Public Health Commons^™

Developing A Stand-Alone Children’S Hospital In Southern Nevada: Needs, Opportunities, And Economic Development Considerations, Tripp Umbach

Policy Briefs and Reports

This independent study developed by Tripp Umbach demonstrates how an independent, research-intensive, stand-alone children’s teaching hospital can significantly enhance the health status of Southern Nevada’s children, reduce outmigration, attract children from neighboring states, and stimulate the healthcare economy. Tripp Umbach evaluated the need for a children’s hospital, the barriers to overcoming its absence, and the advantages of establishing a stand-alone children’s hospital in Southern Nevada for diverse audiences throughout Nevada and nationally.

Planetary Health Learning Objectives: Foundational Knowledge For Global Health Education In An Era Of Climate Change, Kathryn H. Jacobsen, Caryl E. Waggett, Pamela Berenbaum, Brett R. Bayles, Gail L. Carlson, René English, Carlos A Faerron Guzmán, Meredith L. Gartin, Liz Grant, Thomas L. Henshaw, Lora L. Iannotti, Philip J. Landrigan, Nina Lansbury, Hao Li, Maureen Y. Lichtveld, Ketrell Mcwhorter, Jessica E. Rettig, Cecilia J. Sorensen, Eric J. Wetzel, Dawn Michele Whitehead, Peter J. Winch, Keith Martin

Earth and Environmental Sciences Faculty Publications

Planetary health is an emerging field that emphasises that humans depend on a healthy Earth for survival and, conversely, that the sustainability of Earth systems is dependent on human behaviours. In response to member demands for resources to support teaching and learning related to planetary health, the Consortium of Universities for Global Health (CUGH) convened a working group to develop a set of planetary health learning objectives (PHLOs) that would complement the existing ten CUGH global health learning objectives. The eight PHLOs feature Earth system changes, planetary boundaries, and climate change science; ecological systems and One Health; human health outcomes; …

Addressing Patient Loyalty Through Their Commitment Influenced By Electronic Word-Of-Mouth And Hospital’S Image, Al Quadhri Upe, Alida Palilati, Sudirman Zaid, Nasrul Nasrul

Kesmas

This article explores the influence of Electronic Word of Mouth (e-WoM) and hospital image on hospital patient loyalty, emphasizing the mediating role of patient commitment. Amidst the development of the healthcare industry sector in Indonesia, this study highlighted that e-WoM and hospital image significantly enhanced patient loyalty, with patient commitment playing an important mediating role. This article suggested practical strategies for hospitals, such as improving the quality of healthcare services, leveraging positive e-WoM, and implementing loyalty programs to elevate patient commitment and loyalty. These findings underscore the importance of hospital image and e-WoM in patient retention, providing valuable insights for …

Risk Factors For Cognitive Impairment In Adult Population Of Coastal Area: A Cross-Sectional Study In Maringkik Island, Indonesia, Herpan Syafii Harahap, Arina Windri Rivarti, Nurhidayati Nurhidayati, Fitriannisa Faradina Zubaidi, Dini Suryani, Legis Ocktaviana Saputri, Yanna Indrayana, Athalita Andhera, Muhammad Hilam, Abiyyu Didar Haq

Kesmas

Cognitive impairment is a medical condition commonly found in elderly populations, which can be due to vascular risk factors in patients. There remains limited data on risk factors for cognitive impairment among coastal region populations. This study aimed to investigate risk factors for cognitive impairment in the adult population of Maringkik Island, West Nusa Tenggara Province, Indonesia. Data collected were age, sex, education level, hypertension, antihypertensive treatment, diabetes mellitus, cigarette smoking, and body mass index status. A total of 114 participants were recruited using a consecutive sampling method. The participants’ cognitive function assessment used the Mini-Cog instrument. The cognitive impairment …

Exploration Of Positive Deviance In Prevention Of Underweight In The Under-Five: A Qualitative Study On Low-Income Urban Families, Irwan Budiono, Lukman Fauzi, Dewi Sari Rochmayani

