Public Health Commons^™

Preferences And Willingness For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis Among Transfeminine Persons In The Us, 2022-2023, Duygu Islek, Travis Sanchez, Stefan Baral, Carolyn Brown, Joanna A. Caldwell, Jennifer L. Glick, Danielle Friedman Nestadt, Jeb Jones, Iaah L. Lucas, Supriya Sarkar, Annemiek De Ruiter, Patrick S. Sullivan, Mariah Valentine-Graves, Savannah Winter, Vani Vannappagari

School of Public Health Faculty Publications

Background There remains limited information concerning US transfeminine persons preferences across varying PrEP options. We examined PrEP option willingness, preferences, and associated factors among a US nationwide sample of transfeminine persons. Methods Sexually active transfeminine persons age 15 + were recruited online between June 2022-October 2023 through social media advertisements. Transfeminine persons not diagnosed with HIV were asked about willingness to initiate, and ranked preference, of three PrEP options- daily oral (DO), on-demand, and long-acting injectable (LA-PrEP). Log-binomial models were used to examine PrEP modality willingness and associated sociodemographic and behavioral characteristics. Results Among 2657 transfeminine persons not currently using …

Delta-8 Tetrahydrocannabinol Policy And Related Health Impact Among College-Aged Individuals In South Carolina: A Scoping Review, Emily K. Luoma

Senior Theses

After the 2018 Farm Bill passed, loopholes were quickly found that led to the popularization of delta-8 THC, a derivative of delta-9 THC, more commonly known as marijuana. Use of this substance became particularly high in states that criminalized marijuana, such as South Carolina. This scoping review aimed to assess South Carolina’s current delta-8 policies in the context of health-related impacts among college-aged students. Comprehensively analyzing the results of relevant studies, it was determined that there are three commonly observed threats to public health that are direct outcomes of existing policies: 1) a lack of quality control standards; 2) misleading …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

H.B. 22-1326: Analysis Of Colorado’S Fentanyl Policy, William Morris

Undergraduate Theses, Capstones, and Recitals

Fentanyl is one the most potent drugs on the market, its synthetic nature makes it is one of the deadliest at the lowest quantities. Many of its injectors are entirely unaware of its existence when they consume cocaine, methamphetamine, Xanax, ecstasy, and heroin. Nationwide and within Colorado, the use of synthetic fentanyl has perpetuated a crisis that threatens the health and safety of numerous communities, with both fatal and non-fatal overdoses continually on the rise. In 2022, Colorado passed H.B. 22-1326, aimed at curbing fentanyl deaths and non-fatal overdoses, by further criminalizing fentanyl possession. Understanding the effectiveness of felony-heavy drug …

A Narrative Review Of The Covid-19 Infodemic And Censorship In Healthcare, Mitchell Liester, Sohaib Ashraf, Patricia Callisperis, Hector Carvallo, Shankara Chetty, Robert Enzenauer, Carlos Franco-Paredes, Raul Pineda, Panagis Polykretis, Rachel Wilkenson, Peter Mccullough

Secrecy and Society

Ideological and financial motivations have undermined science for decades. In this narrative review, we explore how organizations and governments used misinformation, disinformation, censorship, and secrecy to manage the COVID-19 pandemic. Various rationales for employing censorship and secrecy during the COVID-19 pandemic are examined including how organizations and governments create confusion about the risks associated with their products and blame avoidance to shift responsibility and to avoid accountability for their actions. Methods of censorship employed during the COVID-19 pandemic are reviewed, examples are provided, and the consequences of these actions are reviewed. Information included in this review was obtained from scientific …

