Public Health Commons^™

Depression And Awareness Of Mental Health Resources Among Minority And Non-Minority College Students, Henry David Browne

Walden Dissertations and Doctoral Studies

Minority college students experience higher levels of psychological stress and depression, and lower utilization of mental health resources (MHR) compared to the general student population. The purpose of this quantitative study was to examine the association between self-reported depressive symptoms and awareness of mental health services among college undergraduate minority and non-minority students, controlling for sex, interest in MHR information, and history of mental illness. The self-determination theory guided the study. The study utilized a cross-sectional research design using secondary survey data from the National College Health Assessment (NCHA). The NCHA dataset included 354,262 respondents from 52 self-selected U.S. colleges …

Epidemiology Of Marijuana Use And Mental Health In The Context Of Changing Policies, David G. Harvey Ii

Walden Dissertations and Doctoral Studies

There is a growing body of evidence supporting the association between cannabis use and the development of mental health disorders, but few studies have addressed this association following the recent increase in marijuana legalization laws. Therefore, using the social ecological model and the self-medication theory of addiction as theoretical frameworks, the purpose of this retrospective database study was to assess the relationship between marijuana use and major depression and suicidal ideation in both adults and adolescents in 2008 and 2017. Data from the National Survey on Drug Use and Health were analyzed using logistic regression at the p < .05 threshold for statistical significance. Results demonstrated positive, statistically significant relationships between marijuana use and both major depression and suicidal ideation for both adults and adolescents in both 2008 and 2017. Further, the strengths of these relationships generally increased between 2008 and 2017, coincident with the increase in marijuana legalization laws. These findings provide empirical support to the association between cannabis use and the development of mental health disorders, and that the strength of these associations is increasing following the increase in marijuana legalization laws. This study has important implication for positive social change by identifying significant relationships between cannabis use and the development of mental health disorders and revealing that these relationships are strengthening over time, coincident with the increase in marijuana legalization laws.

Treatment Interventions For Tobacco Cessation At An Inpatient Mental Health Facility, Stephanie Marie Stansell

Walden Dissertations and Doctoral Studies

Tobacco use is the leading cause of preventable death and disease in the United States. According to the Centers for Disease Control and Prevention, 36.5% of adults with any mental illness use tobacco compared to 25.3% of adults without a mental illness; however, there are limited data to determine the best approaches for tobacco cessation among the mentally ill. The purpose of this quantitative, quasi-experimental study was to investigate the differences among 1-on-1 counseling versus group counseling in tobacco cessation rates among psychiatric patients aged 18 years old and older who were identified as a tobacco user upon admission to …

The Relationship Between Mental Illness And Mass Shooting, Priscilla Ngozi Chukwueke

Walden Dissertations and Doctoral Studies

AbstractWhenever a mass shooting occurs, it impacts the immediate families of the perpetrator, victims, and the whole nation: emotionally and financially. The research on the association between mental illness (MI) and mass shooting fatalities is limited. The purpose of this quantitative, cross-sectional study was to explore the association between MI and mass shooting using the archival data of the Stanford University database of mass shootings in America from 2000 to 2016. The theoretical framework was based on Bronfenbrenner’s social-ecological theory and the cognitive-behavioral theory to explain socio-environmental factors that impact human growth and development. The results showed that the proportion …

Emotional Response To Climate Change Learning: An Existential Inquiry, Jennifer Hutchinson

Antioch University Dissertations & Theses

This qualitative study aims to explore and explain the existential underpinnings of learning about climate change and potential emotional responses to climate change learning. Undergraduate students in environmental sciences and studies classes at the University of Washingrounded theory on in Seattle, WA participated in semi-structured interviews. Participants were asked about their experiences learning about climate change and how they responded emotionally to the learning. This dissertation examines the responses from those interviews and builds a theory out of the data analyzed. Constructivist Grounded theory as outlined by Kathy Charmaz (2014) was used to analyze the interviews. Codes were created and …

“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 …

Associations Between Stress, Racial Discrimination, And Cytokine Levels In Black Americans, Takia Williams