Kesmas

Children under the age of five (the under-five) from low-income families are more vulnerable to experience underweight. This nutritional vulnerability is evident in the preliminary study, where 35.1% of the under-five experience underweight, and 28.48% are low-income families. This study aimed to explore Positive Deviance (PD) behaviors in preventing underweight among the under-five. The study applied a qualitative approach with a case study design. Data collection took place in July-August 2022, focusing on low-income families in the Gunung Brintik area. Data were collected through two focus group discussions, seven in-depth interviews, and five key informant interviews. Coding, subtheme, and theme …

The Open Defecation Free Program Evaluation Using The Context, Input, Process, And Product Model In Jambi, Indonesia, Guspianto Guspianto, Willia Novita Eka Rini, Rizalia Wardiah, Susi Desmaryani, Herlina Herlina

Kesmas

The Open Defecation Free (ODF) program was initiated by the government to increase access to healthy latrines. This study aimed to evaluate the ODF program using the CIPP evaluation model. A qualitative and exploratory descriptive method was adopted to investigate informants' experiences regarding the program's implementation. Data was explored through semi-structured interviews with 17 informants and analyzed using content analysis. The results showed that the program was crucial as numerous people engaged in open defecation due to economic, geographical, cultural, and knowledge factors. The absence of ODF policy was due to lack of priority, limited government and private support, insufficient …

Barriers To Early Intervention Access In Under-Resourced Communities: Professionals' Perspectives, Georges Ambroise, Jazminne Orozco-Arteaga

Summer 2024 OTD Capstone Symposium

Limited socioeconomic resources pose a barrier to accessing early intervention (EI) services.

The study yielded 33 participants of EI professionals. The study included an online survey and an optional semi-structured interview. Following data collection, Braun and Clarke’s six-step thematic analysis was utilized to identify themes from the surveys and interview transcriptions (Braun and Clarke, 2006).

The main themes that came from the data analysis are (1) there are barriers impacting access to EI experienced by families in under-resourced communities, (2) there are current supports for families in under-resourced communities accessing EI, (3) EI professionals play a role in decreasing barriers, …

What Is The Economic Benefit Of Annual Covid-19 Vaccination From The Adult Individual Perspective?, Sarah M Bartsch, Kelly J O'Shea, Colleen Weatherwax, Ulrich Strych, Kavya Velmurugan, Danielle C John, Maria Elena Bottazzi, Mustafa Hussein, Marie F Martinez, Kevin L Chin, Allan Ciciriello, Jessie Heneghan, Alexis Dibbs, Sheryl A Scannell, Peter J Hotez, Bruce Y Lee

Center for Medical Ethics and Health Policy Staff Publications

Background: With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward.

Methods: We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine.

Results: For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe …

Improving Patient Care: Expansion Of Access To Free Clinics, Anahis H. Davidian, Gail M. Bloom

Patient Experience Journal

Free clinics provide free or reduced-fee healthcare services for uninsured, underserved, and marginalized populations. Free clinics may be the only source of primary care for socioeconomically disadvantaged individuals lacking health insurance. However, consistently understaffed and underfunded free clinics are struggling to meet growing needs. The demand for services results in long waitlists with long wait times. Most free clinics rely on volunteer providers and staff due to limited financial resources. This case study proposes recommendations that can address the challenges of funding limitations while improving free clinics' ability to offer more accessible and equitable care to serve a greater proportion …

Cerebrovascular Reactivity Mri As A Biomarker For Cerebral Small Vessel Disease–Related Cognitive Decline: Multi-Site Validation In The Markvcid Consortium, Peiying Liu, Zixuan Lin, Kaisha Hazel, George Pottanat, Cuimei Xu, Dengrong Jiang, Jay J. Pillai, Emma Lucke, Christopher E. Bauer, Brian T. Gold, Steven M. Greenburg, Karl G. Helmer, Kay Jann, Gregory Jicha, Joel Kramer, Pauline Maillard, Rachel M. Mulavelil, Pavel Rodriguez, Claudia L. Satizabal, Kristin Schwab, Sudha Seshadri, Herpreet Singh, Ángel G. Velarde Dediós, Danny J. J. Wang, Rita R. Kalyani, Abhay Moghekar, Paul B. Rosenberg, Sevil Yasar, Marilyn Albert, Hanzhang Lu

Neurology Faculty Publications

INTRODUCTION: Vascular contributions to cognitive impairment and dementia (VCID) represent a major factor in cognitive decline in older adults. The present study examined the relationship between cerebrovascular reactivity (CVR) measured by magnetic resonance imaging (MRI) and cognitive function in a multi-site study, using a predefined hypothesis.

