Community Health Commons^™

Building The Foundation For Equitable Diabetes Education: Examining Trust And Digital Access In Rural And Unreserved Population, Niasia Hazelton Smalls

MUSC Theses and Dissertations

Disparities in patient portal use undermine equitable chronic disease management, particularly for adults with diabetes in rural and historically underserved communities. This explanatory sequential mixed-methods study examined the associations among trust in the healthcare system and patient portal use among U.S. adults, using nationally representative data from the Health Information National Trends Survey (HINTS) 2023 (N = 3,711), supplemented by semi-structured interviews with frontline healthcare providers. Bivariate analyses revealed that adults with diabetes reported lower trust (83% vs. 86%, p = 0.003) and lower portal use (62% vs. 66%, p = 0.014) compared to those without a diagnosis. Multivariate logistic …

An Exploratory Study Of Social Determinants And Pediatric Lead Exposure In Chemung County, Ny, Jenna Mccracken, Anika Stundtner, Megan Kerbag, Madison Desantis, Jennifer Coseo, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lead exposure in children is a persistent public health concern due to its irreversible neurological and developmental effects. Children under 6 years old are particularly vulnerable due to frequent hand-to-mouth activity and increased environmental exposure. Existing literature suggests a relationship between adverse social determinants of health (SDOH), such as low parental education and residence in high-poverty areas, and elevated pediatric blood lead levels (BLLs). This study, subsidized through a community service grant from Excellus Blue Cross Blue Shield, aimed to examine the association between BLLs and SDOH among children screened at the ACCEL Community Health Clinic in Chemung County, …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

Social Determinants Of Health Affecting Cardiovascular Health Among South Asian Americans, Ann Mary Thomas

Honors Undergraduate Theses

Background: South Asian Americans experience disproportionately high rates of cardiovascular disease, yet the social determinants contributing to these disparities remain understudied.

Objective: This systematic review examines the role of social determinants of health (SDOH) in shaping cardiovascular outcomes among South Asian Americans.

Methods: A systematic literature search was conducted across PubMed, MEDLINE, and Web of Science using predefined search terms related to South Asian populations, cardiovascular health, and SDOH. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 reporting guidelines, and study screening and management were performed using Covidence. A total …

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Screening And Addressing Food Insecurity At Free Clinics: A Scoping Review, Gautam Ramanathan, William Zak, Daiwik Munjwani, Robert Fisher, Esther May Sarino, Mary J. Scourboutakos

Department of Medicine Faculty Publications

Food insecurity (FI) is highly prevalent amongst patients seeking care at free, student-run health clinics. This study sought to examine the existing literature of food insecurity screenings and interventions at free clinics across the U.S. In this review, we provide the rate of FI screenings, the prevalence of FI, demographic information of patients screened, and interventions and barriers faced by clinics while implementing interventions to improve FI. Studies included in this review needed to implement a FI screening and intervention program in a free clinic within the United States. Additionally, eligible studies could address additional social determinants of health or …

Association Of Unmet Social Needs With Disease-Related Outcomes In Pediatric Patients With Sickle Cell Disease, Molly Sonenklar, Sarah Marks, Cerelia Donald, Cecelia Valrie, Wally Smith, India Sisler

School of Medicine Faculty Publications

Background: Social determinants of health (SDoH) are socioeconomic factors that influence health and well-being, though when unmet can greatly contribute to health disparities. Individuals with sickle cell disease (SCD) are at increased risk of mortality, disability, and healthcare utilization. However, there are limited data linking specific social needs with disease outcomes in this population. Therefore, we sought to identify the unmet needs in one institution and their association with healthcare utilization. Methods: Children with SCD and their guardians answered demographic and SDoH questionnaires during routine Sickle Cell Clinic appointments. We defined an unmet social need as any positive answer to …

Establishing The First Student-Run Clinic To Provide Free Health Care To A South Texas Colonia, John Nicholas Cauba, Andrew B. Callan, Beatriz Tapia

Research Symposium

Purpose: The purpose of the University of Texas Rio Grande Valley School of Medicine Student Run Clinic is to bridge the healthcare gap in the local colonias by providing excellent, compassionate primary care to all who enter our doors, free of charge. We also work to connect our patients to low-cost, high-quality services in the area like women’s health visits, appointments with social workers, and dental services. Additionally, we offer medical students’ opportunities from their first year to serve an underserved population and get hands-on experience with patients.

