Public Health Commons^™

“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 …

Urbanization And Mental Health: The Power Of Green Space, Emma Rosenthal

OHSU-PSU School of Public Health Annual Conference

In this presentation, I will review the negative impacts of urbanization on mental health and the positive role of green space on mental well-being. Moreover, I will provide examples of projects being conducted to increase the amount of green space in urban communities.

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …

Thematic Content Analysis Of Newspaper Coverage Of The Causes Of The Opioid Crisis, Joseph Daniel Eichenlaub, Essma Nasher

Sociology Faculty Publications and Presentations

This nation pioneered modern life. Now epic numbers of Americans are killing themselves with opioids to escape it”[1]. According to the CDC, In 2017 alone, 47,600 people died from opioid-related overdoses [2]. The current opioid epidemic has developed in three distinct waves. Initially there was a sharp rise in opioid overdoses after doctors began prescribing drugs such as Oxycontin, which they were assured by pharmaceutical companies were less addictive than traditional opiates. The second wave began around 2010, when a rapid …

Shifting Coronavirus Disease 2019 Testing Policy And Research To Include The Full Translation Pipeline, Joseph Catania, Jeffrey Martin, M. Margaret Dolcini, E. Roberto Orellana, Jeffrey Henne

School of Social Work Faculty Publications and Presentations

The current severe acute respiratory syndrome coronavirus 2 testing policy and practice limits testing as a prevention tool. Radical shifts are required to increase the scale of rapid testing strategies and improve dissemination and implementation of venue-based and self-testing approaches. Attention to the full translation pipeline is required to reach high-risk segments of the population.

Decolonizing Healthcare: A Black Feminist Analysis Of Sisters Informing Sisters On Topics Of Aids (Sista), Joy Mutare Fashu Kanu

Dissertations and Theses

This mixed methods project combines the conceptual insights offered by institutional ethnography, the deductive and inductive attributes of content analysis, semi structured interviews, and quantitative data analysis to study Sisters Informing Sisters on Topics of AIDS (SISTA), a social skills training program designed for sexually active, heterosexual African American women. This progressive program serves as a site to examine the complex relationship the U.S. state has had, and continues to have, with marginalized populations, particularly African Americans. The program reveals how the state, through the public health service, partners with scholars, researchers, and community-based organizations to produce, reproduce and perpetuate …

Dual Panics: A Media Analysis Of Narratives On The Role Of Unauthorized Migration In America's Overdose Crisis, Morgan Godvin

University Honors Theses

Background: The realms of drug policy and immigration policy have long been fueled by misinformation, where sensationalism and panics help shore up political support. Most recently, the "border crisis" has been invoked to explain the "overdose crisis" in mass media narratives. Although the increase in migration is being blamed for illicit drug flows, drug importation occurs primarily through legal points-of-entry. The extent and excess visibility of false narratives linking overdose to migration in mainstream media is unknown.

Methods: We used the Media Cloud ecosystem to compile and characterize mainstream media content published between June 2021 and July 2021 regarding the …

Evaluation Of The Livewell Method: Final Report, Paula Carder, Serena Hasworth, Diana Cater

Institute on Aging Publications

The LiveWell Method uses a practice-based framework to improve the quality of life for people living and working in long-term care settings, including assisted living and memory care. It is designed to improve teamwork, communication, and morale by helping staff organize, track, measure, and improve daily operations. This evaluation is informed by the LiveWell Method’s “bottom-up and top enabled” approach, which engages and empowers direct care staff and administrators to create a more democratic and transparent workplace. In addition, the evaluation included questions to assess LiveWell’s core values, such as creating care innovations, nurturing dignity, creating community, and honoring elders, …

Aligning Food Environments With Institutional Values: A Mixed Methods Study Of Oregon Health Care Organizations, Elizaveta Walker

Dissertations and Theses

A major driver of the obesity epidemic is obesogenic food environments, characterized by nutrient-poor and energy-dense foods that saturate the collective physical, economic and sociocultural conditions that influence nutritional status. Food environments in organizations such as hospitals and public health agencies warrant special consideration given their health-focused mission. Improving food environments within health care settings has been highlighted by the Centers for Disease Control and Prevention (CDC) as one of seven key strategies to prevent obesity. However, most of the refereed literature examining healthy food environment policies (HFEPs) within hospitals focuses on the inpatient dietary environment, leaving a paucity of …

Smoking Behaviors In Patients Offered Lung Cancer Screening, Sara Elizabeth Golden

Dissertations and Theses

In the United States, smoking causes preventable diseases, including lung cancer, which is the leading cause of cancer deaths. Improving smoking cessation rates is important to decrease lung cancer deaths. Health care visits with a discussion about lung cancer screening (LCS) may help in increasing prevalence of smoking cessation. Importantly, insurers now require clinicians to have a shared decision-making discussion with patients that includes discussion of smoking abstinence before they can receive an LCS scan (i.e., a low-dose computed tomography scan). This discussion may represent a unique opportunity to encourage smoking cessation since it may prompt positive smoking behavior change. …

Exploratory Study Of Obesogenic Commercial School Food Environments In The Portland Metropolitan Area, Sruthi Eapen

University Honors Theses

Objective

The purpose of this exploratory research was to study commercial food environments around high schools in the Portland metropolitan area to explore the question: How do the economic, geographic, and racial demographics of public high schools in the Portland metropolitan area affect the prevalence and make-up of obesogenic commercial food environments surrounding these schools?

Methods

Commercial food environments within a 1 km radius of 35 public high schools in the Portland metropolitan area were surveyed. The “healthiness” of the environment was calculated by establishing a “Food Environment Score.” This score was correlated with economic, geographic, and racial demographics obtained …

How Does The Effect Of Hurricane Katrina Influence Healthcare Infrastructure And Resilience?, Sean Y. Wei

University Honors Theses

In August 2005, Hurricane Katrina brought upon the city of New Orleans, LA one of the costliest natural disasters in U.S. history. This paper looks at how hospitals were prepared before Katrina, responded to, and grappled with the aftermath of this natural disaster. In the aftermath of Katrina, careful investigation of the healthcare system along with its hospitals, physicians, patients, and residents allow us to take innovative measures and provide guidance to create recommendations to better monitor and care for individuals in the future. Frameworks of resilience theories, studies, and recommendations display how and why disaster planning is essential. The …

Toxic Stress Among Black And African American Oregonians, Roberta Hunte, Margaret J.F. Braun

School of Social Work Faculty Publications and Presentations

Toxic stress is a reaction to ongoing adversity such as abuse, neglect, poverty, racism, discrimination, and exposure to violence; it is powerful enough to change brain chemistry and architecture. Toxic stress and associated changes to the brain can lead to poor health outcomes later in life. Adverse childhood experiences (ACEs), racism*, and discrimination can trigger toxic stress and have long term consequences for the health of many people, particularly those in the Black and African American community.

The current project examined toxic stress and its impact on the health of Black and African American Oregonians. We looked at two indicators …

The Role Of Strategic Governance In Reducing Infant Mortality Under Crisis Conditions, Lynn Christine Finley

Dissertations and Theses

The infant mortality rate (IMR) in some developing countries has decreased faster than the global average even though these countries lack strong economic growth, good governance, and democracy (often acknowledged precursors to improved health outcomes). What accounts for the improvement of the IMR in the absence of these traditional pathways to health gains? Some scholars suggest that the concept of "strategic governance" might help direct attention to intermediary factors that reduce neonatal deaths in countries that experience crisis conditions. The main objective of this dissertation is to investigate the set of governance practices that have reduced IMR in two such …

A Public Health Recommendation Countering The Online Anti-Vaccination Movement, Grace M. Neumann

University Honors Theses

The anti-vaccination movement had posed a threat to the health of communities, since the inception of the smallpox inoculation practice. As the anti-vaxx movement continues to grow in strength and reach, public health officials must be prepared to combat the flow of misinformation, with sound scientific data in a way that connects with individuals from all communities. Online platforms such as blogs and social media, allow newfound access to vaccine opinions and information, posing an even greater risk of vaccine misinformation being spread to the public. Different communities hold different reasons for vaccine hesitancy and avoidance. An effective public health …

Frequency Of Limited English Proficient (Lep) Patient Visits And Language Resources: An Assessment Of Rural Oregon's Health Centers And Working With Lep Communities, Gabriel I. Lehrburger

University Honors Theses

Persons with limited English proficiency (LEP) can face barriers when seeking health care. Rural communities often have reduced access to some health resources. However, little is known about how rural communities meet the language needs of their LEP populations. A cross-sectional survey and interview were designed and sent to managerial staff in rural health centers around the state of Oregon. During the months of January – March 2020, survey and interview data were collected to assess the relationship between frequency of LEP patient visits and available language resources in rural Oregon. The study also investigated staff perceptions when working with …

Organizational Risk In Multi-Sector Health Partnerships: A Case Study Of Oregon's Accountable Health Communities, Shauna Jean Nicole Petchel

Dissertations and Theses

The literature on collective action has documented that the perception of organizational risk -- both the uncertainty of potential outcomes and the meaning attached to them -- is an important factor in whether and how organizations engage in cross-sector collaborations. Yet there are few examples to date that document how health and social service leaders perceive organizational risks in cross-sector health partnerships focused on social determinants of health, or how their perceptions influence organizational commitment and willingness to engage in these partnerships over time.

This research aimed to fill this gap through a mixed methods case study of health and …

Life Satisfaction In Division Iaa And Division Iii Football Players, Krista Haunani Francisco

Dissertations and Theses

Level of life satisfaction is not something of which many sit down and take appraisal. However, levels of life satisfaction, especially low levels of life satisfaction, can have a direct effect on health. Low levels of life satisfaction cause an increase in self-reported stress. Inversely, high levels of stress cause a decrease in life satisfaction. This decrease in life satisfaction is associated with poor mental and physical health outcomes. A majority of student-athlete healthcare is centered around the physical aspects of health, with mental health just recently becoming a concern. It was apparent through the research for this study that …

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

It's Not Easy - Impacts Of Suicide Prevention Research On Study Staff, Jason I. Chen, Ginnifer L. Mastarone, Lauren M. Denneson

Communication Faculty Publications and Presentations

Suicide prevention researchers who work with individuals at high risk of suicide or are exposed to details of suicide attempts and deaths may experience negative impacts on their own well-being. This is not unlike the experiences of mental health providers, where repeated exposure to clients' difficult experiences gas long been identified as an occupational risk (Molnar et al., 2017). however, there have been few studies evaluating how exposure to details of suicide-related behavior impacts researcher well-being. This gap in the literature is worrisome, as researcher' mental health and well-being might be negatively impacted by repeated exposure to graphic details of …

A Data Collection Program For Reducing Ipv In Lgbtq+ Communities, Alexandra Michel, Nicholas Cheke, Lourdes Gonzalez, Rachel Greim

OHSU-PSU School of Public Health Annual Conference

Sexual and gender minority populations are not currently being accurately tracked or counted in most domestic violence (DV) and intimate partner violence (IPV) surveillance programs in Oregon. However, research indicates that LGBTQ+ populations experience IPV at rates comparable or even higher than heterosexual populations. Additionally, distrust of law enforcement and services designed around heterosexual experiences of IPV further reduce the ability of LGBTQ+ populations, particularly transgender women, to access IPV services. We propose that through the use of a PRECEED-PROCEED model, a program could be developed to more accurately collect sexual orientation and gender identity data by IPV service providers …

Preventing Infectious Hematopoietic Necrosis In Salmonid Fish Along The Columbia River Basin, Whitney L. Wright

OHSU-PSU School of Public Health Annual Conference

Infectious hematopoietic necrosis virus (IHNV) is a member of the Rhabdoviridae family and causes infectious hematopoietic necrosis (IHN) disease in many salmonid species during the juvenile or “fry” stage of life. IHNV is endemic to Western North America and occurs in the Columbia River Basin, where Steelhead and Chinook salmon are the most abundant IHNV-vulnerable species. IHNV can cause an epidemic in wild or farmed stocks, killing 90-95 percent of the fish it infects. Transmission is currently understood to occur by direct exposure through the gills, and the virus is shed typically from asymptomatic or clinically ill carrier adults at …

Racial Disparities In A State Based Workers' Compensation System, Caroline Kristine Smith

Dissertations and Theses

Racial, ethnic, and linguistic minority workers suffer higher rates of work-related injuries and illnesses in the United States compared to their White counterparts. Explanations for these higher rates include potential socioeconomic causes (education, income, and wealth) and occupational segregation into more dangerous occupations. What is less studied are the post-injury sequelae for minority workers, which is their experiences in the workers' compensation system, as well as their health and return to paid employment. What is known comes primarily from qualitative literature, which includes themes of racial discrimination (from employers, health care providers, and workers' compensation employees), a lack of information …

Patient Empowerment Via Mobile Personal Health Records And Mobile Health Applications: A Review Of The Current Use, Abdulaziz S. Alhomod, Saeed Alzahrani

Engineering and Technology Management Faculty Publications and Presentations

Consumer empowerment has gained a significant attention in the medical field recently, and despite the ambiguity of its definitions, elements and measurement tools, it is apparent that mobile and other communication technology can play a major role in keeping patients informed, involved and empowered. This paper aims to explore methods by which mobile applications contribute to consumer empowerment and allowed enhanced patient control over their health.

Adapting An Elementary School Nutrition Context Assessment For High School Settings And Students, Deborah H. John, Beret Halverson, Tia H. Ho

Urban Studies and Planning Faculty Publications and Presentations

The school nutrition context is comprised of supportive environmental features, programs, policies, and social relationships that shape students’ healthy dietary choices and patterns. When engaging students as change agents, advocates, and partners in making healthy nutrition choices easier, environmental assessment tools developed for adults may be too complex or inappropriately tailored for youth. Adolescents need practical, user-tailored tools that reliably measure the food and beverage environments they encounter in school to inform youth-led changes to the school nutrition context. To meet this need, an evidence-based school environmental assessment was adapted for use in high schools by students as evaluators. Cooperative …