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.

Assessing The Feasibility Of Implementing A Hands-On Diabetes Course Curriculum In Community Settings, April Litchford, Jenna Dyckman, Carrie Durward

Transforming Communities

Diabetes remains a significant health concern in the United States, with millions affected and at risk. Despite the known benefits of diabetes education programs, barriers such as accessibility and engagement persist. To address these challenges, Utah State University Extension developed the Diabetes Cook Along (DCA) program and conducted a study to determine the feasibility of implementing these classes in community settings. The DCA curriculum is based on national standards and emphasizes changes in dietary and lifestyle components critical for diabetes management. Data collection included pre- and post-surveys, along with qualitative feedback. Overall participation in the classes and satisfaction of participants …

Supporting Students’ Physical Activity Self-Efficacy Within High School Physical Education, Ken Murfay, Aaron Beighle, Heather Erwin, Erin Aiello, Sarah Pyszczynski

International Journal of Physical Activity and Health

Research examining physical activity (PA) is significant because of the known benefits of PA. Studying high school (HS) students is particularly important due to the consistent decline in PA as students age. One strategy to increase PA is to increase someone’s self-efficacy (confidence) to be physically active which is commonly positively associated with PA. Most of the research on how to support physical activity self-efficacy (PASE) comes from outside-of-school interventions with minimal literature on how to support students’ PASE within HS physical education (PE). This study attempted to identify and share practices that current HS PE teachers were implementing to …

Impact Of A Suicide Prevention Learning Module For Firearm Training Courses In Louisiana, Claire Houtsma, Lauren Reyes, Katherine Macwilliams, Gala True

School of Medicine Faculty Publications

Background: Firearm suicide is a leading cause of death in the United States. Suicide prevention experts have advocated for upstream interventions that can be implemented prior to the development of suicidal thoughts, particularly those that focus on lethal means safety (LMS; e.g., increasing secure firearm storage). To reach firearm owners with LMS messaging, researchers have developed suicide prevention training content which can be incorporated into firearm training courses. However, no study to date has evaluated impact of such training on firearm course students’ subsequent knowledge, attitudes, and openness related to secure firearm storage. Thus, the current study sought to examine …

Skin Tone Discrimination And Birth Control Avoidance Among Women In Harris County, Texas: A Cross-Sectional Study, Kimberly Baker, Susan Tortolero Emery, Evelyn Spike, Jazmyne Sutton, Eran Ben-Porath

Faculty, Staff and Student Publications

INTRODUCTION: Structural racism plays a major role in reproductive health inequities. Colorism, discrimination based on skin color, may profoundly impact reproductive health access and service delivery. However, quantitative research in this area is limited.

METHODS: We administered an online survey of women (n = 1,299) aged 18-44 from Harris County, Texas to assess the relationship between skin color discrimination and reproductive health service avoidance. The survey included questions on demographics, self-reported skin tone, and dichotomous measures of previous discrimination experiences and avoidance of care because of perceived discrimination. Binary logistic regression was used to examine whether race/ethnicity, skin tone, and …

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; …

Infertility’S Impact On Couples’ Functioning, Elizabeth Sanders

Dissertations

Historically, infertility has been a taboo topic of discussion and is often avoided in conversation because of the stigmatization of the diagnosis. According to the World Health Organization (2022), infertility affects 186 million individuals globally. However, there seems to be a gap in the research as it pertains to the psychological well-being and treatment of men and women diagnosed with this condition. While it has become less of a feared topic, it still is not discussed or researched enough, thus further exacerbating the gap in research on mental health and treatment options. The following dissertation completed a critical review of …

Admixture Mapping Of Cognitive Function In Diverse Hispanic And Latino Adults: Results From The Hispanic Community Health Study/Study Of Latinos, Rui Xia, Xueqiu Jian, Amanda L Rodrigue, Jan Bressler, Eric Boerwinkle, Biqi Cui, Martha L Daviglus, Charles Decarli, Linda C Gallo, David C Glahn, Emma E M Knowles, Jee-Young Moon, Thomas H Mosley, Claudia L Satizabal, Tamar Sofer, Wassim Tarraf, Fernando Testai, John Blangero, Sudha Seshadri, Hector M González, Myriam Fornage

Faculty, Staff and Student Publications

INTRODUCTION: We conducted admixture mapping and fine-mapping analyses to identify ancestry-of-origin loci influencing cognitive abilities.

