Public Health Commons^™

Report: Evaluation Of Seal!Nd: School Year 2021-2022: North Dakota Department Of Health Oral Health Program’S School-Based Dental Sealant Program, Shawnda Schroeder, Tonya Connor

Indigenous Health Faculty Publications

The North Dakota Department of Health (DoH)a Oral Health Program (OHP)b has established a school-based dental sealant program, (SEAL!ND)c , which has been providing dental sealants, fluoride varnish applications, oral health education and dental screenings and referrals for students throughout North Dakota dating back to 2012. All services occur in the school during school hours. School-based sealant programs are a highly effective way to deliver preventive oral health services and dental sealants to children less likely to receive private dental care. The SEAL!ND program prioritizes providing preventive oral health care to low-income and underserved students by targeting schools with 45% …

Improving Healthcare Experiences For Transgender And Intersex Populations, Destiny S. J. Lee, Joanne Chopak-Foss

Journal of the Georgia Public Health Association

Intersex is an umbrella term for individuals who are born with sex characteristics that do not typically fall into male or female categories. Individuals who are intersex make up about 1.7% of the United States population today and are identified within the lesbian, gay, bisexual, transgender, and intersex (LGBTQIA+) community. Many people who are intersex identify as transgender, which relates to the social process of gender change, as they develop into adults. In Georgia, approximately 4% of the population identify as LGBTQIA+. The purpose of this paper is to increase awareness of the perceived discrimination from healthcare providers, non-inclusive organizational …

Health Disparities: Ranking Horry County's Most Disadvantaged Communities, Stephen Borders, Jacob Bradley, Mackenzie Cannon, William Hall

Public Health

Horry County is a rapidly growing region in South Carolina, with a diverse population of over 300,000 residents. Despite this growth, the county faces significant health challenges, including high rates of chronic diseases, such as diabetes and obesity, and a shortage of healthcare providers in certain areas. These challenges are exacerbated by the county's socio-economic disparities, with many low-income residents lacking access to basic health services. Our approach is to address these challenges by identifying the areas within the county with the greatest unmet needs, also known as disadvantaged communities. By identifying the needs of Horry County’s most disadvantaged communities, …

Implementation Of A Decision Aid To Increase The Rate Of Routine Breast Cancer Screening Among Women Between 50 To 74 Years Old At A Federally Qualified Health Center, Dana Mars

Doctor of Nursing Practice Scholarly Projects

Background: Breast cancer is the most prevalent form of cancer in the U.S. Cancer screenings can result in prompt treatments and positive health outcomes. Disparities in screening rates are prevalent among vulnerable populations. At a Federally Qualified Health Center (FQHC), where the project occurred, the rate of breast cancer screening in 2021 (64%) was lower than the target set by the Healthy People 2030 (77%). This quality improvement project aimed to increase the rate of routine breast cancer screening among women aged 50-74 years old in the FQHC.

Methods: Previous studies have reported that decision aids on breast cancer screening …

Predictors Of Future Physician Practice Location, Allegra Latimer

Honors Theses

Healthcare disparities exist throughout the United States. While Mississippi does not stand alone in the maldistribution of physicians and medical practices across the state, it does exist as a state that has been historically medically underserved. According to data collected by The County Health Rankings Model developed by the University of Wisconsin Population Health Institute, in 2019, the ratio of population to primary care physicians in Mississippi was 1860:1. This is nearly 30% higher in disparity than the national average. It is also important to note that of Mississippi’s 82 counties, 79.3% are considered rural with the majority of physicians …

A Systematic Literature Review Of Telehealth For Health Equity In Pediatric And Women's Health Care: Promise Vs Reality, Sharanya Chandu

Honors Scholar Theses

Background: Telehealth interventions can transform the healthcare system to improve accessibility, quality of care, and outcomes for women’s obstetric health.

Objective: This literature review seeks to summarize current research to understand the effect of telehealth on women’s obstetrics and gynecology outcomes.

Methods: A literature review was conducted following the PRISMA methodology to identify a set of papers containing information related to obstetrics and maternal health. The search terms used identified telehealth or telemedicine interventions used for obstetric, maternal, or prenatal care from the period 2013-2023. 19 articles were identified and reviewed.

