Public Health Commons^™

4-H Student Nutrition Advisory Councils Support Positive Youth Development And Health Outcomes Among Underserved Populations, Shannon Klisch, Katherine E. Soule

Journal of Extension

4-H SNAC Clubs engage youth in low-income schools with majority Latinx enrollment in leadership activities to increase schoolwide health and wellness. 4-H SNAC Clubs aim to develop youth health leaders, establish youth-adult partnerships, and increase access to 4-H in Latinx communities. Outcomes related to healthful living and positive youth development were assessed using the Teen Teacher Retrospective Survey (n=59) across five 4-H SNAC Clubs. Results show positive outcomes related to self-reported health behaviors for students and their families and leadership development. 4-H SNAC Clubs can increase access to 4-H among Latinx youth and support healthier communities through the Supplemental Nutrition …

Engaging Rural High School Youth In E-Cigarette Prevention And Advocacy, Melinda J. Ickes, Olivia Zidzik, Nathan L. Vanderford

Journal of Interprofessional Practice and Collaboration

Introduction: Recent national data reinforce over 3.6 million young people across the United States are currently using e-cigarettes, but little research exists on prevention and/or youth engagement strategies.

Purpose: Pilot a peer led e-cigarette prevention and advocacy training and determine attitudes and self-efficacy among participating rural high school leaders post-training.

Methods: The study incorporated a one-group, post-test design. Participants were recruited from an existing student leadership program (N = 16) which provides advanced cancer education and training to high school students who are from Appalachian Kentucky who participated in an e-cigarette prevention and empowerment training in December 2019. Data …

Pulmonary Inflammation And Injury Triggered By Spine Surgery In Recovered Covid-19 Patients Demand Consideration, Luciano Rodrigo Lopes, Silvana Kertzer Kasinski

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Living Environment Considerations On Obesity Prevention Behaviors And Self-Efficacy Among Chinese Americans, Doreen Liou, Jessica A. Karasik

Department of Nutrition and Food Studies Scholarship and Creative Works

The aim of this study is to ascertain if the living environment (type of residential neighborhood and number of household members) will elucidate differences in obesity risk reduction behaviors and self-efficacy in Chinese Americans. A cross-sectional survey design was used to recruit participants from Los Angeles County and New York City metropolitan areas. A total of 650 adults were recruited from diverse socioeconomic backgrounds. Descriptive statistics were measured for 19 behaviors reflecting food intake and portion size control and items measuring self-efficacy and attitudes. T-tests were applied for the two categories of living environment. The mean age of the sample …

Simulated Wildfire Smoke Significantly Alters Sperm Dna Methylation Patterns In A Murine Model, Adam Schuller, Chiara Bellini, Timothy G. Jenkins, Matthew Eden, Jacqueline Matz, Jessica Oakes, Luke Montrose

Public and Population Health Faculty Publications and Presentations

Wildfires are now a common feature of the western US, increasing in both intensity and number of acres burned over the last three decades. The effects of this changing wildfire and smoke landscape are a critical public and occupational health issue. While respiratory morbidity due to smoke exposure is a priority, evaluating the molecular underpinnings that explain recent extrapulmonary observations is necessary. Here, we use an Apoe^−/− mouse model to investigate the epigenetic impact of paternal exposure to simulated wildfire smoke. We demonstrate that 40 days of exposure to smoke from Douglas fir needles induces sperm DNA methylation changes …

Addressing Distress Management Challenges: Recommendations From The Consensus Panel Of The American Psychosocial Oncology Society And The Association Of Oncology Social Work, Teresa L. Deshields, Sharla Wells-Di Gregorio, Stacy R. Flowers, Kelly E. Irwin, Ryan Nipp, Lynne Padgett, Brad Zebrack