Many patients in colonias face challenges like limited transportation options and a …

Creating An Interactive Guide To Support Health Disparities Competency, Lauren E. Robinson, Stephanie Henderson, Cayla M. Robinson, Rebecca J. Morgan, Beth Reeder

2024 R&I Day

Authors share their educational resource developed for the health sciences, that guides users in awareness of health disparities, vulnerable populations, and social determinants of health, directing them to specific guidance and resources available through the library.

Social Determinants Of Health, Telehealth, And Hiv/Aids: Implications For Public Health Research And Practice In The State Of Virginia, Sonal S. Sathe, Adati Tarfa

Virginia Journal of Public Health

Purpose: The purpose of this commentary is to assert the importance of addressing the social determinants of health to support HIV/AIDS control efforts, to describe the importance of telehealth in HIV/AIDS control, and to recommend courses of action to support HIV/AIDS control efforts within the state of Virginia.

Discussion: We provide an overview of the social determinants of health and their role in HIV/AIDS control, telehealth and its uptake within the HIV/AIDS community, and issues in Virginia facing HIV/AIDS control.

Conclusion and Recommendations: We conclude that addressing social determinants of health, especially stigma, is an important measure of HIV/AIDS control …

Integration Of A Culturally Appropriate Method Of Delivering Health Information In A Non-Clinical Setting, Nancy Nguyen, Merett Saad, Andrew Vo, Alejandro Castaneda, Uriel Martinez, Jonathan Do, Kevin Trembley, Imran Javaid, Hargurbir Alhuwalia, Jaskirat Malhi, Carolina Quezada M.D., Joy H. Lewis D.O., Phd

Intellectus

Context:

A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) has an established partnership with Family HealthCare Network (FHCN). Initial meetings with the local community outreach department identified that a substantial majority of the Hispanic population served by this health center may lack access to health education. In particular, Spanish-speaking patients at the health center may face language barriers that impair the transfer of health education between the providers, patients, and their families.

Objective:

The purpose of this study was to provide health educational presentations in Spanish in order to improve health knowledge relating to women’s and children’s health. …

Improving Social Determinants Of Health Screening And Intervening In A Rural Primary Care Setting, Katina Ann Pulos Kuerth

Masters Projects

ABSTRACT

Background: Social determinants of health (SDOH) are associated with an increased risk of poor health outcomes and increased healthcare utilization (Buitron de la Vega et al, 2019). To achieve health equity, social determinants of health are an essential factor to assess. Practitioners (in the evaluated primary care setting) can document, track, update, and report SDOH through the electronic medical record (EMR). Yet, the electronic health record is not consistently being utilized for this purpose.

Objectives: This article describes a new protocol which was implemented, utilizing a module embedded in the EMR, to chart the results of a standardized SDOH …

Piloting An Oral History Approach To Investigate Cancer Perspectives Among Residents Of Appalachian Kentucky, Courtney Martin, Lauren Hudson, Nathan L. Vanderford

Journal of Appalachian Health

Introduction: Kentucky ranks first in the U.S. in overall cancer incidence and mortality rates. Areas of the state that fall within the Appalachian Region, along Kentucky’s eastern border, experience disproportionately high rates of cancer compared to non-Appalachian counties.

Purpose: This pilot study investigates whether oral history interviews can be used to understand perspectives on cancer among residents of Appalachian Kentucky.