METHODS: We conducted the study in a total of three analysis sites and 263 subjects. Each site performed an identical CVR MRI procedure using 5% carbon dioxide inhalation. A global cognitive measure of Montreal Cognitive Assessment (MoCA) and an executive function measure of item response theory (IRT) score were used as outcomes.

RESULTS: CVR …

Health Professional Regulation And Provision Of Quality Health Services; Cross Sectional Analysis Of Private Health Care Providers In Wajir County, Kenya, Ali Ahmed Mohamed Qadar, Wanja Mwaura-Tenambergen, Eunice Muthoni, Luke Wahome Kinyua

Population Health, East Africa

Background: Health professional regulatory bodies oversee and enforce standards in healthcare to safeguard patient safety and prevent harm. However, international consistency in these regulations remains limited. The Kenya health sector relies on various bodies to enforce standards among professionals and institutions, albeit constrained by financial and human resources that hinder effective oversight. This study aimed to assess how regulatory practicessuch as licensing, training oversight, inspection of practice, and quality assurance mechanisms- affect the quality of healthcare provided by private providers.

Methods: The study targeted 108 healthcare providers from 36 private health facilities, primarily nurses and clinical officers. A sample of …

Rural Oral Health Access Disparities In New York State, Renae Williams Atkinson Dmd, Ms, Stacy Mcilduff Cfre, Hayward Derek Horton Phd

The New York State Dental Journal

Disparities in access to dental care for those whose primary/only dental insurance is Medicaid is a known issue. The infamous case of 12-year-old Deamonte Driver from Maryland brought this great need for access to private dental care through Medicaid to the fore. Yet, to this date, there has been no resource to address this great need.

Dentists accepting Medicaid fall into two categories: those who practice in federally qualified health centers (FQHC), and those who practice privately. FQHCs are known anecdotally to have long waitlists, delaying access to needed care (as in the case of Driver). This is compounded by …

Expanding A Behavioral View On Digital Health Access: Drivers And Strategies To Promote Equity, Maura M Kepper, Lauren A Fowler, Isabelle S Kusters, Jean W Davis, Manal Baqer, Sara Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C Yi, Bryan Gibson, Kristin E Heron, Nicole M Alberts, Marissa Burgermaster, Veronica Ps Njie-Carr, Lisa M Klesges

Center for Medical Ethics and Health Policy Staff Publications

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for …

Passive Smoking And Its Correlation With Stunting In Children: A Systematic Review, Anita Rahmiwati, Karlinda Karlinda, Hamzah Hasyim, Febriyansyah Febriyansyah

Kesmas

Passive smoking is a significant risk factor for stunting in children, highlighting the urgent need for effective public health measures. This study aimed to investigate the association between passive smoking and stunting in children aged 0 months-7 years. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across multiple online databases, including PubMed, ProQuest, Science Direct, Willey Online Library, Sage Journal, Cambridge University Press, and Oxford Academic. The quality of included articles reporting observational studies was assessed using the Critical Appraisal Skill Programme (CASP) checklist, presenting data through narrative synthesis. Findings …

The Correlation Of Age With Thrombocytes And D-Dimer Values In Covid-19 Patients At Hospital X In Jakarta, Indonesia, Nanik Prasetyoningsih, Ascobat Gani