Results: The literature review considered three primary aspects from …

Structural Barriers To Health Care Access And Ipv Disclosure In First-Generation Latina Immigrants, Donna L. Schminkey, Deborah Elkins, Karen Jagiello, Sandra Annan, Jamie Robinson, Erika Metzler Sawin

Virginia Journal of Public Health

Background: This study aimed to describe the unique structural barriers faced by Latina women in rural areas of Virginia as they attempt to access the health care system, and, once they have gained access, to identify barriers to intimate partner violence (IPV) disclosure.

Methods: Semi-structured in-depth individual interviews with first-generation Latina immigrants were conducted after initial purposeful convenience sampling and concomitant snowball recruiting. A thematic content analysis using a phenomenological approach was employed to interpret participants' experiences. Initial findings were validated through additional interviews.

Results: The overarching theme expressed by these women was their search for dignity. Emergent sub-themes related …

Vaccine Uptake In The Era Of Covid-19: Associations Between Willingness To Receive The Influenza And Covid-19 Vaccines, Mutaz Alkalbani, Ritsa Frousios, Matilda Francis, Yousef Beidas, Jennifer Ryal, Brynn Sheehan

Virginia Journal of Public Health

Background/purpose. Despite efforts to increase flu vaccine uptake, the rate of vaccination remains below target. Additionally, many Virginians remain unvaccinated or have not maintained a booster schedule in line with recommendations. The current study investigated willingness to receive the flu and COVID-19 vaccines during the COVID-19 pandemic, associations between the likelihood of receiving the two vaccines, and differences in uptake by racial group and insurance status. Methods. Participants were adult patients seen for appointments at an ambulatory clinic in Southeast, VA. Participants completed a questionnaire assessing vaccination history and future vaccination intentions. Results. Results revealed significant associations between having received …

Policy Forum: The Tobacco Surcharge & Sugar-Sweetened Beverage Taxes: Reconciling Equity And Targeted Public Health Interventions, Ben Barber

Virginia Journal of Public Health

Virginia is poised to repeal the tobacco surcharge, an ineffective policy that disproportionately harms low- and middle-income Virginians. (Small, 2023) The Patient Protection and Affordable Care Act (ACA), which otherwise strengthened health care access and equity, allows health insurers in the individual and small-group markets to charge smokers up to 50 percent higher premiums relative to nonsmokers. (ACA, 2010) The law’s financial assistance does not apply to this surcharge, forcing enrollees to bear the entire cost of the penalty. This provision was a compromise between the ACA’s drafters, most of whom opposed the surcharge, and the health insurance industry, which …

An Examination Of Dyadic Diabetes Self-Management Education For Patients And Care Partners: A Scoping Review, Jessica L. Tucker

Honors Theses

Diabetes self-management education and support (DSMES) programs are crucial in equipping individuals with the necessary knowledge and skills. Involving care partners in diabetes management acknowledges that it is a collaborative effort within a social context, emphasizing the importance of integrating care partners into educational interventions. This approach offers benefits like emotional and practical support, shared responsibility in managing diabetes, enhanced treatment adherence, and improved communication.

To understand this concept better, this review's objectives are defining dyadic relationships, exploring implementation logistics, and assessing program outcomes and limitations to inform future research and program development.

This study revealed inconsistent terminology and definitions …

Ethical Considerations Of Clinical Research In Emergency Care Settings: A Review, Adith Velavan

Honors Scholar Theses

Emergency and acute care settings are some of the most volatile and high intensity areas of any healthcare operation. Better understanding of systems and treatments in these spaces are critical to improving outcomes for the high risk patients that are treated there. Clinical research serves as a cornerstone of modern medical research, and is critical to the further improvement of clinical care in these settings. This thesis serves to explore the ethicality of such research given the constraints of emergency medicine settings. Not only does this thesis provide a strong foundation regarding the history and current practices of clinical research, …

Possible Role Of Caffeine In Nicotine Use Onset Among Early Adolescents: Evidence From The Young Mountaineer Health Study Cohort, Alfgeir L. Kristjansson, Steven M. Kogan, Michael J. Mann, Megan L. Smith, Christa L. Lilly, Jack E. James

Public and Population Health Faculty Publications and Presentations

Background

Preventing nicotine use onset among children and youth is an important public health goal. One possible contributor that has received little empirical investigation is caffeine use. The goal of this study was to examine the possible contribution of caffeine to nicotine onset during early adolescence.