Methods: In 2020, participants (n = 5) who identified as being from and/or having strong connections to Appalachian Kentucky were recruited to participate in this pilot study. Participants included individuals working in cancer-related fields, oncology professionals, and those with personal …

Are Human Papillomavirus Knowledge And Vaccine Uptake Associated With Hiv Status And Social Determinants Of Health In Young Sexual Minority Men?, Trisha L Amboree, Alan G Nyitray, John Schneider, Nick Gargurevich, Jacky Kuo, Elizabeth Y Chiao, Lu-Yu Hwang, Kayo Fujimoto

Faculty, Staff and Student Publications

This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of …

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 …

Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas

Sociology Faculty Articles and Research

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …

Seeking Sustainable Solutions To Period Poverty Amongst Homeless Women In Camden County, Nj, Bilal Khan, Alana Smith, Melisa Ibarra-Zavala

Rowan-Virtua Research Day

Health Careers Opportunity Program (HCOP) – National Ambassadors is an effort for underserved high school, undergraduate, and medical students to collaborate on a research-based community service project to equip future health professionals with tools to heal their communities.

The average woman spends up to 3500 days of their life menstruating. Menstrual health is therefore not just a fundamental human right, but a robust indicator of community well-being. Despite the biological inevitably of menstruation, barriers to practicing adequate menstrual hygiene, or “Period Poverty,” are far common and often ignored in public forums. Period products face a luxury goods sales tax in …

Ethnic Comparisons In Perceptions Of Health, Happiness, Hope, And Related Social Determinants Of Health In A Majority-Minority Midwestern Town, Virginia Chaidez, Yumou Qiu, Angela L. Palmer-Wackerly, Julie A. Tippens, Gilbert R. Parra, Patrick Habecker, Kimberly Gocchi Carrasco, Jordan Soliz, Lisa M. Pytlikzillig, Kirk Dombrowski

The Journal of Sociology & Social Welfare

In a rural Midwestern community sample (n=273), large proportions of Somalis and Whites ranked overall health as "Very good" (57% and 50%, respectively), while Hispanics (42%) considered it "Good". Across all groups, most are either "Happy" or "Very happy" with their jobs—64%, 91%, 83%—or their families—85%, 93%, 91.6%— with reference to Hispanics, Somalis, and Whites, respectively. When asked “In the past 30 days, how often did you feel hopeless?”, 83% of Somalis and two-thirds (67%) of Whites responded, "None of the time", while half (50%) of Hispanics indicated the same. Overall, Hispanics appeared to be less …

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 …

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

Racial Segregation As A Social Determinant Of Health: Evidence From The State Of Georgia, Simon Medcalfe, Catherine P. Slade, Divesia Lee

Journal of the Georgia Public Health Association

Background: Despite decades of research, determining the causes of racial disparities in health remains a pernicious problem in the public health arena. Challenges include further refining definitions of health as well as expanding frameworks for social determinants of health to include relevant and related predictors. Racial segregation as a social determinant of health is understudied but of growing interest in the discourse on health disparities. This paper explores empirically the relationship between racial segregation and other predictors of social determinants of health and their collective impact on health outcomes defined in both objective and subjective terms.

Methods: Ordinary least squares …

Adicción Como Un Hecho Político Económico: Un Análisis De Servicios De Atención De Abuso De Drogas Y Alcohol En Arica, Chile, Jack Steffy

Independent Study Project (ISP) Collection

Research question – What is the current landscape of drug abuse in Chile and how has the state attempted to address this problem?

Objectives – The objectives of the paper were to characterize drug use patterns in Chile since 1994, revise drug abuse services, and offer possible improvements for the system of drug abuse treatment.

Background – Chile, despite being one of the most well economically-developed countries in South America, has some of the worst mental health indicators, one of these being drug abuse. Since 1994, use of alcohol and marihuana has increased, while use of cocaine products has remained …