Public Health Commons^™

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …

Examining The Determinants Of Timeliness In Crises Policy Responses: The Case Of Covid-19 In Egypt, Abdelhalim Abdalla

Theses and Dissertations

Timely responses to crises and pandemics play a significant role in navigating and minimizing the adverse impacts of such critical periods on the public and governments worldwide. COVID-19 could show and prove how a single virus originating in a single country can rapidly spread throughout the world, transforming an epidemic in China into a global pandemic. The virus caused more than 6.5 million deaths and around 660 million confirmed cases worldwide, according to the WHO, and sparked the worst economic catastrophe globally in more than a century, as estimated by the World Bank. Evidence suggests that the extent of the …

Effect Of Covid-19 On The Wellbeing Of Healthcare Professionals In Public Isolation Hospitals In Egypt, Shaimaa Sabbah

Theses and Dissertations

One of the most vulnerable groups severely hit by the COVID-19 pandemic has been the Healthcare Professionals (HCPs), especially the physicians, pharmacists, and nurses who work in public Isolation hospitals. The Egyptian medical syndicate declared the death of more than 600 physicians from February 2020 till January 2022. In the meantime, the Egyptian government has worked on different policies for relieving the negative effects of the pandemic on this vulnerable group; however, easing restrictions, no total lockdown implementation, and monitoring bureaucracy has negatively affected the wellbeing of those HCPs. The study aims to figure out recommended policies to protect HCPs’ …

A Coupled Hazard Simulation And Post-Disaster Resource Optimization Framework, Stephen M. Cunningham

Theses and Dissertations

Extreme events, such as natural or human-caused disasters, cause mental health stress in affected communities. While the severity of these outcomes varies based on socioeconomic standing, age group, and degree of exposure, disaster planners can mitigate potential stress-induced mental health outcomes by assessing early, intermediate, and long-term treatment interventions by social workers and psychologists. However, local and state authorities are typically underfunded, understaffed, and have ongoing health and social service obligations that constrain mitigation and response activities. A resource assignment framework is developed as a coupled-state transition and linear optimization model that assists planners in optimally allocating constrained resources and …

Associations Between Social Determinants Of Health And Chlamydia Infections Among Georgia Counties, Bre'auna K. Beasley

Theses and Dissertations

Chlamydia is a growing public health concern that disproportionately impacts southern states. While social determinants of health are not direct causes of chlamydia infections, studies have found that these determinants do influence infections by creating environments that promote or hinder health seeking behaviors, as well as exposure to risk factors. Guided by the Social Ecological Model of Public Health and the Healthy People 2030 Social Determinants of Health Conceptual Framework, this dissertation study aimed to examine the associations between social determinants of health and chlamydia infections among Georgia counties. This study employed a correlational research design. Aggregate-level secondary data for …

Psychological Sense Of Community Among Older Adults In Puerto Rico Two Years After Hurricane María, Thomas D. Buckley

Theses and Dissertations

Hurricane María devastated Puerto Rico in 2017 and resulted in adverse long-term outcomes. Psychological sense of community (PSOC) may serve as a protective factor against the effects of Hurricane María for older adults in Puerto Rico. Using a three-paper format, this dissertation draws on a resilience framework and theories of PSOC and the Ecological Theory of Aging to examine the role of PSOC among older adults in Puerto Rico two years after Hurricane María.

Paper one is a scoping review of the concept of PSOC in research with community dwelling older adults. I begin by presenting findings on study characteristics …

The Association Of Rural Hospital Closures With In-Hospital And 30-Day Post Hospital Discharge Mortality From Emergency Care Sensitive Conditions, Melinda A. Merrell

Theses and Dissertations

Purpose

Over 100 rural hospitals have closed in the U.S. since 2010. Continuous pressures on the rural health care delivery system suggest that the trajectory of closures will continue in at least the short-term. While the causes of rural hospital closures have been described in the literature, the effects on the health outcomes of populations that experience these closures are still poorly understood. The purpose of this study was to determine associations between rural hospital closures and in-hospital and 30-day post hospital discharge mortality rates for affected residents experiencing time-sensitive emergencies in two U.S. states.