Methods

We used data from the Young Mountaineer Health Study Cohort. Survey data were collected from 1,349 (response rate: 80.7%) 6^th grade students (mean age at baseline 11.5 years) in 20 middle schools in West Virginia during the fall of 2020 and spring of 2021. We limited our analyses to students reporting never …

Human Trafficking And Nutrition: Assessing The Effects Of U.S. Public Policy On Food Security And The Malnourishment Of Refugees, Moxie R. Mccandless

Honors Projects

This research paper aims to assess the challenges associated with human trafficking within the lived experience of refugees, specifically focusing on food security, and the resulting system shaped by existing United States policies and programs. By examining this complex relationship, the study seeks to shed light on the influence of power dynamics on fulfilling basic human needs and to propose more effective strategies for improving food security among marginalized populations.

A comprehensive literature review is conducted, and a community nutrition needs assessment is performed in King County, Washington. Qualitative interviews are conducted with human trafficked organizations, government officials, and experts …

Home Oxygen And Monitoring For Covid-19 Patients: A Multidisciplinary Team Approach, Mahta Salehi, Shehrose Chaudry, Rebecca B. Newman, Josette Hartnett, Suzanne J. Rose, Forugh Homayounrooz

Journal of Community Hospital Internal Medicine Perspectives

Introduction: During the initial COVID-19 pandemic peak, Stamford Hospital implemented a home oxygen program (HOP) to create a comprehensive, multi-disciplinary outpatient initiative without sacrificing a safe discharge. Primary care physicians monitored program participants, whose only indication for remaining admitted was an oxygen requirement. We retrospectively examined participant co-morbidities and outcomes, including death and readmission rates to evaluate HOP safety.

Methods: A retrospective analysis of program participants discharged between April 2020-Janurary 2021 was performed. Variables included demographics, oxygen requirement, days enrolled in the HOP, and major comorbidities such as cardiovascular disease (CVD), diabetes (DM), hypertension (HTN), obesity, chronic kidney disease, malignancies …

How Medical Cannabis Took Root In Mississippi, Loral Winn

Honors Theses

How Medical Cannabis Took Root in Mississippi

(Under the direction of Dr. Iveta Imre)

How Medical Cannabis Took Root in Mississippi is a multimedia journalism piece that follows the timeline of medical cannabis’ legalization in Mississippi through the lives and lenses of characters from each sector of the medical marijuana industry. Written in a journalistic style with hints of narrative methods, the article tells the story of medical cannabis advocates, current patients, state registered practitioners, dispensary owners and employees, and a family-owned cultivation facility while also providing concrete evidence and facts about the legislation and regulations included in the state’s …

Calculating Risk: A Scoping Review Of Ncaa D1 Football Players’ Motivations To Play And The Correlation To Demographic Characteristics And Injury Experiences, Kathleen D. Walsh

Honors Theses

The purpose of this research was to investigate the motivations of National Collegiate Athletic Association (NCAA) Division 1 (D1) football players for playing the game and how these motivations are associated with their socioeconomic status (SES). Further, the research aimed to investigate how the uncovered motivations were linked to injury experiences. The original project was designed as a survey-based mixed methods study on a national scale. However, issues with participant recruitment led to sidelining of that primary research. The research presented is a scoping review of the available literature pertaining to the research question: What is known from existing literature …

Understanding Home Visitor Attendance At Well Child Checks: A Mixed Methods Study, Rachel Segal, Sommer Rose, Marcia Dutcher, Tyler Myroniuk, Mary Moffatt, James Anderst

Research Days

Background: Early childhood home visiting programs have variable outcomes on child health across models and studies. Given this variability, novel approaches are needed to foster consistent positive outcomes. One approach is attendance of a home visitor (HV) at medical provider well child checks (WCCs) to provide a stronger link between home visiting and the medical home. This process may be assessed in an exploratory study evaluating the qualitative perceptions and initial quantitative effects of the intervention.

Objectives/Goal: Qualitatively explore perspectives of HVs attending WCCs and quantitatively evaluate effects of the practice on (1) family compliance with American Academy of Pediatrics …

Perspectives On Non-Prescription Antibiotic Use Among Hispanic Patients In The Houston Metroplex, Lindsey Laytner, Patricia Chen, Susan Nash, Michael K Paasche-Orlow, Richard Street, Roger Zoorob, Barbara Trautner, Larissa Grigoryan

Faculty, Staff and Students Publications

BACKGROUND: Non-prescription antibiotic use includes taking an antibiotic without medical guidance (e.g., leftovers, from friends/relatives, or purchased without a prescription). Non-prescription use contributes to antimicrobial resistance, adverse drug reactions, interactions, superinfection, and microbiome imbalance. Qualitative studies exploring perspectives regarding non-prescription use among Hispanic patients are lacking. We used the Kilbourne Framework for Advancing Health Disparities Research to identify factors influencing patients' non-prescription use and organize our findings.

