Public Health Commons^™

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Development Of Vaccines And Antivirals Against Zika Virus, Aryamav Pattnaik

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

The re-emergence of Zika virus (ZIKV), an arbovirus, poses a major global human health concern because of its ability to cause congenital abnormalities and neurological diseases. While many candidate vaccines and antiviral drugs are in the developmental pipeline, none have been approved for use against ZIKV infection. This dissertation describes the characterization of one vaccine and two antiviral drug candidates against ZIKV infection. A bacterial ferritin-based nanoparticle vaccine, termed zDIII-F, is designed to display multiple copies of ZIKV E protein domain III on its surface. These stable nanoparticles are shown to induce robust antibody-mediated protection against lethal ZIKV infection in …

Characterization Of Oral Cavity And Oropharyngeal Cancer In The Texas Rio Grande Valley, Jared A. Sperling, Rachel Giese

MEDI 9331 Scholarly Activities Clinical Years

Cancers of the oral cavity (OC) and oropharynx (OP) account for 3% of cancers diagnosed in the United States each year. A primary cause of death among the Hispanic population in the United States is cancer, accounting for 20% of annual mortality. The Rio Grande Valley (RGV) is a medically-underserved area of South Texas with a large Hispanic population facing health disparities. In this study, we examine the incidence and mortality of OC and OP cancer in the RGV. CDC population-level incidence and mortality rate per 100,000 of OC/OP cancer among patients in the RGV counties of Hidalgo and Cameron …

The Effect Of Nurse Case Coordination On Management Of Chronic Conditions, Aayush Mittal Ms-Hsm

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ishani A, Greer N, Taylor BC, et al. Effect of nurse case management compared with usual care on controlling cardiovascular risk factors in patients with diabetes: a randomized controlled trial. Diabetes Care. 2011;34(8):1689-1694. https://doi.org/10.2337/dc10-2121

for a patient requiring care coordination for management of hypertension, diabetes, and hyperlipidemia.

Microbial Science Research In The Post-Covid Environment, Nguyen K Nguyen, Carey-Ann D Burnham, Arturo Casadevall, Mary K Estes, Rebecca V Ferrell, Suzanne M J Fleiszig, Speakers, Moderators, And Panelists Of The Asm Virtual Symposium: Microbial Science Research In The Post-Covid Environment

Faculty, Staff and Students Publications

Since early 2020, the world has witnessed the unprecedented accomplishments of the scientific community in the fight against the coronavirus disease 2019 (COVID-19) pandemic. In the meantime, we also learned valuable lessons and recognized the challenges that hindered our successes. In this article, we synthesize the ideas discussed at the ASM Virtual Symposium: Microbial Science Research in the Post-COVID Environment on 10 November 2020. We propose three new approaches that microbiology researchers can embrace to overcome these challenges. Moreover, we suggest broad systematic changes to focus on social impacts, teamwork, and diversity, equity, and inclusion. We believe these values are …

“The Clementine Collective”: A Corner Store Intervention Of Clementine Fruits In A High Need Neighborhood In Staten Island, New York, Heather Butts

Faculty of Health Care & Public Administration Publications

Individuals living in underserved neighborhoods face significant barriers to getting fresh produce. It has been extensively researched that providing individuals with fresh fruits and vegetables can have a positive physical and mental impact on the lives of individuals in underserved neighborhoods and the lives of their families. Unfortunately, individuals who reside in such neighborhoods are often viewed as not being motivated to consume fresh fruits and vegetables, even where barriers to eating such foods are removed. This study aims to determine whether, in the COVID-19 era, individuals in underserved neighborhoods would consume fresh fruits if presented with them in an …

Personal Mastery And All-Cause Mortality Among Older Americans Living With Diabetes, Ho-Jui Tung, Ming-Chin Yeh, Randall Ford, Gulzar H. Shah

Health Policy & Community Health: Faculty Publications

Introduction: Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time.
Methods: A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.
Results: A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery …

Perceived Benefits Matter The Most In Covid-19 Preventive Behaviors: Empirical Evidence From Okara District, Pakistan, Gulzar H. Shah, Ansar Ali Faraz, Hina Khan, Kristie Cason Waterfield

Health Policy & Community Health: Faculty Publications

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a faceto- face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara …

Helmet Wearing Saves The Cost Of Motorcycle Head Injuries: A Case Study From Karachi, Pakistan, Asrar Ali, Muhammad Ashar Malik, Uzma Rahim Khan, Umerdad Khudadad, Ahmed Raheem Buksh, Adnan A. Hyder

Department of Emergency Medicine

Purpose: To estimate the difference in healthcare cost of head injuries among motorcycle helmet users and non-users.
Methods: Motorcycle crash victims with head injuries that were brought to a public, tertiary care emergency room in Karachi were studied through a descriptive cross-sectional design. A standard questionnaire was used to collect data on demographics, injury pattern, helmeting practice, length of hospital stay, out-of-pocket payments (OOPs), and healthcare service utilization at the facility to estimate total healthcare and other costs applying micro-costing methods during the hospitalization period.
Results: A total of 323 motorcyclists involved in crash were brought to a public tertiary …

Variations In Regulations To Control Standards For Training And Licensing Of Physicians: A Multi-Country Comparison, Wafa Aftab, Mishal Khan, Sonia Rego, Nishant Chavan, Afifah Rahman-Shepherd, Isha Sharma, Shishi Wu, Zahra Zeinali, Rumina Hasan, Sameen Siddiqi

Community Health Sciences

Background: To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine.
Methods: We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical …

Student Loans And Health-Related Financial Hardship, Sophia T. Anong, Robin Henager

Journal of Student Financial Aid

Research has shown that student loan borrowers in repayment exhibit physical and mental health problems. These can be exacerbated by and contribute to health-related financial hardship. We use the 2015 U.S. National Financial Capability Study to examine the likelihood of having past due medical bills and of avoiding health care services by not purchasing prescribed medication, skipping tests or follow-up with a doctor or not seeking care for a medical problem. Borrowers on income-driven repayment plans and those who made late payments are found to be more likely to have unpaid medical bills and to have avoided required medical attention. …

Frequency And Risk Factors Of Non-Alcoholic Fatty Liver Disease In Helicobacter Pylori-Infected Dyspeptic Patients: A Cross-Sectional Study, Basit Siddiqui, Muhammad Kamran, Shiyam Sunder Tikmani, Rabeea Azmat, Zain Mushtaq, Saad Bin Zafar Mahmood, Muhammad Tahir Khan, Javed Yakoob, Zaigham Abbas

Section of Gastroenterology

Background: In dyspeptic patients with Helicobacter pylori contributes to non-alcoholic fatty liver disease. However, little evidence available from Pakistan.
Objective: The study aims to determine the frequency and risk factors of non-alcoholic fatty liver disease in dyspeptic patients with Helicobacter pylori.
Methods: This cross-sectional study was conducted between 22 November 2016 and 30 June 2018. Adults of age between 18 and 90 years who attended the out-patient department due to abdominal discomfort, pain, fullness, and bloating who underwent upper gastrointestinal tract endoscopy were enrolled after taking informed consent. Patients with celiac disease, inflammatory bowel disease, taking alcohol, pregnant women …

Hr Wellness Programs At Ohiohealth Wellness Department, Yuanze Ma

Masters Theses/Capstone Projects

Goals of this project include learning and practicing related clinical skills, develop work based thinking method, gain clinical knowledge of workplace wellness programs, and expanding knowledge on program’s implementation and improvement, analyze existing programs and challenge me with innovation, learning how wellness program practice during a special environment (epidemic), learning and gain leadership skill through the process, expending vision and formulating future career plans.

There were positive and negative outcomes of this experience. I have learned the wellness program implementation and helped with several programs design and operations. I have gained leadership skills from involving in meeting discussions. I have …

Association Of Ultra-Processed Food Intake With Risk Of Inflammatory Bowel Disease: Prospective Cohort Study, Neeraj Narula, Emily C L. Wong, Mahshid Dehghan, Andrew Mente, Sumathy Rangarajan, Fernando Lanas, Patricio Lopez-Jaramillo, Priyanka Rohatgi, P V M. Lakshmi, Romaina Iqbal

Community Health Sciences

Objective: To evaluate the relation between intake of ultra-processed food and risk of inflammatory bowel disease (IBD).
Design: Prospective cohort study.
Setting: 21 low, middle, and high income countries across seven geographical regions (Europe and North America, South America, Africa, Middle East, south Asia, South East Asia, and China).
Participants: 116 087 adults aged 35-70 years with at least one cycle of follow-up and complete baseline food frequency questionnaire (FFQ) data (country specific validated FFQs were used to document baseline dietary intake). Participants were followed prospectively at least every three years.
Main outcome measures: The main outcome was development of …

Postsecondary Educational Attainment And Health Among Younger U.S. Adults In The “College-For-All” Era, Anna Zajacova, Elizabeth Lawrence

Sociology Faculty Research

Population-health research has neglected differentiation within postsecondary educational attainments. This gap is critical to understanding health inequality because college experience with no degree, vocational/technical certificates, and associate degrees may affect health differently. We examine health across detailed postsecondary attainment levels. We analyze data on 14,750 respondents in Waves I and IV of the nationally representative Add Health panel spanning adolescence to ages 26 to 34. Multivariate regression and counterfactual approaches to minimize the impact of confounders estimate multiple health outcomes across postsecondary attainment levels. Compared to high school diplomas, we find significant returns to bachelor’s degrees for most health outcomes …

The Use Of Mobile Apps To Increase Physical Activity Level: A Systematic Review, Dziyana Nazaruk, Kelli Rouser

Health Policy & Community Health: Faculty Publications

Background: About 82% of the U.S. adult population owns a smartphone. More than half of that population downloaded a fitness or health app to increase the physical activity level. The current review included studies that have utilized mobile apps in conjunction with other intervention strategies to increase physical activity levels. Methods: The search was conducted in five electronic databases. Studies were included if they were randomized controlled trials, utilized mobile apps, physical activity was the primary outcome, written in English, and conducted between the years of 2007 and 2019. Results: Thirteen studies were included in the final review. Results indicated …

Exploring The Perceived Barriers And Benefits Of Physical Activity Among Wounded, Injured, And/Or Sick Military Veterans, Robert Walker, Caroline Limbert, Paul M. Smith

Journal of Social, Behavioral, and Health Sciences

Wounded, injured, and/or sick (WIS) military veterans face significant physical and psychosocial challenges following discharge from service. Physical activity can have many positive effects on the holistic wellbeing of such individuals. However, little knowledge exists regarding the perceived barriers and benefits of physical activity within this population, creating challenges surrounding physical activity promotion. Therefore, this study was designed to identify key barriers and benefits among this population, so that informed approaches to encourage participation in physical activity can be developed. A questionnaire related to the perceived barriers and benefits of physical activity was completed by 105 WIS British military veterans. …

The Digital Divide And Health: Examining Digital Access As A Social Determinant Of Health, Elizabeth Melissa Withers

Dissertations and Theses

This dissertation is comprised of three papers that consider ways in which one's level of digital access may impact self-rated health. Data are from multiple years of three separate nationally representative cross-sectional surveys: National Health Interview Survey, General Social Survey, and Health Information National Trends Survey to address the primary overarching research question: Is there an association between digital access and health? The examination of the relationship between digital access and health is situated within a social determinants of health perspective and draws on van Dijk's (2005) causal and sequential model of digital access. Education, income, race and ethnicity, work …

Exploring The Structural Relationships Between Course Design Factors, Learner Commitment, Self-Directed Learning, And Intentions For Further Learning In A Self-Paced Mooc, Dongho Kim, Eulho Jung, Meehyun Yoon, Yunjeong Chang, Sanghoon Park, Dongsim Kim, Fatih Demir

Public and Population Health Faculty Publications and Presentations

The open and massive characteristics of Massive Open Online Course (MOOC) lead to a lack of instructor presence, which potentially hinders learners' commitment and learning processes. As a result, the effectiveness of MOOCs is contingent upon the extent to which learners direct their own learning. However, learners' self-directed learning and commitment are largely influenced by course design factors due to lack of direct learner-instructor interactions. In order to address the current gap in the literature with regard to how course design factors influence learning processes and outcomes, this study investigated the relationships between MOOC design factors, learner commitment, self-directed learning, …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Feasibility And Acceptability Of Using Mobile Health Apps In Underserved Patients With Diabetes, Jieyu Luo

Theses and Dissertations (ETD)

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. …

Mental Health Outcomes Of Various Types Of Fear Among University Students Who Have An Undocumented Legal Status During The Donald Trump Presidency, Liliana Campos

Doctoral Dissertations

Having an undocumented legal status is a risk factor for mental health conditions such as depression and anxiety among university students. Much of the literature on the experiences of university students who hold an undocumented legal status has primarily focused on better understanding the educational, social, financial, and legal challenges among undergraduate students. The literature has addressed how some of these difficulties impact components of their social and mental health wellness. Yet, there is still a dearth of research focused on further understanding the experiences of students who hold an undocumented legal status from a psychological perspective, and specifically, with …

The Biopsychosocial Model And Clinical Decision Science In The Age Of Black Lives Matter: A Clinical Reflection, Abdul-Rahman M. Suleiman, Samer Ilayan

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the biopsychosocial considerations of elevated blood pressure in teenage African American youth during the era of Black Lives Matter (BLM). Parallels are drawn between Dr. Engel’s biopsychosocial model and clinical decision science.