METHODS: We estimated the association of local ancestry intervals across the genome with five neurocognitive measures in 7140 diverse Hispanic and Latino adults (mean age 55 years). We prioritized genetic variants in associated loci and tested them for replication in four independent cohorts.

RESULTS: We identified nine local ancestry-associated regions for the five neurocognitive measures. There was strong biological support for the observed associations to cognitive function at all loci and there was statistical evidence of independent replication at 4q12, 9p22.1, and 13q12.13.

DISCUSSION: Our …

Changes In The Perceptions Of The Neighborhood Environment And Physical Activity Patterns Among Mexican Americans On The Texas-Mexico Border, Natalia I Heredia, Soo Kyung Park, Minjae Lee, Lisa Mitchell-Bennett, Paul Yeh, Rose Gowen, Arturo Rodriguez, Miryoung Lee, Belinda M Reininger

Faculty, Staff and Student Publications

INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming.

METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, …

Factors Influencing Graduate Students Of Diverse Backgrounds In Their Selection Of Occupational Therapy As A Career, Jeffrey T. Lucas, Scotillia Fogg, Mandie Lynch

The Journal of the Research Association of Minority Professors

The population of the United States is becoming more culturally diverse; however, the profession of occupational therapy does not reflect this change, whether examining educators, practitioners, or students. This study was designed to identify factors influencing graduate students of diverse backgrounds, and how a career in occupational therapy was determined. Participants for this study comprised first- and second-year occupational therapy students enrolled at Lenior-Rhyne University, The University of North Carolina at Chapel Hill, and Winston-Salem State University. A convenience sample was used to obtain the population. These universities were the only graduate-level occupational therapy programs willing to participate in the …

Unraveling The Multilevel Dynamics Of Water, Sanitation, And Child Anthropometry In Indonesia, Rifa Kirana, Ahmad Komarulzaman

Makara Journal of Health Research

Background: Anthropometrics, reflecting nutritional status, growth, and development, are crucial elements that can predict a person’s health and well-being. However, low anthropometric measures among children under 5 years remain a significant issue in Indonesia, often influenced by various factors at the household and community levels. Access to clean water and adequate sanitation has been identified as major determinants of these adverse health outcomes. This study analyzes the relationship between anthropometric measures and access to water and sanitation at household and community levels using a multilevel analysis approach.

Methods: The study employs cross-sectional data from the Indonesian Family Life …

Leveraging The Science Of Early Life Predictability To Inform Policies Promoting Child Health, Laura M. Glynn, Sabrina R. Liu, Candice Taylor Lucas, Elysia Poggi Davis

Psychology Faculty Articles and Research

Addressing the tremendous burden of early-life adversity requires constructive dialogues between scientists and policy makers to improve population health. Whereas dialogues focused on several aspects of early-life adversity have been initiated, discussion of an underrecognized form of adversity that has been observed across multiple contexts and cultures is only now emerging. Here we provide evidence for “why unpredictability?”, including: 1. Evidence that exposures to unpredictability affect child neurodevelopment, with influences that persist into adulthood. 2. The existence of a translational non-human animal model of exposure to early life unpredictability that can be capitalized upon to causally probe neurobiological mechanisms. 3. …

Unveiling Environmental Justice In Two Us Cities Through Greenspace Accessibility And Visible Greenness Exposure, Md Shahinoor Rahman, Mahbubur Meenar, S. M. Labib, Ted Howell, Deepti Adlakha, Ben Woodward

School of Public Health Faculty Publications

Uneven access to greenspaces or visible greenness is an environmental justice (EJ) issue. In this paper, we use a social equity lens to develop geospatial models that measure convenient walking access to urban greenspaces such as parks and street-level green exposure en route to greenspaces. We utilized earth science, geospatial, and demographic datasets to develop two models—Greenspace Accessibility and Visible Greenness Exposure—and applied them in Camden and Jersey City, USA, two communities experiencing environmental injustices. Modeling results show that greenspace accessibility is a concern in both cities, with Jersey City experiencing more prominent disparities. We observed significant positive relationships in …

The Role Of Indonesian Doctors As Content Creators In Fighting Health Hoaxes, Myths, And Stigma On Social Media, Lydia Okva Anjelia, Deddy Mulyana, Jenny Ratna Suminar

JURNAL KOMUNIKASI INDONESIA

Amidst the proliferation of disinformation and misinformation related to health on social media, the public must ensure that the sources of information are trustworthy. This research aims to explain the role of doctors in the fight against health hoaxes, myths, and stigma spread through social media. The study adopts qualitative research with a phenomenological approach to understand doctors' experiences and perceptions regarding their efforts to address health hoaxes, myths, and stigma on social media. Fifteen doctors as content creators in Jakarta and Bandung were selected as informants using purposive sampling. The data was collected through interviews, observation participation, and documentation …

Diabetes Health Literacy, Diabetes Numeracy, And Cognitive Function As Predictors Of Type 2 Diabetes Mellitus Self-Management, Twinkle Gupta

Doctoral Dissertations and Projects

The present study assessed older adults (≥ 45 years old) diabetes health literacy, diabetes numeracy, cognitive function, and its association with their Type 2 Diabetes Mellitus (T2DM) self-management outcomes. These factors are of concern as diabetes is a lifelong condition affecting the body’s conversion of food into energy and may lead to complications and comorbidities if this condition is not properly self-managed. Diabetes health literacy refers to having the necessary capabilities in finding and analyzing diabetes-related information to make informed decisions regarding their health. Numeracy in diabetes has to do with being able to compute diabetes-related math such as insulin …

“Dead Or Alive?” Regression Imputation Of The Binary End-Of-Event Outcome Indicator For The Nemsis Public Research Dataset, Mary E. Helander

Social Science - All Scholarship

Objectives: Recent studies address missing survival outcomes in the National Emergency Medical Services Information System (NEMSIS), a system that stores and shares standardized EMS data from U.S. States and Territories. This study aspired to improve imputed EMS outcome accuracy and establish benchmarks for common medical emergencies treated in prehospital care. Methods: This retrospective cohort study of ground-transported EMS patients with definitive end-of-EMS-event outcomes, based on dataset years 2017 to 2023, predicted the probability of “dead” or “alive” status using logistic regression. K-fold cross-validation assessed over-fitting and internal generalization. Threshold optimization and machine learning classification metrics enabled comparison with a …

Demographic Correlates Of Weight-Loss Strategies In Us Adults: Cross-Sectional Analysis Of Nhanes Data 2017–2020, Anin Mokari-Yamchi, Richard R. Rosenkranz

Kinesiology and Nutrition Sciences Faculty Research

Objective: To investigate the frequency of various weight loss strategies among adults in the United States and to explore which weight-loss strategies are associated with several demographic factors.

Methods: The study utilized 2017–2020 data from the National Health and Nutrition Examination Survey. Adult participants (N = 3,130) who had tried to lose weight during the past year were included. Pregnant women and individuals under age 20y were excluded. Weight-loss strategies were categorized into 6 groups: consuming more healthy options (e.g., more fruits); consuming less un-healthy options (e.g., junk food); quality of diet changes (e. g., changed eating habits); assisted weight-loss …

Phe 302 Social And Environmental Determinants Of Health, Tailisha Gonzalez

Open Educational Resources

This course is an introduction to the social, behavioral, and commercial factors that influence health. Theoretical and methodological approaches to the study of these determinants will be discussed from a social ecological perspective. Social determinants cover five domains: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context. Behavioral determinants include such factors as smoking, physical activity, and alcohol use. Commercial determinants include economic and political domains with examples such as cigarette marketing and the placement of toxic waste sites in low-income communities.

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 …

The Experience Of Pet Ownership During Transitional Housing Process, Kathryn Holden

Student Capstone Papers

Twenty-five percent of people experiencing homelessness have pets, but few transitional housing programs allow pets (Rhoades et al., 2015); therefore, there is a gap in the literature about the experience of pet ownership during the transitional housing process. This study aimed to explore pet owners' experiences at a transitional housing site in San Diego County. The student interviewed two current dog owners and four recent dog owners. All participants prioritized their pets because of the strong bond they shared with their pet. They described their relationship between themselves and their dog to be stronger than their relationships with family members …

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 …

“Dead Or Alive?” Assessment Of The Binary End-Of-Event Outcome Indicator For The Nemsis Public Research Dataset, Mary E. Helander

Social Science - All Scholarship

OBJECTIVE: The broad absence of definitive patient outcomes in the NEMSIS public release data hinders research that seeks to understand the impact of pre-hospital care, operations, and overall patterns of population health – including geospatial and demographic differences. This study evaluated the recently proposed binary end-of-event outcome indicator to provide additional validity of the method, to evangelize its employment for more studies to analyze survival impact following an emergency medical event, and to identify appropriate use and interpretation given imperfection in predicted outcomes. METHODS: A recently published binary end-of-event outcome indicator was applied to datasets for each year from 2017 …

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 …

Teacher Implementation Profiles: A Response To Top-Down Mandate Of Movement Integration, Zack Beddoes, Jeanne Barcelona, Darla Castelli

International Journal of Physical Activity and Health

This study examined teacher implementation practices to meet a state mandate requiring 135 minutes of student physical activity (PA) weekly. Teachers were required to implement a video-based movement integration (MI) program. Using an embedded mixed-methods design, provider characteristics of 42 teachers and the organizational capacity of six schools were developed from interviews, surveys, observations, and artifacts. Data analysis revealed three teacher profiles (a) Dynamic Experientialists, (b) Coachable Constructivists, and (c) Cautious Behaviorists, and three school profiles (a) Whole Child Approach, (b) Grade Level Champions, and (c) Back to Basics. Findings suggest that school, teacher, …

Epigenome-Wide Association Study Of Prostate Cancer In African American Men Identified Differentially Methylated Genes, Anders Berglund, Kosj Yamoah, Steven A. Eschrich, Rana Falahat, James J. Mulé, Sungjune Kim, Jaime Matta, Julie Dutil, Gilberto Ruiz-Deya, Carmen Ortiz Sanchez, Liang Wang, Hyun Park, Hirendra N. Banerjee, Tamara Lotan, Kathryn Hughes Barry, Ryan M. Putney, Seung Joon Kim, Clement Gwede, Jacob K. Kresovich, Youngchul Kim, Hui Yi Lin, Jasreman Dhillon, Ratna Chakrabarti, Jong Y. Park

School of Public Health Faculty Publications

Introduction: Men with African ancestry have the highest incidence and mortality rates of prostate cancer (PCa) worldwide. Methods: This study aimed to identify differentially methylated genes between tumor vs. adjacent normal and aggressive vs. indolent PCa in 121 African American patients. Epigenome-wide DNA methylation patterns in tumor DNA were assessed using the human Illumina Methylation EPIC V1 array. Results: Around 5,139 differentially methylated CpG-sites (q < 0.01, lΔβl > 0.2) were identified when comparing normal vs. tumor, with an overall trend of hypermethylation in prostate tumors. Multiple representative differentially methylated regions (DMRs), including immune-related genes, such as CD40, Galectin3, OX40L, and STING, were detected …

Socioeconomic Status, Physical Inactivity, And Bmi In Transitional Urban China: Contextualizing The Theory Of Fundamental Causes, Jun Xu, Fang Gong, Wei Zhao

International Journal of Physical Activity and Health

Drawing insights from the theory of fundamental causes of disease, this study examined the relationships between socioeconomic status (SES) and selected risk factors in transitional urban China. Specifically, under China’s distinct institutional and sociocultural environment, we examined how contextualized SES (i.e., party membership, hukou status, housing ownership, and subjective social status) and conventional SES indicators (i.e., education, income, and occupation) were associated with physical inactivity and body mass index (BMI). Utilizing the urban subsample of the 2017 Chinese General Social Survey (CGSS), we found that individuals with higher education, income, Communist Party membership, and urban hukou status had lower risks …

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 …

Recruitment And Retention Of Physician Assistants In Rural Medicine: A Novel Approach, Sean Grabbe

Theses and Graduate Projects

Improving the health of patients requires having access to well trained medical providers. This is one of the main goals of the physician assistant profession. For many years research has documented how to recruit and retain physician assistants in the rural areas of the United States. Although created to fill the gaps in primary care medicine physician assistants have moved as all of medicine has into specialization. This gap in primary care has not closed and is most significant in rural areas. This paper reviews the plethora of research and elaborates on the known and best methods for recruitment and …