Theses and Dissertations

Inflammation is a common pathophysiological pathway for a number of chronic diseases and is influenced by exposure to stress. Although there are racial disparities in health outcomes, relatively little is known about factors that may influence the inflammatory response in Black American individuals. This study examined whether racial discrimination and other forms of stress are associated with the balance of pro- and anti- inflammatory cytokines in Black American adults. Data from 22 participants were drawn from a larger study of Black American children (ages 5-12) and their primary caregivers drawn from low income neighborhoods in Richmond, Virginia. Caregivers reported demographics, …

A Theoretically-Based Mixed Methods Approach To Examining Mental Health Disorders And Help-Seeking Behaviors Among University-Enrolled African American Men, Kofoworola D.A. Williams

Theses and Dissertations

Recent studies show that African American men in college are disproportionately experiencing high levels of psychological distress, increasing their risk of developing mental health symptoms associated with depression and anxiety. Despite being at higher risk for developing mental health symptoms, university-enrolled, African American men are not seeking help even when experiencing high levels of stress and anxiety, impacting their academic performance. The evidence base describing mental health symptom prevalence and evidence-based prevention strategies among university-enrolled, African American men is limited. To that end, this dissertation work utilized a concurrent, mixed methods approach, theoretically-based in the Social Ecological Model (SEM), to …

A Qualitative Analysis Of Caregiver Goals For Urban Children With And Without Asthma, Megan M. Carlson

Theses and Dissertations

Pediatric asthma is a major public health concern that disproportionately affects children of color and youth living in low-income, urban areas. The implications for public health, child health, and family functioning necessitates our understanding and addressing experiences by families who are facing barriers within their socio-demographic context in addition to the stressors associated with managing pediatric asthma. The current study applied qualitative methods to interviews with caregivers of children with and without asthma in an effort to more deeply connect with caregivers’ experiences and yield richer information about the intersection of identities as Black caregivers living in an urban setting …

Black Women And Body Image: Implications Of The Racialized Beauty Aesthetic, Rachel L. Boutte

Theses and Dissertations

Black women have the highest prevalence of overweight and obesity relative to any other demographic group in the United States, however current weight management interventions appear least effective for them. Although several hypotheses have been proposed to explain these outcomes, few studies have collected data to evaluate how well they fit the lived experiences of Black women. In particular, the potential roles of body image and body dissatisfaction in the development and maintenance of overweight and obesity in Black women are not well understood. Extant literature largely reports that Black women are inoculated from body dissatisfaction due to cultural factors, …

Maternal Mortality Among African American Women In The State Of Georgia, Causes, Policy, And Ethical Considerations, Zahra Shahin, Isabella M. Hardwick, Nancy Jeffery, Jalisa Jordan, William Mase

Health Policy & Community Health: Faculty Publications

Background

The U.S. is currently one of thirteen countries where maternal mortality rates (MMR) is worse now than it was fifteen years ago. Reducing maternal mortality is one of the significant challenges facing the health system in the United States, especially in the State of Georgia, which has one of the highest MMR in the nation. The purpose of this review is to explore the causes, policy, and ethical contextual factors contributing to increased maternal mortality rates among African American women in the State of Georgia. Also, identifying and addressing weaknesses and gaps that exist in the healthcare system and …

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 …

Larc Method Appropriateness In Substance Use Treatment: A Quality Improvement Project For Integrated Care, Malia Johnson Dnp, Fnp, Alexa Curtis Phd, Fnp-Bc, Neda Afshar Dnp, Fnp-C, Msn, Cgrn

Doctor of Nursing Practice (DNP) Projects

Problem: Individuals with substance use disorder (SUD) have disproportionately higher rates of unintended pregnancy when compared to the general population, estimated to be 85% (Heil et al., 2011). Not only are poor maternal and fetal outcomes associated with unplanned pregnancies, but pregnancies in women with SUD are further complicated by additional risks and adverse outcomes (Black & Day, 2016).

Context: Addiction treatment centers and programs are primed with opportunity to offer family planning services, when contact with medical providers is increased for substance use treatment. In response to the opioid crisis and unprecedented rates of unintended pregnancy, this project …

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 …

Changing Minds: Measuring The Impact Of A Student-Led Club To Reduce Mental Health Stigma Among Teenagers, Jennifer Anolin

Master's Projects and Capstones

Introduction: Stigma is a major barrier for teenagers to access mental health services. Additional barriers include low health literacy, and demographic factors, such as gender, socioeconomic status, and race/ethnicity. Studies show that successful solutions to decreasing stigma involve interventions inside of schools. The purpose of this project was to measure impact of the Bring Change 2 Mind (BC2M) program and recommend program improvement needs.

Methods: Four survey instruments were used to evaluate BC2M’s student-led club program and to determine the club’s impact on reducing stigma at each participating high school. Each survey consisted of both qualitative and quantitative questions fielded …

Offering Medical Providers Capacity And Competence In Caring For Transgender And Non-Binary Patients: Evaluation Of A Pilot Digital Training Program, Lexis Manzara

Master's Projects and Capstones

Purpose: Stigma and discrimination in health care settings contribute to health disparities for transgender and non-binary (TGNB) people. Evidence suggests that a lack of training on the care for transgender and non-binary TGNB patients in medical school curricula has contributed to providers feeling unprepared to provide quality care for this population. Health care providers have the opportunity to play a key role in the reduction of health disparities for TGNB patients.

Methods: Twenty-five health care providers completed the eight-module digital training program. Pre- and post-tests assessed provider knowledge, self-efficacy, preparedness, and behavior. Paired samples t-tests were conducted to compare pre-and …

Prescription Drug Abuse: A Guide For Pharmacists, Brieann J. Miller, Amanda C. Mcdavid, Nicholas J. Edmonds, Joshua P. Stevens, Cynthia C. Nguyen, Ryan W. Naseman, Michael M. Milks

Pharmacy and Wellness Review

Millions of Americans use prescription psychotherapeutc drugs for nonmedical purposes. The most commonly abused prescription drugs are painkillers, followed by sedatives and stimulants. The first step towards ending prescription drug abuse must be taken by the pharmacist. Professional and student organizations, as well the as the newly founded Ohio Rx Abuse Prevention (OhioRAP) Coalition, provide resources to pharmacists and pharmacy students who want to reduce prescription drug abuse. This article discusses these various resources and provides a guide for pharmacists to take an active role in reducing prescription drug abuse and positively impact patient outcomes and their communities.

Flowers Or Flora?: Understanding The Effects Of Probiotics On Depression, Nicole Collopy

Senior Theses

The human gut is populated with hundreds of types of bacteria and fungi. In North America, both intestinal and mood disorders are prevalent, presenting health problems that challenge health care professionals and patients alike. A scholarly literature review was conducted to explore this important relationship.

The investigation of the literature revealed that there is an association between gut health disorders and mood disorders, mainly anxiety and depression. This is due to bi-directionality between the brain-gut pathways, meaning that gastrointestinal health may have an effect on mental health and vice versa.

This connection between gut and mood can have substantial implications …

Collection Of Analyzed Data From Health And Human Services Professionals: Stressors And Self-Care Practices, Yesenia Alcala

Capstone Projects and Master's Theses

Alliance on Aging is a nonprofit agency in Salinas, California. It was established in 1970, and they help serve the needs of the senior citizen community by offering multiple services. Working professionals experience high levels of stress in the workplace. Although there are many contributing factors for high stress in the workplace, the main factors at play are the lack of self-care and lack of support Zastrow (pg. 332, 2015). Because working professionally in the human services field experience high stress the consequences they may face are burnout, high turnover rates, and poor overall health. The capstone project will assess …

Trends And Associated Factors Of Use Of Opioid, Heroin, And Cannabis Among Patients For Emergency Department Visits In Nevada: 2009-2017, Pearl C. Kim, Ji Won Yoo, Chris R. Cochran, Seong-Min Park, Sungyoun Chun, Yong-Jae Lee, Jay J. Shen

