Public Health Commons^™

Exploring Decolonial And Indigenous Mental Health Framework And Practice To Address Complex Trauma Among Palestinian Youth Living Under Violence Of Settler-Colonialism, Vivian L. Duong, Corrin Murphy

OHSU-PSU School of Public Health Annual Conference

The growing settler colonial project of Israel forced indigenous Palestinians to flee from their homeland to further the Zionist movement of establishing a Jewish-majority state. The forced dispossession and displacement of Palestinians at this time was referred to as the Nakba, or catastrophe (Masalha, 2002). From 1947 and 1949, approximately 750,000 Palestinians from a population of 1.9 million were made refugees (Al Jazeera, 2017). Also referred to as the ethnic cleansing of Palestine, Zionists forcibly took over 78 percent of Palestine, destroyed about 530 villages and cities, and killed around 15,000 Palestinians including more than 70 massacres (Al Jazeera, 2017). …

Inequities In Chronic Stress Exposure At The Intersection Of Race, Gender, And Sexual Identity In A Nationally Representative Sample Of Us Adults, Jordan M. Lancaster, Efrain H. Chavez Martinez

OHSU-PSU School of Public Health Annual Conference

Background

Social inequity rooted in systemic oppression is robustly associated with mental and physical health; chronic stress is highlighted as a key mechanism. Limited research examining the association between sexual identity alone and C-reactive protein (CRP) – an upstream biological marker of chronic stress exposure – has yielded mixed results.

Purpose

To examine whether race/ethnicity, gender, and sexual identity interact to produce unequal levels of CRP.

Methods

Using cross-sectional data from the 2003-2010 waves of the National Health and Nutrition Examination Survey, we examined intersectional (self-reported race*gender*sexual identity) patterns in log-transformed CRP levels using a multivariable linear model among 10,885 …

Self-Reported Follow-Up Care Needs Can Be Met In Both Facility And Self-Managed Abortion: Evidence From Low- And Middle-Income Countries, Laura E. Jacobson Mph

OHSU-PSU School of Public Health Annual Conference

Objective: To understand in-facility follow-up care-seeking behavior among both people who self-managed medication abortions (SMA) and those who obtained facility-managed care in six countries and to explore factors that contribute to meeting individual’s self-reported care needs that are core to person-centered care.

Study Design: We conducted a qualitative thematic analysis of 67 in-depth interviews conducted with facility or SMA seekers. We first classified individuals as having their care needs met or not, and whether they sought follow-up care. We then identified predisposing, enabling, or need factors that contributed to having care needs met or not.

Results: A total of n=67 …

Centering Communities Of Color In The Modernization Of A Public Health Survey System: Lessons From Oregon, Daniel F. López-Cevallos, Kusuma Madamala, Mira Mohsini, Andres Lopez, Roberta Hunte, Ryan Petteway, Tim Holbert

School of Social Work Faculty Publications and Presentations

Context: Public health survey systems are tools for informing public health programming and policy at the national, state, and local levels. Among the challenges states face with these kinds of surveys include concerns about the representativeness of communities of color and lack of community engagement in survey design, analysis, and interpretation of results or dissemination, which raises questions about their integrity and relevance.

Approach: Using a data equity framework (rooted in antiracism and intersectionality), the purpose of this project was to describe a formative participatory assessment approach to address challenges in Oregon Behavioral Risk Factor Surveillance System (BRFSS) and Student …

The Impact Of Sars-Cov-2 On The Consolidated Meatpacking System In The United States, Judith R. Solomon

Anthós

The Sars-Cov-2 virus has had a particularly intense impact on the meatpacking industry in the United States. In this paper I provide a brief introduction to the social, economic, and political realities that lead to mass deaths of meatpacking workers from COVID, and the impact of a consolidated meatpacking system on disease mitigation. These workers are considered expendable due to a lack of power.

The Association Of Patient-Provider Language Concordance With Healthcare Comprehension Among Latino/As In Oregon, Grace Parra

University Honors Theses

Background: The purpose of this study is to describe the need and preferences among Mexican-origin Latinos in Oregon for language-concordant healthcare providers. We hypothesize that the presence of a language concordant provider is associated with greater health care comprehension.

