Public Health Commons^™

Association Between Participation In Annual Physical Examinations And Risk Factors For Noncommunicable Diseases In Adults With Disabilities: Evidence From Shanghai, China, Yugang Li, Qi Zhang, Xiaohong Li, Mei Sun, Jun Lu, Gang Chen

Community & Environmental Health Faculty Publications

The relationships between regular participation in annual physical examinations and the risk factors for noncommunicable diseases (NCDs) among adults with disabilities remains unclear. To address this gap, we used data from 130,899 individuals with disabilities in Shanghai (2014-2016) and evaluated four risk factors for NCDs: hypertension, hyperglycemia, hyperlipidemia, and being overweight. Overall, 4540 individuals participated in annual physical examinations across all three years and 11,388 missed examinations in 2015 (group without regular participation). Chi-squared tests and binary logistic regression were used to assess differences in patient characteristics and explore correlations between variables. Significant differences in age (χ² = 102.620, …

Health Priorities, Current Lifestyle Behaviors, And Barriers To A Healthy Lifestyle Among Emergency Department Nurses, Shannon C. White

Theses and Dissertations--Kinesiology and Health Promotion

Background: Emergency nurses are tasked with managing the hectic, unpredictable, and constantly changing environment of an ED. In addition, emergency nurses have been shown to have high levels of stress, irregular meal schedules, rotating shift work, long hours, and a lack of physical activity. Furthermore, research has suggested that nurses are at an increased risk for non-communicable diseases, such as diabetes, hypertension, and coronary heart disease (Phiri, et al., 2014), in addition to a high prevalence of obesity (Kyle, et al., 2016).

Methodology: In this study, 23 emergency nurses completed a 43-item survey regarding current behaviors and constructs of …

Tobacco Use And Nicotine Withdrawal Among Patients With Mental Illness, Yazan Daher Al-Mrayat

Theses and Dissertations--Nursing

People with mental illness (MI) are disproportionately affected by tobacco use compared to the general population. In fact, it is estimated that people with MI consume approximately 44% of cigarettes smoked in the United States. Moreover, the MI population is at greater risk for the negative social, economic, and health consequences associated with tobacco use and are reported to have 25-year shorter life expectancies than the general population. The impact of tobacco use is further noticeable among patients with MI who require psychiatric hospitalization. Quitting smoking in this population has been linked to fewer discharges against medical advice, better quality …

Contextualizing Performance Of Coordinated Care Network Of Veteran Services In Virginia, Marina Saitgalina, Donta Council

School of Public Service Faculty Publications

Coordinated care network is an approach to human service delivery that is recognized to improve client outcomes at a reduced cost. However, general mixed findings on the effectiveness of coordinated care networks warrant research contextualization. This article seeks to discover factors influencing the performance of a coordinated care network delivering social services to veterans and their families. The study provides a contextual analysis of a coordinated care network launched in 2016 in southeastern Virginia for two samples of 1,512 and 375 veterans and their families. Results of the regression analyses indicate that initial progress has been made both in efficiency …

Evaluation Of A Remote Symptom Assessment And Management (Sam) System For People Receiving Adjuvant Chemotherapy For Breast Or Colorectal Cancer: Mixed Methods Study, Lisa Whitehead, Laura Emery, Deborah Kirk, Diane Twigg, Deborah Brown, Joanna Dewar

Research outputs 2014 to 2021

©Lisa Whitehead, Laura Emery, Deborah Kirk, Diane Twigg, Deborah Brown, Joanna Dewar. Background: The Symptom Assessment and Management (SAM) program is a structured, online, nurse-supported intervention to support symptom self-management in people receiving adjuvant chemotherapy post surgery for breast or colorectal cancer. Objective: The objective of this study was to describe the development, implementation strategy, and evaluation of the SAM system. Methods: The development of the SAM program involved 3 phases. In phase 1, the web app was developed through consultation with consumers and clinicians and of the literature to ensure that the system was evidence-based and reflected the realities …

Mechanisms Of Pathogen Inactivation In Wastewater And Pharmaceutical Applications, Christa L. Meingast

Dissertations, Master's Theses and Master's Reports

Infectious diseases are a significant threat to public health. Though society enacts practices to prevent the spread of these dangerous diseases, challenges remain. Therefore, continual advancements in treatment and prevention are required. Wastewater treatment and viral clearance in pharmaceutical applications are two key health measures that prevent the spread of infections.

A low-cost, low-technology biosolids treatment process was developed to improve wastewater treatment by collecting key information on storage temperature, ammonia, volatile solids, moisture content, pH, and pathogen inactivation in biosolids over long-term storage at two wastewater treatment plants located in northern climates of the United States. Inactivation of pathogens …

Do Paramedics Have A Professional Obligation To Work During A Pandemic? A Qualitative Exploration Of Community Member Expectations, Cameron Anderson, Julie Ann Pooley, Brennen Mills, Emma Anderson, Erin Smith

Research outputs 2014 to 2021

Objectives:

Previous research has identified a lack of clarification regarding paramedic professional obligation to work. Understanding community expectations of paramedics will provide some clarity around this issue. The objective of this research was to explore the expectations of a sample of Australian community members regarding the professional obligation of paramedics to respond during pandemics.

Methods:

The authors used qualitative methods to gather Australian community member perspectives immediately before the onset of the coronavirus disease 2019 (COVID-19) pandemic. Focus groups were used for data collection, and a thematic analysis was conducted.

Results:

The findings revealed 9 key themes: context of obligation …

Resources To Access Health Care For Low Socioeconomic Status Youth Athletes, Stephanie Walsh

College of Graduate Studies: Theses & Dissertations

Background: Approximately 60 million youth participate in organized sports, with 13.5 million receiving care for sports related injuries each year. Most youth sports organizations do not have readily accessible health care resources; relying on parents and guardians to manage injuries. However, a majority of parents and guardians are untrained in appropriate management of injuries, therefore there is a need for understanding the availability of health care resources within the community. Resources necessary to access health care include health services, health insurance, transportation, and communication. Barriers to these resources may affect lower socioeconomic status family’s accessibility to care. Purpose: Investigate the …

Assessing The Percieved Barriers To Early Detection, Treatment, And Management Of Cervical Cancer Among Ghanaian Women, Angela D. Blackwell

College of Graduate Studies: Theses & Dissertations

Introduction: The purpose of this study was to assess the perceived barriers and strategies for improvement of timely detection, treatment, and management of cervical cancer among Ghanaian women in a tertiary hospital setting. Methods: Sixty semi-structured interviews, comprised of thirty-five cervical cancer patients and twenty-five healthcare professionals who provide cervical cancer care, were conducted. Two focus groups were conducted, including four healthcare professionals and another with two healthcare professionals—the data were analyzed using NVivo 12. A theoretical thematic analysis was utilized to identify common themes and sub-themes that arose from the participant interviews. The social-ecological model framework was employed to …

The Effect Of Patient And Hospital-Level Factors On 30-Day Readmission After Initial Hospitalization Due To Stroke, Emmanuel Akowuah

College of Graduate Studies: Theses & Dissertations

Background: Hospital readmissions account for a large part of healthcare costs, especially among stroke patients. Readmission is common among disabled stroke survivors because they often suffer some neurological deficits, functional impairment, and other preexisting cardiovascular conditions. Although previous studies have explored the relationship between hospital readmissions after initial hospitalization due to stroke and a set of predictors using various analytical models, it often remains uncertain which predictors are most influential or essential. This study aimed to assess the effect of patient and hospital-levels factors on 30-day readmission after initial hospitalization due to stroke using the Anderson model of healthcare …

Trajectories Of Hiv-Related Internalized Stigma And Disclosure Concerns Among Art Initiators And Non-Initiators In South Africa, Brian T. Chan, Brendan G. Maughan-Brown, Laura M. Bogart, Valerie A. Earnshaw, Gugulethu Tshabalala, Ingrid Courtney, Janan J. Dietrich, Catherine Orrell, Glenda Gray, David R. Bangsberg, Alexander C. Tsai, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-related stigma among people living with HIV (PLHIV) is associated with worse health outcomes. We used longitudinal data from a multisite cohort in South Africa to assess changes over time in stigma after HIV diagnosis and determine whether antiretroviral therapy (ART) initiation is associated with stigma reduction. We administered the Internalized AIDS-Related Stigma Scale (IARSS, a six-item dichotomous scale questionnaire) at baseline, 3 months, and 6 months to newly diagnosed ART-eligible participants between 2014 and 2015. A confirmatory factor analysis indicated that the IARSS contained a four-item internalized stigma factor (α = .80) and a two-item disclosure concerns factor (α …

