Public Health Commons^™

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …

A National Assessment Of Household, Community, And Environmental Situations On Breastfeeding Decisions, Marnita Siglar Thomas

Walden Dissertations and Doctoral Studies

Exclusively breastfeeding has been proven to be an effective preventive measure for childhood obesity; however, breastfeeding practices decline after 6 months. Secondary data from the 2018-2019 combined National Survey of Children's Health were used for this study to determine the household, community, and physical environment relationship between individuals' decisions to breastfeed and sustainment in the United States (N=16,750). Grounded by the theoretical framework of the socio-ecological model, the results suggested that household, community, and physical environments predict individuals' decisions to initiate breastfeeding and sustainment nationally (p < 0.001). Binary logistic regression, controlling for maternal age, indicated a statistical significance between breastfeeding initiation and income (p = 0.043, p = 0.041), family structure (p = 0.003, p < 0.001), education (p < 0.001, p < 0.001, p < 0.001), neighborhood support (p < 0.001), and neighborhood amenities (p = 0.039, p <0.001, p < 0.001). A statistical significance between breastfeeding duration and family structure (p = 0.061), education (p < 0.001, p < 0.001), maternal overall health (p <0.001), neighborhood support (p = 0.008), neighborhood safety (p = 0.006), and neighborhood amenities (p = 0.019) was found when controlling for maternal age. Implications for positive social change include providing health professionals with knowledge on breastfeeding decision making to encourage new recommendations and implement new practices and policies to promote breastfeeding and ultimately reduce the incidence of overweight and obesity in children nationwide.

Language Barrier: An Unmet Challenge For Low Screening Of Colorectal Cancer Among Hispanic Americans In Texas, Moses Owusu

Walden Dissertations and Doctoral Studies

AbstractHispanic population represents the fastest growing minority group in the United States, and only California surpasses Texas with Hispanic residents in the United States. Overall, non-Hispanic Whites have higher rates of colorectal cancer (CRC) incidence than Hispanics; however, Hispanic Americans have lower survival rates than non-Hispanic Whites. Using cross-sectional analysis, CRC screening modalities were examined to assess disparities among White only, non-Hispanic, Black only, non-Hispanic, and Hispanic populations in Texas to evaluate the impact of limited English proficiency (LEP) on CRC screening among Hispanic Americans residents. The age of study participants ranged from 50 to 79 (mean age = 65.8 …

Nutrient Pollution And Chlorophyll-A As A Precursor To Harmful Algal Blooms And Cyanotoxins In Rehabilitated Machado Lake, California, Michael E. Shiang

Walden Dissertations and Doctoral Studies

Algal blooms result in the formation of cyanotoxic conditions in a freshwater lake causing severe detrimental impacts to community and public health. Nitrogen, phosphorous, and ammonia stimulate the growth of phytoplankton biomass and algae, as measured by chlorophyll. This retrospective quantitative research study, grounded in the socioecological model, examined the relationship between nutrient pollutants and chlorophyll-a (Chl-a) that forecast harmful algal blooms, a precursor to cyanotoxins. A former impaired lake, Machado Lake in California, provided an ideal setting to assess relationships among nutrient indicators and Chl-a post-lake rehabilitation. Correlation and multiple regression analyses were performed to determine if a relationship …

The Application Of Time Series Analysis To Injury Epidemiology Data, Eric Wayne Lundstrom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Injury fatality rates in the United States (US) decreased throughout the majority of the 20th century, mostly due to declining rates of occupational and motor vehicle injuries. However, near the beginning of the 21st century, fatal injury rates in the US began to increase. This is principally due to the nation’s opioid epidemic, which has been characterized by different epidemic “waves”, each driven by overdoses associated with specific substances. Given the temporally dynamic nature of US injury trends, this study aimed to explore the application of time series analysis to injury data in the US. First, rates of non-fatal …

Changes In Severity Of Diabetes At Diagnosis Following The Onset Of The Sars-Cov-2 Pandemic, Annelise King

