Public Health Commons^™

Colorectal Cancer Screening Uptake: Differences Between Rural And Urban Privately-Insured Population, Mesnad Alyabsi, Jane L. Meza, K. M. Monirul Islam, Amr Soliman, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

Earlier studies investigated rural-urban colorectal cancer (CRC) screening disparities among older adults or used surveys. The objective was to compare screening uptake between rural and urban individuals 50-64 years of age using private health insurance. Data were analyzed from 58,774 Blue Cross Blue Shield of Nebraska beneficiaries. Logistic regression was used to assess the association between rural-urban and CRC screening use. Results indicate that rural individuals were 56% more likely to use the Fecal Occult Blood Test (FOBT) compared with urban residents, but rural females were 68% less likely to use FOBT. Individuals with few Primary Care Physician (PCP) visits …

Analysis Of Genetic Structure And Pathogen Dynamics Of Ixodes Scapularis In Southwestern Virginia, Leemu Jackson

Undergraduate Honors Theses

Ixodes scapularis, or the blacklegged tick, is the primary vector of Borrelia burgdorferi. This pathogen is the causative agent of Lyme disease, the most common vector-transmitted disease in the United States. Although I. scapularis is distributed throughout the eastern U.S., Lyme disease is only considered endemic in the northeastern region of the country. Prior to 2007, Lyme disease was uncommon in Virginia, but since then cases of Lyme disease have increased dramatically with a hotspot forming in the Roanoke-Blacksburg area. The purpose of the current study was to determine whether B. burgdorferi prevalence and the genetic structure of I. …

The Caregiver Advise Record And Enable (Care) Act And Compassion Fatigue In The United States, Karen Marie Johnson

Walden Dissertations and Doctoral Studies

The transition from hospital to home can be complicated, leaving family caregivers in stressful situations that they may not know how to handle. The burden that is placed on these individuals has led researchers to focus on the public health implications of caregiving in hopes of identifying at-risk caregivers. This quantitative analysis identified what relationships exist between caregiver compassion fatigue among family caregivers and training or education received per the Caregiver Advise Record and Enable (CARE) Act and if education influences readmission rates. A purposive sample of 385 family caregivers participated in this study. The Care Transitions Measure (CTM-15), the …

The Cholera Crisis In Yemen: Case Studies On Vulnerability And Resilience In Sana'a, Al Hudaydah, And Ma'areb, Noor Albannein A. Al-Saad

Honors Theses and Capstones

The largest recorded cholera epidemic in history is happening right now in Yemen, a country which has reported over 2 million cases of cholera as of 2020. Yemen has a history of endemic cholera, but prolonged conflict in the country has led to deteriorating conditions that have triggered massive outbreaks of the disease. The purpose of this study is to investigate the direct and indirect causes of the cholera epidemic in Yemen by proposing factors that may confer vulnerability and resilience in Yemeni governorates. Case studies were constructed for three governorates: Sana’a and the inner municipality of Amanat Al Asimah; …

Tetanus Immunity Among Adults In The Democratic Republic Of The Congo, Sue K. Gerber

Walden Dissertations and Doctoral Studies

Although tetanus is not a contagious disease, it can be deadly for people who are exposed and do

not have protective immunity against tetanus, which can be acquired only through vaccination.

Most studies on adult tetanus protective immunity are from high-income countries; limited

studies occur in Africa, and none has been reported from the Democratic Republic of the Congo

(DRC). This study sought to determine protective immunity against tetanus among adults in

DRC in relation to their age, sex, place of residence, and for women, antenatal care. The primary

purpose of this observational cross-sectional study using a nested serosurvey within …

Meat Intake And Prostate Cancer In African American Men, Uchenna Njoku

Walden Dissertations and Doctoral Studies

African American men have more prostate cancer and are more than twice as likely to die of the disease as Caucasian men, and the reasons for this racial disparity have not been clarified. Identifying lifestyle and dietary risk factors of prostate cancer is an important public health issue. Studies on the association between meat intake and prostate cancer risk have produced inconsistent results. The purpose of this cross-sectional quantitative study was to determine whether there is an association between total meat intake and total prostate cancer risk among African American men when controlling for age, income, educational level, physical activity, …