Violence And Abuse Among Working Children In Urban And Suburban Areas Of Lower Sindh, Pakistan, Meesha Iqbal, Zafar Fatmi, Kausar S. Khan, Asaad Ahmed Nafees

Community Health Sciences

Background: Child labourers are exposed to an insecure environment and higher risk of violence. Violence among child labourers is an under-studied phenomenon which requires contextual assessment.
Aims: We applied Bronfenbrenner's ecological model (micro-, exo- and macro-system) to understand the interplay of individual, community, societal and policy context fuelling violence.
Methods: Focus group discussions and family ethnographies of child-labourers working in common occupational sectors of suburban areas of Sindh were carried out to gain in-depth understanding of their immediate environment and abuse (micro-system). Frequency of emotional, physical and sexual violence (5-14 years; n = 634) was also determined. Indepth interviews with …

Improved First Trimester Maternal Iodine Status With Preconception Supplementation: The Women First Trial, Amy E. Young, Jennifer F. Kemp, Charis Uhlson, Jamie L. Westcott, Sumera Aziz Ali, Sarah Saleem, Ana Garcès, Lester Figueroa, Manjunath S. Somannavar, Shivaprasad S. Goudar

Community Health Sciences

Maternal iodine (I) status is critical in embryonic and foetal development. We examined the effect of preconception iodine supplementation on maternal iodine status and on birth outcomes. Non-pregnant women in Guatemala, India and Pakistan (n ~ 100 per arm per site) were randomized ≥ 3 months prior to conception to one of three intervention arms: a multimicronutrient-fortified lipid-based nutrient supplement containing 250-μg I per day started immediately after randomization (Arm 1), the same supplement started at ~12 weeks gestation (Arm 2) and no intervention supplement (Arm 3). Urinary I (μg/L) to creatinine (mg/dl) ratios (I/Cr) were determined at 12 weeks …

Review Of Fetal Alcohol Spectrum Disorder (Fasd) Among Aboriginal And Torres Strait Islander People, Sharynne Hamilton, Michael Doyle, Carol Bower

Australian Indigenous HealthBulletin

Fetal Alcohol Spectrum Disorder (FASD) is a preventable, lifelong disability that disproportionately affects Aboriginal and Torres Strait Islander people. This review provides a comprehensive synthesis of the available information on FASD among Aboriginal and Torres Strait Islander people, with reference to the limitations on population-based data and evaluated programs. The review outlines; the harms of alcohol use in the context of colonisation, cultural perspectives on assessment and diagnosis, effective prevention programs and a summary of state and national policies. Health impacts, educational outcomes and the effects of FASD on vulnerable populations such as children in protection and young people in …

Weight Reduction Motivation In Osteoarthritis Patients Through Nurse Practitioner Driven Education And Follow-Up: A Pilot Project, Caoilfhionn Mulvey, Martha Fuller Phd

Doctor of Nursing Practice Final Manuscripts

Purpose of Project: The ultimate goal of this short-term pilot project is for

overweight or obese osteoarthritis patients to increase their knowledge on the benefits of

weight loss and physical activity. Research shows that for every kilogram of weight lost,

2.2–4.0 kilograms of weight is taken off of the joint and could reduce joint pain up to

thirty to fifty percent and improve quality of life. Following education from the provider,

patients will understand the correlation of osteoarthritis symptom management with

weight loss.

EBP Model/Frameworks: This project utilizes the Iowa Model of Evidence-Based

Practice to Promote Quality Care. This addresses …

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …

Exploring The Therapeutic Relationship As A Central Focus Through Expressive Arts Therapy In Oncology, Akshata Parekh

Expressive Therapies Capstone Theses

The treatment for cancer can be physically, mentally, emotionally and socially challenging. These treatments have side effects like physical body pain, hair loss, changes in weight, energy, nausea and more. These physical changes impact the social, mental and emotional well-being of the patient and makes this journey of the life-threating prognosis of cancer very tough to confront. Expressive arts therapy provides a safe space for the patients to address their mental health concerns as a result of this treatment. The Capstone Thesis Project explored expressive arts therapy interventions with 95 patients through single or multiple sessions while going through their …