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

During the SARS-CoV-2 pandemic it was seen that diabetes was a risk factor for severe COVID-19. The objective of this study is to assess the severity of diabetes at diagnosis during the COVID-19 pandemic compared to pre-pandemic to see how the pandemic and SARS-CoV-2 infection impacted the severity of diabetes. This study used University of Kentucky electronic health records of 13,794 patients who developed diabetes. The majority of patients were female, white non-Hispanic, 65+, and living in an urban area. There were differences seen between the COVID-19 positive and negative cohorts in the DKA and HbA₁c variables, with …

Community Pharmacy Provision Of Extended-Release Injectable Naltrexone In Kentucky: Perspective Of People Who Use Opioids, Anye Wamucho

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

Aim: To identify demographic, socio-economic, and other factors associated with likelihood of obtaining extended-release injectable naltrexone (EIN) if provided in a private space at a local pharmacy among people who use opioids (PWUO) in rural Appalachian Kentucky.

Methods: People who used opioids in the past 6 months in rural Appalachian Kentucky (n=170) completed interviewer-administered questionnaires eliciting demographic, socio-economic, and other characteristics. Participants were also asked about whether they will be more likely to obtain EIN if provided in a private space at a local pharmacy. Factors associated with increased likelihood to obtain pharmacy-provided EIN were assessed using unadjusted univariate and …

Impact Of Race And Socioeconomic Factors On Infant Mortality Between Non-Hispanic Black And White Women, Chukuma Clifton Chijioke

Walden Dissertations and Doctoral Studies

Abstract This quantitative retrospective study with a correlational design examined the impact of race and socioeconomic factors on the high infant mortality (IM) among non-Hispanic Black women compared to non-Hispanic White women in one midwestern US state county. Though the IM in the U.S. has consistently decreased, a disparity exists between non-Hispanic Black and non-Hispanic White women. Non-Hispanic Black women are twice as likely to experience infant deaths as non-Hispanic White women. This study utilized secondary data derived from vital records maintained by the county public health department. The research was grounded in the ecological model. Logistic regression was used …

Workplace Aggression Against Healthcare Workers In A Spanish Healthcare Institution Between 2019 And 2021: The Impact Of The Covid-19 Pandemic, Aitor Díaz, Mireia Utzet, Joan Mirabent, Pilar Diaz, Jose Maria Ramada, Consol Serra, Fernando G Benavides

Faculty, Staff and Student Publications

OBJECTIVES: Describe the incidence of first aggressions among healthcare workers (HCWs) before and during the COVID-19 pandemic in a Spanish healthcare institution, according to workers' socio-occupational characteristics and analyze the impact of the pandemic on it.

METHODS: A cohort involving HCWs who worked in the institution for at least 1 week each year from 1 January 2019 to 31 December 2021. Adjusted relative risks (aRR) were estimated using generalized estimating equations and negative binomial models to calculate the differences in WPA between the different time periods. All analyses were stratified by gender.

RESULTS: Among women, the incidence was 6.8% (6.0; …

Regional Disparities In Major Cancer Incidence In Korea, 1999–2018, Eun Hye Park, Mee Joo Kang, Kyu-Won Jung, Eun Hye Park, E Hwa Yun, Hye-Jin Kim, Hyun-Joo Kong, Chang Kyun Choi, Jeong-Soo Im, Hong Gwan Seo

Faculty, Staff and Student Publications

OBJECTIVES: This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018.

METHODS: The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance.

RESULTS: Regional disparities …

Health Misinformation During Epidemiological Crises, Bethany Stefan, Alexis L. Emich, Katrina R. Lamp

Williams Honors College, Honors Research Projects

Health misinformation is more prevalent than ever in the modern age and poses serious risks for those who believe it. Medical fallacies can become especially harmful during periods of widespread disease when the misinformed respond in ways that increase threats to public health. The purpose of this systematic review is to describe and critically appraise the evidence about how health misinformation during endemics and pandemics can influence behaviors and responses, as well as the implications of interventions affecting these behaviors. A systematic search of the literature with inclusion/exclusion criteria using CINAHL Plus with Full Text, MEDLINE, and PsychINFO resulted in …

