Public Health Commons^™

Addressing And Evaluating Health Literacy In Mhealth: A Scoping Review, Margaret Emerson, Sydney Buckland, Maxwell A. Lawlor, Danae Dinkel, David J. Johnson, Maria S. Mickles, Louis Fok, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

BACKGROUND: Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs. The aims of this study are to discover how health literacy is addressed and evaluated in mHealth app development.

METHODS: A …

Mothers' Perceptions Of Their Children's Weight: Opportunity For Health Promotion In Kuwait, Abdullah Al-Taiar, Nawal Alqaoud, Reem Sharaf-Alddin, Muge Akpinar-Elci

Community & Environmental Health Faculty Publications

Background: Mothers’ perceptions of their children’s weight remain mostly unknown in oil-rich countries of the Middle East.

Aims: To compare maternal perceptions of their children’s weight with actual body weight.

Methods: We used the Kuwait nutritional surveillance data for 5 consecutive years (2015-2019) (N = 5119), which were collected through face-to-face interviews with mothers of children aged 2-5 years attending vaccination centres.

Results: Of the 5119 mothers in the study, 163 (3.18%) and 332 (6.48%) had obese or overweight children, respectively. Among 4624 mothers who had normal weight children, 1350 (29.20%) perceived their children’s weight as …

Health Department Prevention/Education Plans And Perceived Risks Of Zika Infection, Lacey Jacques

Walden Dissertations and Doctoral Studies

AbstractZika virus is an infectious disease caused by the bite of an infected mosquito that has been linked to increased rates of microcephaly and other devastating birth defects. The existing body of knowledge has focused on the individual-level factors that influence a person’s decisions about prevention activities and risk perceptions related to Zika virus. The purpose of this study was to determine the relationship between state-level plans for prevention and education and individual-level risk perceptions. Rosenstock’s health belief model lays a foundation for why individuals make the health decisions they do and helps explain how these can be influenced for …

Attitudes Of State Public Health Laboratory Directors Towards Iso/Iec 17025 Accreditation, Christine Kilonzo

Walden Dissertations and Doctoral Studies

The impact of ISO/IEC 17025 accreditation in state public health laboratories (SPHLs) is understudied. There is a scarcity of research on SPHLs involving behavioral intent regarding ISO/IEC 17025 accreditation. The theory of planned behavior (TPB) was utilized to evaluate SPHL directors’ attitudes towards and intent to seek or maintain ISO/IEC 17025 accreditation. To test the questions of whether the three constructs of the TPB, attitude, subjective norms and perceived behavioral control are significant predictors of intent to seek or maintain ISO/IEC 17025 accreditation, and whether there are significant differences in these constructs towards the accreditation between SPHL directors based on …

Disability In An American Indian Community : Prevalence, Distribution, And The Role Of Polychlorinated Biphenyls, Thoin Farzana Begum

Legacy Theses & Dissertations (2009 - 2024)

The Akwesasne reservation along the St. Lawrence River has experienced significant exposure to several persistent organic pollutants due to rapid industrialization. The Aluminum Company of America, General Motors, and Reynolds Metals operated aluminum foundries that used polychlorinated biphenyls (PCBs) as hydraulic fluids, which contaminated the community environment, the soil, air and water, and community food sources with PCBs. We administered the World Health Organization Disability Assessment Schedule II (WHODAS II) to 119 Akwesasne Mohawk adults residing along the St. Lawrence River in New York. We used exploratory factor analysis to summarize the 36- items comprising the WHODAS II. The 7 …

Association Between Antiretroviral Therapy And Severe Covid-19 Outcomes Among Hospitalized Hiv Positive People With Sars-Cov-2 In Nys, Aizhan Kyzayeva

Legacy Theses & Dissertations (2009 - 2024)

IMPORTANCE The role of antiretroviral therapy (ART) type in people living with HIV (PLWDH) co-infected with acute respiratory syndrome coronavirus 2 (SARS-Cov-2) remains unclear. There is evidence that certain classes of ART may mute the risk of severe COVID-19 outcomes.