Methods

Rural hospital closures were …

Beyond The Sentimental Cliche: How Local Communities Impact Residents And Shape Public Opinion, Kate Brunk

Theses and Dissertations

The Trump administration has recently established a rule that will prohibit abortion services providers from receiving Title X funds for the non-abortion family planning services they provide. Little public opinion research has focused on family planning and reproductive health topics outside of abortion. I find statistically significant experimental evidence that increasing perceptions of local need for a local reproductive health clinic caused subjects to be more supportive of federal reproductive health funding for local clinics. I did not find statistically significant correlational evidence that objective measures of poor reproductive health at the county level influence public opinion on federal reproductive …

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …

Introduction Of Innovative Medical Practices In Mayo Clinic: Effect Of The Interventions On Patient Outcomes, Duaa I. Aljabri

Theses and Dissertations

Purpose: Assessment of health technologies in medical practice is an ongoing process to provide clinicians and policymakers with information on the value of those applications. This dissertation aims to add to the existing body of literature and fill the gaps in prior studies by assessing two health technologies in Mayo Clinic Florida (MCF). The first paper provides an assessment of patient portal adoption and activity during hospitalization among cancer patients, and determines whether a portal application is associated with selected indices of patient safety, utilization and satisfaction. The second paper provides an assessment of a new approach in pain …

Association Of Insurance And Provider Type With Patients’ Perceived Cost And Ease Of Access To Healthcare Services Among Medicare Beneficiaries Diagnosed With Diabetes, Metria Harris

Theses and Dissertations

Medicare beneficiaries diagnosed with diabetes are likely to have health complications or episodes associated with diabetes, resulting in higher health care utilization and costs. Andersen’s Health Care Utilization Behavior Model (HCBM) includes predisposing, enabling, and need factors, but it excludes perception. Ajzen’s Theory of Planned Behavior (TPB) shows that perception influences health service use. This study was performed using a real-world model integrating Andersen’s HCBM and Ajzen’s TPB to determine whether there was an association between insurance type (Medicare Part D versus non-Part D) and perceived ease of access or cost among Medicare beneficiaries with diabetes. The second objective was …

How Do Health System Employees With Established Musculoskeletal Complaints Decide On Their Treatment Pathway? A Qualitative Approach, Noor Alshareef

Theses and Dissertations

Purpose: Non-pharmacologic treatment such as physical therapy (PT) are advocated for musculoskeletal pain for decreasing opioid use. Early access to PT has been shown to decrease costs and improve outcomes through direct access via self-referral. Although self-referral to PT is permitted in the majority of U.S states, health insurance coverage has been identified as a barrier preventing some patients with musculoskeletal complaints from using it. There are few studies examining patient factors related to early access to physical therapy via self-referral. The purpose of this study was to identify the factors outside of insurance that influence the choice to access …

The Effect Of Paid Sick Leave On Physician Office-Based Visits, Korvin Vicente

Theses and Dissertations

This paper uses a balanced sample of workers from cross-sections of the National Health Interview Survey to estimate the causal effects of paid sick leave on the medical care seeking behavior of individuals, as measured by physician office-based visits.

Establishing Sustainable Community Garden Interventions With Aid From Health Promotion Organizations, Rachel Joann Buenemann

Theses and Dissertations

Community garden interventions provide policy, system and environmental change at the community level to establish health behaviors, which act in contest to obesity risk factors. Limited research examines factors, which influence the sustainability of community garden interventions. Therefore, in this study, a sample of 10 Midwestern community gardens associated through funding from a health promotion organization in 2013, collected data through the interviewing and surveying of 10 garden administrators and surveying of 12 garden volunteers. The study identified garden benefits perceived by garden administrators and volunteers to include contributions to social justice, continued education, enhanced social cohesion, increased access to …

Three Essays On Public Policy And Health, Darin F. Ullman

Theses and Dissertations

This dissertation consists of three chapters. My first chapter examines the effect of mandatory first time offender ignition interlock laws. Specifically, I use difference in difference techniques to estimate the effect of the laws on alcohol related fatal accidents. I also discuss and link behavioral models of deterrence and incapacitation to the results, so that finding can easily be interpreted. Results of the study provide pivotal policy relevant information that are essential to maximizing public health and reducing dangerous alcohol related crashes. In particular, results show that states which adopt legislation that requires mandatory participation of first time offenders in …

Influence Of Public Insurance On Healthcare Access And Cancer Care, Wafa W. Tarazi

Theses and Dissertations

Medicaid expansion under the Affordable Care Act (ACA) facilitates access to care among vulnerable populations, but 21 states have not yet expanded the program. Tennessee’s Medicaid program experienced a dramatic Medicaid contraction when the program disenrolled approximately 170,000 nonelderly adults in 2005. Pre-ACA expansions were associated with better access to and utilization of healthcare services. However, little is known about the effect of these policy changes on improvement in health outcomes for women diagnosed with breast cancer, access to care for cancer survivors, and the effect of generosity and duration of expansion on access to care.