Uncovering The Role Of Fat-Infiltrated Axillary Lymph Nodes In Obesity-Related Diseases With Statistical And Machine Learning Analyses, Qingyuan Song

Dartmouth College Ph.D Dissertations

The link between obesity and pathogenesis is a complex and multifaceted area of research that is yet to be fully understood. Ample evidence exists to demonstrate the direct relationship between excessive internal fat and various health conditions such as cancer, and metabolic and cardiovascular diseases. The infiltration of ectopic fat into axillary lymph nodes, observable on breast cancer screening images, has been shown to be correlated with body mass index (BMI) in women undergoing screening. This study aimed to explore the relationship between fat-infiltrated axillary lymph nodes (FIN) and obesity-related diseases, with the goal of evaluating the clinical value of …

Anxiety Risk Factors And Social Isolation Among Young Adults, Jennifer Clancy

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic is a public health concern that impacted the world. Increased feelings of loneliness and social isolation during the pandemic were reported to be associated with those seeking help for symptoms of anxiety and depression. Though symptoms of anxiety have been associated with social isolation, research is limited on the association between the anxiety risk factors and social isolation among young adults in the United States. Using the socioecological model, the association between social isolation (dependent variable) with financial stress, health anxiety, and perceived impact of COVID-19 (independent variable), and the influence of gender, race, and household status …

Effect Of Treatment, Stage Of Lung Cancer, And Socioeconomic Status On Life Expectancy Within Marginalized Communities, Elsadig Ahmed Elsharif

Walden Dissertations and Doctoral Studies

Lung cancer is one of the most common cancers in the United States, and it accounts for 25% of cancer deaths. About 70% of cancer cases are diagnosed during late stages, leading to poor outcomes. An estimated 60% of cancer cases involve underserved and disadvantaged communities. However, there are limited studies had addressed effects of treatment, stage of lung cancer, and socioeconomic status on life expectancy within marginalized communities. Research questions examined effect of treatment, stage of lung cancer, and socioeconomic status on life expectancy of lung cancer patients between 2009 and 2019. This study was grounded in the deductive …

Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern

Walden Dissertations and Doctoral Studies

Tobacco use has been a long-standing known modifiable risk factor to maternal health. Although there have been many efforts to encourage smoking cessation, use of electronic cigarettes in pregnancy has been increasing over the years. Understanding potential factors that may play a role in the increased use of electronic cigarettes is important to improve maternal and fetal health outcomes. The social ecological model provides the theoretical framework for this study. The purpose of this study is to determine whether a woman’s primary language and pregnancy health care factors (i.e., access to health care 12 months prior to pregnancy, access to …

Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi

Walden Dissertations and Doctoral Studies

AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …

Age, Race/Hispanic Origin, And Covid-19 Mortality Among Sickle Cell Disease Patients In The United States, Joe Lamont Ndula

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic remains a global health challenge, with 6.7 million deaths worldwide as of January 2023. It has illuminated the health iniquities in underserved communities and populations like those with sickle cell disease (SCD). Researchers have associated the COVID-19 outcome among SCD patients in other regions of the globe. The purpose of this retrospective cross-sectional observational study was to investigate the relationship between age, race/Hispanic origin, and COVID-19 mortality among persons with SCD in the United States from January 2020 to March 2021. The Krieger ecosocial theory of disease distribution framed the study. Data were drawn from an existing …

An Association Of The Transgenerational Implications Of Redlining And Obesity On Pediatric Type Ii Diabetes, Carlin Dexter Nelson

Walden Dissertations and Doctoral Studies

s the prevalence and incidence of childhood obesity has increased, so has the number of cases of pediatric Type 2 diabetes mellitus (T2DM). Although made unconstitutional in 1968, the transgenerational implications of redlining can be observed in disinvestments resulting in neighborhood detraction. Utilizing the 2019–2020 National Children’s Health Survey, the purpose of the study was to evaluate the relationship between obesity, T2DM, and neighborhood detraction elements as well as assessed indicators of T2DM in non-institutionalized children 6 through17 years of age (N = 34,725). The social determinants of health perspective served as the conceptual framework for the study. Results indicated …

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.