Kesmas

Coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus, spread globally, with research indicating that prognosis severity can be assessed by thrombocyte and D-dimer levels; while, patient age serves as a mortality predictor. This study aimed to analyze the relationship between age with thrombocytes and D-dimer in COVID-19 patients. This cross-sectional study used laboratory testing samples from 667 COVID-19 patients at Hospital X in Jakarta, Indonesia, collected from August 2020 until May 2021. The data was collected using cluster random sampling and analyzed using descriptive statistics and the Chi square test (95% CI). The results showed that age and thrombocytes positively …

Capitation Management Through Performance-Based Capitation Mechanism Of Primary Health Care In Malang, Indonesia, Ayu Tyas Purnamasari, Herlinda Dwi Ningrum, Anggi Ardhiasti, Asri Hikmatuz Zahroh

Kesmas

Primary health care (PHC) has one of the largest funding sources, capitation, which BPJS Healthcare Security transfers monthly. Capitation fund receipts were frequently insufficient due to failure to meet performance-based capitation/Kapitasi Berbasis Kinerja (KBK) targets, including for PHC in Malang City, Indonesia. This study aimed to examine the management and utilization of capitation funds through a KBK mechanism. This descriptive study used a qualitative approach supported by quantitative data. This study was conducted from July to August 2023 and purposely selected nine informants from BPJS Healthcare Security, the local health office, and PHC. The interviews were transcribed verbatim and analyzed …

Data Mining Analysis With Orange In The Development Of Tuberculosis Among Diabetes Mellitus Patients, Malahayati Rusli Bintang, Adang Bachtiar, Cicilya Candi

Kesmas

Prevention and treatment of diabetes will have a positive influence on tuberculosis (TB) since people may get TB because they have diabetes mellitus (DM). Recording and reporting through the TB Information System are not run optimally because of many factors. The information system must be strengthened to be used by private health facilities. This study used secondary data from the 2013 and 2018 Indonesian Basic Health Research (IBHR). The data was analyzed univariately and analyzed further using Orange Data Mining Tools to test the screening tool model used to predict TB in diabetic individuals. The total sample in this study …

New Approach To Mapping Regional Vulnerability In Controlling Tuberculosis Disease In Indonesia, Maria Holly Herawati, Asep Hermawan, Dasuki Dasuki, Hadi Supratikta, Al Asyary, M Rokhis Khomarudin, Muhammad Priyatna, Raflizar Raflizar, Kristina Kristina, Noer Endah Pracoyo, Dina Bisara, Cahya Tri Purnami, Mentari Nur Farida Suteja, Yusrial Bachtiar, Noor Edi Widya Sukoco, Doni Lasut

Kesmas

Tuberculosis (TB) in Indonesia is still a health problem. The TB prevalence in Indonesia ranks second in the world after India in 2023. Regional factors, inadequate healthcare facilities, and limited resources (financial, human, and infrastructure) are challenges requiring innovation to help the government control TB. TB eradication efforts need to be made with a comprehensive and effective approach. One method used is to look at the vast territory of Indonesia, therefore, mapping the TB disease vulnerability is a highly recommended method. The use of a Geographic Information System is expected to help map the TB vulnerability areas in Indonesia. Given …

Double Burden Of Persons With Disabilities: Are Those More Likely To Suffer From Chronic Disease?, Salsabila Kusumawardani, Hardiyani Puspitasari, Muhammad Ciro Danuza, Yusuf Faisal Martak

Masyarakat: Jurnal Sosiologi

This study examines the likelihood of persons with disabilities experiencing chronic diseases compared to those without disabilities, emphasizing the role of demographic characteristics. Prior research shows that individuals with disabilities have a higher risk of chronic diseases due to pre-existing health conditions, secondary complications, healthcare access barriers, and limited health education. Beyond these factors, we argue that demographic characteristics—such as age, gender, insurance status, and living environment—also shape daily habits and lifestyles that influence long-term health outcomes. Using probit regression analysis, this study quantifies the probability of chronic disease among persons with disabilities. Our findings indicate that individuals with disabilities …

Smoking Habit At Home And Upper Respiratory Infection In Infants Aged 6-12 Months, Musfardi Rustam, Nur Pelita Sembiring, Taswir Effendy

