Public Health Commons^™

Thinking Ethically About Hiv Pre-Exposure Prophylaxis: Retention In Care And Sexually Transmitted Infection Testing In A Southeastern United States Local Health Department In The Time Of Covid-19, Ellie Purdy

College of Graduate Studies: Theses & Dissertations

Local Health Departments (LHDs) are critical providers of Human Immunodeficiency Virus (HIV) and sexually transmitted infection (STI) prevention efforts. HIV Pre-Exposure Prophylaxis (PrEP) is an evolving public health initiative and practitioners should consider PrEP interventions in context of ethical decision-making and a broad STI prevention strategy as global incidence of bacterial STIs remains high and those at-risk for HIV are generally at-risk for other STIs. An evaluation of the Thinking Ethically framework and LHD PrEP services was performed to fill a gap in the literature and support program decision-making. A retrospective review of PrEP user medical records from a LHD …

Development And Validation Of A Psychometric Scale To Assess Attitude Towards Safe Abortions In Pakistan, Xaher Gul, Junaid-Ur-Rehman Siddiqui, Miraal Mavalvala, Waqas Hameed, Muhammad Ishaque

Community Health Sciences

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor …

The Influence Of Coronavirus Disease-2019 (Covid-19) On Parkinson’S Disease: An Updated Systematic Review, Vikash Jaiswal, Danah Alquraish, Zouina Sarfraz, Azza Sarfraz, Shavy Nagpal, Prakriti Singh Shrestha, Dattatreya Mukherjee, Prathima Guntipalli, Diana F. Sánchez Velazco, Arushee Bhatnagar

Department of Paediatrics and Child Health

Background: COVID-19 has affected global communities with multiple neurological complications in addition to other critical medical issues. COVID-19 binds to the host's angiotensin-converting enzyme 2 (ACE2) receptors, which are expressed in the neurons and glial cells, acting as an entry port to the central nervous system (CNS). ACE2 receptors are abundantly expressed on dopamine neurons, which may worsen the prognosis of motor symptoms in Parkinson's disease (PD). SARS-CoV-2 may lead to an indirect response via immune-mediated cytokine storms and propagate through the CNS leading to damage. In this systematic review, we aim to provide thorough analyses of associations between COVID-19 …

Housing Is Healthcare Measuring The Cross-Sector Impact Of A Major Housing Initiative In Portland, Oregon, Keri B Vartanian, Aisha K Gilmore, Kyle Jones

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No abstract provided.

Increasing Physical Activity In Older Australians To Reduce Falls: A Program Evaluation, Kristy Robson, Nazmul Ahasan, Carly Barnes, Kylie Murphy, Rodney Pope

Internet Journal of Allied Health Sciences and Practice

Purpose: As people age, they are at greater risk of injurious falls. Falling has a significant impact not only on the individual but also the wider community. Undertaking physical activity is effective in reducing the rate of falls in this population. Therefore, providing targeted education during group-based falls prevention programs may increase the awareness and amount of physical activity older people undertake to assist in reducing their risk of falling. Methods: A longitudinal cohort design involving a pre-post intervention survey was conducted over an eight-month period with community-dwelling older adults who participated in a fall-prevention program. Participants were N = …

Why Do You Wear A Mask? Children’S Conceptualizations Of Covid-19 And Contagion Avoidance Behaviors, Emily Hillman

Scripps Senior Theses

With the outbreak of the COVID-19 pandemic, a need has emerged for psychological research on children’s understanding of infectious disease transmission. However, little existing research examines the link between children’s cognitive reasoning about illness and their subsequent behaviors regarding its transmissibility. This study will examine children’s conceptualizations of contagious illnesses such as COVID-19 and their subsequent contagion avoidance. A mixed methods approach will be used to establish the content of children’s conceptualizations of contagion and level of causal reasoning related to illness transmission. Dyads will be constructed comprising 4-12-year-old children and their parents. It is expected that parental contagion avoidance …

Reducing Objectification Could Tackle Stigma In The Covid-19 Pandemic: Evidence From China, Youli Chen, Jiahui Jin, Xiangyang Zhang, Qi Zhang, Weizhen Dong, Chun Chen

Community & Environmental Health Faculty Publications

Stigmatization associated with the coronavirus disease 2019 (COVID-19) is expected to be a complex issue and to extend into the later phases of the pandemic, which impairs social cohesion and relevant individuals' well-being. Identifying contributing factors and learning their roles in the stigmatization process may help tackle the problem. This study quantitatively assessed the severity of stigmatization against three different groups of people: people from major COVID-19 outbreak sites, those who had been quarantined, and healthcare workers; explored the factors associated with stigmatization within the frameworks of self-categorization theory and core social motives; and proposed solutions to resolve stigma. The …

Time Trends Of Overweight And Obesity Among Schoolchildren In Kuwait Over A 13-Year Period (2007-2019): Repeated Cross-Sectional Study, Abdullah Al-Taiar, Nawal Alqaoud, Ali H. Ziyab, Faheema Alanezi, Monica Subhakaran, Reem Sharaf Alddin, Hueiwang Anna Jeng, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Objectives: This study aimed to examine age-specific trends in the prevalence of overweight and obesity in schoolchildren in Kuwait over a 13-year period (2007 to 2019) using the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC) and the International Obesity Taskforce (IOTF) definitions.

Design: Using cross-sectional approach, Kuwait Nutrition Surveillance System (KNSS) objectively measured weight and height of schoolchildren over a 13-year period. Log-binomial regression models were used to examine age-specific trends of obesity and overweight over the study period.

Setting: Public primary, middle, and high schools in all provinces of Kuwait.

Participants: Schoolchildren aged 5-19 …

Assessment Of Cooking Matters Facebook Platform To Promote Healthy Eating Behaviors Among Low-Income Caregivers Of Young Children In The United States: A Pilot Study, Qi Zhang, Jill Panichelli, Leigh Ann Hall

Community & Environmental Health Faculty Publications

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes …

An Analysis Of The Sleep Quality Of Undergraduate Students, Brianna N. Carter, Joanne Chopak-Foss

Phi Kappa Phi Research Symposium (Archived)

Background and Aims: The purpose of this study was to measure the sleep quality of a sample of undergraduate students and compare it to the recommendations for young adults from the National Sleep Foundation. Methods: A sample of undergraduate students from a mid-sized public university in the Southeast were recruited for this study (N=86). The Pittsburgh Sleep Quality Index (PSQI) was employed to assess sleep quality of the students. Results: Frequency analysis found that most students did not get the minimum amount of sleep as recommended by the National Sleep Foundation. A nonparametric correlation (listwise) analysis found …

"Who's The Man?" Examining The Relationships Between Black Masculinity, Perceived Social Support, And Sexual Behavior In Black Male College Students, James Thomas

College of Graduate Studies: Theses & Dissertations

Introduction: Sexual health disparities in college-aged Black men remains a critical public health issue. Black men are likely to have an earlier sexual debut, acquire sexually transmitted infections (STIs) and HIV at higher rates, and enter fatherhood at earlier ages than their White counterparts. Previous research has identified masculinity and perceived social support as predictors of sexual risk behavior for men in the U.S. However, when exploring masculinity’s influence on sexual behavior, studies that are culturally sensitive to Black men’s experiences and perspectives on manhood are few. The purpose of this study was to explore the relationship between Black masculinity, …

Cardio-Pulmonary Sequelae In Recovered Covid-19 Patients: Considerations For Primary Care, Zouina Sarfraz, Azza Sarfraz, Alanna Barrios, Radhika Garimella, Asimina Dominari, Manish Kc, Krunal Pandav, Juan C. Pantoja, Varadha Retnakumar, Ivan Cherrez-Ojeda

Department of Paediatrics and Child Health

Background: Current literature lacks characterization of the post-recovery sequelae among COVID-19 patients. This review characterizes the course of clinical, laboratory, radiological findings during the primary infection period, and the complications post-recovery. Primary care findings are presented for long-COVID care.
Methods: Adhering to PRISMA guidelines, 4 databases were searched (PubMed, Embase, CINAHL Plus, Scopus) through December 5, 2020, using the keywords "COVID-19 and/or recovered and/or cardiovascular and/or long-term and/or sequelae and/or sub-acute and/or complication." We included published peer-reviewed case reports, case series, and cross-sectional studies providing the clinical course of COVID-19 infection, and cardiopulmonary complications of patients who recovered from COVID-19, …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Determinants Of Private Well Water Testing In Maine, Jenny Carwile, Shravanthi M. Seshasayee, Kritika Anand, Abby F. Fleisch

Costas T. Lambrew Research Retreat 2021

Objectives: Describe sociodemographic characteristics associated with ever testing well water using data from the 2014-2017 Maine Behavioral Risk Factor Surveillance System (BRFSS) (n= 12,152).

Applying Mixed-Effects Modeling To Behavioral Economic Demand: An Introduction, Brent A. Kaplan, Christopher T. Franck, Kevin Mckee, Shawn P. Gilroy, Mikhail N. Koffarnus

Family and Community Medicine Faculty Publications

Behavioral economic demand methodology is increasingly being used in various fields such as substance use and consumer behavior analysis. Traditional analytical techniques to fitting demand data have proven useful yet some of these approaches require preprocessing of data, ignore dependence in the data, and present statistical limitations. We term these approaches “fit to group” and “two stage” with the former interested in group or population level estimates and the latter interested in individual subject estimates. As an extension to these regression techniques, mixed-effect (or multilevel) modeling can serve as an improvement over these traditional methods. Notable benefits include providing simultaneous …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

The Impact Of The Hospital Value-Based Purchasing Program On Healthy Days, Health Inequity, And Hospital Community Benefit Spending, Samhita Kadiyala

Scripps Senior Theses

The Hospital Value-Based Purchasing Program (HVBP) is a Centers for Medicare and Medicaid Services (CMS) program implemented in 2012 to reward acute-care hospitals with incentive payments for the quality of care provided to Medicare patients in inpatient settings. Under this policy, payment adjustments are made based on a variety of factors including clinical quality, patient experience, and cost reductions. This paper uses state-level variation in the implementation of HVBP to ascertain whether the policy led to improvements in Healthy Days (a CDC-designed composite measure of individuals’ self-reported number of physically and mentally “healthy” days per month), health disparities, and community …

Barriers To Purchasing Narcan® In Georgia: A Survey Of Pharmacy Staff, Thomas E. Griner, Sheryl Strasser, Stacie Kershner, Ashli Owen-Smith, Matthew J. Hayat

Journal of the Georgia Public Health Association

Background: In Georgia, recent measures have expanded public access to naloxone-containing products like Narcan® to combat opioid-related overdose deaths. Although laypersons may legally purchase naloxone products without a prescription for use during opioid-related overdose events, barriers may remain.

Methods: We conducted an anonymous telephone survey to investigate three potential barriers to purchasing naloxone (Narcan®) in Georgia: availability, price, and working knowledge of legal requirements among pharmacy representatives. We surveyed pharmacy representatives in select Georgia counties with high volumes or high rates of poisoning deaths compared with other counties. We also compared responses among chain and non-chain representatives. Descriptive statistics are …

United States Nursing Homes And Health Equity During The Covid-19 Pandemic, Carla Cooper

College of Graduate Studies: Theses & Dissertations

Objective: The COVID-19 pandemic disproportionately affected older populations, with nursing homes impacted early on by the disease. The contribution of race/ethnicity of nursing home residents and facility characteristics on COVID-19 were unknown. The Donabedian model framework was used to study the relationship between the racial/ethnic characteristics of nursing home residents and COVID-19 outcomes and to examine if this relationship was moderated by the racial/ethnic composition of the county of nursing home location.

Method: Cross-sectional research design merging data from five publicly available sources. Laboratory confirmed COVID-19 cases and deaths were compared by the racial composition of the county and nursing …

Clinical Test Versus Self-Test For Prediabetes: Outcomes In Diabetes Prevention Based On Mode Of Diagnosis, Debra J. Rich

All Master's Theses

Approximately 34.2 million U.S. adults were diagnosed with type 2 diabetes in 2018 and diabetes prevalence is projected to reach 60.6 million by 2060. A predicted 88 million adults have prediabetes, but only 15.3% have been diagnosed by a medical provider. Approximately 15-30% of the population with prediabetes will develop diabetes within 5 years without lifestyle modification to decrease risk. Reduced incidence of diabetes is an urgent priority for Healthy People 2030 and increased participation in lifestyle change programs is a primary objective. The Diabetes Prevention Program promotes behavior modification to prevent or delay diabetes. Despite evidence to support effective …

Mental Health Risks & Patterns Among On-Campus Resident Students During The Covid-19 Pandemic, Brooke Writer

All Master's Theses

Objective: This study examined the effects of the COVID-19 global pandemic on the mental health and well-being of college students residing in a rural community. Eligible students reported on their mental health statuses, coping strategies, distresses, demographics, and original items to capture students’ experiences. Participants: Participants were 372 undergraduate and graduate student's living in residence halls or on-campus housing enrolled in a public university between January and March 2021. Methods: Univariate and bivariate statistical analyses were utilized. Open-text responses about navigating mental health challenges during the COVID-19 pandemic are summarized. Results: Students who identified as LGBTQ+ (pp=0.0022) scored …

Indoor Cooking Practices And Associated Health Factors Among Participants In The Dominican Republic And Nicaragua: A Collaborative Study Between Respiratory Therapy Students And Comunidad Connect, Rachel Culbreth, Rachel Trawick, Jon Thompson, Douglas S. Gardenhire

Internet Journal of Allied Health Sciences and Practice

The purpose of this study is to determine factors associated with indoor cooking practices and specific vital signs across two middle-income countries, Dominican Republic and Nicaragua. This study used data from Nicaragua (n=76) and Dominican Republic (n=62) (collected in 2018-2019). Multivariable linear regression was utilized to determine factors associated with carbon monoxide levels and systolic blood pressure. Among all participants (n=138), approximately half lived in Nicaragua (n=76, 55.1%) and half lived in Dominican Republic (n=62, 44.9%). The overall smoking prevalence in each country was low (9.2% in Nicaragua and 4.8% in Dominican Republic). Age was associated with higher carbon monoxide …