Factors Impacting College Students’ Receipt Of Human Papillomavirus Vaccination, Joy Yvette Payne

Walden Dissertations and Doctoral Studies

Less than half of U. S. students entering college have had a human papillomavirus (HPV) vaccination, placing them at risk for HPV-related cancers. This study’s purpose was to identify predictors of HPV vaccination initiation in college students. Andersen’s behavioral model of health services use was used to examine the differences in predisposing, enabling, and need factors in U.S. college students ages 18–26 years who received an initial HPV vaccination in college compared to those who never received an HPV vaccination. The study was a quantitative, cross-sectional survey design using multivariable logistic regression for data analyses. Data were collected through an …

The Effect Of An Educational Handout On Knowledge, Awareness And Attitudes Of Pre-Exposure Prophylaxis (Prep) Among Participants At A Needle And Syringe Exchange Site, Mckenzie Buckel

DNP Projects

Background: In 2018, the total number of HIV cases in the United States was 1.2 million. Almost 186,500 of these cases were attributed to intravenous drug use. With the adherence to pre-exposure prophylaxis (PrEP) there is approximately a 49% decrease in the rates of HIV among people who inject drugs and the most significant barrier to PrEP among this population is a lack of awareness and knowledge.

Objective: The purpose of this study was to determine participants’ of a needle and syringe exchange site knowledge, awareness and attitudes of PrEP after reviewing an educational handout about PrEP.

Methods: A quasi …

Development And Validation Of A Questionnaire To Assess Awareness And Knowledge Of Nonalcoholic Fatty Liver Disease, A Liver Cancer Etiological Factor, Among Chinese Young Adults, Yi Du, Fedja A. Rochling, Dejun Su, Kendra Ratnapradipa, Jianghu James Dong, Evi A. Farazi

Journal Articles: Epidemiology

PURPOSE: Despite the increasing prevalence of nonalcoholic fatty liver disease (NAFLD), a liver cancer etiological factor, among Chinese young adults (CYA), there is a lack of valid, reliable, ready-to-use survey instruments for assessing awareness and knowledge of NAFLD in this population. The aims of this study were to develop, validate, and assess the reliability of a web-based, self-administered questionnaire evaluating awareness and knowledge of NAFLD among CYA.

METHODS: Based on review of relevant literature, a draft questionnaire was initially developed. Face and content validity of the questionnaire was evaluated by an expert panel of seven gastroenterologists. The construct validity was …

Relationship Between Maternal Language And Use Of Electronic Cigarettes In Pregnancy, Tara Halpern

Walden Dissertations and Doctoral Studies

Tobacco use has been a long-standing known modifiable risk factor to maternal health. Although there have been many efforts to encourage smoking cessation, use of electronic cigarettes in pregnancy has been increasing over the years. Understanding potential factors that may play a role in the increased use of electronic cigarettes is important to improve maternal and fetal health outcomes. The social ecological model provides the theoretical framework for this study. The purpose of this study is to determine whether a woman’s primary language and pregnancy health care factors (i.e., access to health care 12 months prior to pregnancy, access to …

Gender Disparities: 5 Year Survival Rates Of Elderly Colorectal Cancer Patients With Depression, Riya Joshi

Walden Dissertations and Doctoral Studies

AbstractColorectal cancer (CRC) is a life-threatening health condition known to greatly affect the elderly than younger populations. CRC, if comorbid with mental condition such as depression, can seriously affect patients’ quality of life with a direct influence on the survival rate. There is a connection between depression and worsened cancer progression and survival rate of CRC, little is known on gender differences in survival rates on elderly CRC patients with pre-existing depression (PD). A socioeconomic model study was used to evaluate gender, initial diagnostic stage, and marital status (MS) at diagnosis as major independent variables and 5-years survival rate (5-YS) …

Self-Efficacy Facilitated Sleep, Physical Activity, Towards Regulating Bmi Of Permanent 12-Hour Shift Registered Nurses, Veronica Brock