Kesmas

Upper Respiratory Tract Infection (URI) is an acute infection caused by viruses, fungi, and bacteria. Smoking habit at home is a risk factor for URI in infants. This study aimed to determine a relationship between smoking at home and the incidence of URI in infants. This study was conducted the fourth week of February 2010 until the third week of April 2010 in Kampar District, Indonesia. This analytical study used a case-control design and cluster random sampling. The samples comprised 162 cases and 162 controls, infants aged 6-12 months. The cases were 162 infants aged 6-12 months suffering from URI …

Decentralized Clinical Trials For Medications To Reduce The Risk Of Dementia: Consensus Report And Guidance, Leanne Howard, Carla Abdelnour, Erin Abner, Ricardo F. Allegri, Hiroko H. Dodge, Serge Gauthier, Camilla M. Hoyos, Gregory Jicha, Patrick G. Kehoe, Catherine J. Mummery, Adesola Ogunniyi, Nikolaos Scarmeas, Xiaoying Chen, Jodie R. Titiner, Christopher R. Weber, Ruth Peters

Neurology Faculty Publications

INTRODUCTION: Recent growth in the functionality and use of technology has prompted an increased interest in the potential for remote or decentralized clinical trials in dementia. There are many potential benefits associated with decentralized medication trials, but we currently lack specific recommendations for their delivery in the dementia field.

METHODS: A modified Delphi method engaged an expert panel to develop recommendations for the conduct of decentralized medication trials in dementia prevention. A working group of researchers and clinicians with expertise in dementia trials further refined the recommendations.

RESULTS: Overall, the recommendations support the delivery of decentralized trials in dementia prevention …

A Phase 2 Clinical Trial To Evaluate The Safety, Reactogenicity, And Immunogenicity Of Different Prime-Boost Vaccination Schedules Of 2013 And 2017 A(H7n9) Inactivated Influenza Virus Vaccines Administered With And Without As03 Adjuvant In Healthy Us Adults, Christina A Rostad, Robert L Atmar, Emmanuel B Walter, Sharon Frey, Jeffery L Meier, Amy C Sherman, Lilin Lai, Rachel Tsong, Carol M Kao, Vanessa Raabe, Hana M El Sahly, Wendy A Keitel, Jennifer A Whitaker, Michael J Smith, Kenneth E Schmader, Geeta K Swamy, Getahun Abate, Patricia Winokur, Wendy Buchanan, Kaitlyn Cross, Ashley Wegel, Yongxian Xu, Inci Yildirim, Satoshi Kamidani, Nadine Rouphael, Paul C Roberts, Mark J Mulligan, Evan J Anderson

Center for Medical Ethics and Health Policy Staff Publications

Introduction: A surge of human influenza A(H7N9) cases began in 2016 in China from an antigenically distinct lineage. Data are needed about the safety and immunogenicity of 2013 and 2017 A(H7N9) inactivated influenza vaccines (IIVs) and the effects of AS03 adjuvant, prime-boost interval, and priming effects of 2013 and 2017 A(H7N9) IIVs.

Methods: Healthy adults (n = 180), ages 19-50 years, were enrolled into this partially blinded, randomized, multicenter phase 2 clinical trial. Participants were randomly assigned to 1 of 6 vaccination groups evaluating homologous versus heterologous prime-boost strategies with 2 different boost intervals (21 vs 120 days) and 2 …

Supporting Ontario Public Health Units To Address Adverse Childhood Experiences In Pandemic Recovery Planning: A Priority-Setting Exercise, Kimberly B Harding, Erica Di Ruggiero, Erick Gonzalez, Amanda Hicks, Daniel W Harrington, Sarah Carsley

Faculty, Staff and Student Publications

BACKGROUND: Adverse childhood experiences (ACEs) are potentially traumatic exposures experienced during childhood, for example, neglect. There is growing evidence that the coronavirus disease 2019 (COVID-19) pandemic and related socioeconomic conditions contributed to an increased risk of ACEs. As public health programs/services are re-evaluated and restored following the state of emergency, it is important to plan using an ACEs-informed lens. The aim of this study was to identify and prioritize initiatives or activities that Public Health Ontario (PHO) could undertake to support Ontario public health units' work towards ACEs-informed pandemic recovery plans.