Radical Trachelectomy For Invasive Cervical Cancer : A Pathway To Fertility For Some, But Not Without Repercussions, Erica Jamro-Comer

Legacy Theses & Dissertations (2009 - 2024)

BackgroundRadical trachelectomy (RT) is a surgical procedure that offers a substantial benefit to women diagnosed with invasive cervical cancer: fertility preservation. However, as a newer surgical option, there are still many unknowns about the characteristics and outcomes of women who undergo this procedure after a cervical cancer diagnosis. Initial research in this area indicates that some disparities exist in who has the surgery versus the standard radical hysterectomy procedure; however, these are not fully understood and characterized. Furthermore, little is known about how women plan their families and how their high-risk pregnancies are managed in the absence of a standard …

Maternal Antifungal Use During Pregnancy : A Study Of Prevalence Of Use And The Risk Of Birth Defects, Eleni A. Papadopoulos

Legacy Theses & Dissertations (2009 - 2024)

Fungal infections, especially vulvovaginal candidiasis (VVC), are common among pregnant women. Therefore, it is important to study the effect that antifungal medications may have on the developing fetus. Recent studies have suggested there are positive associations between birth defects and specific oral antifungals. In this dissertation, maternal antifungal use during pregnancy was examined using data from the National Birth Defects Prevention Study (NBDPS). The NBDPS was multi-site, population-based, case-control study and included women with estimated delivery dates during October 1997 through December 2011. It was designed to investigate risk factors associated with more than 30 categories of major birth defects. …

Genomic Epidemiology Of Clinical Salmonella Enterica In New Hampshire, 2017-2020, Madison R. Turcotte

Legacy Theses & Dissertations (2009 - 2024)

Antimicrobial resistance in Salmonella enterica remains a challenging public health threat. We aim to characterize the population structure and evolutionary history of 394 genomes of S. enterica isolates recovered from human clinical cases in New Hampshire, USA from 2017 to 2020. The population is phylogenetically diverse, consisting of 78 STs and 67 serotypes. We detected 61 genes associated with resistance to14 different antimicrobial classes. Rather than a single multidrug resistant clone expanding in the state, we found multiple lineages carrying different combinations of independently acquired resistance determinants. New or emerging lineages can therefore rapidly spread over relatively short timeframes. In …

The Influence Of Race And Ethnicity On The Prevalence Of Social Stigma For People With Type 1 Diabetes Mellitus, Donielle Hyde

Walden Dissertations and Doctoral Studies

Various studies attempting to evaluate the prevalence of health-related social stigma in people with type 1 diabetes mellitus (T1DM) identified themes that coincide with increased prevalence including anxiety, low self-esteem, depression, fear of judgement, anger, and feeling ashamed. This phenomenon is believed to be due to the lack of knowledge and understanding about the differences between the diagnosis, treatment, and prevention strategies for T1DM and type 2 diabetes mellitus (T2DM). The Resilient, Empowered, Active Living intervention dataset (n=115) was utilized to further examine this phenomenon by determining whether race and ethnicity influence the prevalence of the following health-related social stigma …

Preconception Substance Use And Risk Of Unintended Pregnancy, Saima Shafique

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: In the United States, unintended pregnancy is a serious public health issue due to its persistent high prevalence. In the series of three studies, our first two investigations examined the risk and potential determinants of unintended pregnancy among substance and polysubstance using women of childbearing age. In the third study, we conducted a systematic review (SR) with meta-analysis (MA) to assess the association of illicit and recreational drugs to the risk of unintended pregnancy.

Methods: We performed a secondary data analysis on a subset of Pregnancy Risk Assessment Monitoring System (PRAMS) 2016-17 phase 8 data (n=75,543). The outcome variable …

Incidence Of Cancer, Depression, And Economic Burden Of Prescription Nsaids Among Older Adults With Osteoarthritis: Statistical And Machine Learning Approaches, Nazneen Fatima Mohammed Umer Shaikh

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding the role of chronic inflammation among older adults is critical because of its implications on chronic inflammatory conditions as well as its interaction with anti-inflammatory medications. Osteoarthritis (OA) is a heterogeneous multi-faceted joint disease with multi-tissue involvement of varying severity, and increasing evidence demonstrates a key role of chronic inflammation in its pathogenesis. Approximately 30 million adults in the United States have OA, and it is reported that a large proportion (43%) of them are older than 65 years. OA is typically treated using non-steroidal anti-inflammatory drugs (NSAIDs) for minimizing pain and reducing inflammation. NSAIDs have consistently shown clinically …

Risk Factors Of Infant Mortality Among Sub-Saharan Immigrants In The United States, Roland Lankah

Walden Dissertations and Doctoral Studies

While prepregnancy body mass index (BMI), gestational weight gain (GWG), and birthplace have been suggested to play a key role in predicting infant mortality outcomes, they have not been thoroughly investigated across all races/ethnicities. The purpose of this study was to examine the associations between prepregnancy BMI, GWG, birthplace as independent variables, and infant mortality as the outcome variable within the United States Sub-Saharan African Immigrants (SSAI). A quantitative cross-sectional study design grounded in the biopsychosocial model was used. Data were extracted from the 2017-2018 natality-linked birth/infant death file from the Centers for Disease Control and Prevention Wonder Database. It …

Role Of Hypertension In Low-Birth-Weight Racial Disparities Among Virginian Women, Ashli Owen

Walden Dissertations and Doctoral Studies

Low birth weight (LBW) is a leading cause of infant mortality globally, but it disproportionately burdens the Black community in the United States, with a rate twice that of White women. Further, hypertensive disorders of pregnancy (HDsP) increase LBW incidence. The purpose of the study was to assess the association between HDsP and LBW, maternal race and LBW, and the moderation effect of HDsP on race and LBW on Black and White women in Virginia. The theoretical framework for this study was based on the lifecourse health development model, which states that health should be viewed as an outcome of …

Factors Influencing Human Papillomavirus Vaccination Among Hispanic Youth In Bexar County, Texas, Timothy Edward Wallum

Walden Dissertations and Doctoral Studies

A high number of Hispanic youth in Bexar County, Texas, face morbidity and mortality related to human papillomavirus (HPV) infection due to inadequate vaccination coverage youth. A better understanding of the factors that influence vaccination might help public health authorities to increase coverage. The aim of this quantitative, cross-sectional study, which was based on the socioecological model and involved analysis of weighted survey data from the 2016 to 2018 National Immunization Survey-Teen, was to better understand the multilevel factors influencing HPV vaccine use among Hispanic youth. The weighted sample was representative of the study population in terms of survey characteristics …

Addressing Ascertainment Bias In The Study Of Cardiovascular Disease Burden In Opioid Use Disorders - Application Of Natural Language Processing Of Electronic Health Records, Jade Huang Singleton

Theses and Dissertations--Epidemiology and Biostatistics

In the United States, the prevalence of long-term exposure to opioid drugs, for both medically and nonmedically indicated purposes, has increased considerably since the mid-1990’s. Concerns have emerged about the potential health effects of opioid use. There is also growing interest in other possible connections with opioid use including cardiovascular disease. Electronic health records (EHR) contain information about patient care in the form of structured codes and unstructured notes. Natural language processing (NLP) provides a tool for processing unstructured textual data in EHR clinical notes and extracts useful information for research with structured formats. The purpose of this dissertation was …

Opioid Use Disorder Treatment With Buprenorphine: Analysis Of Treatment Utilization And Associated Outcomes In Kentucky, Feitong Lei

Theses and Dissertations--Epidemiology and Biostatistics

Opioid use disorder (OUD) is chronic opioid use that results in clinically significant suffering, impairment, or even death. The opioid epidemic in the United States has become a public health and economic crisis, affecting patients' well-being and the nation's overall health and welfare. Eastern Kentucky was among the first regions affected by the opioid crisis, and Kentucky has historically ranked among the top five states for age-adjusted drug overdose mortality rate.

There are three medications (buprenorphine, methadone, naltrexone) approved by the U.S. Food and Drug Administration to treat OUD. As a partial opioid agonist, buprenorphine is a safe medication for …

Endocrine Disruptors: Challenges And Future Directions In Epidemiologic Research, V. Ho, L. Pelland-St-Pierre, S. Gravel, M. F. Bouchard, M.-A. Verner, F. Labrèche

Études primaires

Public concern about the impact of endocrine disrupting chemicals (EDCs) on both humans and the environment is growing steadily. Epidemiologic research provides key information towards our understanding of the relationship between environmental exposures like EDCs and human health outcomes. Intended for researchers in disciplines complementary to epidemiology, this paper highlights the importance and challenges of epidemiologic research in order to present the key elements pertaining to the design and interpretation of an epidemiologic study on EDCs.