School of Medicine Faculty Research

To examine trends and contributing factors of opioid, heroin, and cannabis-associated emergency department (ED) visits in Nevada. The 2009 to 2017 Nevada State ED database (n = 7,950,554 ED visits) were used. Use of opioid, heroin, and cannabis, respectively, was identified by the International Classification of Diseases, 9th & 10th Revisions. Three multivariable models, one for each of the 3 dependent variables, were conducted. Independent variables included year, insurance status, race/ethnicity, use of other substance, and mental health conditions. The number of individuals with opioid, heroin, cannabis-associated ED visits increased 3%, 10%, and 23% annually from 2009 to 2015, particularly …

Improving Access To Mental Health Care With Nurse Practitioners, Jessica Whelan

Dissertations

Problem: Over 40% of those with mental illness are untreated since the supply of psychiatrists does not meet the demand. The psychiatric mental health nurse practitioner (PMHNP) may be an adjunct in providing those services. The purpose of this quality assurance study was to evaluate outcomes of care between a PMHNP and a psychiatrist (medical doctor [MD]).

Methods: An observational, descriptive design with a retrospective medical record review of adult patients over a six-month period in a suburban, Midwestern, privately owned psychiatric practice.

Results: A total of 787 individual patients encountered at least one visit (N=787) although 3,679 …

Enhancing Emergency Care Environments: Supporting Suicidal Distress And Self-Harm Presentations Through Environmental Safeguards And The Built Environment, Stephanie Liddicoat

Patient Experience Journal

Self-harming and suicidal distress are prevalent, worldwide healthcare issues. Existing literature explains that both self-harm and suicidal presentations at Emergency Departments are increasingly occurring, correlating to high costs in healthcare service delivery. This scoping review aimed to (1) identify the current body of literature which examined the relationship between design practice and service user experiences within Emergency Departments for self-harm and suicidal distress presentations, and (2) identify the ways in which the built environment could increase the efficacy of therapeutic efforts through improving service user outcomes and experiences. This scoping review established that there was a paucity of research at …

Aberrant Epigenomic Modulation Of Glucocorticoid Receptor Gene (Nr3c1) In Early Life Stress And Major Depressive Disorder Correlation: Systematic Review And Quantitative Evidence Synthesis, Laurens Holmes Jr., Emily Shutman, Chinacherem Chinaka, Kerti Deepika, Lavisha Palaez, Kirk W. Dabney

Community & Environmental Health Faculty Publications

Early life stress (ELS) induced by psychological trauma, child maltreatment, maternal separation, and domestic violence predisposes to psycho-behavioral pathologies during adulthood, namely major depressive disorder (MDD), anxiety, and bipolar affective disorder. While environmental data are available in illustrating this association, data remain to be established on the epigenomic underpinning of the nexus between ELS and MDD predisposition. Specifically, despite the observed aberrant epigenomic modulation of the NR3C1, a glucocorticoid receptor gene, in early social adversity and social threats in animal and human models, reliable scientific data for intervention mapping in reducing social adversity and improving human health is required. We …

Implication Of Spiritual Network Support System In Epigenomic Modulation And Health Trajectory, Laurens Holmes Jr., Chinacherem Chinaka, Hikma Elmi, Kerti Deepika, Lavisha Palaez, Michael Enwere, Olumuyiwa T. Akinola, Kirk W. Dabnet

Community & Environmental Health Faculty Publications

With challenges in understanding the multifactorial etiologies of disease and individual treatment effect heterogeneities over the past four decades, much has been acquired on how physical, chemical and social environments a ffect human health, predisposing certain subpopulations to adverse health outcomes, especially the socio-environmentally disadvantaged (SED). Current translational data on gene and adverse environment interaction have revealed how adverse gene-environment interaction, termed aberrant epigenomic modulation, translates into impaired gene expression via messenger ribonucleic acid (mRNA) dysregulation, reflecting abnormal protein synthesis and hence dysfunctional cellular differentiation and maturation. The environmental influence on gene expression observed in most literature includes physical, chemical, …

Preliminary Evaluation Of An Approach To Rehabilitation Aimed At Promoting Return-To-Work In Individuals With Co-Morbid Musculoskeletal Pain And Depression, Michael J. L. Sullivan, Timothy Wideman, Aliki Thomas

