Population Health Commons^™

Tele-Psychiatry Adoption And Its Effect On Rural Mental Health Service Availability, Anna Heineman, Kaylee Canterbury, Taylor Carpenter

Theses, Dissertations and Capstones

Purpose of study: This study examined the association between tele-psychiatry implementation and mental health service availability in rural healthcare settings. The analysis compared tele-psychiatry to traditional in-person psychiatric care among rural populations, focusing on access and utilization outcomes, including time to first psychiatric appointment, number of completed visits, and appointment no-show rates.

Methods: A qualitative literature review following a systematic approach was conducted using peer-reviewed articles published between 2016-2026. Databases included PubMed, ProQuest Health, CINAHL, Journal of Medical Internet Research, and the National Library of Medicine, with Google Scholar used as a supplemental source. The review followed PRISMA …

Impact Of Gender-Affirming Hormone Therapy On Dry Eye, Keith E. Arnold, Michael J. Foster, Tomasz A. Tabernacki, Chase A. Turner, Peter A. Netland, Kirtishri Mishra

Department of Ophthalmology Faculty Publications

Purpose

To determine whether gender-affirming hormone therapy (GAHT) influences tear system health in transgender individuals.

Methods

This retrospective cohort observational study analyzed data from transgender men and women ages ≥18-years between 2004 and 2024 via electronic medical record (EMR) data. Following propensity score matching, subjects on hormone therapy included 23,623 transgender men, 15,933 transgender women, and an equal number in each matched control group.

Results

Among transgender men and women, respectively, tear system disorders occurred in 0.90% and 0.94% of those using GAHT and 0.90% and 1.17% of those not using GAHT (p = 0.211, p = 0.072). There was …

The Association Between Social Vulnerability And Racial Disparities In Preterm Birth, Anita Pershad, Gabby Adams, Lindsay Robbins, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

To evaluate the association between county-level social vulnerability and preterm birth and assess whether racial disparities vary across levels of vulnerability.

Methods

This cross-sectional study utilized restricted Centers for Disease Control and Prevention natality data from 2023. We included Black or White births with singleton pregnancies across 3123 US counties from 50 US states and the District of Columbia. Participants were grouped into quartiles based on the county-level Social Vulnerability Index (SVI), with quartile 4 representing the most socially vulnerable populations. The primary outcome was preterm birth, defined as delivery before 37 weeks. Secondary outcomes included small for gestational …

Nurses' Perspectives On Caring For Critically Ill Children During A Measles Outbreak: A Case Report, Cara Everard Gallegos, Melissa Gale Robinson, Brittny Ayola, Lacey Kovar, Nicole Roehrig

Covenant Nurses Week 2026

No abstract provided.

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Timelines Of Care: Analyzing Treatment Access For Women With Ongoing Reproductive Health Needs, Nyla M. Keith

Honors Undergraduate Theses

Mandates in the United States created pressure on an already strained healthcare system post-COVID-19 pandemic. With new regulations placed upon abortion care forcing the closing of low-cost health clinics such as Planned Parenthood, legislation that has made health insurance more expensive, and rising pharmaceutical prices, women’s OB/GYN care in America has struggled to meet patient needs. A cross-sectional survey was developed and distributed to four clinics in the Orlando area to assess patients' perceived access to care and identify barriers to receiving OB/GYN care. The survey took approximately 10 – 15 minutes to complete, was available in print and online …

Net Effects Of Correlated Determinants Of Health Among U.S. Older Adults, Haomiao Jia, E I. Lubetkin

Publications and Research

Background

The health effect produced by a contributing factor alone may be different from the effect when other interacting factors are present. The effects of a set of contributors, estimated by regression coefficients, may be invalid or inappropriate if some of the predictors are correlated or the model has interaction and nonlinear terms. The net effect (NE) of a given contributing factor is the effect produced by the factor alone, not by other factors due to their correlations with the factor of interest. This study estimated NE of selected determinants of health for U.S. older adults.

Methods

Participants, aged ≥ …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Depressive Disorders, Bad Mental Health Days, And Diabetes Management Behaviors Among Non-Hispanic American Indian/Alaska Native Adults: Findings From The Behavioral Risk Factor Surveillance System, Kaipeng Wang, Luohua Jiang, Jie Zhu, Spero M. Manson

Graduate School of Social Work: Faculty Scholarship

Objective

This study examined the association between diagnosis of depressive disorder, the number of bad mental health days per month, and diabetes management behaviors among American Indian/Alaska Native (AI/AN) adults with diabetes.

Research design and methods

Data were drawn from the Behavioral Risk Factor Surveillance System (2018–2021), including 2,272 self-identified non-Hispanic AI/AN adults diagnosed with non-gestational diabetes. Key variables included a self-reported prior diagnosis of depressive disorder and the number of bad mental health days in the past month. Outcome variables were seven diabetes management behaviors, such as taking a diabetes management class and performing daily foot checks. Statistical analyses …

Not Just A Biblical Disease: Hansen’S Disease (Leprosy) Oregon’S Unique Differential, Zach Taylor, Justin Jin, Andrea Roast, Amy Dechet

Books, Presentations, Posters, Etc.

Background: Hansen’s disease (leprosy) is caused by a gram-positive, acid-fast bacilli called Mycobacterium leprae. It is very slow growing and has an indolent disease process. The disease is more prevalent in underdeveloped countries with poor access to care including Brazil, India, sub-Saharan Africa, and the Pacific Islands including Micronesia and the Philippines. However, it is becoming in creasingly common in the United States, specifically in areas with high levels of immigration from Micronesia. Case: Our patient was a 35-year-old Micronesian man who presented with 7 days of non-traumatic right hand pain with progressive swelling. He migrated to US from Micronesia …

Association Between Self-Reported Body Mass Index And Active Life Expectancy In A Large Community-Dwelling Sample Of Older U.S. Adults, Haomiao Jia, Erica I. Lubetkin

Publications and Research

Background: Obesity may have a protective effect (greater survival) in older adults, a finding known as the "obesity paradox." This study examined the association between self-reported body mass index (BMI) and active life expectancy (ALE) among older U.S. adults.

Methods: Using the Medicare Health Outcomes Survey Cohort 15 (2012 baseline, 2014 follow-up), we estimated life expectancy and ALE by participants' baseline BMI and age using multi-state models. A participant was classified as in an active state if this person reported having no difficulty for any of these six activities of daily living (ADLs).

Results: Small differences in life expectancy were …

Young-Onset Hypertension In Malaysia: A Mixed-Methods Study, Yi Yi Khoo

Student Works (2020-2029)

The continuous cumulative presence of raised blood pressure (BP) when young is a strong predictor of future cardiovascular risk. This study, which was conducted between June 2018 and December 2019, aimed to elucidate the epidemiology of young-onset hypertension (YOH) in Malaysia during the period 2006–2015, and to explore the underlying experiences and perspectives of young adults living with hypertension. Phase I involved a systematic review to identify variables for the secondary data analysis. In Phase II, data on respondents aged 18–39 diagnosed with YOH according to the 7th Joint National Committee Report (United States) were extracted from three National Health …

Native Outreach: A Report To American Indian, Alaska Native And Native Hawaiian Communities, C.S. Glover, F.S. Hodge

Native Health Database Full Text

The National Cancer Institute (NCI) is presenting a monograph written specifically for community leaders, health professionals and lay health workers serving Native American communities. Native Americans have higher mortality rates than the general U.S. population for several major cancer sites. This publication focuses on the need to reduce those rates through effective interventions at the grassroots level.

Alaska Native Cancer Survival Report, A.P. Lanier, P. Holck, J. Kelly, B. Smith, T. Mcevoy

Native Health Database Full Text

This report presents Alaska Native cancer survival rates and stage of disease at diagnosis. Data on survival and stage at diagnosis are given for all cancers combined, and for select primary cancer sites (the organ in which the cancer first began). Survival rates are given for only those cancers for which there were enough patients to calculate reliable estimates. The focus is on five-year relative survival rates because these rates are most commonly used in the cancer literature and most appropriate for comparisons between populations.