Impact Of Education On Hiv Testing Among African American Women In The United States, Florence Matimbah Mbangowah

Walden Dissertations and Doctoral Studies

Improved and increased human immunodeficiency virus (HIV) testing among African American women in the United States could facilitate early detection of the virus. The purpose of this cross-sectional quantitative study was to determine if there was a significant association between HIV testing participation and education level (i.e., high school, college, post-college level) based on access to healthcare after accounting for insurance, income, employment, marital status, English language proficiency, and vision quality. The integrated theory of health behavior change, the theoretical framework used for this research, proposes that changes in health behavior can be improved by various factors such as fostering …

Sociopolitical Determinants Of Parental Acceptance Of Childhood Vaccination In Abuja, Nigeria, Lawrence Madu Ohammah

Walden Dissertations and Doctoral Studies

Despite the efficacy of vaccines, some parents still reject vaccination of their children, resulting in low vaccination coverage, a greater burden of vaccine-preventable diseases, and high infant mortality. The purpose of this study was to investigate the sociopolitical determinants of vaccination status among children, aged 0-24 months, and identify the factors that drive vaccine hesitancy. The social ecological model served as the theoretical framework. The study research design was a quantitative cross-sectional survey. An interviewer-administered questionnaire was used to collect primary data from parents and caregivers in 384 randomly selected households from 48 settlements in the Abuja Municipal Area Council. …

Risk Factors For Polysubstance Abuse: A National Secondary Data Analysis Study, Dakota Mcmurray

Walden Dissertations and Doctoral Studies

Substance abuse is a serious public health problem in the United States and globally. Abuse of more than one substance is considered polysubstance abuse and can cause more harm than abuse of only one substance. Polysubstance abuse compounds the problems of addiction because of the variety of substances that may be used and the resulting side effects. This quantitative cross-sectional secondary data analysis, guided by the socio-ecological theory, assessed patient characteristics and how predictive they were for polysubstance abuse. The study sample of 986 patients was analyzed by binomial logistic regression to assess the association between patient-related factors and polysubstance …

Reviving Focused Scrutiny In The Constitutional Review Of Public Health Measures, Robert Gatter

All Faculty Scholarship

This article re-examines the "focused scrutiny" standard proposed by Prof. Scott Burris in 1989 and argues for its application particularly during an infectious disease emergency such as the COVID-19 pandemic. Focused scrutiny seeks to tie judicial review of the constitutionality of public health measures closely to the facts of the particular disease and to evidence of the efficacy of each governmental action to prevent the spread of that disease, even when courts adopt rational basis testing.

Spina Bifida Mortality By Clinical And Demographic Characteristics Using The New York State Birth Defects Registry, 2008-2016, Anaclare Mackenzie Sullivan

Legacy Theses & Dissertations (2009 - 2024)

Background: Spina bifida is the most common neural tube defect. It has been associated with increased mortality, disability, and may require lifelong medical care. Few previous studies have assessed the impact that maternal race/ethnicity or variations in clinical features of the disease may have on mortality.

The Impact Of The Residency Area On Risk Factors For Tuberculosis Among People Living In Three Different Regions Of Kazakhstan, Assel Bukharbayeva

Legacy Theses & Dissertations (2009 - 2024)

Background and introduction:

A Comparative Spatial And Climate Analysis Of Human Granulocytic Anaplasmosis And Human Babesiosis In New York State (2013-2018), Collin J. O'Connor

Legacy Theses & Dissertations (2009 - 2024)

Human granulocytic anaplasmosis (HGA) and human babesiosis are tick-borne diseases spread by Ixodes scapularis (the blacklegged or deer tick) and are the result of infection with Anaplasma phagocytophilum and Babesia microti, respectively. In New York State (NYS), incidence rates of these diseases increased concordantly until around 2013, when rates of HGA began to increase more rapidly than human babesiosis, and the spatial extent of the diseases diverged. Surveillance data of tick-borne pathogens (2007 to 2018) and reported human cases of HGA (n=4,297) and human babesiosis (n=2,986) (2013 to 2018) from the New York State Department of Health (NYSDOH) showed a …