Methods: This is a cross sectional study in collaboration with the General Consulate of Mexico. We developed a 20-item survey that includes questions about socio-demographics, a validated language-based acculturation scale, and questions regarding language concordant care experience and preferences used in previous studies. We are recruiting at the Mexican Consulate 500 Latino/as ages 18 or older who had a healthcare visit …

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …

Paperwork, Paradox, And Prn: Psychotropic Medication Deficiencies In Assisted Living, Sarah Dys, Paula Carder

Institute on Aging Publications

Individual state approaches to assisted living/residential care (AL/RC) licensing and oversight in the United States result in different practice standards and requirements, including psychotropic medication use. We examined 170 psychotropic medication deficiency citations issued to 152 Oregon AL/RC settings from 2015 to 2019. Applied thematic analysis resulted in the following themes: (1) documentation issues are primarily responsible for noncompliance, (2) unclear parameters place direct care workers in a role paradox, and (3) there is a persistent disconnect about when to seek qualified expertise before requesting psychotropic medications. AL/RC-specific mechanisms for medication prescription and administration are necessary to improve the structure …

Beyond The Bmi: Expanding Quantitative Methods To Study Health For All Bodies, Kieran Chase, Daniel Oron

OHSU-PSU School of Public Health Annual Conference

The public health field is beginning to reckon with its role in perpetuating and reinforcing systemic anti-fatness. Emerging evidence for the devastating health impacts of stigma call into question decades of research and policy that labels the size of people’s bodies as diseased. However, even as we acknowledge the harmful effects of stigma, the field is materially and institutionally invested in a health paradigm that centers weight loss and size-related proxies for health, such as the BMI. Public health scholars interested in questions related to nutrition, chronic disease, and exercise must begin to expand their research focus to imagine non-stigmatizing …

(Un)Weighted Assumptions: Anti-Fatness & Health, Kieran Chase, Nell Carpenter, Madysen Schreiber

OHSU-PSU School of Public Health Annual Conference

This lecture/discussion session aims to expand and add nuance to public health students’, professors’, and practitioners’ understanding of the interplay between body size and health. We will begin by naming and challenging common assumptions about the relationship between bodyweight and health outcomes. We will then argue for the consideration of weight-related stigma as a Fundamental Cause of Disease as defined by Phelan and Link, and for institutionally embedded anti-fat bias at the policy level (e.g., insurance policy, medical equipment) as a cause of population health inequity as defined in Whitehead’s Health Equity Framework. We offer these frameworks in contrast to, …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Investing In Family Planning, Education, And Empowering Of Women And Girls To Mitigate The Impact Of Climate Change: An Exemplary Case Of Rwanda., Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Countries where population growth is high are often highly impacted by the climate crisis despite not being a significant contributor to historical greenhouse gas emissions. This has created a global inequality in that countries with poorly developed infrastructure are 15 times more likely to have deaths due to climate related disasters such as floods, droughts, and storms compared to wealthy countries that can better protect against similar events. While the climate crisis impacts everyone, women and girls are at a higher risk because of their unique health needs and roles in the community. The effects of climate change can be …

Impact Of Industrial Disasters On The Mental Health Of Vietnamese Americans On The Gulf Coast, Vivian L. Duong

OHSU-PSU School of Public Health Annual Conference

An explosion on the Deepwater Horizon oil rig caused 200 million gallons of crude oil to spill on the Gulf Coast over a five-month span. About 16,000 miles of coastline, ecosystem and marine life along Alabama, Florida, Louisiana, Mississippi, and Texas were contaminated. This disaster and the recovery process caused social, financial, and ecological shocks, resulting in adverse psychosocial and physical health outcomes, health disparities, and socioeconomic inequality. Among the oil spill's most affected and vulnerable populations are the Vietnamese American communities that settled on the Gulf Coast after the end of the Vietnam War in 1975. The plight of …

Homelessness, Water Access, And Environmental Justice In An Urban Environment, Alicia Gamble

Environmental Science and Management Professional Master's Project Reports

Only in recent years has houselessness been viewed as an environmental justice issue, and little is understood about the environmental injustices of water insecurity among unhoused individuals, especially during the COVID-19 pandemic. In order to understand the environmental injustices (i.e., distributive, procedural, and recognition) of the water insecurity process using the cause-response-effect theoretical model, unhoused participants living near services were interviewed in Portland, Oregon about their lived experiences gaining access to water, the barriers they encounter when trying to access water, and the impacts that result from these barriers. Results revealed that COVID-19 was a barrier to water access and …

The People’S Social Epi Project: Pdx With Ryan Petteway, Ryan J. Petteway

PDXPLORES Podcast

In this episode of PDXPLORES, Ryan J. Petteway, Associate Professor at the Oregon Health & Science University-Portland State University School of Public Health, discusses the research behind The People's Social Epi Project: PDX. Providing a counternarrative to the settler-colonial and racial capitalist practices of traditional epidemiological research on health inequities, Petteway's PSEP: PDX initiative is a portfolio of three projects centering around youth-led participatory research, music, and poetry. PSEP: PDX seeks to "center the margins'' to advance health and epistemic justice.