Family Medicine Faculty Publications

Distress management (DM) (screening and response) is an essential component of cancer care across the treatment trajectory. Effective DM has many benefits, including improving patients’ quality of life; reducing distress, anxiety, and depression; contributing to medical cost offsets; and reducing emergency department visits and hospitalizations. Unfortunately, many distressed patients do not receive needed services. There are several multilevel barriers that represent key challenges to DM and affect its implementation. The Consolidated Framework for Implementation Research was used as an organizational structure to outline the barriers and facilitators to implementation of DM, including: 1) individual characteristics (individual patient characteristics with a …

Cost-Effectiveness Analysis Comparing Integrated And Malaria-Only Social And Behavior Change Programming In Nigeria: Initial Costing Data, Avenir Health

Sexual and Reproductive Health, Rights, and Choices

Breakthrough RESEARCH is conducting an effectiveness evaluation of social and behavior change (SBC) programming implemented by Breakthrough ACTION in Nigeria, comparing an integrated SBC program in Kebbi and Sokoto states with a malaria-only SBC program in Zamfara state. Using these results on impact, a cost-effectiveness analysis will determine which approach is more cost-effective in achieving improvements in health. This report presents estimated costs for the initial stage of the project, from April 2018 through December 2019, in the three northern states where the study is being conducted.

Duration Of Cessation Of Smoking Before Elective Surgery: Impact On Intraoperative Hemodynamics And Early Postoperative Pain In Developing Country, Mohsin Nazir, Gauhar Afshan, Muslima Ejaz, Amir Raza

Department of Anaesthesia

Aim and Background: It is estimated that up to 20% of patients coming for elective surgery are smokers and carry a risk of perioperative complications. Though smoking cessation and its impact on perioperative outcome are widely investigated worldwide we were unable to find any data in Pakistan. The objective of the study is to determine the impact of the duration of smoking cessation before elective surgery on intraoperative hemodynamics and postoperative pain in Pakistani population.
Methods: It was a prospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan, for one-year duration. A total of 260 patients scheduled …

Facilitating Aging In Place And Community By Empowering Participation In Society: A Mixed Methods Study On The Co-Development Of A Theory Of Change With Suburban-Dwelling Older Adults, Emily Balog

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: Baby boomers are steadily aging in America and represent an increased population in nearly every sector. In suburban communities today, older adults make up 51% of the population. Ninety-five percent of all older adults live in community settings and have expressed a desire to avoid costly institutionalization and to remain in their homes and communities, also called aging in place. Older adults in moderate income suburban communities are increasingly at a higher risk for institutionalization should their health or finances decline as the access to their wealth is within the home in which they dwell. This process …

Theoretical Mediators Of Diabetes Risk And Quality Of Life Following A Diabetes Prevention Program For Latino Youth With Obesity, Erica G Soltero, Stephanie L Ayers, Marvyn A Avalos, Armando Peña, Allison N Williams, Micah L Olson, Yolanda P Konopken, Felipe G Castro, Kimberly J Arcoleo, Colleen S Keller, Donald L Patrick, Justin Jager, Gabriel Q Shaibi

Children’s Nutrition Research Center Staff Publications

Purpose: This study tested self-efficacy and social support for activity and dietary changes as mediators of changes in type 2 diabetes related outcomes following a lifestyle intervention among Latino youth.

Setting and intervention: Latino adolescents (14-16 years) with obesity (BMI% = 98.1 ± 1.4) were randomized to a 3-month intervention (n = 67) that fostered self-efficacy and social support through weekly, family-centered sessions or a comparison condition (n = 69).

Measures: Primary outcomes included insulin sensitivity and weight specific quality of life. Mediators included self-efficacy, friend, and family social support for health behaviors. Data was collected at baseline, 3-months, 6-months, …

Risk Factors Leading To Pulmonary Exacerbation In Patients With Cystic Fibrosis: A Systematic Review, Danish Abdul Aziz, Syeda Khadija Fatima, Hasan Nawaz Tahir