Rapports de recherche scientifique

Nombre de personnes ayant subi une blessure au travail présentent des symptômes de douleur et de dépression. La combinaison de symptômes de douleur et de dépression peut avoir un effet négatif sur le rétablissement de l’individu. La présence de symptômes de dépression peut nuire à la capacité d’accomplir de nombreuses activités importantes de la vie quotidienne, inclusion faite des activités professionnelles. Des études ont démontré que les travailleurs blessés qui présentent des symptômes de dépression demeurent absents du travail deux fois plus longtemps que les travailleurs blessés non dépressifs. Les interventions utilisées pour traiter la douleur et l’incapacité fonctionnelle chez …

Is There Less Opioid Abuse In States Where Marijuana Has Been Decriminalized, Either For Medicinal Or Recreational Use? A Clin-Iq, Aaron M. Wendelboe, Richard Mathew, Tana Chongsuwat, Elizabeth Rainwater, Mark A. Wendelboe, Elizabeth Wickersham Md, Ann F. Chou

Journal of Patient-Centered Research and Reviews

Opioid use, abuse, and associated mortality have reached an epidemic level. In some states, cannabis is being used to treat chronic pain. To examine the hypothesis that medical marijuana legislation may reduce adverse opioid-related outcomes if patients substitute cannabis for opioids for pain management, we conducted a clinical inquiry (Clin-IQ). We searched Ovid MEDLINE, Ovid MEDLINE In-Process, and Embase for studies using the search terms marijuana, cannabis, legal, marijuana smoking, medical marijuana, opioid-related disorders, cannabis use, medical cannabis, legal aspect, and opiate addiction. We included population-based articles published from January 1, 2012, through December 5, 2018, that assessed the relationship …

Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore

Journal of Patient-Centered Research and Reviews

Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.

Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …

I Live Alone But Don't Feel Alone: Social Isolation And Loneliness From The Patient Perspective, Julia Bedard-Thomas, Christian Gausvik, Jonathan Wessels, Saundra Regan, Keesha Goodnow, Anna Goroncy

Journal of Patient-Centered Research and Reviews

A growing homebound population may be at risk for social isolation and loneliness. Health-related social needs play a contributing role in these conditions. Research shows social isolation and loneliness are drivers of health outcomes. This pilot feasibility study seeks to explore patient-centered insight into perceptions of social isolation and loneliness in a homebound population. Eight participants were recruited from a home-based primary care practice within a family medicine residency program. One 30-minute semi-structured interview was completed in participants’ homes. The interview focused on loneliness and social isolation, using the 6-item De Jong Gerveld loneliness scale. Three qualitative analysts open-coded transcriptions …

Determination Of Cannabinoids, Cathinones, And Synthetic Fentanyls Using Wastewater-Based Epidemiology, Catherine O'Rourke, Bikram Subedi

Posters-at-the-Capitol

Unregulated new psychoactive substances (NPS) in “pure” or “preparation” forms are designed to mimic the effects of controlled substances, and are introduced and reintroduced in the market as a cheap substitute for established regulated drugs in quick succession to loophole the law enforcement efforts on combating drugs. For example, carfentanil, a synthetic opioid activates the opioid receptors similar to morphine but it is astoundingly potent compared to a typical drug of abuse (100 times more potent than fentanyl and 10,000 times more powerful than morphine). Based on the cost- and time-intensive forensic analysis, National Drug Early Warning System reported the …

Neonatal Abstinence Syndrome From Selective Serotonin Reuptake Inhibitor Use During Pregnancy, Elizabeth Kramer, Maria Patnella, Rachel Bulko, Allie Harrison, Hannah Lamb, Manoranjan D'Souza

Pharmacy and Wellness Review

Neonatal abstinence syndrome (NAS) is a concern for infants born to mothers receiving treatment with a selective serotonin reuptake inhibitor (SSRI) throughout the pregnancy. The risk of NAS associated with SSRI use during pregnancy varies with the specific SSRI that is used by the patient during pregnancy. Common symptoms of NAS include premature delivery, gastrointestinal disturbances, irritability, low birth weight, short length and lack of response to various stimuli. Neonates that present with these symptoms can be scored using either the Finnegan or Lipsitz scoring tools. Neonates experiencing NAS can be calmed or treated using nonpharmacologic methods such as swaddling, …