METHODS: Our study includes Hispanic primary care clinic patients with different types of health insurance coverage in the Houston metroplex who endorsed non-prescription use in a previous survey. Semistructured interviews explored the factors …

5-Prong Approach Taken By Tsu College Of Pharmacy And Health Sciences To Mitigate Covid-19, Zuri Dale, Rashid Mosavin, Cynthia Johnson

COVID Research

The TSU COVID-19 Implementation and Response White Paper outlines Texas Southern University's (TSU) multifaceted approach to managing the COVID-19 pandemic, led by the College of Pharmacy and Health Sciences (COPHS). The initiative, focused on the safety of the TSU community, included creating a COVID Prevention Center (CPC) to enhance collaboration, public health adherence, and campus-wide surveillance.

Key Strategies:

1. Education and Communication: Weekly informational broadcasts, social media engagement, and an internal COVID guide aimed to inform the TSU community and counter vaccine hesitancy.
2. Integration and Coordination: Campus services were streamlined to improve communication and enhance response efficiency, with a comprehensive guide …

Detection Of Sars-Cov-2 Mutations In Vermillion, Sd, Wastewater Utilizing Probe-Based Rt-Qpcr, Matthew J. Schmitz

Honors Thesis

The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the subgenus Sarbecovirus, has presented numerous public health challenges for communities across the globe. As demonstrated by the Delta variant (B.1.617.2) and the recent Omicron variants, the virus can mutate and pose new risks for communities, such as reinfection, increased transmissibility, and variable mortality. As such, accurately monitoring the spread of specific variants has become a priority for public health agencies. However, clinical testing faces various limitations, and the increased use of at-home test kits inhibits surveillance. Wastewater-based epidemiology (WBE) can monitor infection rates of entire …

The Threat Of Hospital Wastewater: An Evidence-Based Call To Action, Ann P. Nguyen

DNP Qualifying Manuscripts

Introduction: Hospital wastewater carries a unique composition of pollutants, a burden that includes high chemical and biological residuals. These pollutants are discharged into sewage treatment plants and natural environments where they contaminate human water sources and larger ecosystems. Water treatment plants are not designed to treat the high loads of biomedical waste and persistent organic compounds found in hospital wastewater and therefore pollutants survive in conventionally treated water. Evidence of contaminated soil, municipal wastewater, surface water, ground water, and even drinking water have been demonstrated in studies conducted around the world highlighting the ubiquity of the problem. Hospital effluent as …

Cardiovascular Disease Prediction Modelling: A Machine Learning Approach, Usmaan Al-Shehab, Maduka Gunasinghe, Yousuf Elkhoga, Nimay Patel, Juliana Yang

Rowan-Virtua Research Day

The objective of this project is to utilize the UCI Heart Disease dataset to identify physiological biomarkers that are highly correlated with heart disease incidence. A predictive model can then be developed using these biomarkers to estimate the likelihood of someone having or developing a heart-related condition. This study compares the efficacy of predicting cardiovascular disease as an outcome using three machine learning algorithms: Support Vector Machine, Gaussian Naive Bayes, and logistic regression. Support Vector Machine works by creating hyperplanes between data points to conduct classification. Gaussian Naive Bayes works by using the conditional probabilities of events to classify the …

Differences Between Complementary And Alternative Medicine Use Among Chinese Immigrants, Emily Wang, Heet Patel, Jiexi Hu

Rowan-Virtua Research Day

Among Asian-American patients, complementary and alternative medicine is utilized at an exceedingly high rate alongside conventional medicine, due to it being more readily accessible and affordable. It is also a form of medicine that Asian people are more attuned to due to having been used for generations in their culture.1 Surveys conducted by Mackenzie et al., demonstrate that complementary and alternative medicine (CAM) is reportedly used at a higher rate in females of Asian descent and amongst uninsured patients as well as with patients of a lower educational status. 2 In addition, multiple studies have also demonstrated that patients suffering …

The Correlation Between Serum C-Reactive Protein Level And Risk Of Future Cardiovascular Disease: A Neurodivergent Population Dilemma, Brandon Cunha, Andrea Iannuzzelli, Venkateswar Venkataraman