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

Home Health Care Resource Binder: A User-Friendly Guide For Crossroads Hospice And Palliative Care, Deanna Eder

Williams Honors College, Honors Research Projects

Patients and families searching for home health care need accurate information regarding the community resources available to them to promote aging in place and to maintain their quality of life. In connection to the social workers at Crossroads Hospice and Palliative Care, the researcher identified a need for a centralized source of up-to-date information regarding local home health care agencies due to the current resource deficit. Social workers and other health care professionals are expected to benefit from a concise list of resources readily available to provide their patients and families with adequate support to make informed decisions about a …

Reducing Disparities In Smoking For Adults With Mental Illness: Are U.S. Tobacco Prevention Policies Effective?, L. Morgan Snell

Theses and Dissertations

One in five people in the U.S. are estimated to experience “any mental illness” (AMI); however this group represents an estimated 40% of the annual, adult cigarette consumption in the U.S. Tobacco prevention policies have been successful at reducing smoking prevalence among the U.S. population as a whole, however it is unclear whether these efforts have had significant impact on tobacco use rates among individuals with AMI. The three papers that comprise this project combined longitudinal, nationally-representative data and online behavioral experiments from U.S. adults to compare demand for cigarettes among adult smokers with and without AMI. Taken together, our …

The Allied Health Work Readiness Study: Identifying Personal Characteristics Signalling Work Readiness In Allied Health Students, Maxine O'Brien, Kelli Troy, Jayne Kirkpatrick

Internet Journal of Allied Health Sciences and Practice

Purpose: Clinical placements associated with university degrees for the allied health professions aim to support the preparation of students for post graduate employment through the practical application of theoretical constructs. However, employers recognise that a range of generic skills and attributes outside of technical and academic achievement impact of work readiness. Allied health clinical educators within Darling Downs Health (DDH) sought to identify these generic characteristics, and their relative importance, with a view to further supporting the work readiness of students completing placements in the district. Method: The study utilised the knowledge and experience of allied health clinical educators, experienced …

Digital Technologies As Antecedents To Process Integration And Dynamic Capabilities In Healthcare: An Empirical Investigation, Tulika Chakravorty, Karunakar Jha, Sunil Barthwal, Samyadip Chakraborty

Journal of International Technology and Information Management

Healthcare has been in focus over the past decade due to its criticality and continuous revolution. In this digital era, with the advent of various technologies, healthcare is undergoing a massive transformation. This study attempts to analyze the impacts of three major digital technologies which are being adopted in the healthcare sector which are electronic medical records (EMR), enterprise resource planning (ERP) and internet-of-things (IoT) enabled medical wearables in the hospital context. Focusing towards analyzing the impact of these technologies towards process-integration and further towards dynamic capabilities like quality, agility and responsiveness; the study framework is well-grounded by two theoretical-underpinnings …

Health Care Professionals’ Compliance To Tracheal Suctioning Policy At A Tertiary Care Hospital, Rozina Khimani, Fauziya Ali, Salma Amin Rattani, Mohammad Sohail Awan

Department of Surgery Docs

Objective: To assess the compliance of tracheal suctioning practices against the standard guidelines of a tertiary care hospital, with regard to the participants’ professional characteristics.
Methods: Using cross sectional study design, forty health care professionals (HCPs) were assessed twice, using a quantitative structured observational design, for tracheal suctioning practices, in one of the surgical care units of the tertiary care hospital. Tracheal suctioning policy which was used as a tool, its inter-rater reliability was tested and each step showed the Kappa value of 0.65 to 1.000. Data was analyzed using epidata info version 3.5.1 and SPSS version 19.
Results: From …

Standardized Knowledge And Behavior Of Food-Protection Staff To Help Reduce The Potential For Incidences Of Foodborne Illness, Joshua A. Dufresne

College of Graduate Studies: Theses & Dissertations

Background: Environmental public health has always been at the forefront of issues that affect the health and wellbeing of the general public when it comes to food safety. However, with the workforce moving from one of technological laggards toward faster progress toward new and improved systems in performing food service, the question becomes: What are the needs of the environmental health and food safety workforce, and how does one get there? Logically, another question follows: are our current training programs helping to make a difference in the number of foodborne-illness risk-factor violations being issued?

Purpose: This study was to …

#Science: The Potential And The Challenges Of Utilizing Social Media And Other Electronic Communication Platforms In Health Care., Violette Gijsen, Michele H. Maddux, Adam Lavertu, Graciela Gonzalez-Hernandez, Nilam Ram, Byron Reeves, Thomas Robinson, Victoria Ziesenitz, Valentina Shakhnovich, Russ Altman

Manuscripts, Articles, Book Chapters and Other Papers

Electronic communication is becoming increasingly popular worldwide, as evidenced by its widespread and rapidly growing use. In medicine, however, it remains a novel approach to reach out to patients. Yet, they have the potential for further improving current health care. Electronic platforms could support therapy adherence and communication between physicians and patients. The power of social media as well as other electronic devices can improve adherence as evidenced by the development of the app bant. Additionally, systemic analysis of social media content by Screenome can identify health events not always captured by regular health care. By better identifying these healthcare …

“Is Therapy For Me?” Perceptions Of Therapy Inclusivity And Willingness To Seek Help Among Black Emerging Adults, Randl B. Dent

Theses and Dissertations

Mental health issues are prevalent among Black emerging adults; however, they tend to underutilize mental healthcare services. The goals of the current study were to examine whether: (1) perceived therapy inclusivity would predict willingness to utilize mental healthcare services and (2) the relationship between perceived therapy inclusivity and willingness would be moderated by two indices of racial identity (i.e., centrality and private regard). Results provide evidence that greater perceptions of therapy inclusivity are associated with greater willingness to seek mental health services even after controlling for factors, such as gender, self-stigma, and previous mental healthcare utilization. Additionally, there was no …

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

Articles

Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …

Multimorbidity, Immune Checkpoint Inhibitor Use, And Healthcare Expenditures Among Older Patients With Late-Stage Melanoma, Pragya Rai

Graduate Theses, Dissertations, and Problem Reports (ETD)

With decades of unchanged cancer care with no added survival benefit, immune checkpoint inhibitors (ICI) changed the treatment landscape of late-stage melanoma in 2011. A key factor in determining the use of ICIs is the presence of pre-existing chronic conditions, which can influence the outcome. However, the prevalence of multimorbidity (defined as presence of two or more chronic conditions) among older patients with late-stage melanoma remains unknown. It also remains unknown if the presence of multimorbidity factors into the use of ICIs. Hospital-related factors associated with ICI use have been studied. Yet, patient-level factors, such as age, sex, marital status, …

Asthma-Copd Overlap: Economic Burden And Medication Adherence, Mona Nili

Graduate Theses, Dissertations, and Problem Reports (ETD)

In many older adults, asthma and chronic obstructive pulmonary disease (COPD) coexist as “Asthma-COPD overlap” (ACO). This dissertation pursued three Aims: 1) estimate the economic burden of ACO and its contributory factors; 2) evaluate the association of ACO to “cost-related medication nonadherence” (CRN); and 3) identify adherence trajectory patterns and examine the impact of initial maintenance therapies (IMT) type (inhaled corticosteroids monotherapy (ICS) vs. fixed-dose combination of ICS and long-acting beta agonist (ICS/LABA)) on adherence trajectory patterns among older adults Medicare Beneficiaries. The first and second Aims were cross-sectional studies by using Medicare Current Beneficiary Survey data. For the third …

Three Essays On Health Economics And Policy Evaluation, Shishir Shakya

Graduate Theses, Dissertations, and Problem Reports (ETD)

This dissertation consists of three essays on the U.S. Health care policy. Each paragraph below refers to the three abstracts for the three chapters in this dissertation, respectively. I provide quantitative evidence on how much Prescription Drug Monitoring Programs (PDMPs) affects the retail opioid prescribing behaviors. Using the American Community Survey (ACS), I retrieve county-level high dimensional panel data set from 2010 to 2017. I employ three separate identification strategies: difference-in-difference, double selection post-LASSO, and spatial difference-in-difference. I compare how the retail opioid prescribing behaviors of counties, that are mandatory for prescribers to check the PDMP before prescribing controlled substances …

Breaking The Chain: Evaluating The Links Between Opioid Use Disorder, Overdose, And Suicide, Amanda Nicole Stover Mph

Graduate Theses, Dissertations, and Problem Reports (ETD)

Previous research has estimated that 20–30% of individuals with opioid use disorder (OUD) have a history of both suicide attempt and unintentional opioid overdose. In 2018, more than 1.9 million adults 18 years and older had an OUD; while 1.4 million adults attempted suicide that same year (SAMHSA, 2019). The key to understanding this relationship is examining behaviors that precede these potentially fatal behaviors. One such precursory behavior is self-injury. Self-injurious behaviors (SIB) are one of the most important risk factors for future suicide (Cavanagh et al.,2003). This study has three primary objectives. The first is to conduct a systematic …

How Does Access To Healthcare Affect Life Expectancy?, Yara Mahmoud

Senior Honors Projects, 2010-2019

Access to health care is a pressing issue in the United States, whether it be the cost of care or not having enough of it. To emphasize the importance of this topic, this paper assesses the impact of access to health services on life expectancy. A comparison is made between the universal health systems in France and Spain and the mixed system in the United States. Even though the United States spends the most on health care in the world, its statistics fall below those of other developed countries. After addressing other risk factors, it was found that individuals under …

Redefining Trauma: Utilizing Restorative Justice To Repair Care Systems, Emebet Aklilu

Master's Projects and Capstones

This project examined the ways in which restorative justice programming can improve trauma informed care among the African American population in Oakland, CA. With 23% of African American men and women living at or below the poverty line in the United States, this project assesses gaps in current trauma informed care practices as evident in the literature. Following a rigorous document review the author coded and organized key programming components following six factors detailed by Rowher, Schoones, and Young (2014). Further examination of these program components was conducted using Bloom’s taxonomy levels to assess program outcomes associated with specific modules …

Partial Psychiatric Hospitalization Program Availability In Non-Metropolitan And Metropolitan Hospitals Nationally, Timothy Williams, Tyrone F. Borders, Lindsey Jasinski

Rural & Underserved Health Research Center Publications

Overview of Key Findings

Partial psychiatric hospitalization programs (PPHPs) are intended to reduce or avoid inpatient stays by allowing patients to reside at home while receiving intensive psychiatric services in outpatient settings.

A significantly smaller proportion of non-metropolitan than metropolitan hospitals offer PPHPs.

• 11.4% of non-metropolitan compared to 38.7% of metropolitan hospitals offer PPHPs.
• Regardless of location, hospitals that offer PPHPs have higher patient volumes and more beds than hospitals that offer PPHPs through affiliated providers or do not offer PPHPs at all.

Heterogeneity Introduced By Ehr System Implementation In A De-Identified Data Resource From 100 Non-Affiliated Organizations., Earl F. Glynn, Mark A. Hoffman

Manuscripts, Articles, Book Chapters and Other Papers

Objectives: Electronic health record (EHR) data aggregated from multiple, non-affiliated, sources provide an important resource for biomedical research, including digital phenotyping. Unlike work with EHR data from a single organization, aggregate EHR data introduces a number of analysis challenges.

Materials and Methods: We used the Cerner Health Facts data, a de-identified aggregate EHR data resource populated by data from 100 independent health systems, to investigate the impact of EHR implementation factors on the aggregate data. These included use of ancillary modules, data continuity, International Classification of Disease (ICD) version and prompts for clinical documentation.

Results and Discussion: Health Facts includes …

Blueprint For Shared Safety Strategic Plan, Reann Ramos

Capstone Projects and Master's Theses

The Blueprint for Shared Safety strategic plan will be adopted by Santa Cruz County Community Corrections Partnership as a framework of principles and practices that community leaders can use to lead shared safety strategies. By shifting the focus from the traditional criminal justice system to investments that can truly make our communities safer, the Blueprint aims to re-envision public safety together. The Community Corrections Partnership Community Education and Engagement Workgroup (CCP CEEW) has conducted data analysis to identify the key assets and gaps in Santa Cruz County. After identifying the key assets and gaps there were recommendation review sessions that …