Public Health Commons^™

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Journal of Patient-Centered Research and Reviews

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Factors Associated With Perceived Accuracy Of The Undetectable = Untransmittable Slogan Among Men Who Have Sex With Men: Implications For Messaging Scale-Up And Implementation, H Jonathon Rendina, J T. Parsons

Publications and Research

Introduction: Recent research has shown high efficacy of HIV treatment for reducing the risk of HIV transmission to sexual partners. As the efficacy of treatment as prevention (TasP) has proliferated, a new messaging campaign, Undetectable = Untransmittable, has been gaining popularity. The purpose of this paper was to assess factors associated with the perceived accuracy of this TasP messaging strategy among a large and diverse sample of gay, bisexual, and other men who have sex with men (GBMSM) in order to inform subsequent efforts at large-scale and implementation of the HIV prevention message.

Methods: We conducted a nationwide survey of …

An Educational Intervention To Raise The Awareness Of Limited Health Literacy And The Need To Utilize Recommended Strategies And Interventions Among Healthcare Clinicians In A Program Of All-Inclusive Care For The Elderly Setting, Esther Carpenter

Doctoral Dissertations and Scholarly Projects

Health literacy is a complex, common, and challenging issue facing the United States and the world today. Occurring in the context of care delivery and significantly impacting the quality of care provided, health literacy is not simply a patient problem; but places a substantial burden on healthcare clinicians to ensure they are providing clear communication. Research suggests a lack of awareness and training among healthcare clinicians related to health literacy, resulting in clinicians being unaware of and unprepared to address this issue in practice. The purpose of this evidence-based practice project was to raise the awareness of limited health literacy …

Fusion, 2018, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Niger: Meningitis, Rodrigo Medeiros

Global Public Health

Niger is a semi-presidential republic located in western Africa. The majority of the population lives in the most extreme southern part of the country since 80% of Niger’s territory is occupied by the Sahara desert. The desert has been spreading in recent years forcing people to leave their subsistence farms. The majority of the population lives with less than 1 dollar per day. The first meningitis outbreak lasted from 2002 until 2012, but the 2015 outbreak was the one that caused more damage to the countries located in the meningitis belt of sub-Saharan Africa. The meningitis belt is the place …

The Inception Of A Prediabetes Prevention Program In County Government, Gregory R. Grier

Education Dissertations and Projects

With the increasing prevalence and high cost of treatment, diabetes places an enormous demand on economic resources. To combat this issue and rising health care costs,Cleveland County Government took a proactive approach and partnered with its local YMCA. The YMCA was contracted to provide Prediabetes Prevention and Diabetes Control program classes to County employees. The programs were designed to (a) decrease the A1c level of program participants, (b) lower health care costs for the County, and (c) provide education about prevention and maintenance.

The ultimate goal of the program was to assist county administration and staff in their efforts to …

Gender Disparities In The Association Between Socio-Demographics And Non-Communicable Disease Risk Factors Among Adults With Disabilities In Shanghai, China, Youran Zhang, Gang Chen, Qi Zhang, Jun Lu, Huijiong Yu

Community & Environmental Health Faculty Publications

BACKGROUND. Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China.

METHODS. We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and …

Medium To Long Term Impacts On Former Participants Of The Shoulder To Shoulder Global Brigades To Ecuador, Craig Borie

Theses and Dissertations--Community & Leadership Development

Medium to Long Term Impacts on Former Participants of the Shoulder to Shoulder Global Brigades to Ecuador. International service learning and voluntourism programs in global health evoke benefits for both community and the intervener. While it is clear that the Shoulder to Shoulder Global program at the University of Kentucky provides a service to an economically resource poor community in Santo Domingo, Ecuador, what is unclear is the impact these interprofessional experiences have on the participants that travel with the four times a year health brigades. This study proposes to answer the question of what are the educational, personal and …

Development And Validation Of A Measure Assessing Blind Patients' Perceptions Of Their Healthcare Providers' Stereotype Content, Nazanin Mina Heydarian

Open Access Theses & Dissertations

People with disabilities (PWDs) constitute about 15-20% of the total population. Health disparities among PWD's are due, in part, to stereotypes about PWDs as incompetent. These stereotypes may lead some healthcare providers (HCP) to patronize PWDs, over-focus on the PWDs' impairments and potentially neglect their presenting problem. Moreover, if the PWD violates stereotypical assumptions, the HCP may actively interfere with the PWD's goals. This Dissertation focused on the blind population because this is a large, stigmatized and understudied subpopulation of PWDs. In Study 1, the content of stereotypes about blind patients in the clinical setting were examined from the patient …

Mapping Opioid Mortality Rates Across Treatment Capacity To Identify Need And Access, Garrett K. Wong, Justin R. Chang, Chase Greco, Yadunandan Pillai, Mohammad A. Shahrezaei, Melissa H. Burton, Rob Lawrence, Alan Dow

Graduate Research Posters

Background: The opioid and heroin overdose epidemic is a public health emergency in the state of Virginia, resulting in the death of more than 1,100 people in 2016. In order to overcome this epidemic, we need to match the places with the greatest need for services related to substance use disorders with the appropriate healthcare workforce.

Aims: As the data about the overdose outbreak and related socioeconomic factors grow in size and complexity, data scientists have attempted to utilize big data techniques to identify communities and risk factors contributing to addiction.

Methods: Using data obtained from the …

Nutrition Label Accuracy And The Theory Of Triadic Influence: The Impact Of Knowledge On Healthy Food Choices In A Predominantly Hispanic Sample, Mosi Staudt Dane'el

Open Access Theses & Dissertations

Unhealthy food choices and the outcomes of those choices are a significant concern in the United States. Multiple governmental agencies recommend using nutrition labels to promote healthier food choices. This study investigated this claim using the theory of triadic influence to examine the efficacious use of nutrition labels on food choices. The theory of triadic influence presents a model of variables that affect food choice, including knowledge pathways on which this study focuses. Within the model, we expected increased scores on two measures of health knowledge to predict nutrition label understanding, which predict healthy food attitudes. Next, we expected that …

Global Health Elective, Santiago, Dominican Republic, March 2018, July K. Jean Cuevas

Posters

Describes a global health learning experience to improve the knowledge of health care professionals and families about common developmental conditions, autism and ADHD.

Home-Based Pre-Exposure Prophylaxis (Prep) Services For Gay And Bisexual Men: An Opportunity To Address Barriers To Prep Uptake And Persistence, Steven A. John, H Jonathon Rendina, Christina Grov, Jeffrey T. Parsons

Publications and Research

Gay, bisexual, and other men who have sex with men (GBM) are disproportionately affected by the HIV epidemic. Despite the promise of pre-exposure prophylaxis (PrEP) in reducing HIV transmission risk, barriers for uptake and persistence exist. We sought to identify whether GBM in a nationwide cohort who have not yet initiated PrEP (n = 906) would prefer to get PrEP-related care from a primary care provider (PCP) compared to a specialist clinic or provider. We then sought to identify their level of interest and factors associated with preference for using home-based PrEP services (i.e., HB-PrEP), defined to participants as conducting …

Medical Sciences 4300: London-Middlesex Suicide Prevention Council, Harshith Bhaskar, Adnan Husein, Ramin Javaheri-Poya, Sabrina Jetly, Christopher Nguyen, Serena Tejpar

Community Engaged Learning Final Projects

Suicide is an issue that affects people of all backgrounds, and takes the lives of many individuals every year. The London-Middlesex Suicide Prevention Council (LMSPC), an organization established in 1990, seeks to provide suicide prevention training to members of the community. They seek to engage community members in prevention and intervention by recognizing warning signs that may exist among the London-Middlesex region. The three main programs that strive to deliver these skills are ASIST, ASK, and safeTALK, each with a slightly different focus. LMSPC’s current goal is to increase access to these services through external grants and potential partnerships. Our …

Antibiotic Resistance In Escherichia Coli Iron Transport Mutants, Madeline Brandt

Honors Projects

Studies previously completed on Escherichia coli mutants suggested the possibility of iron uptake as an influence on the antibiotic resistance seen in different strains. The research focused on the TonB energy transduction system and its contributions to efflux-mediated antibiotic resistance. To test the hypothesis that iron uptake has an influence on antibiotic resistance in Escherichia coli, the sensitivity to a variety of antibiotics was evaluated in strains of E. coli lacking genes that relate to the uptake of iron or the efflux system that is necessary for the uptake of iron. To test the efflux systems TolC and TonB …

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Push For Progress Inspired Improved Outcomes, Jacob L. Bidwell

Journal of Patient-Centered Research and Reviews

The author and issue editor describes the changing faces of health care as well as movements undertaken by U.S. health systems over the last two decades to improve the treatment and documented outcomes of minority or impoverished patients and to understand the impact of cultural differences on patient care. While much progress has been made, achieving health equity will require the continued efforts of many working toward this goal.

Health Care Disparities Knowledge, Attitudes, And Behaviors In Resident Physicians, Rebecca Hammarlund, Diana Hamer, Kathleen Crapanzano, Rachel Bernard, Carine Nzodom, Courtney James, Angie Johnson, Diane Kirby, Laura Hetzler, Chris Woodward, Jesse Sulzer, Lauren Rabalais, Laurinda Calongne

Journal of Patient-Centered Research and Reviews

Purpose: Health care disparities are an important but sometimes underrepresented topic in graduate medical education. In this study we measured the impact of educational and behavioral interventions on resident knowledge about and attitudes toward health care disparities.

Methods: Faculty from 6 residency programs designed and presented an hour-long educational intervention to emphasize the importance of and increase resident knowledge about health care disparities. Selected residents then helped design a month-long behavioral intervention to engage their peers in conversations about disparities with patients. Surveys were administered pre- and post-educational intervention as well as post-behavioral intervention in order to measure the impact …

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November …

Positive Impact On Patient Satisfaction And Caregiver Identification Using Team Facecards: A Quality Improvement Study, Nicole M. Martin, Khalil Odeh, Lamya Boujelbane, Marvi V. Rijhwani, Susan Olet, Aijaz Noor, Colleen Nichols, Richard Battiola

Journal of Patient-Centered Research and Reviews

Background: Patients satisfaction is an increasingly important metric in measuring the quality of care that hospitals and physicians provide. It can be difficult for patients to remember their providers and their roles, all of which may potentially impact a patient’s overall satisfaction.

Purpose: To see if giving facecards with pictures and names of caregivers and description of roles improved patient satisfaction and identification of care team members.

Methods: Team facecards were designed and distributed to the patients during the interventional period of the study. Patients’ identification of team members, the role of each physician and overall satisfaction was measured using …

Identifying And Targeting Age-Related Colorectal Cancer Screening Rate Disparities In Family Medicine Residency Clinics, Jonathan J. Blaza, Jasmine R. Wiley, Matthew Gill, Alonzo Jalan, Will Lehmann, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Health care systems continuously seek to improve patient care through population-level analysis of clinical quality metrics and patient characteristics to identify disparities in care. Nationally, disparities in colorectal cancer (CRC) screening rates have been identified with lower screening rates reported for patients who are uninsured and/or lower socioeconomic status, African American/black, Asian, and non-English-speaking Hispanic patients. No age-related CRC screening rate disparities with associated interventions have been reported.

Purpose: Determine and address CRC screening disparities in care provided to eligible patients > 50 years old in two primary care residency clinics.

Methods: Retrospective analysis using REAL-G (race, ethnicity, age, preferred …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

College Students, Experiences On Smart Phone Technology Usage: A Qualitative Content Analysis Study, Fatemeh Jafarzadeh-Kenarsari, Parand Pourghane

The Qualitative Report

Besides many benefits of the cell phone technology, numerous arguments are raised on the different and important negative effects of such a technology. This qualitative content analysis study explored the common usages of smart phone technology, its challenges, and benefits among Iranian college students. Participants were 32 bachelor degree students who were recruited using purposive sampling method with maximum variation. Data were collected through 11 individual semi-structured interviews and 3 focus group discussions (5-8 students in each group). Data analysis was done based on a conventional content analysis approach. Data analysis resulted in 3 main themes and 12 sub-themes. The …

Developing A Mobile Application: Improving Health Care Students’ Ability To Communicate, Kiersten Walters, Ilya Rybakov, Patricia L. Darbishire

Purdue Journal of Service-Learning and International Engagement

The purpose of this project was to develop, pilot, assess, and describe a new interdisciplinary, game-based phone application. The application is intended to help health care students better communicate medication and medical terminology to their patients and to other health care providers and insurance companies. This IRB-approved project called “PharmPhrase” was developed using an application-development software program. The pilot involved multiple groups of competing teams composed of volunteer pharmacy students in their first professional years who were randomly assigned into teams of three to five. The PharmPhrase user explains a randomly generated medical term to team members based on assumptions …

Increasing Fitness Engagement Among Ohiohealth Employees, Kristen Goins

Masters Theses/Capstone Projects

This presentation focuses on how to increase fitness engagement among the employees of a large medical facility.

Palliative Players: Project Development And Initial Implementation, Eliza Eager

Muskie School Capstones and Dissertations

The Palliative Players are screened and trained hospice volunteers who provide a low-cost, sustainable, role-playing resource for use teaching communication skills to healthcare workers who discuss serious illness with patients and their families. The Palliative Players project was conceived and developed in early 2017 by Dr. Lauren Michalakes, Medical Director of Palliative Care at Coastal Healthcare Alliance (CHA); Sarah Dwelley, RN; Flic Shooter, Director of Hospice Volunteers of Waldo County (HVOWC); and Eliza Eager, Project Coordinator; to provide believable, emotive simulated patients (SPs) for role-play in workshops teaching healthcare workers communication tools and skills for use in conversations with patients …

Las Condiciones De Vida De Los Usuarios Adultos Mayores Del Hospital Makewe / The Living Conditions Of Elderly Users Of Makewe Hospital, Taylor Selembo

Independent Study Project (ISP) Collection

Life conditions are a fundamental aspect of the health of senior citizens, as these are the factors that determine their quality of life and capacity to satisfy their needs. Life conditions are dependent on the particular social, political, economic, and geographic context of the region. This study intends to answer the following question: How are the life conditions of senior citizens belonging to Hospital Makewe, located in the IX region of Chile? This quali-quantitative study utilized observation, surveys (n = 40) and interviews (n = 15) in order to accomplish the main objective. The main objective was to describe senior …