Walden Dissertations and Doctoral Studies

Shift workers with obesity-related comorbidities have reduced health and lifespan. Registered nurses (RNs) are ranked fifth among the most obese professionals in the United States, according to recent studies. Researchers have not examined the relationship between self-efficacy, physical activity, sleep, and 12-hour night shift RNs despite demonstrating that self-efficacy inspires confident health habits in the general population. For this quantitative study, the social cognitive theory was applied to study the interrelationships among the independent variables, sleep self-efficacy, self-efficacy for physical activity, and body mass index (BMI), with multiple dependent demographic variables, quality and quantity of sleep, and the level and …

Relationship Between Homelessness, Substance Use, Employment, Living On A Reservation And Tuberculosis Among Northern Plains Native Americans, Darla Mccloskey

Walden Dissertations and Doctoral Studies

Native Americans in the Northern Plains have a long history of tuberculosis (TB) infections. There is limited research on the causes of latent TB infections (LTBI) and TB in this population. The purpose of this quantitative study was to assess the relationship between latent TB and factors of homelessness, substance use, employment, living on a reservation, and active or latent TB among this population using the eco-social theory as the theoretical framework. Data from 146 TB cases of Native Americans living in the Northern Plains and diagnosed with TB from 1999 to 2019 were analyzed using chi-square tests that showed …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Risk Factors Influencing Poliomyelitis Seroprevalence In Polio High Risk Areas Of Afghanistan, Wasan Abdulaziz Al-Tamimi

Walden Dissertations and Doctoral Studies

Afghanistan is one of the remaining polio endemic countries in the world. Nearly one million children under 5 years of age have missed polio vaccination in Afghanistan from May 2018 until January 2021. This quantitative study used the socioecological model as the theoretical framework and secondary data analysis of the 2020 polio serosurvey (N = 1384) to investigate various risk factors such as gender, parental education, family origin (language/location), wealth, distance to nearest health facility, and number of polio vaccine doses on the level of antibodies (i.e., seroprevalence) against all three types of polioviruses in children of two age groups, …

Predictors Of Retention Among Individuals With Hiv Initiating Antiretroviral Therapy In Ghana, Ivy Ama Okae

Walden Dissertations and Doctoral Studies

Abstract Managing HIV requires lifelong therapy. Retaining clients on lifelong therapeutic antiretroviral therapy (ART) ensures the suppression of viral replication and better health outcomes. The time of the start of ART management is also a factor in determining better health outcomes for persons living with HIV. This study examined the association between initiation criteria (treat all, Option B+, and CDC T-cell count < 500) and retention on ART at 12 months for 17,974 randomly selected clients in the Ghana Health Service's HIV patient electronic database. Analyses controlled for age, gender, educational status, alcohol use, treatment/adherence monitoring, and tuberculosis disease treatment. Bronfenbrenner's ecological systems theory guided the interpretation of the findings. Results shows that retention was positively associated with all treatment initiation criteria. Clients initiated with CD4 count ≤ 500 criteria seemed to be retained at 12 months on ART at a higher rate than initiation criteria based on Option B+ and treat all. The study results may contribute to positive social change by supporting CD4 testing for clients before initiation of ART to improve retention and ensure the availability and use of adherence counseling, no tuberculosis disease and its prevention, and low use of alcohol among people living with HIV. The results of this study may also provide opportunities for public health policy intervention efforts requiring a personalized, group-based approach to service delivery at the intrapersonal level, interconnected with interpersonal, meso, and meta factors at the community level.

Associations Of Stress, Health Behaviors, And Obesity Among African American Immigrants, Wole David Akinsola

Walden Dissertations and Doctoral Studies

AbstractObesity has been identified as a predisposing factor that poses a serious threat for the development of chronic diseases and contributes to health disparities affecting both minority and vulnerable populations. Though previous studies reported the association of stress with health status and behavior, there is little or no research on the heterogeneity of obesity predictors in specific minority populations in the United States. The purpose of this study was to examine the predictors of obesity among adult African American immigrant populations in the United States. Studying obesity in this population may help policymakers tailor interventions that could reduce obesity prevalence. …