This dissertation has three …

Demand And Supply Factors Affecting Maternal Healthcare Utilization Pattern In Nigeria, Dumbiri Joy Powell

Theses and Dissertations

Given poor maternal services utilization and associated high maternal mortality risk in Nigeria, we document policy-amenable supply and demand factors impacting women’ use of skilled ANC and institutional delivery services. Using a cross-sectional design, we analyzed data from the Nigeria State Health Investment Project health facility and household surveys on 418 health facilities and 3,726 women with a pregnancy within 24 months prior to survey living in 241 geographic wards of two states. Logistic regression was used to study associations of women’s use of each maternal service with ward facilities’ ANC outpatient satisfaction, healthcare staff job satisfaction, surveyorverified facility infrastructure, …

Examining The Relationship Among Patient-Centered Communication, Patient Engagement, And Patient’S Perception Of Quality Of Care In The General U.S. Adult Population, Jumee Wang

Theses and Dissertations

Introduction: Patient-centered care is a major focus of healthcare organizations, policy makers, and researchers. Patient-centered communication by the provider and patient engagement are important components of patient-centered care. Despite increasing attention to these topics, we do not fully understand how patient-centered communication and patient engagement relate to perceived quality of care as reported by patients. This study takes some initial steps in exploring these relationships. The study also identifies patient-related factors such as sociodemographic, health-related, and health system factors that are associated with patient-centered communication, patient engagement, and perceived quality of care.

Method: This study used survey data …

Healthcare Utilization And Expenditure Patterns Among Older Adults With Functional And Medical Decline, Ashley Shields Robertson

Theses and Dissertations

Purpose. As the aged population of this country grows, the U.S. healthcare system will face increased pressure to provide long-term care services and supports to increasing numbers of elderly Medicare beneficiaries. Studies have indicated that unmet long-term care need can lead to increased, unnecessary utilization of the healthcare system, thus further taxing the Medicare system. Little is known about how type of long-term care, as well as how long-term care policies—specifically payment policies—affect health care utilization. The objective of this original dissertation research was to examine the effects of place of residence (community versus residential long-term care facility) and …

Effects Of Traffic And Air Pollution On Risk Of Preterm Birth And Low Birth Weight Outcomes In Milwaukee County, 2005-2010, Deborah Lynn Pasha James

Theses and Dissertations

Between 2005 and 2010, infants born to non-Hispanic black mothers experienced a 3-fold elevated risk of infant mortality compared to those born to white and Hispanic mothers. Preterm birth (PTB) and low birth weight (LBW) are strong predictors of infant mortality. To our knowledge, this is the first study of Wisconsin births to evaluate the effect of social and environmental factors on risk of PTB and LBW. We hypothesize that the observed racial inequalities in PTB and LBW are related to traffic density and air pollution. The Milwaukee INFANTS Study used 2005-2010 electronic birth record data (N = 85,045) geocoded …

Combating Biological Terrorism From Imported Food, Jeffrey S. Nelson

Theses and Dissertations

There is a threat that a terrorist or terrorist organization will use access to the US food supply to kill or sicken Americans by contaminating imported food products from Mexico. The food that Americans eat is coming more and more often from foreign countries such as Mexico. Foodborne diseases infect nearly fifty million people in the US each year, resulting in over three thousand deaths. There are many terrorist organizations that would like to deliberately contaminate American food. Drug cartels and terrorist organizations currently operate in Mexico, one of the leading food importers into the US. The purpose of this …

Relief Society Grain Storage Program, 1876-1940, Jessie L. Embry

Theses and Dissertations

This thesis will describe and interpret the development of this Relief Society wheat storage program from its inception in 1876 to 1940 when the program was transferred to the General Church Welfare Committee. Emphasis will be placed on the sisters' attempts to store grain and the problems they encountered. The thesis will also discuss the effects of outside forces on the program and the different ways the sisters used the grain. The final chapter will deal with the relationship between the movement and the history of the Relief Society and its parent organization, the Mormon Church.