture into traditional mental health services and increasing AI/AN presence in mental health occupations.

The Impact Of The Covid-19 Pandemic On Mental Health And Stressors Among Asian American And Pacific Islanders, Ava Lu Kupperman

University Honors Theses

The Asian American and Pacific Islander (AAPI) community, along with the rest of the population globally, has been facing disruptions emerging from the COVID-19 pandemic in all parts of life. However, with the significant rise in racism, the AAPI community has had to confront a set of new challenges in their lives. Utilizing studies and literature written over the course of the pandemic, the purpose of this literature review is to examine the impacts observed on mental health outcomes among AAPIs as a result of the COVID-19 pandemic. This paper aims to collect and present information surrounding the impact on …

Awareness Of Human Papillomavirus And Reported Human Papillomavirus Vaccine Uptake In A High-Risk Population, Trisha L Amboree, Jane R Montealegre, Paige Padgett Wermuth, Osaro Mgbere, Kayo Fujimoto, Charles Darkoh

Faculty, Staff and Student Publications

INTRODUCTION: Disparities in human papillomavirus (HPV) awareness and HPV vaccine uptake are likely exacerbated among racial/ethnic minority populations living in low-income areas. This study aims to determine the prevalence and correlates of HPV awareness and HPV vaccine uptake in an urban, low-income, racial/ethnic minority population.

METHODS: Secondary data analyses were performed in 2021 using 380 participants aged 18-45 years from the 2019 National HIV Behavioral Surveillance for high-risk heterosexuals, which monitors HIV risk behaviors among individuals living in high-poverty, high HIV prevalence neighborhoods. Prevalence estimates and modified Poisson regression models were used to assess the relationship between HPV awareness and …

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, …

“My Attitude On Telehealth Has Completely Changed.”: Facilitators And Barriers To Implementing Technology For Care Delivery In Community Mental Health Centers, Suzanne Meller, Justin Tauscher, Dror Ben-Zeev

Journal of Technology in Counselor Education and Supervision

The purpose of this study was to explore facilitators and barriers aiding community mental health centers in implementing technology-assisted care during the COVID-19 pandemic. Six key informants were interviewed and 28 clinicians were surveyed from three community mental health centers. Interviews focused on technology-assisted care implementation efforts and factors that facilitated adoption. Surveys focused on clinician beliefs and experience with technology-assisted care in addition to training needs. Barriers to technology-assisted care implementation included beliefs about the quality of virtual services and a lack of technology access. An increase in service utilization was reported. Technology-assisted care facilitators included reimbursement policy changes …

A Tide Of Technical Trends: Technology Competence Among Licensed Counselors, Brittany G. Suggs, Mary Sanderfer Stull, Spencer R. Baker, Kathie T. Erwin, David M. Savinsky

Journal of Technology in Counselor Education and Supervision

The inclusion of technology in mental health care can revolutionize the accessibility, affordability, and effectiveness of counseling services, while furnishing practical solutions to reduce mental health disparities and meet widening care demands. Steered by the Coalition for Technology in Behavioral Science (CTiBS) telebehavioral health (TBH) competencies, this study employed a descriptive survey design to investigate licensed counselors’ (LCs’) perceived technology competence in mental health care. The following research question steered the study’s exploration: What is the nature of perceived technology competence among LCs? The overarching hypothesis speculated that LCs’ exposure, familiarity, and current utilization of various mental health technologies would …

Successful Aging Through Aging In Place : The Perspectives Of The Elderly And Adult Children In Shenzhen, Feng Huang

Lingnan Theses (Doctoral degree)

Aging in place (AIP) has been adopted to cope with the aging population worldwide. The present research invoked the concept of successful aging as a theoretical perspective on AIP with Shenzhen, China as the backdrop. This study adopted the successful aging model of Rowe and Kahn (1987, 1997, 1998) and employed a mixed methods with qualitative and quantitative research. It examined the AIP policies in China and Shenzhen and how the “users” (the elderly and adult children) perceive AIP and successful aging. It also explored which factors would affect successful aging through AIP. Findings showed that financial security and intergenerational …

Let's Get Physical: Exploring The Socioemotional Motivators Of Group Exercise For Older Adults, Tessneem S. Hasan, Alyssa R. Minton, Jason Snyder, Joseph A. Mikels

DePaul Discoveries

Approximately 75% of active adults in the U.S. do not meet the recommended levels of overall physical activity (CDC, 2021a). Given the beneficial impact of physical activity on health, an 8-week long, evidence-based group exercise program—Fit & Strong! (F&S!)—was created to improve the health of older adults (Hughes et al., 2004, 2006, 2010). Despite the clear physical benefits of F&S!, it remains unknown what motivates F&S! participants to initially participate in the program and also throughout the program. Drawing from core notions of socioemotional selectivity theory (SST; Carstensen, 2006), research has found that older adults are highly motivated to exercise …