METHODS: The Child Health and Nutrition Research Initiative method …

Equity In Access For Veterans In The Va Community Care Program, Baligh R. Yehia, Said A. Ibrahim

Department of Medicine Faculty Papers

No abstract provided.

The Cost Of Long-Term Care In The Mountain West, 2023, Madison Dwyer, Freddy Nie, Annie Vong, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet examines data on the cost of long-term care for the Mountain West states of Arizona, Colorado, Nevada, New Mexico, and Utah from the Genworth “Cost of Care Survey.” Data on long-term care includes home health care, adult day health care facilities, licensed assisted living facilities, and certified and licensed nursing homes.

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Determining Factors For Improved Uptake Of Harm Reduction Services In The United States: A Study Of Inclusive, Culturally Sensitive Messaging, Lauretta Ekanem Omale

Dissertations

Harm reduction refers to public health policies and programs aimed at decreasing the adverse consequences associated with drug use. While harm reduction services (e.g., syringe exchange programs) can mitigate health risks, marginalized groups face barriers to service access and utilization, partially due to ineffective messaging approaches that fail to align with cultural values and experiences. A one-size-fits-all approach to messaging can negatively impact service utilization, health outcomes, and health disparities. Ineffective communication can lead to poor adherence to treatment, poorer health outcomes, and increased adverse events.

Culturally insensitive communication contributes to stigma, mistrust, and lack of perceived relevance, discouraging service …

Contextual Factors Influencing The Association Between The Affordable Care Act’S Medicaid Expansion And Veteran Va-Medicaid Dual Enrollment, Patrick N O'Mahen, Chase S Eck, Cheng Rebecca Jiang, Laura A Petersen

Center for Medical Ethics and Health Policy Staff Publications

Objective: To evaluate changes in dual enrollment after Affordable Care Act Medicaid expansion by VA priority group, (e.g., service connection), sex, and type of state expansion.

Study setting: Our cohort was all Veterans ages 18-64 enrolled in VA and eligible for benefits due to military service-connection or low income from 2011 to 2016; the unit of analysis was person-year.

Study design: Difference-in-difference and event-study analysis. The outcome was dual VA-Medicaid enrollment for at least 1 month annually. Medicaid expansion, VA priority status, whether a state expanded by a Section 1115 waiver, and sex were independent variables. We controlled for race, …

Performance Of Stunting Reduction Acceleration Team: An Explorative-Qualitative Study In Indonesia-Timor Leste Border Area, Maria Paula Marla Nahak, Veronika Nitsae

Kesmas

Stunting is a complex issue influenced by multiple factors, including specific factors within and outside the health sector. Achieving a significant reduction in stunting needs the involvement of relevant local government offices in the Stunting Reduction Acceleration Team (SRAT). This study aimed to investigate SRAT performance in a specific context of accelerating stunting reduction in Malaka District. This qualitative study, with a phenomenological approach, was conducted in Malaka District, Indonesia, and Timor Leste Border Area from July to September 2023. This study revealed four major themes of SRAT performance to accelerate stunting reduction in Malaka District: activities to accelerate stunting …

The Influences Of Medical Students' Consent To Participate In Thalassemia Research, Raditya Wratsangka, Donna Adriani, Endrico Xavierees Tungka, Aditya Krishna Murthi

Kesmas

An effective way of learning about thalassemia, a complex public health issue with multiple perspectives, is through participating in research. This study used an inductive approach to presume the influencing factors of students' consent to participate in thalassemia research voluntarily. Nested in the preliminary stage of a research series on thalassemia, this study used a consecutive sampling to recruit 140 medical undergraduates. Their knowledge, experience, and attitude to thalassemia and the perception of self-quality life were assessed using self-administered questionnaires. Blood samples were drawn for carrier screening. Students' GPAs were collected from faculty records. Of 140 participants, only 123 had …