Knowledge, Attitudes, And Practices Of Healthcare Professionals Working In Schools Regarding Tickborne Disease Prevention And Lyme Disease In New York State And Maryland, Kristen Howard

Legacy Theses & Dissertations (2009 - 2024)

Background: Ticks, Lyme disease, and other tickborne diseases are a concern of public health entities in Maryland and New York State. Children are at an increased risk of contracting a tickborne disease. Healthcare professionals working in schools (HPWS) are often front-line providers and health educators for school-aged children. The knowledge, attitudes, and practices of HPWS regarding ticks and tickborne disease is currently unknown. While there are educational materials available, uptake and use of these programs is also unknown.

Implementing A Police Assisted Addiction Recovery Initiative In Rural New York : How Police-Provided Transportation May Reduce Barriers To Treatment Uptake, Emily Mae Bruce

Legacy Theses & Dissertations (2009 - 2024)

Background:

All-Cause And Cause-Specific Mortality Among Medicaid-Insured Women With Preexisting Type 2 Diabetes Mellitus Diagnosed With Breast Cancer : An Epidemiological Analysis Of Linked New York State Medicaid And Cancer Registry Data, Wayne Rashaan Lawrence

Legacy Theses & Dissertations (2009 - 2024)

Background: The present study investigated the influence preexisting type 2 diabetes mellitus (T2DM) and antidiabetic drugs have on all-cause and cause-specific mortality among Medicaid-insured women diagnosed with breast cancer by menopausal status.

Demographics, Naloxone Accessibility, And Repeat Opioid Overdose In The United States, Craig Hamp Booker

Walden Dissertations and Doctoral Studies

Approximately 2.1 million people in the United States suffer from opioid use disorder, and over 47,600 people die from opioid-related overdoses each year. Opioid overdose is often treated with naloxone, a quick-acting medication that counteracts the effects of an overdose. This quantitative, correlational study was conducted to determine whether demographics (gender, age, and race) and naloxone accessibility were predictors of repeat opioid overdose in a Tennessee county in the United States. The study was developed and conducted using principles of the diffusion of innovations theory. Descriptive and inferential analyses were conducted using secondary, county-level data (n = 967) from emergency …

Identification And Evaluation Of Epidemic Prediction And Forecasting Reporting Guidelines: A Systematic Review And A Call For Action, Simon Pollett, Michael Johansson, Matthew Biggerstaff, Lindsay C. Morton, Sara L. Bazaco, David Brett-Major, Anna M. Stewart-Ibarra, Julie A. Pavlin, Suzanne Mate, Rachel Sippy, Laurie J. Hartman, Nicholas G. Reich, Irina Maljkovic Berry, Jean-Paul Chretien, Benjamin M. Althouse, Diane Myer, Cecile Viboud, Caitlin Rivers

Journal Articles: Epidemiology

INTRODUCTION: High quality epidemic forecasting and prediction are critical to support response to local, regional and global infectious disease threats. Other fields of biomedical research use consensus reporting guidelines to ensure standardization and quality of research practice among researchers, and to provide a framework for end-users to interpret the validity of study results. The purpose of this study was to determine whether guidelines exist specifically for epidemic forecast and prediction publications.

METHODS: We undertook a formal systematic review to identify and evaluate any published infectious disease epidemic forecasting and prediction reporting guidelines. This review leveraged a team of 18 investigators …

Reduction Of Polyunsaturated Fatty Acids With Tumor Progression In A Lean Non-Alcoholic Steatohepatitis-Associated Hepatocellular Carcinoma Mouse Model, Elizabeth M. Vlock, Shilpa Karanjit, G. Talmon, Evi A. Farazi

Journal Articles: Epidemiology

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in Western countries. While obesity and diabetes are the hallmarks of NAFLD, it also develops in lean individuals in the absence of metabolic syndrome, with a prevalence of 7 percent in the U.S. and 25-30 percent in some Asian countries. NAFLD represents the spectrum of liver disease, starting with excess liver fat accumulation (NAFL) that can progress to nonalcoholic steatohepatitis (NASH), cirrhosis and ultimately hepatocellular carcinoma (HCC). To date, the pathogenesis of lean NASH-HCC is poorly understood and a mouse model is lacking. We aimed …

An Ecological Approach To Understanding Lethal Violence In The Us Using Stream Analogy, Jacqueline Seals

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

ABSTRACT OF CAPSTONE

Background: Lethal violence, homicides and suicides, is a growing issue in the US. Historically homicides and suicides have been studied separately, but with stream analogy of lethal violence homicides and suicides are both currents of lethal violence, just branching in opposite directions. The purpose of this study is to understand which county-level factors increase risk of lethal violence.

Methods: This ecological study combined open-source datasets to create one dataset of socioeconomic risk factors of lethal violence. Counties with 10 or more lethal violent deaths were included (n=2751). Negative Binomial models examined the relationship between risk factors and …

Risks For Hiv Infection Among Adolescent Girls And Young Women In Mozambique, Isabelle Casavant

Walden Dissertations and Doctoral Studies

Adolescent girls and young women (AGYW) living in Sub-Saharan African countries constitute 17% of the population, yet they account for one third of all new human immunodeficiency virus (HIV) infections. To prevent HIV infections among AGYW, it is necessary to understand why they are disproportionally infected. The purpose of the dissertation was to identify risk for HIV among AGYW living in a southern district of Mozambique. The analysis was driven by the Modified Socio Ecological Model and performed using a quantitative dataset collected for the Chokwe Combination Prevention of HIV (N=3354). Logistic regression analysis was conducted to assess whether an …

Planned Behavior And Congolese Physicians’ Practice: Predicting Advanced Preventive Health Services Provision, Jean-Clément Milabu Mumbusi

Walden Dissertations and Doctoral Studies

The provision of preventive services, health promotion, and health maintenance has become the cornerstone of primary care practice in the United States and other Western countries to prevent morbidity and premature mortality and to increase the quality and years of a healthy life. Unfortunately, the delivery of these advanced preventive health services (APHS) has been sporadic in the Democratic Republic of Congo, a country with poor health indicators. The purpose of this cross-sectional mixed-method study was to apply Ajzen’s theory of planned behavior (TPB) to predict the intention of Congolese primary care physicians (PCPs) in the provision of APHS. Using …

Medical Skepticism And Diabetes Management In African Americans, Pamela Bouyer

Walden Dissertations and Doctoral Studies

Type 2 diabetes (T2DM) in African Americans is a manageable disease, and self-management interventions reduce complications and hospital stays. However, in the African American population, traditional T2DM self-management interventions do not produce long-term effects on lifestyle and behavior changes. Researchers have analyzed the barriers and interventions associated with the disease, but the problem still exists. Medical skepticism may influence T2DM management and health outcomes in African Americans. However, there is scarce literature addressing the relationship between medical skepticism and health outcomes (eye and kidney problems). The purpose of the study is to assess the relationship between medical skepticism and outcomes …

Health Behaviors Of Fruit And Vegetable Consumption, Physical Activity, And Breast Cancer Among African American Women, Nicole Ekoue

Walden Dissertations and Doctoral Studies

Breast cancer incidence is suddenly increasing among African American women. Recent studies indicate that health behaviors are thought to confer important health benefits and have the potential to lowering breast cancer incidence. Guided by the social ecological model, the purpose of this quantitative, cross-sectional study was to investigate the association between health behaviors of fruit consumption, vegetable consumption, and physical activity and breast cancer after adjusting for age, body mass index, and smoker status. Social support and income level were assessed as modifiers. Using the 2012 to 2017 Health Information and National Trends Survey data, this study was conducted with …

Meaningful Measurement Matters: Defining Potentially Inappropriate Medication Use To Target Cognitive Outcomes, Ashley I. Martinez