Department of Paediatrics and Child Health

Objective: To ascertain major risk factors associated with pulmonary exacerbation and pulmonary function decline in cystic fibrosis.
Methods: The systematic review was conducted at Aga Khan University, Karachi, in September 2018, and comprised electronic search of PubMed, Ovid, Science Direct and Cumulative Index of Nursing and Allied Health Literature databases of studies conducted from January 1990 to September 2018 which were categorised into 3 sets; 1990-98, 1999-2007 and 2008-18. Studies included for review focussed on articles with pulmonary exacerbation as the health outcome indicator, and had diagnosis of cystic fibrosis as the inclusion criteria, while risk factors were the exposure …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Food Deserts: Hungry For Answers, Lawren Cumberbatch

Symposium of Student Scholars

In 2010, the United States Department of Agriculture (USDA) reported that 23.5 million people in the United States live in food deserts. As defined by the USDA, a “food desert” is a neighborhood that lacks healthy food sources. This can be measured by distance to a store, number of stores in an area, individual-level resources such as family income or vehicle availability, and neighborhood-level resources such as availability of public transportation. Past research provides evidence that food deserts are especially likely to occur in communities heavily populated by minorities. As a Black Indian pre-med student aiming to join the world …

Impact Of Covid-19 On Health Disparities In The United States - A Preliminary Study, Alina Panjwani

Symposium of Student Scholars

Health disparities are the differences in health outcomes and health status among people belonging to different groups. This means that people with low socioeconomic status, old age, racial and ethnic minorities, who are often those with limited access to healthcare may often face a higher disease burden and experience worse health outcomes. The current pandemic of Coronavirus 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, provides a painful reminder of why inequities harm all of us as the devastating impact of the pandemic is apparent. This paper examines the differences in and possible cause of the rates of COVID infections, …

Examining The Relationship Between African-Americans And Their Physicians, Genesis Weever

Symposium of Student Scholars

For years, there has been a bad history amongst the relationship between African-Americans and their fellow medical institutions. Many African-Americans do not believe that medical professionals have their best interest at heart. Oftentimes, their white counterparts may receive better care, even when they have the same condition. Many African-Americans may even face barriers that their white counterparts will not experience, and will be denied access to healthcare. This results in more deaths and critical illnesses of African-Americans. In order to discover the underlying problem and a possible solution, a review of the literature was initiated. Using a literature matrix and …

Genetic Testing Reveals Germline Mutations Among Patients Undergoing Surgery For Colorectal Carcinoma In A Community Hospital Setting, Alex R. Jones, Dana Greer Rn, Bsn, Ocn, Karin L. Cole Md

Journal of Maine Medical Center

Introduction: Defined germline mutations contribute to 5% to 10% of cases of colorectal carcinoma (CRC). While protocols for universal tumor screening have been adopted to detect mismatch repair (MMR) protein deficiency, widespread multigene panel testing has not been achieved. Barriers to implementing testing protocols may occur in community settings.

Methods: A total of 160 patients presenting for surgical management of CRC between 2011 and 2020 were considered for retrospective analysis in a single-surgeon, single-institution, community-based cohort. The rate of multigene panel testing and prevalence of germline mutations were calculated, and patient characteristics were assessed.

Results: A total of 32/160 (20%) …

Perceptions Of Maine Health Care Providers On Youth Tobacco Use And Prevention Efforts, Titilola Balogun, Toho Soma, Liam O'Brien

Journal of Maine Medical Center

Introduction: Tobacco use causes preventable morbidity and mortality, and leads to high medical costs annually. In Maine, both cigarette and electronic cigarette (e-cigarette) use among high school students are higher than the national average. To what extent Maine health care providers are familiar with tobacco use prevention is unknown. We aimed to describe the knowledge, attitudes, and practices of Maine health care providers regarding youth tobacco use. We also determined what preventive services they provide, and measured their self-efficacy regarding screening and counseling for tobacco use.

Methods: In this cross-sectional study, health care providers were surveyed about their knowledge, attitudes, …

Breathing Wildfire Smoke Can Affect The Brain And Sperm, As Well As The Lungs, Luke Montrose, Adam Schuller

Public and Population Health Faculty Publications and Presentations

Wildfires burning in the western U.S. are sending smoke into communities far from the fires themselves, creating hazardous air for days or weeks at a time. A lot of people are wondering: What does breathing all that smoke do to our bodies?