Stakeholders’ Perspectives On The Safety Of An Adaptive Riding Program For Adults Living With Dementia And Care Partners, Alicia A. Oestreich, Beth E. Fields

People and Animals: The International Journal of Research and Practice

The purpose of this qualitative community-based participatory research was to explore the safety perspectives of stakeholders involved in an adaptive horseback riding program designed to enhance the quality of life of adults living with dementia and their care partners. Human–animal interactions are becoming increasingly popular therapeutic interventions; however, there is still a lack of understanding about the safety considerations for providing adults living with dementia opportunities to interact with horses and the equine environment. To advance our understanding, researchers analyzed 10 semistructured interviews and two focus groups with therapeutic riding program instructors and staff, aging network specialists, and care partners …

Impact Of Biosecurity Measures, Social Pressure And Bullying On Attitudes, Perceptions, And Job Satisfaction Levels Among Healthcare Workers During The Covid-19 Pandemic: A Cross-Sectional Survey, Azza Sarfraz, Zouina Sarfraz, Genesis Camacho-Leon, Geovanny Efraín Alvarado-Villa, Derly Madeleiny Andrade-Molina, Juan Carlos Fernandez-Cadena, Arjola Agolli, Zeynep Yukselen, Miguel Felix, Juan Carlos Gallardo Bastidas

Department of Paediatrics and Child Health

Introduction: The extent and nature of social pressure and bullying towards healthcare workers (HCWs) during the COVID-19 remains unclear. The following study identifies the effect of social pressure and bullying directed towards HCWs when using biosecurity measures during the COVID-19 pandemic; further, the impact on perceptions, attitudes and job satisfaction level is also explored.
Methodology: We conducted a cross-sectional survey-based study among 684 Ecuadorian HCWs. The survey consisted of 38 questions related to the frequency, attitudes, and perceptions of biosecurity measures during the COVID-19 pandemic. Exploratory factor analysis was performed to assess the validity of the questionnaire. Associations between variables …

Measuring Contraceptive Method Mix, Prevalence, And Demand Satisfied By Age And Marital Status In 204 Countries And Territories, 1970-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019, Annie Haakenstad, Olivia Angelino, Caleb M S Irvine, Zulfiqar Ahmed Bhutta, Kelly Bienhoff, Corinne Bintz, Kate Causey, M Ashworth Dirac, Nancy Fullman, Emmanuela Gakidou

Department of Paediatrics and Child Health

Background: Meeting the contraceptive needs of women of reproductive age is beneficial for the health of women and children, and the economic and social empowerment of women. Higher rates of contraceptive coverage have been linked to the availability of a more diverse range of contraceptive methods. We present estimates of the contraceptive prevalence rate (CPR), modern contraceptive prevalence rate (mCPR), demand satisfied, and the method of contraception used for both partnered and unpartnered women for 5-year age groups in 204 countries and territories between 1970 and 2019.
Methods: We used 1162 population-based surveys capturing contraceptive use among women between 1970 …

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

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 …

Community-Based Asthma Assessment In Young Children: Adaptations For A Multicentre Longitudinal Study In South Asia, Mohammad Shahidul Islam, Samin Huq, Steven Cunningham, Jurgen Schwarze, Asmd Ashraful Islam, Mashal Amin, Farrukh Raza, Benazir Baloch, Muhammad Imran Nisar, Sajid Bashir Soofi

Department of Paediatrics and Child Health

Background: Systematic assessment of childhood asthma is challenging in low- and middle-income country (LMIC) settings due to the lack of standardised and validated methodologies. We describe the contextual challenges and adaptation strategies in the implementation of a community-based asthma assessment in four resource-constrained settings in Bangladesh, India, and Pakistan.
Method: We followed a group of children of age 6-8 years for 12 months to record their respiratory health outcomes. The study participants were enrolled at four study sites of the 'Aetiology of Neonatal Infection in South Asia (ANISA)' study. We standardised the research methods for the sites, trained field staff …

From Isolation To Connection: A Cross-Sectional Analysis Of Older Adults’ Social Participation Using The Cov19-Qol Scale, Kathleen Melei, Jill Linder

The Open Journal of Occupational Therapy

Background: Social isolation during COVID-19 has the capacity to impact older adults’ physical health, mental health, and quality of life. Using an occupational therapy perspective of social participation as an occupation, the current study explores (a) the extent to which social participation (habits/routines) has changed following the onset of the COVID-19 pandemic, (b) differences in perceptions of social participation in relation to the COVID-19 pandemic, and (c) differences in scores on the COVID-19 Quality of Life (COV19-QoL) scale by demographics, access to health care, and lifestyle routine.