Addressing Health-Related Myths In The Culturally Diverse African American Population: A Call To Action, Lucson Joseph

Internet Journal of Allied Health Sciences and Practice

African Americans (AAs) experience numerous challenges that socially, economically, and physically affect their communities. Recent studies have found that a diverse array AAs encounter many struggles as they navigate the United States (U.S.) healthcare system to access care and receive healthcare services. AA communities are significantly affected by the burden of chronic diseases. They face considerable barriers to healthcare services that contribute to adverse health outcomes. This paper explains the daily struggles many AAs face within their communities to access and navigate the healthcare system due to culturally held myths and barriers. This paper discusses commonly held myths among Afro-Caribbean …

Parental Awareness Of Early Intervention For Hispanic Children With Communication Disorders, Ruth Crutchfield, Sonya N. Salinas, Roy K. Chen

Internet Journal of Allied Health Sciences and Practice

Purpose: Children at risk of delayed speech and language development and speech-language disorders come from a broad range of demographic backgrounds, including ethnicities, sexes, and socioeconomic statuses. A vast body of research in speech-language pathology has demonstrated that early intervention is crucial for helping children acquire the necessary communication skills they need to become effective communicators, successful students, and ultimately accomplished adults. Currently, commercials, billboards, online sources, and personal referrals are the methods most often used to promote awareness of early childhood intervention services. Method: This study aimed to identify whether the current promotional methods used to increase parental awareness …

From The Legal Literature: Covid And The Criminal Law, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

No abstract provided.

Health Systems Approach To Ensure Quality And Safety Amid Covid-19 Pandemic In Pakistan, Nousheen Pradhan, Anam Shahil Feroz, Syed Mairajuddin Shah

Community Health Sciences

Ensuring quality and safe care during the coronavirus disease 2019 (COVID-19) pandemic offers a challenge to already strained health systems in low and middle-income countries (LMICs), such as Pakistan with less shock-absorbing capacities. There is a dearth of evidence on mechanisms to provide optimum quality care to COVID-19 patients in the resource-constrained healthcare environment. The lessons learned from the Ebola virus outbreak for the deficient health systems and quality improvement are considered to propose strengthening the health systems response to deliver quality-assured care to patients during the current pandemic. In this regard, the World Health Organization (WHO) health systems framework …

Age-Dependent Chronic Lung Injury And Pulmonary Fibrosis Following Single Exposure To Hydrochloric Acid, Ruben M.L. Colunga Biancatelli, Pavel Solopov, Christiana Dimitropoulou, John D. Catravas

Bioelectrics Publications

Exposure to hydrochloric acid (HCl) represents a threat to public health. Children may inhale higher doses and develop greater injury because of their smaller airways and faster respiratory rate. We have developed a mouse model of pediatric exposure to HCl by intratracheally instilling p24 mice (mice 24 days old; 8–10 g) with 2 µL/g 0.1 N HCl, and compared the profile of lung injury to that in HCl-instilled adults (10 weeks old; 25–30 g) and their age-matched saline controls. After 30 days, alveolar inflammation was observed with increased proteinosis and mononuclear cells in the bronchoalveolar lavage fluid (BALF) in both …

Prevalence And Correlates Of Secondary Syringe Exchange (Sse) Among People Who Inject Drugs (Pwid) In Rural Kentucky, Jordan R. Wilson

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Aim: To describe the prevalence of secondary syringe exchange (SSE) in a sample of syringe service program (SSP) clients in rural Appalachian Kentucky and to identify the correlates of SSE.

Methods: Participants (n=338) completed interviewer-administered questionnaires. Only those who reported having ever exchanged syringes at a SSP (n=140) were included in analysis. SSE was measured through self-report of obtaining syringes for someone else at a SSP in the past 6 months. Prevalence and correlates of SSE were examined using bivariate analysis and multiple logistic regression.

Results: Overall, 30% of participants reported SSE. Participants in the second [aOR= 3.83; 95% CI: …

Occupational Health Practices Among Dental Care Professionals Before And During The Covid-19 Pandemic, Sean Banaee, Denise M. Claiborne, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

BACKGROUND: The COVID-19 pandemic has posed a substantial burden on dental care professionals. While dentistry is known as one of the most exposed and high-risk professions, dental care professionals are indeed at even greater risk.

OBJECTIVE: The aim of this study was to assess knowledge, attitudes, occupational health practices, personal protective equipment usage, and mental stressors during COVID-19 pandemic among dental care professionals.

METHODS: A cross-sectional study was conducted among dental care professionals who were subscribers to a dental hygiene journal using a self-administered online survey (n = 1047 respondents). Cross-tabulations were performed to determine differences in the responses to …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …