Public Health Commons^™

Identifying Factors Associated With Syringe Reuse Among People Who Inject Drugs (Pwid) In Appalachia Kentucky, Grayson Keith Fuller

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

Aim: Syringe reuse contributes to the spread of infectious diseases. The purpose of this study is to identify factors associated with syringe reuse among people who inject drugs (PWID) in Kentucky.

Methods: PWID (n=238) completed interviewer-administered questionnaires to collect data on syringe reuse and demographic, behavioral, and clinical characteristics. Negative log binomial regression was used to model the associations.

Results: On average, people reused each syringe 9.3 times (median: 3; IQR: 2-10, range 1-95). Syringe reuse was higher among men [aOR=1.386; 95% CI: 1.041-1.845] and those who injected methamphetamine [aOR=2.122; 95% CI: 1.445-3.116]. Reuse was also higher among those who …

Papanicolaou (Pap) Test And Human Papillomavirus (Hpv) Test Adherence: Sexual Violence Victims And Fear Of Retraumatization, Murielle Sighe Ngoumkam

CGU Theses & Dissertations

To include all vulnerable women population who faced barriers to participating in preventive cervical cancer screening, the public health community must better understand the factors that affect their decision for getting Pap and HPV tests. Public health must understand the sexual violence victims, a subgroup of women who faced the onset of trauma and explore their adherence to routine screening. This study investigated whether sexual women with a history of sexual violence (SV), likelihood to get screened for cervical cancer would be impacted given the fear of suffering from secondary trauma during conventional screening procedures. Methods: Knowledge of cervical screening …

Humidity Reduces Rapid And Distant Airborne Dispersal Of Viable Viral Particles In Classroom Settings, Antun Skanata, Fabrizio Spagnolo, Molly Metz, Davida S. Smyth, John J. Dennehy

Publications and Research

The transmission of airborne pathogens is considered to be the main route through which a number of known and emerging respiratory diseases infect their hosts. While physical distancing and mask wearing may help mitigate short-range transmission, the extent of long-range transmission in closed spaces where a pathogen remains suspended in the air remains unknown. We have developed a method to detect viable virus particles by using an aerosolized bacteriophage Phi6 in combination with its host Pseudomonas phaseolicola, which when seeded on agar plates acts as a virus detector that can be placed at a range of distances away from an …

Factors Associated With Mask Use In New York City Neighborhood Parks During The Covid-19 Pandemic: A Field Audit Study, Lisa Hitch, Marie A. Sillice, Hanish Kodali, Katarzyna E. Wyka, Javier Otero Peña, Terry Tk Huang

Publications and Research

Background: Mask use is a cost-effective measure to decrease COVID-19 transmission. Mask mandates intend to increase mask compliance but are often ambiguous when it comes to public outdoor spaces.

Methods: We used a field audit study to examine mask use in New York City neighborhood parks during COVID-19. 1453 park visitors were observed in 13 parks during July–August 2020 using a modified and validated park use audit tool (System for Observing Play and Recreation in Communities) that included items on general and proper mask use (i.e., mask covering both nose and mouth). Generalized estimating equation regression was used to determine …

Work-Based Concerns Of Australian Frontline Healthcare Workers During The First Wave Of The Covid-19 Pandemic, Michella Hill, Erin Smith, Brennen W. Mills

Research outputs 2014 to 2021

Objective: This research sought to gauge the extent to which doctors, nurses and paramedics in Australia were concerned about contracting SARS-CoV-2 during the country's first wave of the virus in April 2020.

Methods: Australian registered doctors, nurses and paramedics (n=580) completed an online questionnaire during April 16–30, 2020 (period immediately following the highest four-week period (first wave) of SARS-CoV-2 confirmed cases in Australia).

Results: During April 2020, two-thirds of participants felt it was likely they would contract SARS-CoV-2 at work. Half the participants suggested Personal Protective Equipment (PPE) supplies were inadequate for them to safely perform their job, with two-thirds …

Covid-19 Outcomes In Myasthenia Gravis Patients: Analysis From Electronic Health Records In The United States, Youngran Kim, Xiaojin Li, Yan Huang, Minseon Kim, Aziz Shaibani, Kazim Sheikh, Guo-Qiang Zhang, Thy Phuong Nguyen

Faculty, Staff and Student Publications

BACKGROUND: Myasthenia gravis (MG) is an autoimmune, neuromuscular condition and patients with MG are vulnerable due to immunosuppressant use and disease manifestations of dyspnea and dysphagia during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: We conducted a retrospective cohort study using the Optum® de-identified COVID-19 Electronic Health Record (EHR) dataset. Primary outcomes, such as hospitalization, ventilator use, intensive care unit (ICU) admission, and death in COVID-19 patients with MG, were compared with those of COVID-19 patients without MG: the subgroups of non-MG included those with rheumatoid arthritis (RA), systemic lupus (SLE), and multiple sclerosis (MS). We further analyzed factors affecting …

Characterizing Cancer And Covid-19 Outcomes Using Electronic Health Records, Youngran Kim, Liang Zhu, Huili Zhu, Xiaojin Li, Yan Huang, Chunhui Gu, Heather Bush, Caroline Chung, Guo-Qiang Zhang

Faculty, Staff and Student Publications

PURPOSE: Patients with cancer often have compromised immune system which can lead to worse COVID-19 outcomes. The purpose of this study is to assess the association between COVID-19 outcomes and existing cancer-specific characteristics.

PATIENTS AND METHODS: Patients aged 18 or older with laboratory-confirmed COVID-19 between June 1, 2020, and December 31, 2020, were identified (n = 314 004) from the Optum® de-identified COVID-19 Electronic Health Record (EHR) derived from more than 700 hospitals and 7000 clinics in the United States. To allow sufficient observational time, patients with less than one year of medical history in the EHR dataset before their …

"Don't Know Where To Go For Help": Safety And Economic Needs Among Violence Survivors During The Covid-19 Pandemic, Leila Wood, Elizabeth Baumler, Rachel Voth Schrag, Shannon Guillot-Wright, Dixie Hairston, Jeff Temple, Elizabeth Torres

Faculty, Staff and Student Publications

The COVID-19 pandemic and related quarantine has created additional problems for survivors of interpersonal violence. The purpose of this study is to gain a preliminary understanding of the health, safety, and economic impacts of the COVID-19 pandemic on people that are experiencing or have previously experienced violence, stalking, threats, and/or abuse. An online survey, open from April to June 2020, was taken by people with safety concerns from interpersonal violence. Participants were recruited from IPV and sexual assault-focused agencies, state coalitions, and social media. Quantitative data were summarized using descriptive methods in SPSS and coding methods from thematic and content …

Outcome Measure Of Female Inmates In West Amazon, Carlos Eduardo Siqueira, Luiz C De Abreu, Italla M Pinheiro Bezerra

Gastón Institute Publications

Introduction: the prison system in the Brazilian state of Acre, located in the Western region of the Amazon, is a branch of the criminal justice system that has been suffering from issues such as overcrowding and growth in internal organized crime. The prevalence of these matters directly affects the resocialization of prisoners and inhibits the successful re-engineering of their social values and beliefs. Objective: to analyze the epidemiological profile of jailed women in the State of Acre, Brazil. Methods: in a cross-sectional descriptive study, 129 participants were recruited from female penitentiaries in the state of Acre. Conducted between August and …

Selective Participation In Syphilis Partner Services And Implications For Control Efforts, Fulton County, Georgia, 2013-2015, Sarah Hamid, Udodirim N. Onwubiko, David P. Holland, Allison T. Chamberlain

Journal of the Georgia Public Health Association

Background. Partner services is an important component of syphilis control, but not all persons with syphilis participate, limiting the strategy’s potential effectiveness and possibly introducing selection biases into analyses of risk factors for reinfection. This study aimed to describe demographic and clinical differences between partner-services participants and non-participants in Fulton County, Georgia, and to assess the association between participation and syphilis re-diagnosis.

Methods. Using surveillance data, we identified primary and secondary syphilis cases in Fulton County with a first diagnosis in 2013-2015. We compared the distributions of demographic and clinical characteristics between participants and non-participants using chi-squared tests. …

Trends And Correlates Of Breakthrough Infections With Sars-Cov-2, Jose-Miguel Yamal, Savitri Appana, Mengxi Wang, Luis Leon-Novelo, Eric Bakota, Yuanqing Ye, Shreela Sharma, Alanna C Morrison, Dritana Marko, Stephen H Linder, Alison Rector, Katelyn K Jetelina, Eric Boerwinkle, Marcia De Oliveira Otto

Faculty, Staff and Student Publications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) delta variant has been hypothesized to decrease the efficacy of COVID-19 vaccines. Factors associated with infections with SARS-CoV-2 after vaccination are unknown. In this observational cohort study, we examined two groups in Harris County, Texas: (1) individuals with positive Nucleic Acid Amplification test between 12/14/2020 and 9/30/2021 and (2) the subset of individuals fully vaccinated in the same time period. Infected individuals were classified as a breakthrough if their infection occurred 14 days after their vaccination had been completed. Among fully vaccinated individuals, demographic and vaccine factors associated with breakthrough infections were …

Incidence Rate Of Psychiatric Disorders In 2020: The Pivotal Role Played By Sars-Cov-2 Infection, Antonio L Teixeira, Regina M Hansen, Joseph S Wozny, Caroline M Schaefer, Rodrigo Machado-Vieira, Lokesh Shahani, Scott D Lane, Jair C Soares, Trudy M Krause

Faculty, Staff and Student Publications

IMPORTANCE: The Coronavirus Disease (COVID-19) pandemic has significantly impacted mental health outcomes. While the frequency of anxiety and depressive symptoms has increased in the whole population, the relationship between COVID-19 and new psychiatric diagnoses remains unclear.

OBJECTIVE: to compare the population incidence rate of emergence of de novo psychiatric disorders in 2020 compared to the previous years, and to compare the incidence rate of new psychiatric disorder diagnoses between people with vs without COVID-19.

DESIGN, SETTING, AND PARTICIPANTS: This study utilized administrative claims data from the Clinformatics® Data Mart database, licensed from Optum®. The study is a cross-sectional analysis that …

Sociodemographic Factors As Predictors Of Low Influenza Vaccination In Chicago, Illinois, Ingrid L. Jeske

Walden Dissertations and Doctoral Studies

Outbursts of seasonal influenza contribute to morbidity and mortality in the United States. Influenza is a contagious disease caused by influenza viruses. The main subtypes of the influenza virus are Type A and Type B. Influenza vaccines are among the most effective methods in preventing the spread of the influenza virus because they offer the best immune defense. However, health care providers face significant challenges due to low patient compliance with current vaccine recommendations and misinformation. Scholars have yet to expand and further explore the reasons for the gap in influenza vaccination between White individuals and minorities, such as the …

Primary Care Physicians’ Knowledge, Attitudes, And Practices Regarding Lyme Disease In High- Versus Low-Incidence Lyme Disease Midwestern States, Alexander Karnga

Walden Dissertations and Doctoral Studies

AbstractThe purpose of this quantitative cross-sectional study, guided by the barriers to physician behavior change (BPBC) framework, was to address the gaps in the Lyme disease empirical literature by examining whether there were significant differences in Lyme disease knowledge, attitude, and practices between primary care physicians in Wisconsin, a high-incidence Midwestern Lyme disease state, and Michigan, a low-incidence Lyme disease Midwestern state. The study was conducted with 65 physicians (53.8% male and 46.2% female). The study hypotheses were tested by conducting a one-way multivariate analysis of covariance (MANCOVA), controlling for physicians’ years of practice (the number of patients seen per …

Perceptions Of Hiv Testing Among African-Born Immigrants In Washington State, Phoebe Kirigo Mugo

Walden Dissertations and Doctoral Studies

African born immigrants (ABIs) face challenges associated with HIV testing. As a result, many ABIs are not tested for HIV, and this population is among some of the most diagnosed at late stages of HIV/AIDS. The purpose of this qualitative phenomenological study was to explore and seek to understand the lived experiences of ABI adults ages 25 to 49 living in Washington State. I gathered data to gain their perceptions of HIV testing through in-depth interviews. The study was informed by the health belief model, which helped to understand the complex nature of healthcare-seeking behaviors among this population and how …

Variables On The Proportion Of Children With Sickle Cell Hemoglobin, Oyekola Oluyimika Oloyede

Walden Dissertations and Doctoral Studies

AbstractThe case fatality rate among children living with sickle cell disease was approximately 50% to 90% in Sub-Saharan Africa. Though researchers have contributed social determinants of health more broadly, they have not provided adequate screening information on children living with sickle cell disease aged 6 months to 59 months. The purpose of this cross-sectional study was to examine the association between sickle cell disease status, infection prevention, pain and anemia management, demography, socioeconomic status, and healthcare use. This study included approximately 11,536 genotype results of children under 5-years-old in Nigeria. Bronfenbrenner’s systems theory and Krieger’s ecological theory formed the theoretical …

Non-Disclosure Of Child Sexual Abuse: The Lived Experience Of Victims In South Africa, Chima Obiora Ozor