Wildfire smoke is a mix of chemicals and tiny particles that are small enough to evade the body’s defenses and directly affect the lungs. But the damage may not stop there.

As environmental toxicologists, we have been investigating the health effects of wildfire smoke on humans, including on parts of the body that you might not expect: sperm …

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

A 10-Year Post-Analysis Of The Maya Health Toolkit For Medical Providers, Lorenna Garcia-Bochas

Master of Science in Integrative Biology Theses

Researchers have often overlooked America's Indigenous community when conducting health disparities research. In Central and South America, The World Bank 2015 report identifies 774 indigenous groups living today (Davis-Castro, n.d.). One of the oldest known is the Maya people. The Maya have been through various cultural struggles, from the Spanish conquistadors of the past to current anti-indigenous discrimination, violence, and rhetoric. The historical conflict and prejudice have contributed to why many Maya migrate north to the United States for a better opportunity and a more peaceful life for their families. In doing so, they face many health risks to their …

Disparities In Covid-19 Rates Among Various Demographics And Lack Of Racial Representation In Medical Texts, Diangelo Gonzalez

Celebration of Learning

The 2019 novel coronavirus (COVID-19) outbreak, which originated in Wuhan, China in December of 2019, has impacted nations all over the globe. Given the health disparities which existed within the United States prior to the COVID-19 pandemic, this pandemic continued to pose a significant challenge to the health of the public. The aims of this research study were twofold: (1) to analyze the incidence rates of COVID-19 among different racial and ethnic groups within the United States and (2) to describe the occurrence of diversity within medical texts. Overall, the COVID-19 pandemic exacerbated health disparities within the United States. Understanding …

Environmental Scan Of Primary Care Needs In The Last Decade (2010-2020), Ravninder Bahniwal

Family Medicine Publications

No abstract provided.

Why Should People Use Face Masks In The Time Of Covid? The Jri Position, Jose Bordon, Alex Glynn, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mindfulness-Based Cognitive Therapy Staff Training Program To Tackle Postpartum Depression, Helen Xumin Chen

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: Women in the process of childbirth go through significant physical and psychological changes. The internal changes along with other external factors can be overwhelming. There is a high rate of new mothers suffering from postpartum depression (PPD) as a result. Problem: High prevalence of PPD is a public health crisis. The condition has a negative impact on the mother-baby unit and the wellbeing of the whole family. Aside from the implications on the health of new mothers and babies, PPD is also costly to the economy. Methods: Mindfulness-Based Cognitive Therapy (MBCT) is a common and effective intervention for …

No Difference In Clinical Outcomes For African American And White Patients Hospitalized With Sars-Cov-2 Pneumonia In Louisville, Kentucky, Julio A. Ramirez, Stephen P. Furmanek, Thomas Chandler, Stephen S. Hanson, Dawn Balcom, Subathra Marimuthu, Sathya Krishnasamy, Jose Bordon, Rodrigo Cavallazzi, Amr Aboelnasr, Mahder A. Tella, William A. Mattingly, Ashley M. Wilde, Daisy Sangroula, Demetra Antimisiaris, Donghoon Chung, Guillermo Cabral, Gabino R Fernandez-Botran, Jiapeng Huang, Martin Gnoni, Ozan Akca, Paul Schulz, Phillip F. Bressoud, Priya Krishnan, Sally Suliman, William P. Mckinney, Bryan Moffett, Leslie A Wolf, Mark Burns, Alex Glynn, Ruth Carrico, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Current literature indicates that African American individuals are at increased risk of becoming infected with the SARS-CoV-2 virus and suffer higher SARS-CoV-2-related mortality rates. However, there is a lack of consensus as to how the clinical outcomes of African American patients differ from those of other groups. The objective of this study was to define the clinical outcomes of African American and White hospitalized patients with SARS-CoV-2 community-acquired pneumonia (CAP) in Louisville, Kentucky.