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Conspiracy Theories And Ebola: Lessons Learned Important For Future Pandemics, Shawn C. Smallman

International & Global Studies Faculty Publications and Presentations

The public health campaign against Ebola in the Democratic Republic of the Congo faced serious challenges, some due to conspiracy theories and denial. These beliefs were so powerful that they even caused repeated attacks upon health care providers and medical centers. These conspiracy theories were nothing new, as they are a common feature of all frightening epidemics, such as HIV and COVID-19. These narratives also circulated during the 2015 West African Ebola outbreak. Addressing conspiracy theories during an epidemic requires a coordinated campaign involving not only local leaders but also the cooperation of social media organizations

3 Selections From "Upon The Body: Poems Of/To A Black Social Epi, Pt.Ii--Love//Resistance In The Time Of Covid", R. J. Petteway

Amplify: A Journal of Writing-as-Activism

The 3 poems included here are from a collection written between January and August 2020. The full collection—27 poems total—examines intersections of structural racism, racialized police violence, and COVID-19, drawing from generations of creative resistance produced and embodied by Black artists, activists, and scholars like Nina Simone, Langston Hughes, Paul Laurence Dunbar, Audre Lorde, Ida B. Wells, James Baldwin, and W.E.B. DuBois. The collection as a whole is crafted as counternarrative to public health’s ahistoric, apolitical, racist, and homophobic proclivities in times of crisis. The 3 poems here are from Part II, "LOVE//Resistance in the Time of COVID.” These selections …

Reflecting On Resilience: Insight Into Resiliency Development And Utilization In Oregon's Older Adults From 2020 To 2022, Riley A. Wilton

University Honors Theses

The events of the last 2 years have complicated the lives of older adults throughout the world. For many, their survival can be traced back to one key trait: resilience. In the state of Oregon, the years 2020-2022 came with a host of issues that expanded past the COVID-19 pandemic. These events provide context for the world our storytellers discuss.

Using a snowball recruitment strategy through the efforts of community organizations and senior centers, 4 storytellers sat down to describe their resilience in different ways. They were asked to reflect on their own life experiences, how it influenced their resilience, …

Fortunate People In A Fortunate Land: Dwelling And Residential Alienation In Santa Monica's Rent-Controlled Housing, Lauren E.M. Everett

Dissertations and Theses

The importance of safe and stable housing for individual and community wellbeing is widely acknowledged. However, for the one third of Americans who rent their homes, housing-related stress and precarity (residential alienation) may undermine stability and a sense of home. Rent control is perhaps the most well-known tenant protection policy in the United States, but it remains highly controversial and its efficacy has been debated for decades. This research is the first academic inquiry to examine the policy through the experience of residents of rent-controlled housing. In academic discourse dominated by quantitative inquiry from the discipline of economics, this study …

Examination Of An Individual-Level Stigma Reduction Tactic In Front-Line Service Encounters, Christopher J. Waterbury, Nicholas A. Smith Phd., Larry Martinez Phd., Shi (Tracy) Xu Phd.

OHSU-PSU School of Public Health Annual Conference

Minority stress theory links short- and long-term negative health outcomes to stigma and discrimination. It is important that workers have the agency to effect change in the processes of discrimination as a social determinate of health. Identity management strategies are elective tactics that workers may wish to use to reduce discrimination. Front line service workers may be discriminated against by customers in the form of negative customer service evaluations. Group-level stereotypes may influence customer service perceptions more than objective service quality. In this poster, we report findings from two studies in which we examined the effectiveness of an individual-level stigma …

Effect Of Sin Lek Rice Intervention On Cognitive Function, Dietary Patterns, And Fecal Microbiota Of Elementary School Children In Chiang Rai, Thailand, Angie Setthavongsack, Siam Popluechai, Jackilen Shannon, Justin Denny, Eleni Gentekaki, Kongkiat Kespechara, Lucsame Gruneck, Thomas J. Sharpton, Kullawong Niwed, Lisa K. Marriott

OHSU-PSU School of Public Health Annual Conference

Thailand has struggled with malnutrition rates in young children. Rice is a key component of Southeast Asian diets and a whole grain rice varietal (Sin Lek) may support improved nutrition. Diet can influence cognitive function and human gut microbiota, which were explored in the context of a rice intervention. We conducted a pilot study using a non-randomized, crossover clinical trial of Sin Lek rice versus traditional white rice consumption in elementary school children in Chiang Rai, Thailand. Outcomes related to diet, anthropological factors, cognitive function (e.g., short-term working memory, attention, impulsivity), and gut microbial populations were measured at baseline and …

2022 Zero Suicide Implementation In Oregon: Cross‐Site Follow‐Up Change Report, Karen Cellarius, Aliza Tuttle

Regional Research Institute for Human Services

This implementation self‐assessment and the accompanying web survey were adapted for the Oregon Health Authority (OHA) by Portland State University in collaboration with the OHA Youth Suicide Prevention staff. The assessment was adapted from three existing Zero Suicide resources available at http://zerosuicide.org/.

The Organizational Self‐Study is a questionnaire about the extent to which each component of the Zero Suicide approach is in place at a single organization. Zero Suicide recommends completing this self‐study at the start of an organization’s Zero Suicide initiative, then every 12 months after that as a measure of fidelity to the model. The self‐study questions …

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

The Longitudinal Effects Of A Family And Sleep Supportive Intervention On Service Member Anger And Resilience, Shalene Joyce Allen

Dissertations and Theses

The vast majority of workplace intervention research on employee anger and resilience primarily focuses on individual-level strategies for mitigating employee anger and resilience outcomes in the workplace, with no studies having examined these outcomes with tangible occupational health interventions utilizing organizational-level techniques. Thus, the current study extends the literature on how to provide improvements in employee anger and resilience using higher system and organizational change mechanisms by providing evidence-based support for the effectiveness of a Total Worker Health® intervention, referred to as the Family and Sleep Supportive Intervention Training (FaSST). This approach employs both health protection and health promotion strategies …

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Treatment Satisfaction And Self-Efficacy In Hispanic Diabetes Patients At A Free Clinic Setting, Lhanze Tum

University Honors Theses

Diabetes continues to be one of the leading causes of death within the United States, with the Hispanic population having an especially high risk of developing diabetes. Understanding the different factors that may affect adherence to diabetes self-care, such as self-efficacy, duration of diabetes, and patient treatment satisfaction is important to reduce diabetes-related health complications. The aim of this study is to examine the relationship between patient self-efficacy for diabetes management and satisfaction with treatment, as well as whether the duration of diabetes is associated with self-efficacy for disease management. Baseline data was collected on 16 Hispanic patients with diabetes …

The Digital Divide And Health: Examining Digital Access As A Social Determinant Of Health, Elizabeth Melissa Withers

Dissertations and Theses

This dissertation is comprised of three papers that consider ways in which one's level of digital access may impact self-rated health. Data are from multiple years of three separate nationally representative cross-sectional surveys: National Health Interview Survey, General Social Survey, and Health Information National Trends Survey to address the primary overarching research question: Is there an association between digital access and health? The examination of the relationship between digital access and health is situated within a social determinants of health perspective and draws on van Dijk's (2005) causal and sequential model of digital access. Education, income, race and ethnicity, work …

Identifying The Cost Of Preventable Chronic Disease In Prison: Can Illness Prevention Of Adults In Custody Save Money?, Molly Bineham

Dissertations and Theses

This study investigates the cost of preventable health problems and ailments when compared to other costs of incarceration. The purpose of this study is to examine the impact of imprisonment on the costliest chronic illness. The health of adults in custody related to the general population and the overall fiscal cost of the deadliest chronic illness among incarcerated adults is discussed. Linear regression is used to analyze the occurrence of heart disease and diabetes among adults in custody while controlling for other factors. The results of this analysis provide insight that chronic diseases like heart disease and diabetes should be …

An Intervention To Increase Detection Of Developmental Delays In Wic Programs, Mohadeseh Solgi, Julie A. Reeder, Sherri Alderman, Katharine E. Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Low-income children are at risk for under-detection of developmental disabilities DD. WIC clinics see low-income children regularly in early childhood and could be an important source of referrals to developmental services.

Objectives: To increase the number of referrals to EI/ECSE from non-primary care settings such as WIC.

Methods: This was a site-randomized trial of an intervention to train WIC staff in early identification of DD’s, using CDC’s LTSAE developmental monitoring materials. 7 county WIC agencies in Oregon enrolled; 4 intervention agencies and 3 control agencies. The intervention consisted of an on-site, half-day training regarding signs of developmental delays, use …