Walden Dissertations and Doctoral Studies

Child sexual assault (CSA) has been reported all over the world. Studies indicated that South Africa has one of the highest incidences with far reaching social, physical and emotional consequences. However, non-disclosure is common, which increases the risk of revictimization. Understanding the complexities surrounding the low reporting and non-disclosure will provide guidance for better intervention of CSA in South Africa. This study explored the past experiences of adults who were sexually abused as minors, and how their experiences and outcomes may have been influenced by factors at the micro, meso, macro, and chrono-system levels of Bronfenbrenner’s social ecological model. The …

Impact Of Poverty On Antibiotic Prescribing Rates In The United States Through Mediation Effects Of Underlying Health Conditions, Nato Tarkhashvili

Walden Dissertations and Doctoral Studies

Resistance to antibiotics among bacteria develops largely due to frequent use of antibiotics in human and animal medicine. Little is known about how patients’ socioeconomic factors, in conjunction with chronic health conditions, impact antibiotic prescribing rates in the United States. The research questions aimed to explore the relationship between poverty and antibiotic prescribing rates while also adjusting for confounders such as population aged ≥ 65, physician density, prevalence of obesity, diabetes, and chronic obstructive pulmonary disease (COPD). The relationships were evaluated using a quantitative, ecological study design using the ecosocial theory and mediation analysis of 2020 survey results provided by …

Vitamin K Deficiency And Ischemic Stroke In Atrial Fibrillation Patients On Warfarin, Kimberly Therese Thompson

Walden Dissertations and Doctoral Studies

Individuals with poor nutritional vitamin K status can suffer from atrial fibrillation (AF) due to misinterpretation of warfarin instructions by healthcare providers. The purpose of this quantitative study was to determine if there was an association between inadequate dietary vitamin K intake in AF patients and stroke outcomes to address the lack of research surrounding stroke outcomes in patients with true vitamin K deficiency. Grounded in the health belief model, this study assessed if individual beliefs from health education influenced the nutritional quality of their diet and health outcomes. The study is a secondary data analysis of the Framingham Heart …

Gestational Weight Gain, Level Of Education, And Infant Mortality Among African American Women, George Lee Amanambu

Walden Dissertations and Doctoral Studies

Abstract

African American (AA) women in Mississippi have a higher burden of infant mortality, especially those with low income and educational levels, as compared to other regions of the country. However, it is unknown if abnormal gestation weight gain (GWG) is contributing to this increased burden. This quantitative cross-sectional study examined the association between GWG (25-35lbs), level of education, income, and infant mortality among AA women with normal prepregnancy body weight who were between 30 to 47 years old in the state of Mississippi from 2016 to 2018. Biopsychosocial and ecosocial models were used as the theoretical foundation to design …

Weight Change And Hyponatremia As Predictors Of Polydipsia Among Persons With Schizophrenia, Kingsley Okechukwu Nwachukwu

Walden Dissertations and Doctoral Studies

AbstractPolydipsia is found in 20% of inpatients with chronic severe mental disorders. Of this, 80% are diagnosed with chronic schizophrenia, hence polydipsia is strongly associated with chronic schizophrenia. Despite the prevalence and serious health complications of coexisting polydipsia in this population, its current method of detection is flawed. The purpose of this quantitative study was to accurately identify comorbid polydipsia in schizophrenia using periodic weight change and hyponatremia. The Wilson’s complexity theory and primary data were used to attempt to explain the relationship between weight change and hyponatremia and polydipsia, in a cross-sectional study design. The dependent variable was polydipsia, …

Risk Factors Associated With Access To Intermittent Preventive Treatment For Malaria Among Pregnant Women In Uganda, Mayanja Simon Peter

Walden Dissertations and Doctoral Studies

Intermittent preventive treatment of malaria in pregnancy (IPTp) is an intervention consisting of the full course of therapeutic antimalarial medicine administered to pregnant women during routine antenatal visits regardless of whether the woman is infected with malaria. The use of intermittent preventive treatment of malaria in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) has been reportedly low in most of the malaria endemic areas, including Uganda. The coverage of IPTp in Uganda has been estimated to be as low as 17%. An in-depth secondary data analysis using the 2016 Uganda Department of Health Services survey was conducted to understand the causal relationships between …

Depression, Drug Use, And Hsv-2 Among Women Who Have Sex With Women, Viani Picchetti

Walden Dissertations and Doctoral Studies

Herpes simplex virus type 2 (HSV-2), the main cause of genital herpes, is an incurable sexually transmitted infection responsible in 2018 for 18.6 million infections in the United States. HSV-2 is twice as frequent in women than in men. Women who have sex with women (WSW) have a higher prevalence of depression and drug use than women who have sex exclusively with men (WSM), which are each related to HSV-2 as they increase the likelihood of engaging in risky sexual behaviors. The purpose of this study was to assess the predictive relationship between depression status, nonprescription drug use status, and …