Method: Community-dwelling adults (N = 230) 65 years of age or …

Coping Strategies For Inner Conflicts Between Gay Bear Identity And Health Concerns, Chichun Lin, Darren D. Moore

The Qualitative Report

Gay bear refers to a burly gay man with a hirsute body and face. Chinese gay bear men are highly homogeneous and strictly emphasize a uniform bear appearance; however, obesity is an obvious health issue in this population. This study aims to explore the Chinese gay bear men's inner conflicts between bear identity and health concerns. Eleven Chinese gay bear men including four Taiwanese, two mainland Chinese, two Hong Kong, two Malaysian, and one Singaporean were interviewed. The study used a thematic analysis approach and found three coping strategies including (a) Eat healthy but maintain a minimal bear standard; (b) …

Prevalence Of Health-Risk Behaviors And Mental Well-Being Of Asean University Students In Covid-19 Pandemic, Hanif Abdul Raman, Areekul Amornsriwatanakul, Khadizah H. Abdul-Mumin, Denny Agustiningsih, Surasak Chaiyasong, Michael Chia, Supat Chupradit, Le Quang Huy, Katiya Ivanovitch, Ma. Henrietta Teresa O. De La Cruz

Ateneo School of Medicine and Public Health Publications

The prevalence of epidemiological health-risk behaviors and mental well-being in the COVID-19 pandemic, stratified by sociodemographic factors in Association of South East Asian Nations (ASEAN) university students, were examined in the research. Data were collected in March–June 2021 via an online survey from 15,366 university students from 17 universities in seven ASEAN countries. Analyzed data comprised results on physical activity, health-related behaviors, mental well-being, and sociodemographic information. A large proportion of university students consumed sugar-sweetened beverages (82.0%; 95%CI: 81.4, 82.6) and snacks/fast food daily (65.2%; 95%CI: 64.4, 66.0). About half (52.2%; 95%CI: 51.4, 53.0) consumed less than the recommended daily …

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 …

Engaging Public Health Critical Race Praxis In Local Social Determinants Of Health Research: The Youth Health Equity And Action Research Training Program In Portland, Or—Yheartpdx, Ryan J. Petteway, Lourdes Gonzalez

OHSU-PSU School of Public Health Faculty Publications and Presentations

The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research on racial health inequities—SDH-related or otherwise—continues to grow, communities of color remain grossly underrepresented as public health researchers and practitioners. Additionally, although SDH are experienced in a very local sense, much research and practice fails to more deeply and thoroughly engage and center local community knowledges. Thus, much work around SDH and racial health inequities presents, ironically, …

Health Inequities As Measured By The Eq-5d-5l During Covid-19: Results From New York In Healthy And Diseased Persons, Erica I. Lubetkin, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, Gouke J. Bonsel

Publications and Research

Introduction: The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

Methods: Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to …

Solution Focused Brief Therapy And Vicarious Resilience In Bolivian Protective Family Services Workers, Marcos Pérez Lamadrid, Adam S. Froerer

Journal of Solution Focused Practices

Vicarious resilience (VR) is defined as the positive effects caregivers experience within their personal lives, their work lives, and within their worldview as a whole, that come from witnessing the resilience that clients demonstrate in facing their traumatic experiences. This research study is a quasi-experimental pilot study about how solution focused brief therapy (SFBT) influences the vicarious resilience of family protective system (SLIM) workers in Bolivia. The Vicarious Resilience Inventory (VRI) was administered in a pretest/posttest design for an experimental group (applying SFBT) and a control group (training as usual). Both groups experienced an increase in vicarious resilience, but the …

Vaccine Hesitancy And Betrayal Aversion, Abdelaziz Alsharawy, Esha Dwibedi, Jason Aimone, Sheryl Ball

Faculty, Staff and Student Publications

The determinants of vaccine hesitancy remain complex and context specific. Betrayal aversion occurs when an individual is hesitant to risk being betrayed in an environment involving trust. In this pre-registered vignette experiment, we show that betrayal aversion is not captured by current vaccine hesitancy measures despite representing a significant source of unwillingness to be vaccinated. Our survey instrument was administered to 888 United States residents via Amazon Mechanical Turk in March 2021. We find that over a third of participants have betrayal averse preferences, resulting in an 8-26% decline in vaccine acceptance, depending on the betrayal source. Interestingly, attributing betrayal …

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 …

Manos En Acción, Sandra Patricia Carmona Urueña, Maria Nieves Avila Avila, Claudia Del Rocío Contreras Rodríguez

Ciencias de la Salud

La cartilla Manos en acción está dirigida a los trabajadores agrícolas y sus familias, contiene prácticas que orientan el uso racional y aprovechamiento de los recursos naturales disponibles en el medioambiente, y busca crear conciencia ambiental y disminuir la explotación y contaminación ocasionada a este, facilitará información acerca de estrategiasagroecológicas y el aprovechamiento racional de los recursos ambientales presentes en las veredas donde se cultiva y viven los trabajadores agrícolas. Está divida en seis unidades: agroecología, recorrido gira técnica, bioplaguicidas, tipos de fungicidas, abonos orgánicoslumbricultura.