Methods: This was a retrospective cohort study of hospitalized patients with SARS-CoV-2 CAP at eight hospitals in Louisville, Kentucky. Severity of CAP at time of hospitalization …

Factors Associated With Voluntary Refusal Of Emergency Medical System Transport For Emergency Care In Detroit During The Early Phase Of The Covid-19 Pandemic, Nicholas E. Harrison, Robert R. Ehrman, Andrea Curtin, Damon Gorelick, Alex B. Hill, Erin Brennan, Robert Dunne

Urban Studies and Planning Faculty Research Publications

Importance
Emergency department (ED) and emergency medical services (EMS) volumes decreased during the COVID-19 pandemic, but the amount attributable to voluntary refusal vs effects of the pandemic and public health restrictions is unknown.

Objective
To examine the factors associated with EMS refusal in relation to COVID-19 cases, public health interventions, EMS responses, and prehospital deaths.

Design, Setting, and Participants
A retrospective cohort study was conducted in Detroit, Michigan, from March 1 to June 30, 2020. Emergency medical services responses geocoded to Census tracts were analyzed by individuals’ age, sex, date, and community resilience using the Centers for Disease Control and …

The Double Burden Of Malnutrition And Associated Factors Among South Asian Adolescents: Findings From The Global School-Based Student Health Survey, Sara Estecha Querol, Romaina Iqbal, Laura Kudrna, Lena Al-Khudairy, Paramijit Gill

Community Health Sciences

The health and nutrition of the global adolescent population have been under-researched, in spite of its significant size (1.2 billion). This study investigates the prevalence and associated factors of malnutrition (stunting, thinness and overweight) among adolescents living in South Asia. The sample analysed was 24,053 South Asian schooled adolescents aged 12-15 years that participated in the cross-sectional Global School-Based Student Health Survey (GSHS) between 2009 and 2016. The prevalence of stunting, thinness and overweight was calculated using the World Health Organization (WHO) Child Growth Reference 2007. Associations between the three forms of malnutrition and their possible associated factors were assessed …

Strongyloides Stercoralis Hyperinfection And Disseminated Tuberculosis, Hernan Terroba, Alejandra González, Diana Vera Gonzalez, Roxana Mariela Godoy, Analia Santos, Marisol Arrojo

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Does Supportive Supervision Intervention Improve Community Health Worker Knowledge And Practices For Community Management Of Childhood Diarrhea And Pneumonia? Lessons For Scale-Up From Nigraan And Nigraan Plus Trials In Pakistan, Wafa Aftab, Suneel Piryani, Fauziah Rabbani

Community Health Sciences

Background: Lack of programmatic support and supervision is one of the underlying reasons of the poor performance of Pakistan's Lady Health Worker Program (LHWP). This study describes the findings and potential for scale-up of a supportive supervision intervention in two districts of Pakistan for improving LHWs skills for integrated community case management (iCCM) of childhood diarrhea and pneumonia.
Methods: The intervention comprised an enhanced supervision training to lady health supervisors (LHSs) and written feedback to LHWs by LHSs, implemented in Districts Badin and Mirpur Khas (MPK). Clinical skills of LHWs and LHSs and supervision skills of LHSs were assessed before, …

Focused Ethnography: Storytelling For Hispanics With Low Health Literacy And Diabetes, Virginia H. Cadenhead

Nursing Theses and Dissertations

Background: Storytelling is an intervention for health communication that has many forms, addresses varied health issues, and is suitable for low health-literate populations. Storytelling can impact knowledge, behaviors, attitudes, and health outcomes. Population Focus: Fictional storytelling has not been researched as an educational adaption in diabetes self-management for Hispanics with low health literacy. Forty-one percent of Hispanics in the United States have low health literacy, a contributing factor to poor health outcomes in chronic disease management. The Hispanic population has disproportional rates of diabetes complications. Research Question: How can short, fictional, orally presented stories be developed as culturally-adapted educational tools …