Diabetes, Obesity, Geographic Location Of The Patient And Clostridium Difficile Infection In The United States, Mary (Maribeth) Greenway

Walden Dissertations and Doctoral Studies

AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey …

Bullying, Participation In Violence, Suicidal Ideation, And Behavior Among African American Youth, Kierystan Lorquoyea Johnson

Walden Dissertations and Doctoral Studies

Suicide is the second leading cause of death among adolescent, teens, and young adults. Suicidal ideation is a predictor of suicide attempts. Guided by the integrated motivational-volitional model and social cognitive theory, Youth Risk Behavior Surveillance Survey data were used to investigate whether traditional bullying, cyberbullying, and participation in physically violent behavior (independent variables) were associated with suicidal ideation and behavior (dependent variables) among African American high school aged youth controlling for age, gender, physical, and sexual abuse. It was found that experiencing traditional bullying increased suicidal ideation significantly, as there is an 82% increase in likelihood. There was also …

Microaggression Experiences Among African American Women And Their Effects On Health In Academia, Anta'sha Moni Jones

Walden Dissertations and Doctoral Studies

Racial microaggressions are brief daily negative verbal behaviors and environmental slights directed as intentional or unintentional towards minorities. These negative interactions lead minorities to feel powerless and oppressed in their environments. These adverse experiences result from stressors in their environment that negatively affect the human body by causing acute and chronic stress. This qualitative study aimed to investigate the relationship between personal, racial microaggression experiences, and their impact on health through a phenomenological approach. The critical race theory provided a framework to explore and understand how systematic discrimination experiences impacted the 17 African American faculty member participants’ health. A phenomenological …

External Validation And Modification Of A 30-Day Readmission Risk Prediction Model For Heart Failure Patients, Debra Kelly

Walden Dissertations and Doctoral Studies

The development and validation of 30-day readmission risk prediction models, such as the LACE index, have been of interest to researchers and healthcare organizations, especially since the Centers for Medicare and Medicaid Services began to impose monetary penalties on hospitals with higher than expected 30-day readmission rates. However, there is a lack of consensus concerning the efficacy of the LACE index in the heart failure population. The purpose of the study was to examine the discriminative accuracy of the LACE index to predict all-cause 30-day readmission for heart failure patients and to build a modified 30-day readmission risk prediction model …

Stigma And Discrimination’S Effect On Hiv Testing Of Pregnant Women In Nigeria, Charles Echezona Nzelu

Walden Dissertations and Doctoral Studies

The utilization of HIV testing services among pregnant women in Nigeria has not been optimal. Although much is known about the determinants of HIV testing among pregnant women, there is a gap in knowledge on determinants for pregnant women infected with the virus, specifically whether stigma and discrimination are barriers. The purpose of this study was to examine the effect of stigmatizing attitudes and personal knowledge of discriminatory practices towards persons living with HIV/AIDS on the decision by pregnant Nigerian women aged 15-49 years to test for HIV during antenatal visits or childbirth. The health belief model served as the …

Evaluating The 2012 Vaccination Reporting Mandate: Applications To Adventist Health Network, May Abdalla

Walden Dissertations and Doctoral Studies

Influenza is a public health concern that claims up to 56,000 lives annually in the United States, though it is a vaccine-preventable disease. Influenza vaccination among health care personnel (HCP) is highly encouraged to prevent influenza transmission in health care settings. The objective of this study was to examine the relationship between mandatory reporting of HCP influenza vaccination rates (implemented in 2012) and HCP influenza vaccination intake in a health care network with 20 hospitals. The protection and motivation theory was used as the theoretical framework. Data collected from surveys of hospital administrators and archives of the Center for Medicare …

Treatment Outcomes And Associated Factors In Tb/Hiv-Coinfected Patients In Namibia, Esland Shilongo

Walden Dissertations and Doctoral Studies

AbstractHIV and TB have merged into a deadly co-epidemic in Namibia. Currently, though, TB and HIV data at the national, regional, and district level might be underreported and insufficient to understand the full burden and outcome rates of TB and HIV. Targeting the TB outcomes rate among TB/HIV-coinfected individuals is an effective strategy for decreasing future TB burden and furthering the gains in the control of both diseases. The objective of this study was: to assess the outcomes of patients registered for anti-TB treatment in //Karas Region which has the largests burden of TB in Namibia. A 5-year retrospective cohort …