The conduct of observational studies on EDCs derives from a thoughtful research question, which will help determine the subsequent methodological choices surrounding the careful …

An Ecological Study Of Glyphosate Use And Non-Hodgkin’S Lymphoma, Dexter Corlett, Steven R. Browning

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

Glyphosate is currently the most widely used herbicide in the world. Initially thought to be non-carcinogenic in humans, in 2015 glyphosate was classified as a “probable carcinogen” by the International Agency for Research on Cancer due to several small epidemiological studies indicating a link between the pesticide and hematologic cancers, especially non-Hodgkin’s lymphoma (NHL). The current work is an ecological study using counties in Kentucky, Arkansas, and Iowa to compare glyphosate usage to NHL incidence using a multivariate Poisson regression. We found no significant correlation between glyphosate use and NHL incidence, though caution should be taken to draw significance from …

Structural Violence & Small Victories: Political Epidemiology Of Hiv Among Msm In Nigeria, 2000-2010, Debbie A. Dada

Harvey M. Applebaum ’59 Award

No abstract provided.

Longitudinal Assessment Of Hospital Utilization Among Infants With Neonatal Abstinence Syndrome And Mothers With Opioid Use, Florida 1998-2018, Amanda Louise Elmore

Theses and Dissertations

Over the past few decades, maternal opioid use and Neonatal Abstinence Syndrome (NAS) have significantly increased. However, few studies have examined prevalence trends by sociodemographic variables. Therefore, the first aim of my dissertation was to determine the prevalence by year for each outcome for the total sample and by maternal race/ethnicity, education level, and insurance type.

Prenatal opioid exposure (POE) poses neonatal risks including Neonatal Abstinence Syndrome (NAS) and studies suggest the effects may extend through childhood. However, there are critical gaps in literature on the long-term developmental outcomes of opioid-exposed infants by presence of NAS. Therefore, the second aim …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Qualitative Analysis Of Cancer Care Experiences Among Rural Cancer Survivors And Caregivers, Kendra L. Ratnapradipa, Jordan Ranta, Krishtee Napit, Lady Beverly Luma, Tamara Robinson, Danae Dinkel, Laura Schabloske, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

PURPOSE: Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services.

METHODS: We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska.

FINDINGS: Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging …

Gut Microbiome Dysbiosis In Antibiotic-Treated Covid-19 Patients Is Associated With Microbial Translocation And Bacteremia, Lucie Bernard-Raichon, Mericien Venzon, Jon Klein, Jordan E. Axelrad, Chenzhen Zhang, Alexis P. Sullivan, Grant A. Hussey, Arnau Casanovas-Massana, Maria G. Noval, Ana M. Valero-Jimenez, Juan Gago, Gregory Putzel, Alejandro Pironti, Evan Wilder, Yale Impact Research Team, Lorna E. Thorpe, Dan R. Littman, Meike Dittmann, Kenneth A. Stapleford, Bo Shopsin, Victor J. Torres, Albert I. Ko, Akiko Iwasaki, Ken Cadwell, Jonas Schluter, Abeer Obaid, Alice Lu-Culligan, Allison Nelson, Anderson Brito, Angela Nunez, Anjelica Martin, Annie Watkins, Bertie Geng, Chaney Kalinich, Christina Harden, Codruta Todeasa, Cole Jensen, Daniel Kim, David Mcdonald, Denise Shepard, Edward Courchaine, Elizabeth B. White, Eric Song, Erin Silva, Eriko Kudo, Giuseppe Deluliis, Harold Rahming, Hong-Jai Park, Irene Matos, Jessica Nouws, Jordan Valdez, Joseph R. Fauver, Joseph Lim, Kadi-Ann Rose, Kelly Anastasio, Kristina Brower, Laura Glick, Lokesh Sharma, Lorenzo Sewanan, Lynda Knaggs, Maksym Minasyan, Maria Batsu, Mary Petrone, Maxine Kuang, Maura Nakahata, Melissa Campbell, Melissa Linehan, Michael H. Askenase, Michael Simonov, Mikhail Smolgovsky, Nicole Sonnert, Nida Naushad

Journal Articles: Epidemiology

Although microbial populations in the gut microbiome are associated with COVID-19 severity, a causal impact on patient health has not been established. Here we provide evidence that gut microbiome dysbiosis is associated with translocation of bacteria into the blood during COVID-19, causing life-threatening secondary infections. We first demonstrate SARS-CoV-2 infection induces gut microbiome dysbiosis in mice, which correlated with alterations to Paneth cells and goblet cells, and markers of barrier permeability. Samples collected from 96 COVID-19 patients at two different clinical sites also revealed substantial gut microbiome dysbiosis, including blooms of opportunistic pathogenic bacterial genera known to include antimicrobial-resistant species. …

Pain That Only She Must Bear: On The Invisibility Of Women In Judicial Abortion Rhetoric, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

The graphic and bodily facts of a legal question of rights are relevant to the courts, particularly in questions that directly implicate physical bodies and pain, such as right to die cases, or what level of search may be allowable and when. However, in the case of abortion, or more specifically the bodily ramifications of pregnancy and childbirth, this detail is conspicuously absent. This article, relying on a content analysis of over 220 legal opinions on abortion rights, documents this absence of rhetoric. Particularly in the context of other discussions of pain and physical health risks in these very same …

Factors Associated With Accidental Drug Exposure In U.S. Adults Over 65 Years Of Age, Edwin Raj

Walden Dissertations and Doctoral Studies

Medication errors are a major public health issue and a leading cause of fatalities in the United States and globally. Older adults who rely on medications to address age-related health issues are at higher risk of medication errors. Accidental exposure to drugs is a major type of medication error that impacts older people more than other age groups. The purpose of this quantitative correlational study was to examine the association between patient gender, age group, and reporter type and accidental exposure to drugs in older people. The ecological model was used to guide the study. Logistic regression analysis was used …

Looking Upstream For Factors Influencing Mental Illness In A Low-Resource Setting, Adewole Adebola Adefalu

Walden Dissertations and Doctoral Studies

An investigation into the upstream determinants of mental disorders could provide insight into pathways by which these risk factors could relate to different groups of mental illness. The study was a quantitative inquiry using constructs within the Rothman’s sufficient and component cause framework to examine the pathways existing between upstream risk factors for schizophrenic and mood disorders. The study population was drawn from a convenience sample of clients accessing services at the psychiatry departments of a secondary mental health institution in North-Central Nigeria. The mean age of the participants in this study was 35.5years. The majority were males (53.4%), single …

Predictors Of Glycemic Control Among Type 2 Diabetes Mellitus Patients In Owerri, Nigeria, Jideuma Ikenna Egwim

Walden Dissertations and Doctoral Studies

Diabetes mellitus (DM) is a significant public health concern globally and in Owerri, Nigeria. The deleterious effects of diabetes have been linked to poor glycemic control. According to the International Diabetes Federation, poor glycemic control is reflected in glycosylated hemoglobin (HbA1c) levels greater than 7.0%, which are associated with substantial morbidity and mortality. Studies have shown a dramatic rise in diabetic complications in Nigeria, particularly in Owerri. However, evidence is lacking on specific risk factors associated with poor glycemic control among DM patients in Owerri. With health insurance assuming a significant position in healthcare service delivery in Nigeria, addressing this …

Major Depressive Disorder And Perceived Everyday Discrimination Among The Jamaican Diaspora In The United States., Warren Williams

Walden Dissertations and Doctoral Studies

Overt racial discrimination in the United States has been supplanted by subtle forms of everyday discrimination known as microaggressions. Researchers have found perceived everyday discrimination (PED) to be associated with major depressive disorder (MDD) among African Americans but have often treated the African American subpopulation as a homogeneous group. The purpose of this cross-sectional study grounded in the theory of microaggression was to illuminate probable associations between microaggressions based on weight, age, gender, ethnicity, and race and lifetime MDD among the Jamaican diaspora in the United States. Secondary data from the Collaborative Psychiatric Epidemiologic Surveys were analyzed. Statistically significant associations …

Risk Factors Associated With Type 2 Diabetes Among Adults In Alabama, Peter Okeke

Walden Dissertations and Doctoral Studies

In the 21stcentury Diabetes mellitus is recognized as one of the most important public

health challenges that carry a substantial individual and community burden.

It is necessary to do a detailed search regarding DM2 from adolescence till adulthood is in

Alabama which should aim to provide recent information. T2D is influenced by a many

factors including demographics including age, sex, income level, educational, BMI,

physical activities, etc. Identification of the associated risk factors is very important to

inform decision making by concerned bodies and T2D management. The study aimed to

examine the risk factors associated with T2D in adults aged …