Association Of Messenger Rna Coronavirus Disease 2019 (Covid-19) Vaccination And Reductions In Post Covid Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection In A Us Prospective Cohort Of Essential Workers, Josephine Mak, Sana Khan, Amadea Britton, Spencer Rose, Lisa Gwynn, Katherine D Ellingson, Jennifer Meece, Leora R Feldstein, Harmony Tyner, Laura J Edwards, Matthew S Thiese, Allison Naleway, Manjusha Gaglani, Natasha Solle, Jefferey L Burgess, Julie Mayo Lamberte, Meghan Shea, Taryn Hunt-Smith, Alberto Caban-Martinez, Cynthia Porter, Ryan Wiegand, Ramona Rai, Kurt T Hegmann, James Hollister, Ashley Fowlkes, Meredith Wesley, Andrew L Philips, Patrick Rivers, Robin Bloodworth, Gabriella Newes-Adeyi, Lauren E W Olsho, Sarang K Yoon, Sharon Saydah, Karen Lutrick

Center for Medical Ethics and Health Policy Staff Publications

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was …

Mobilizing Prevention And Early Detection Of Alzheimer's Disease And Related Dementias (Adrd) In Allegheny County Through The Area Agency On Aging (Aaa), Laiba N. Mirza

Public Health Capstone Projects

1. Objectives: In collaboration with the Department of Human Services (DHS): the Area Agency on Aging (AAA) using the Healthy Brain Initiative (HBI), my capstone project will involve the development of a comprehensive literature review examining the impacts of Alzheimer’s disease and related dementias (ADRD) on patients and their caregivers. The project aims to help the AAA focus on strategies to delay the onset of ADRD in Allegheny County. It also seeks to evaluate and enhance early detection programs for ADRD established by the AAA in communities within the county. Additionally, the project will explore how public health initiatives can …

Health Equity & Parental Leave: Addressing Gaps In Maternal Health Policy, Destiny L. Smith

Public Health Capstone Projects

Objective: This capstone project at Duquesne University will address health equity by focusing on employer-provided maternal and parental leave policies in the United States among underserved groups. It aims to address the gaps in these policies and analyze how disparities in leave policies across different industries can impact maternal and infant health outcomes.

Priority Population Served: This study will primarily target underserved employees who had to take some type of leave policy while working for an intended employer.

Methods: This project will engage in data analysis of the 2024 BIRTH survey results that the Pittsburgh Business Group on …

Assisted Reproductive Technology (Art) In The Mountain West, 2022, Caitlin J. Saladino, Kristian Thymianos, William E. Brown Jr., Monserrat Cristando-Romo, Taylor Volk, Yashesvi Sharma

Health

This fact sheet examines data on Assisted Reproductive Technology (ART) clinics located in five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. The Centers for Disease Control and Prevention 2022 Fertility Clinic Success Rates Report includes data from all 50 states and provides information on ART services offered by individual clinics, including data on total cycles, fertility preservation cycles, pregnancies, deliveries, and total infants born.

National Cancer Centers And Cancer Rates In Nevada, 2017-2021, Yashesvi Sharma, Ivan Sun, Taylor Volk, Caitlin J. Saladino, William E. Brown Jr., Fatma Nasoz

Health

This fact sheet presents data from the National Institutes of Health including the National Cancer Institute’s (NCI) “State Cancer Profiles” report and includes age-adjusted cancer incidence rates by race/ethnicity in Nevada, between 2017 and 2021. The fact sheet also shows data from the 2024 National Cancer Institute’s “NCI-Designated Cancer Centers” map, listing NCI-Designated Cancer Centers by state, and the distance to the nearest NCI-Designated Cancer Centers from the Las Vegas metro and Reno metro.

Analysis Of Systematic Trade-Offs Between Military And Healthcare Expenditure Alongside Gdp Growth Of Select Asian And Western Exporting Economies In The 21st Century, Rahul Balamurugan, Carlos Gershenson, Preethi Nanjundan, Hiroki Sayama

Northeast Journal of Complex Systems (NEJCS)

This study explores the complexity in the trade-offs between military expenditure, healthcare expenditure, and GDP growth across select Asian nations and major weapon-exporting countries, examining how nations allocate finite resources between national security and human well-being over the past two decades. Using a systems science approach, the research integrates Granger causality testing to analyze temporal and directional relationships among GDP growth, military expenditure, and healthcare expenditure, uncovering their dynamic interdependencies. The methodology includes trend and slope analysis, Granger causality testing, outlier detection, and clustering to identify heterogeneity in resource allocation strategies. Developed, weapon-exporting nations exhibit complementary trends, with strong causality …

Exploring Physician Well-Being: A Bibliometric Analysis Of Mental Health, Suriya Kumareswaran, Bala Murali Sundram, Vanitha Thurairasu

Kesmas

This bibliometric study examined the evolving research landscape on physician mental health from 2010 to 2023, analyzing key themes, publication trends, and global contributions. A total of 3,360 articles, including 3,137 original research and 223 reviews, were sourced from Web of Science and Scopus. Findings revealed a significant increase in research output, particularly during the COVID-19 pandemic, with burnout, depression, and anxiety emerging as dominant themes. The US accounted for most publications, while research from low- and middle-income countries remains limited, indicating a substantial global disparity. Thematic analysis highlighted variations in burnout assessment methodologies, underscoring the need for standardized evaluation …

Determinants Of Adolescent Resilience Levels In Surabaya City, East Java Province, Indonesia, Riris Diana Rachmayanti, Fatwa Sari Tetra Dewi, Diana Setiyawati, M Dody Izhar, Andrei Ramani

Kesmas

Assessing adolescent resilience may provide valuable insights into adult resilience. This study aimed to analyze the relationship between determinants and adolescent resilience in Surabaya City. The participants of this cross-sectional study were 277 adolescents aged 12–19 years who were in senior high school. The outcome was the resilience levels. This study's findings indicated relationships between resilience levels and stress experience (p-value = 0.01), access to mental health information (p-value = 0.00), life satisfaction (p-value = 0.00), family harmony (p-value = 0.03), presence of adults to share (p-value = 0.04), feeling safe at home, school, and community (p-value = 0.00), perception …

Five-Year Journey Of Technical Assistance In Health Governance Reforms: A Case Report, Popy Yuniar, Indang Trihandini, Ibnu Muyassar, Latifatul Khoiriyah, Minawati Minawati, Fathiyya Aliyah Birjaman, Tyra Septi Diana, Annabel Serafina, Hertina Raisa Putri, Rana Maimunah, Riko Setiawan, Nadazaira Alifia Ramadhianisa, Aris Diyanto

Kesmas

Many districts and cities in Indonesia continue to have Public Health Development Index scores below the national average, highlighting the need for improved health governance. This study assessed the five-year impact (2019–2023) of a mentoring program for 149 District Health Offices in preparing annual work plans, focusing on stagnation or performance declines. Using a qualitative approach, the study analyzed annual work plan scores before and after technical assistance, conducted focus group discussions, and carried out in-depth interviews to identify challenges. Key barriers included data management issues, weak advocacy, knowledge transfer gaps, and poor cross-sectoral coordination, which hindered decision-making and program …

Public Health Entrepreneurship In Indonesia: What Is Next?, Hadi Pratomo, Roy Darmawan, Karina Samaria

Kesmas

Public health has been demanded to search for ways to improve well-being by tackling societal and ecological factors that influence health through cooperative strategies and partnerships across various fields. More interdisciplinary, interprofessional, and action-oriented approaches toward sustainable public health programs are recommended to be made. Therefore, public health entrepreneurship is an indispensable approach to creating new interventions that address future public health problems. The Indonesian Ministry of Health conceptualized five public health entrepreneurship skills as standard competence for public health personnel. In addition, the Association of Indonesian Public Health Higher Education Institutions has identified several study materials and learning outcomes …

Thai Sugar-Sweetened Beverage Tax: Does It Really Help?, Sitaporn Suriya, Buraskorn Torut

Kesmas

A solution recommended by the World Health Organization to prevent and control noncommunicable diseases is the Sugar-Sweetened Beverage (SSB) tax. This study aimed to evaluate the Thai SSB tax efficiency affecting the change in post-tax individual-level consumption and find causal explanations for the people’s consumption behavior after the SSB tax was implemented. This study used a Productivity Model, and stratified random sampling was conducted by selecting 1,200 people. An in-depth interview was conducted to seek causal explanations for post-SSB tax consumption behavior with 15 key informants. The results revealed the SSB tax’s efficiency in terms of perception and understanding at …

Socio-Epidemiological Perspectives Of Sexual Trauma Experiences And Influential Factors On Sexual Orientation In Men Who Have Sex With Men, Rico Januar Sitorus, Misnaniarti Misnaniarti, Legiran Legiran, Rizma Adlia Syakurah, Diana Dewi Sartika, Asri Maharani, Retta Patresia

Kesmas

The complexity of sexuality and sexual trauma experiences, including harassment, unwanted touching, sexual urges, and forced sexual intercourse, should not be underestimated because of the tendency to initiate adverse psychosocial impacts. Sexual harassment can increase mental health risks, which may influence sexual orientation decisions. This quantitative study, using a cross-sectional design, aimed to determine a relationship between sexual trauma experiences and sexual orientation in men who have sex with men (MSM). This study population was MSM living in Palembang and Prabumulih City, with a sample size of 216 respondents. The proportion of respondents with homosexual orientation was 57.1%, and the …

Contextualizing Policy Adoption: A Case Study Of Tuberculosis Control Policy In Depok City, Tri Auri Putri Ayuningtyas, Adang Bachtiar

Journal of Indonesian Health Policy and Administration

This study analyzes the formulation and implementation process of Depok Mayor Regulation No. 61 of 2023 on Tuberculosis (TB) Control using Friedman’s legal system theory (1975) and the eight General Principles of Good Governance (Asas Umum Pemerintahan yang Baik – AUPB). The regulation provides a comprehensive framework, encompassing promotive, preventive, curative, and rehabilitative aspects to support TB control. The legal structure includes the establishment of a cross-sectoral Tuberculosis Control Acceleration Team, involving government agencies and community organizations. Findings reveal that while the regulation has fulfilled several AUPB principles, such as legal certainty, utility, and public interest, there are areas …

The Relationship Between Self-Efficacy And Self-Management Behavior In Gestational Diabetes Mellitus Control, Fatimah Dwi Cahyani, Shrimarti Rukmini Devy

Journal of Indonesian Health Policy and Administration

Diabetes mellitus gestasional (DGM) merupakan kondisi kesehatan yang meningkat dalam kehamilan dan dapat menyebabkan komplikasi serius bagi ibu dan janin. Self-management yang mencakup pemahaman, penerapan, dan pemeliharaan perilaku kesehatan memiliki peran kunci dalam mengelola DGM. Health Belief Model (HBM) digunakan sebagai kerangka kerja teoretis yang membentuk dasar intervensi untuk meningkatkan self-efficacy pada ibu hamil dengan GDM. Studi ini menganalisis hubungan antara efikasi diri dan manajemen diri dalam pengendalian diabetes gestasional pada ibu hamil. Artikel ini adalah tinjauan pustaka dengan menerapkan metode pencarian literatur. Pencarian literatur dilaksanakan melalui tiga basis data yaitu PubMed, Scopus, dan Google Scholar, yang mencakup artikel-artikel yang …

Implementation Of Emr System In Indonesian Health Facilities: Benefits And Constraints – A Case Study Of Two Clinics In Central Java, Rasyid Juliansyah, Bukhori Aqid, Andien Putri Salsabila, Kurnia Nurfiyanti

Journal of Indonesian Health Policy and Administration

This paper delves into the widespread implementation of Electronic Medical Records (EMR) within healthcare facilities across Indonesia. It addresses the challenges encountered by clinic owners and healthcare providers in transitioning to these digital systems. The study is supported by empirical data collected through a mixed-method approach, combining internal data from Klinik Pintar with qualitative validation from key stakeholders responsible for clinic operations. The research focuses on two case studies: Lembaga Pemasyarakatan (LAPAS) II Purwokerto Clinic and Palang Merah Indonesia (PMI) Purbalingga Clinic, where the adoption of EMR is analyzed in terms of efficiency, compliance with regulatory standards set by the …

The Readiness For Integrated Primary Health Care (Ilp) At Puskesmas Pamulang In Tangerang Selatan City, Firda Safitri Rachmaningsih, Kurnia Sari

Journal of Indonesian Health Policy and Administration

. Integrated primary healthcare (ILP) is part of the transformation of primary healthcare aimed at improving access to quality healthcare. This study aims to analyze the readiness of Pusat Kesehatan Masyarakat (Puskesmas) and their networks to implement ILP. This research used a qualitative approach, focusing on a case study of a Puskesmas in an urban setting, specifically in the operational area of Puskesmas Pamulang in South Tangerang. Data collection methods include in-depth interviews, observations, and document reviews. This research adopts the conceptual framework of PHC monitoring based on WHO and Weiner's theory of organizational change readiness. The research findings indicate …

Analysis Of Covid-19 Prevention And Control Policy Implementation In Islamic Boarding Schools In Dki Jakarta, Dickha Adi Wibowo, Fajar Ariyanti

Journal of Indonesian Health Policy and Administration

Indonesia, as one of the countries affected by COVID-19, has implemented various efforts to prevent the transmission of COVID-19. One effort that can be implemented is the implementation of COVID-19 prevention protocols. Apart from that, according to the COVID-19 Handling Task Force, Islamic boarding schools are locations with high mobility. This research aims to determine the implementation of policies related to the prevention and control of COVID-19 in Islamic boarding schools in the DKI Jakarta Province. This research used descriptive research with a qualitative approach, with the number of respondents being three Islamic boarding school leaders and students. The results …

Determinants Of Physicians' Brain Drain In Egypt, Mennatallah Elbeheiry

Theses and Dissertations

Egypt is enduring a significant shortage of physicians, despite the annual graduation of approximately 10,000 medical students from its 27 medical schools. In 2016, the physician density was alarmingly low, with only one doctor per 12,285 people. This shortage is exacerbated by a physicians’ brain drain, as Egypt is a leading exporter of physicians to countries like the United Kingdom and Australia. As of 2020, the Egyptian Medical Syndicate reported 212,835 registered physicians, yet 56 percent of them work abroad, and only about 62,000 are actively employed in public hospitals, serving a population of over 110 million. The government’s efforts …

The Healing Power Of Antitrust, Theodosia Stavroulaki

Northwestern University Law Review

Millions of Americans live in hospital deserts—communities where people lack geographic access to hospitals and primary care physicians. People living in these deserts often miss doctor appointments, delay necessary care, and stop adhering to their treatment. In this way, hospital deserts exacerbate the health disparities plaguing America. This Article demonstrates that hospital deserts are not inevitable but the result of several business strategies—including noncompete agreements and merging with competitors—and antitrust enforcers’ unwillingness to recognize these harmful practices as antitrust violations. To cure the issue of hospital deserts, this Article makes three proposals. First, antitrust enforcers and the courts should expand …

An Evaluation Of Nhmrc Funded Dementia And Diabetes Research, Etienne Vignola-Gagné Phd, Dmitrii Malkov, Elisabeth Browning, Jörg Hellwig Phd, Luigi Rocco Phd, Henrique Pinheiro, Alexandre Bédard-Vallée

Public Reports

This report, commissioned by the National Health and Medical Research Council (NHMRC), provides comprehensive insights into the research outputs, outcomes, and impacts of NHMRC-funded health and medical research in the areas of dementia and diabetes to support NHMRC's mission of ‘building a healthy Australia.’

Antibiotic Resistance: The Growing Threats And Potential Solutions, Olisaemeka Zikora Akunne, Blessing Nkechi Emmanuel, Umar Faruk Saidu, Ayobami Sunday Akinnawo, Nasiru Ademola Adeyemi, Livia Chinaza Egoh, Malami Aishatu Muhammad, Olusegun Ayo Ade-Adekunle, Deborah Ahuoyiza Peter, Anne Amina Freitas

Department of Biomedical and Translational Sciences Faculty Publications

Antibiotic resistance (AR) has become a critical global health crisis, threatening the efficacy of antibiotics and increasing healthcare costs, morbidity, and mortality. The One Health approach, which emphasizes the interconnectedness of human, animal, and environmental health, is increasingly recognized as an essential framework for addressing the complex drivers of AR. This review explores the mechanisms of resistance, such as genetic mutations, horizontal gene transfer, and biofilm formation, along with contributing factors such as the overuse of antibiotics in healthcare and agriculture. We assess both traditional and emerging strategies to combat AR, including antimicrobial stewardship, the development of new antibiotics, and …

Global, Regional, And National Burden Of Cardiovascular Diseases And Risk Factors In 204 Countries And Territories, 1990-2023, Global Burden Of Cardiovascular Diseases And Risks 2023 Collaborators, Benjamin A. Stark, Nicole K. Decleene, Emily C. Desai, Johnathan M. Hsu, Catherine O. Johnson, Laura Lara-Castor, Kate E. Legrand, Prof Bhoomadevi A., Mohammad Amin Aalipour, Nasir Abbas, Madineh Abbasi, Mohammadreza Abbasian, Hedayat Abbastabar, Abdallah H. A. Abd Al Magied, Samar Abd Elhafeez, Gregory A. Roth, Et Al.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Cardiovascular diseases (CVDs) are the leading cause of mortality and are among the foremost causes of disability globally. CVD burden has continued to increase in most countries since 1990, with trends driven by changing exposures to harmful risk factors, population growth, and population aging.

Objectives

We report estimates of global, national, and subnational CVD burden, including 18 subdiseases and 12 associated modifiable risk factors. We analyzed change in CVD burden from 1990 to 2023 and identified drivers of change including population growth, population aging, and risk factor exposure.

Methods

The Global Burden of Disease (GBD) 2023 study, a multinational …

Rural Hospital Closure And Medicaid Expansion, Jason White

Theses, Dissertations and Capstones

Introduction: In the United States, hospitals in rural areas have been under financial pressure and have been closing at an increasing rate.  This reduces access to care for rural citizens.  The Affordable Care Act of 2010 was passed in order to increase access to medical care, partially through an optional expansion of Medicaid coverage to a larger percentage of the population.  As some states adopted the expansion and some states did not, an opportunity was created to examine the policy’s effect on rural hospital stability.

Purpose of the Study:  This study was designed to examine the effect of …

Infant Health Equity In Oklahoma: A Mixed-Methods Exploration Of Personal, Organizational, Environmental, And Policy Factors Contributing To Black Infant Mortality, Ayesha M. Lampkins

West Chester University Doctoral Projects

Black women experience higher rates of adverse birth outcomes, including infant mortality. There is a gap in the literature on multilevel strategies to achieve infant health equity and engage Black women. This study is unique in that no others have looked at the views of Oklahoma Black women to inform and address infant health equity strategies and utilize these views to provide context to existing infant mortality data. The study research questions are: 1) What views on infant health equity and infant mortality are held by Black women in Oklahoma? 2) What differences exist between Black and White mothers in …

Politics In Public Health: Growing Partisan Divides In Covid-19 Vaccine Attitudes And Uptake Post-2021 Presidential Inauguration, Hongbin Fan, Zhongliang Zhou, Guanping Liu, Chi Shen, Qi Zhang

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objectives: To investigate whether the 2021 U.S. presidential inauguration contributed to a widening of partisan divides in COVID-19 vaccine attitudes and uptake. Methods: We leverage the presidential inauguration as a natural experiment and analyze data from the Household Pulse Survey and CDC vaccination records. Using a difference-in-differences framework with continuous treatment, we examine how the transition differentially affected state-level vaccine refusal rates and county-level vaccination rates, based on varying levels of partisanship as measured by the Trump-Biden vote gap. Results: Following Biden's inauguration, vaccine refusal declined more in pro-Biden states. Distrust in government and vaccines accounted for approximately 80% of …