Theses and Dissertations--Pharmacy

Preventable and unintended consequences of medication use occur in more than 25% of ambulatory and hospitalized patients, and nearly half of long-term care patients. Unfortunately, many medications used to treat common health conditions in older adults (such as anxiety, behavioral disturbances, incontinence, insomnia, depression, and pain) have also been linked to cognitive impairment and decline. Recently, substantial efforts to investigate medications and medication classes that may be associated with cognitive impairment and decline in older adults have been undertaken. Unfortunately, studies have used a wide variety of different tools to define “potentially inappropriate medication” (PIM) use, and no published literature …

Opioid Use In Vulnerable Populations, Gyeon Oh

Theses and Dissertations--Epidemiology and Biostatistics

Opioid-related negative health outcomes, such as substance use disorder, misuse, and overdose deaths, have risen as long-term opioid use has increased. The benefit of using long-term opioids for pain is yet to be established. The Centers for Disease Control and Prevention provides guidelines for opioid prescribing in chronic pain, but detailed recommendations on opioid prescribing for vulnerable populations are missing due to lack of evidence-based studies. The purpose of this dissertation is to describe patterns and predictors of opioid use and assess outcomes related to prescribing opioid medications in vulnerable populations, specifically older adults with various levels of cognitive function, …

Mitigating A Covid-19 Outbreak Among Major League Baseball Players - United States, 2020, Meghan T. Murray, Margaret A. Riggs, David M. Engelthaler, Caroline Johnson, Sharon Watkins, Allison Longenberger, David Brett-Major, John Lowe, M. Jana Broadhurst, Chandresh N. Ladva, Julie M. Villanueva, Adam Macneil, Shoukat Qari, Hannah L. Kirking, Michael Cherry, Ali S. Khan

Journal Articles: Epidemiology

Mass gatherings have been implicated in higher rates of transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), and many sporting events have been restricted or canceled to limit disease spread (1). Based on current CDC COVID-19 mitigation recommendations related to events and gatherings (2), Major League Baseball (MLB) developed new health and safety protocols before the July 24 start of the 2020 season. In addition, MLB made the decision that games would be played without spectators. Before a three-game series between teams A and B, the Philadelphia Department of Public Health was notified of a team A …

Lifestyle Factors And Social Determinants As Predictors Of Weight/Body Mass Index, Uthman Alhaji Baba

Walden Dissertations and Doctoral Studies

Obesity is a major public health concern that includes the risk of developing cardiovascular disease and premature death in adults. Previous studies have established the relationship between gender, educational level, household income and respondents’ weight but additional research is needed to factor the nature of education in relation to gender differences, diet, and other important behavioral mediators such as social determinants. The purpose of this quantitative cross-sectional study is to determine the extent to which frequency of physical activity, household income, social determinants of health (money for balanced meals, finances at the end of month, and poor mental health), respondent …

Association Between Certificate-Of-Need Laws And The Health Outcomes Of Home Health Patients, Peter A. Atemnkeng

Walden Dissertations and Doctoral Studies

The Certificate of Need (CON) law on home health limits start-ups and expansions by providers. Seventeen states and the District of Columbia maintained CON restrictions in 2015. The regulation was intended to control health care cost and expenditure, and to promote quality public health outcomes, as postulated in the public interest theory. The purpose of the study was to assess the association between the CON laws by the states and the health outcomes of the Medicare patients that used home health services in 2015. The provider ratings data from Home Health Compare were analyzed using multiple linear regression models and …

Rethinking Global Governance To Address Zoonotic Disease Risks: Connecting The Dots, Kelley Lee

Animal Sentience

Large-scale changes in human behaviour are urgently needed to prevent future pandemics involving zoonotic diseases such as COVID-19. However, this will not happen to the required degree, and with sufficient speed, without a major shift in how humanity collectively governs itself. Alongside a shift in focus from individual behaviours to the structural conditions underpinning the world economy that shape human behaviours, effective global governance presses us to connect more dots than ever before. The One Health approach is an important starting point but we need to go much further.