Rowan-Virtua Research Day

Extensive research on neurotypical (NT) populations has demonstrated that a chronically elevated level of serum C Reactive Protein (CRP) is a strong predictor of future cardiovascular disease (CVD). Interestingly, many neurodivergent (ND) populations experience chronically elevated CRP levels higher than NT controls. Current research is concerned with establishing the significance of this relationship to accurately predict CVD risk for potentially at risk ND patients. To contribute to this gap in knowledge, the Rowan-Virtua Regional Integrated Special Needs (RISN) Center patient population will be studied to identify trends in baseline serum CRP levels across a multitude of ND conditions. A clinical …

What More Can Be Done? Childhood Obesity In Glassboro, Nj, N. Mirmanesh, Seth Spicer, Stephen Acheampong, Mary K. Duggan

Rowan-Virtua Research Day

Childhood obesity is a growing public health concern in the United States, with an estimated 20% of American children being obese. In New Jersey (NJ), 9% of high school students are obese, and there are disparities in obesity rates based on gender, sexual identity, and race/ethnicity. In Gloucester County, NJ, limited data is available on childhood obesity rates, but 36.4% of adults are obese, and lower SES is related to higher rates of obesity in youth. To address this issue, this research poster proposes a partnership with the Boys and Girls Club of Glassboro to provide nutritional resources and create …

Barriers To Colorectal Cancer Screening For Low-Income Hispanic Men In Urban Areas Between 50-75, Alex Vega

Rowan-Virtua Research Day

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States. Although CRC screening rates have improved in non-Hispanic whites (NHW), Hispanic adult males (HAM) aged 50-75 in urban areas continue to experience low screening rates and higher CRC morbidity and mortality. This review aims to identify the barriers to CRC screening among HAM and propose targeted interventions to increase screening rates. A comprehensive literature review was conducted using databases such as PubMed, Scopus, and Google Scholar. Key search terms included "colorectal cancer", "screening", "Hispanic adult males", "urban", "barriers", and "interventions". Factors identified include poverty, language …

Improving Access To Community Resources For Mothers In Southern New Jersey, Ariana Blake, Josalynn Maree, Nayarith Lopez, Vanessa Pizutelli

Rowan-Virtua Research Day

Maternal mortality rates have skyrocketed across the nation. New Jersey specifically has one of the highest rates across all 50 states. According to the New Jersey Maternal Health Report, southern New Jersey has the highest maternal mortality ratio, with 91% of the maternal deaths throughout New Jersey between 2016-2018 being preventable. It is crucial that families are receiving support during pregnancy and postpartum from the health care system and their community in order to reduce this trend. Acenda Integrated Health’s Connecting NJ aims to provide community support by connecting expectant mothers and families with children under the age of 3 …

Food Insecurity And Dietary Restrictions, Courtney Williams, Savana Rodriguez, Tiffany Guerrero, Stephen Acheampong, Vanesa Pizutelli

Rowan-Virtua Research Day

According to the USDA Food Insecurity affects around 10.2 percent of the US population as of 2021. For families that have members with certain dietary restriction such as, but not limited to diabetes, hypertension, gluten intolerance, lactose intolerance, and food allergies, the challenge of securing food becomes an even greater burden with having to navigate food banks or discount stores that may not offer food items that meet their dietary requirements. Families with dietary restrictions often face greater food insecurity and less access to food. More research is needed to understand the challenges families with dietary restrictions face regarding food …

Healthcare Disparities In The Lgbtqia+ Community: A Scoping Review Of Community Vs Provider Experiences, Uttara Hardikar, Alisha Vincent, Venkateswar Venkataman, Millicent Channell

Rowan-Virtua Research Day

Background: It is well-established that healthcare disparities exist in the LGBTQIA+ community. The divide is a growing concern exacerbated by recent changes in the healthcare and sociopolitical climate. To eliminate this divide and find ways to deliver better outcomes to the LGBTQIA+ is a dire need. This report analyzes the possible reasons from the community as well as the providers perspective, with a goal to find best practices that could be implemented in both components.

Methods: A scoping literature review was carried out as described below to collect perspectives from both sides: patients as well as providers.

Results: From patient …

Challenges To Implementing Screening, Brief Intervention, And Referral To Treatment (Sbirt) For Substance Use In Primary Care Settings At Rowan-Virtua, Alissa Hochman, Kristy Straub, Nancy Chase, Samuel Damiri, Jenna Destefano, Allyson Distel, Sana Farhat

Rowan-Virtua Research Day

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers …