Public Health Commons^™

Understanding Polarizing Community Perspectives On Harm Reduction Strategies: Challenges To Addressing The Opioid Crisis In Appalachian Pennsylvania, Stephanie L. Creasy Mph, Jessica R. Thompson Med, Christina F. Mair Phd, Jessica G. Burke Phd

Journal of Appalachian Health

Introduction: Rural communities face barriers to opioid treatment and overdose prevention including concerns about stigma and lack of harm reduction services.

Purpose: The aim of this study was to explore community perspectives and understanding of harm reduction approaches to opioid use and overdose in a high-risk Northern Appalachian case community in Pennsylvania.

Methods: A small town approximately 10 miles from Pittsburgh was identified as the community with the greatest predicted probabilities of epidemic outbreak using posteriors from spatial models of hospitalizations for opioid use disorders. We interviewed 20 key stakeholders in the case community in using a semi-structured interview guide …

Zero Balancing: Conscious Touch And Transformation Book Review, Misty L. Rhoads

Journal of Transformative Touch

Zero Balancing: Conscious Touch and Transformation by pioneering transformative touch practitioner and teacher James McCormick is a profound and engaging textbook that teaches readers a multi-layered approach to working with the body, mind, and spirit through skilled, conscious touch.

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Opioid Use Disorder (Oud) And Pregnancy In Utah, Saralyn Margetts, Erin Fanning Madden, Lauran Hymas, Katie Zaman, Gabriela Murza, Suzanne Prevedel, Sandra H. Sulzer

All Current Publications

Over the past twenty years, opioid use during pregnancy has become much more common (Haight et al., 2018). Opioids may be prescribed for pain management or the treatment of an opioid use disorder (OUD). For example, methadone or buprenorphine are medications recommended for pregnant women with OUD. Opioid use may also include misusing prescription painkillers or using illicit drugs such as heroin. Regardless of the nature of opioid use, it is important for pregnant women to know how opioid use can impact their pregnancy and what treatment options are available.

Intergenerational And Intragenerational Connections Within A University Art Museum Program For People With Dementia, Sujal Manohar, Jessica Kay Ruhle

International Journal of Lifelong Learning in Art Education

This visual essay highlights the impacts of the Nasher Museum of Art’s Reflections program, which engages people with dementia (PWD) and their care partners through interactive art museum tours. This program’s conversation-based tours with built-in time to socialize are designed to foster intergenerational and intragenerational connections between PWD and museum gallery guides, PWD and care partners, and between PWD. Discussions about artwork are visitor-driven and encourage lifelong learning among participants. Anecdotal feedback from Reflections participants and gallery guides confirms the value of relationship building, improving quality of life for PWD.

By fostering community and strong connections, Reflections programs help reduce …

If You Suspect Your Child Is Using Opioids, Gabriela Murza, Timothy Keady, Paige Wray, Elizabeth Elsmore, Gabriel Glissmeyer, Suzanne Prevedel, Sandra H. Sulzer

All Current Publications

Opioid use disorders touch the lives of many families, and numerous factors influence the decision to use substances. Your child’s drug use does not mean that you are unsuccessful at parenting. This fact sheet considers actions a parent can take to support a child suspected of using opioids. A number of local and national resources are also listed for further guidance and support services.

Advancing Behavioral Health Literacy, James Scollione

Journal of Social, Behavioral, and Health Sciences

Accessing, comprehending, and using information to make informed decisions and improve one’s overall health or well-being are the foci of health literacy. The concept of behavioral health was introduced in the early 1980s and, since then, it has influenced new ideas (e.g., behavioral health literacy and integrated behavioral health care) and gained research and public attention. My aim is to provide an overview of definitions (i.e., health literacy, mental health literacy, and behavioral health literacy) and their connection to each other. I propose an expanded and honed definition of behavioral health literacy to enhance the behavioral health literacy and well-being …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Knowledge, Attitudes, And Beliefs About Safe Sleep Among Preconception Adolescents​, Keita Oumou, Krystal Hunter, Erica Levin, Lori Feldman-Winter

Cooper Rowan Medical Journal

Introduction–To protect against SUID/SIDS, the American Academy of Pediatrics (AAP) released recommendations on creating a safe sleep environment. Studies about teen parents indicate gaps in knowledge regarding infant safe sleep practices, however there are no published studies about adolescents who are preconception. The objective of this stud is to investigate adolescents’ knowledge, attitudes, and beliefs regarding infant safe sleep practices prior to conceiving.

Methods–This was a cross-sectional study of adolescents aged 14-22 years recruited from two outpatient primary care pediatric sites in Southern NJ. Following consent, participants completed a 27-question survey about infant safe sleep practices. For analysis, …

Stress Management Podcast Capstone Project, Jessica A. Thomas

IPS/BAS 495 Undergraduate Capstone Projects

The Stress Management Podcast Capstone Project sought to answer the question of how I might raise awareness about integrating holistic mental health services into my health coaching practice. This relevant topic centered on developing an innovative solution by drawing together two opposing perspectives from public health opinions and holistic health mindset. Launching a podcast proved to be a creative means for offering value to all stakeholders involved. Listeners received free holistic stress support, community and mental health professionals gained additional tools for their clients, while I established myself as an expert on mental health coaching. Exercising emotional intelligence regarding the …

Barriers To Human Papillomavirus Vaccine Uptake Among Racial/Ethnic Minorities: A Systematic Review, Trisha L Amboree, Charles Darkoh

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus (HPV) is associated with poor health outcomes, including cervical cancer. Racial/ethnic minority populations experience poor health outcomes associated with HPV at higher rates. A vaccine is available to protect against HPV infections and prevent HPV-related sequelae; however, vaccination rates have remained low in the United States (U.S.) population. Thus, there is an urgent need to increase the HPV vaccination rate. Moreover, little is known about barriers to HPV vaccination in racial/ethnic minority groups. This paper highlights the most recent findings on barriers experienced by these groups.

METHODS: The PubMed database was searched on July 30, 2020, for …

Los Efectos Psicosociales Que Produce El Embarazo En Las Vidas De Madres Adolescentes En Quito, Ecuador, Kaylee Howell

Independent Study Project (ISP) Collection

Research Question: What are the psychological and social effects of teen pregnancy facing teen mothers in 2021 and how do they impact their lives? Objective: The general objective is to describe the psychosocial implications produced by teen pregnancy. Background: Teen pregnancy rates of Latin America and the Caribbean are second in the world, second only to the region of Subsaharan-Africa. Within Latin America, Ecuador has the highest rates of adolescent pregnancy, surpassed only by Venezuela. Recently, the taboo surrounding reproductive health has been challenged, with the matter of abortion being brought to the supreme court. In conjunction with the matter …

Comparación Entre Las Percepciones Médicas Y Psicológicas De La Diabetes Tipo 2 Y La Tuberculosis En El Ecuador, Héctor Ortiz

Independent Study Project (ISP) Collection

Research Question: What are the differences and similarities between the perceptions of the medical and psychological management of both type 2 diabetes and tuberculosis? Objectives: The principal objective of this study is to understand the perceptions behind DM2 and TB as well as how these perceptions affect the care of these diseases. Secondary objectives are to define the epidemiological transition, describe the medical and psychological management and care of DM2 and TB, analyze how the people perceive the management and psychological care of DM2 and TB, and analyze the comparison of the perceptions of both diseases. Background: The epidemiological transition …

Evaluating The Pragmatic And Moralistic Approach To Drug Policy And Addiction In Opioid Epidemic Outcomes, Brielle Seidel

Independent Study Project (ISP) Collection

Drug use, policy and outcomes differ in all countries; however, trends exist in response to these circumstances and can typically be evaluated through a pragmatic and moralistic lens. The public health, and evidence-based pragmatic approach differs from the law enforcement-centered moralistic approach, specifically in outcomes of people suffering from substance use disorder. Particularly for opioid use disorder, countries that have taken the pragmatic approach in response to opioid epidemics have had dramatic results. Two of the countries discussed include Switzerland and Portugal, with additional information on the Netherlands. In contrast, current opioid epidemics exist in certain countries who maintain a …

Crisis Preparedness In Acute And Intensive Treatment Settings: Lessons Learned From A Year Of Covid-19, Jarrod M Leffler, Cassandra L Esposito, Elisabeth A Frazier, Michelle A Patriquin, Meredith K Reiman, Alysha D Thompson, Carl Waitz

Staff and Researcher Publications

The impact of COVID-19 changed the use and delivery of health care services, requiring an abrupt shift in treatment and staffing models 1,2. This is particularly salient in youth acute and intensive treatment services (AITS), including inpatient psychiatric hospitals (IPH), intensive outpatient programs (IOP), and partial hospitalization programs (PHP), because of challenging issues of maintaining high-quality care and a safe therapeutic milieu during increased demand for acute services,3 all while limiting transmission of COVID-19 on locked units, in close quarters, and for youths traveling back and forth to day-programs. Over the past year, AITS adapted and evolved without the ability …

Addressing And Supporting Mental Health Today: Society-Wide And In Hospital Emergency Departments, Kira La Sage

University Honors Theses

Mental health has become one of the most pressing public health issues of the 21st Century. Westernized societies offer much of their attention to childhood obesity, to COVID-19, to undiagnosed and diagnosed Americans living with diabetes. America even sees extended U.S. Senate hearings focusing on opioid use and abuse. Each of these concerns legitimately commands public health official attention, but what the world does not see is any level of sustainable attention given to emotional and mental health crises affecting tens of millions in Westernized countries. Suicide, the most serious of mental health crises, has become the second leading cause …

Spatial Disparities: The Role Of Nativity In Neighborhood Exposure To Alcohol And Tobacco Retailers, Georgiana Bostean, Luis A. Sánchez, Jason A. Douglas

Sociology Faculty Articles and Research

Studies of retail environment, one of the social determinants of health, document racial/ethnic disparities in exposure to alcohol and tobacco (A and T) retailers, but have largely overlooked nativity. We examined associations between A and T retailer density and rates of foreign-born Latinx and foreign-born Asian residents in California census tracts (N = 7888), using spatial regressions and controlling for population and ecological confounders (e.g., population density, zoning, residential instability, urbanicity). Socio-demographic data came from the American Community Survey (2012–2016); census tract density of A and T retailers came from geocoded addresses from state license data for off-sale alcohol distributors …

Associations Between Air Pollution Exposure And Empirically Derived Profiles Of Cognitive Performance In Older Women, Andrew J. Petkus, Diana Younan, Xinhui Wang, Daniel P. Beavers, Mark A. Espeland, Margaret Gatz, Tara Gruenewald, Joel D. Kaufman, Helena C. Chui, Joshua Millstein, Stephen R. Rapp, Joann E. Manson, Susan M. Resnick, Gregory A. Wellenius, Eric A. Whitsel, Keith Widaman, Jiu-Chiuan Chen

Psychology Faculty Articles and Research

Background:Elucidating associations between exposures to ambient air pollutants and profiles of cognitive performance may provide insight into neurotoxic effects on the aging brain. Objective:We examined associations between empirically derived profiles of cognitive performance and residential concentrations of particulate matter of aerodynamic diameter < 2.5 (PM2.5) and nitrogen dioxide (NO2) in older women. Method:Women (N = 2,142) from the Women’s Health Initiative Study of Cognitive Aging completed a neuropsychological assessment measuring attention, visuospatial, language, and episodic memory abilities. Average yearly concentrations of PM2.5 and NO2 were estimated at the participant’s addresses for the 3 years prior to the assessment. Latent profile structural equation models identified subgroups of women exhibiting similar profiles across tests. Multinomial regressions examined associations between exposures and latent profile classification, controlling for covariates. Result:Five latent profiles were identified: low performance across multiple domains (poor multi-domain; n = 282;13%), relatively poor verbal episodic memory (poor memory; n = 216; 10%), average performance across all domains (average multi-domain; n = 974; 45%), superior memory (n = 381; 18%), and superior attention (n = 332; 15%). Using women with average cognitive ability as the referent, higher PM2.5 (per interquartile range [IQR] = 3.64μg/m3) was associated with greater odds of being classified in the poor memory (OR = 1.29; 95% Confidence Interval [CI] = 1.10–1.52) or superior attention (OR = 1.30; 95% CI = 1.10–1.53) profiles. NO2 (per IQR = 9.86 ppb) was associated with higher odds of being classified in the poor memory (OR = 1.38; 95% CI = 1.17–1.63) and lower odds of being classified with superior memory (OR = 0.81; 95% CI = 0.67–0.97). Conclusion:Exposure to PM2.5 and NO2 are associated with patterns of cognitive performance characterized by worse verbal episodic memory relative to performance in other domains.

What Predicts How Safe People Feel In Their Neighborhoods And Does It Depend On Functional Status?, Alfredo J. Velasquez, Jason A. Douglas, Fangqi Guo, Jennifer W. Robinette

Health Sciences and Kinesiology Faculty Articles

Feeling unsafe in one's neighborhood is related to poor health. Features of the neighborhood environment have been suggested to inform perceptions of neighborhood safety. Yet, the relative contribution of these features (e.g., uneven sidewalks, crime, perceived neighborhood physical disorder) on perceived neighborhood safety, particularly among people with disabilities who may view themselves as more vulnerable, is not well understood. We examined whether sidewalk quality assessed by third party raters, county-level crime rates, and perceived neighborhood disorder would relate to neighborhood safety concerns, and whether functional limitations would exacerbate these links. Using data from the 2012/2014 waves of the Health and …

Deviating From The Zero Balancing Protocol, John Hamwee

Journal of Transformative Touch

When is it appropriate to deviate from the Zero Balancing protocol? John Hamwee shares when there are exceptions to the rule and the times it makes more sense to deviate from the protocol than to observe it.

Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell

Journal of Wellness

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses.

Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance …

The Association Of Parent-Child Communication With Internet Addiction In Left-Behind Children In China: A Cross-Sectional Study, Jingjing Cai, Yun Wang, Feng Wang, Jingjing Lu, Lu Li, Xudong Zhou

Pharmacy Faculty Articles and Research

Objective: Internet addiction has emerged as a growing concern worldwide. This study aimed to compare the prevalence of Internet addiction between left-behind children (LBC) and non-left-behind children (non-LBC), and explore the role of paternal and maternal parent-child communication on LBC.

Methods: We conducted a cross-sectional survey in rural areas in Anhui, China. The complete data were available from 699 LBC and 740 non-LBC. Multivariable logistic regression was used to examine 1) whether LBC were more likely to develop Internet addiction, and 2) the association between parent-child communication and Internet addiction among LBC.

Results: LBC had a higher likelihood to report …

Use Of Electronic Health Records To Manage Tobacco Screening And Treatment In Rural Primary Care, Jean A. Talbot Phd, Erica C. Ziller Phd, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Researchers at the Maine Rural Health Research Center, University of Southern Maine examined whether the use of electronic health records by rural primary care physicians facilitates their use of best practices in addressing tobacco dependence. The study used the National Ambulatory Medicare Care Survey (2012-2015) to explore how rurality and use of tobacco-related electronic health record functions were related to smoking status documentation and cessation treatment at adult primary care visits. Rural-urban comparisons were also examined.

The authors conclude that rural primary care physicians were at least as successful as their urban counterparts in leveraging electronic health records to enhance …

Health-Related Quality Of Life And Mental Well-Being Of Healthy And Diseased Persons In 8 Countries: Does Stringency Of Government Response Against Early Covid-19 Matter?, Di Long, Juanita A. Haagsma, Mathieu F. Janssen, John N. Yfantopoulos, Erica I. Lubetkin, Gouke J. Bonsel

Publications and Research

Objectives

Our study aimed to (1) assess health-related quality of life (HRQoL) and mental well-being of healthy and diseased persons in the general population during the early stage of the COVID-19 pandemic and (2) examine the relationship between HRQoL and mental well-being and individual characteristics and government response against COVID-19, as measured by the stringency index.

Methods

A web-based survey was administered to a cohort of persons from the general population of eight countries: Greece, Italy, the Netherlands, Russia, South Africa, Sweden, the United Kingdom (UK) and the United States of America (US) from April 22 to May 5 and …

Training And Individual Predictors Of Attitudes Toward Serious Mental Illness Amongst Clinical Psychology Doctoral Students, Lauren K. O'Connor

Dissertations, Theses, and Capstone Projects

Clinical psychologists are grossly underrepresented in treatment provision for individuals with serious mental illness (SMI; Roe, Yanos, Lysaker, 2006). Systemic (e.g., emergence of managed care) and training-based (e.g., limitations to SMI specific training) factors contribute to the establishment of this underrepresentation, while mental health stigma amongst psychologists may play a role in perpetuating it. Many individual and experiential factors have been found to impact clinicians’ attitudes toward those with SMI (Henderson et al., 2014; Schulzes, 2007). Though many of these factors are present and relevant from the beginning of one’s career and may involve elements related to training, little research …

Make Your Wishes Known: Understanding The Challenges And Barriers For Providing Effective Ethics Consults To Low-Income African American Men, Ruth Nwefo

Symposium of Student Scholars

The distrust of the U.S. health care system is prevalent, especially within the African American (AA) community. This distrust is largely based on infamous cases such as the Tuskegee Syphilis Experiment and experiments conducted by James Marion Sims on slave women without anesthesia. While these experiments along with many others further advanced medicine, they severed trust between health care institutions and the African American community, bringing upon repercussions still felt today. Although many steps have been taken to rebuild trust in the health care system by establishing effective ethical guidelines, more needs to be done in terms of rebuilding the …

Opioid Abuse: Are Doctors Creating The Problem?, Nguyen Tran

Symposium of Student Scholars

Opioid abuse and overdose are serious health problems in the United States. Current research has concentrated on the treatment and prevention of opioid abuse. Using data from the Controlled Substance Utilization Review and Evaluation System (CURES) for California zip codes, my research focuses on the causes of opioid overdose by considering the relationships between the following variables within each zip code: population size, average number of prescriptions per doctor, percentage of people who receive opioid prescriptions, percentage of people receiving the same prescription drug from 3 or more doctors, average number of opioid pills per prescription and number of people …

Utilizing Digital Technology To Address Loneliness And Isolation In Older Adults Through A Community-Based Connection Model: Responding To A Pandemic, Melissa A. Nagel

Doctor of Nursing Practice (DNP) Projects

Problem: Loneliness and social isolation, both of which can have serious detrimental effects on health and well-being, have become more prevalent during the recent COVID-19 pandemic, particularly in the older adult population. During part of the past year, older adults were strongly encouraged to follow strict quarantine measures because of their vulnerability to the virus. This forced isolation exacerbated the already existing issue of loneliness and social isolation in this population.

Interventions: Older adults who are members of a local non-profit community organization, focused on increasing independence and social vitality, were invited to participate in a virtual, interactive social engagement …

County And Demographic Differences In Drug Arrests And Controlled Substance Use In Maine, Trajan F. Hyde, Amadea D. Bekoe-Tabiri, Amalie K. Kropp Lopez, Luis G. Devia, Belsy D. Gutierrez, Matthew C. Lara, Anthony R. Soto, Daniel E. Kaufman, Matthew T. Moran, Kevin J. Simpson, Dipam T. Shah, Michelle Foster, Clare E. Desrosiers, John Hebert, Stephanie D. Nichols, Kenneth Lee Mccall, Brian J. Piper

Journal of Maine Medical Center

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Introduction: The Diversion Alert Program (DAP) was established to curb misuse of drugs and help identify people who may need treatment for substance use disorder (SUD). Law enforcement compiled arrest data into a database accessible by health care providers. Our objectives were to identify regional and demographic differences in drug use and misuse in Maine.

Methods: All arrests (N = 11 234) reported to the DAP from 2013 to 2018 were examined by county and arrestee demographics, and classified into families (opioids, stimulants, sedatives). The Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) tracks the distribution …

Skilled Maneuvering: Evaluation Of A Young Driver Advanced Training Program, Samantha A. Slinkard-Barnum, Laura K. Gryder-Culver, Kavita Batra, Paul J. Chestovich, Deborah A. Kuhls

Department of Surgery Faculty Research

BACKGROUND: Young drivers (YDs) are disproportionately injured and killed in motor vehicle crashes throughout the United States. Nationally, YDs aged 16 to 20 years constituted nearly 9% of all traffic-related fatalities in 2018. A Nevada Advanced Driver Training (ADT) program for YDs aims to reduce YD traffic injuries and fatalities through four modules taught by professional drivers. The program modules include classroom-based didactic lessons and hands-on driving exercises intended to improve safe driving knowledge and behaviors. The overarching purpose of this study was to determine if theNevada ADT programachieved its objectives for improving safe driving knowledge and behaviors based on …