Public Health Commons^™

Incarceration Vs Treatment: Is One More Effective Than The Other In Preventing Recidivism For Drug Abuse?, Scott G. Kang

Student Theses

This study aims to determine the most effective approach for reducing recidivism among drug offenders, comparing incarceration with treatment. Two hypotheses were formulated for this research: 1) Drug offenders undergoing residential treatment will experience lower recidivism rates compared to those sentenced to incarceration. 2) Extended therapeutic treatment is more likely to positively influence behavior change among drug abusers compared to longer prison sentences. These hypotheses were tested using data from 263 participants in the Drug Treatment Alternative-to-Prison (DTAP) program, analyzed through logistic regression in SPSS. The results indicate that therapeutic interventions, specifically rehabilitative treatment, are more effective than incarceration in …

Influence Of Parental Nativity And Perceived Neighborhood Environment On Physical Activity And Screen Time Of United States Youth, Natalia I Heredia, Ethan T Hunt, Kevin Lanza

Faculty, Staff and Student Publications

OBJECTIVE: This study assessed how parental nativity and perceived environment are associated with physical activity and screen time of U.S. children and adolescents.

METHODS: Data originated from the 2020-21 U.S. National Survey of Children's Health. We conducted multivariable Poisson regression to assess the cross-sectional association of parental nativity and perceived neighborhood environment variables on parental reports of youth meeting national physical activity and screen time guidelines. We tested interactions of parental nativity and neighborhood environment variables on both outcomes. Analyses were conducted using STATA v17 and p < 0.05 indicated statistical significance.

RESULTS: The sample of 24,928 children and 30,951 adolescents was 11.6 years of …

Trends In Fatal Opioid-Related Overdose In American Indian And Alaska Native Communities, 1999-2021, Cici Bauer, Ghada H Hassan, Ric Bayly, Jack Cordes, Dana Bernson, Cedric Woods, Xiaona Li, Wenjun Li, Leland K Ackerson, Marc R Larochelle, Thomas J Stopka

Faculty, Staff and Student Publications

INTRODUCTION: Opioid-related overdose mortality rates have increased sharply in the U.S. over the past two decades, and inequities across racial and ethnic groups have been documented. Opioid-related overdose trends among American Indian and Alaska Natives require further quantification and assessment.

METHODS: Observational, U.S. population-based registry data on opioid-related overdose mortality between 1999 and 2021 were extracted in 2023 using ICD-10 codes from the U.S. Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research multiple cause of death file by race, Hispanic ethnicity, sex, and age. Segmented time series analyses were conducted to estimate opioid-related overdose mortality growth …

Polarization, The Pandemic, And Public Trust In Health System Actors, Alessandro Del Ponte, Alan S. Gerber, Eric M. Patashnik

Political Science Faculty Articles and Research

Context: Public opinion on the performance of health system actors is polarized today, but it remains unclear which actors enjoy the most or the least trust among Democrats and Republicans, whether the COVID-19 pandemic has influenced how people view their own physicians, and whether doctors have retained the ability to influence public beliefs about policy issues.

Methods: The authors conducted two national surveys in 2022 and 2023 to examine these questions.

Findings: Democrats rated the performance of medical research scientists and public health experts during the pandemic more highly than did Republicans and independents. About three in ten Republicans said …

I See You! Play: A Therapeutic Playgroup For Caregivers And Their Intensive Care Group Infants, Mariana Cerqueira Aokalani

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

This paper articulates a new therapeutic playgroup for caregivers of Intensive Care Unit (ICU) infants, named I See You! Play. This intervention is an adaptation of WePlay! (Gross et al., 2021), a cooperative learning and therapeutic playgroup for caregivers and their children from 6 to 36 months old. Dr, Tracy Vozar developed this program inspired by Saleem Penny’s program with the same name in Chicago. Parents of ICU infants face several challenges that can affect their experience of parenthood, their parenting skills, caregivers' sensitivity, their mental health, and their relationship with their premature infant. This in turn affects infant’s attachment …

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 …

Mobility Repertoires: How Chinese Overseas Students Overcame Pandemic-Induced Immobility, Jiaqi M. Liu, Rui Jie Peng

Research Collection School of Social Sciences

The burgeoning field of immobility studies focuses on how migratory aspirations and capabilities shape a given (im)mobility status but devotes scant attention to how people traverse different (im)mobility categories. Through a case study of Chinese students in the United States during the COVID-19 pandemic, this article develops two arguments to shed light on migrants’ experiences and strategies in mobility transitions. First, during the pandemic, while China's restrictive travel policies and unfavorable public discourses made return migration extremely difficult, Chinese overseas students also felt unwelcome in the United States, due to visa restrictions and Sinophobic violence. This dilemma of being unable …

A Dual-Angle Exploration Towards Understanding Lapses In Covid-19 Social Responsibility, Sean T. H. Lee, Jerome J. X. Mah, Angela K. Y. Leung

Research Collection School of Social Sciences

Breaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health-risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self-perceived infection should provide an impetus to engage in …

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, …

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 …

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 …

Exploring The Implementation Of Safety Resilience Assessment In Industries: A Systematic Literature Review, Mufti Wirawan, Fatma Lestari, Zulkifli Djunaidi, Azka Hafia, Agra Mohamad Khaliwa, Muhammad Schehan Al Azhar

Kesmas

Safety Resilience discusses how a work process can run properly not only aims at preventing adverse events, but also increasing work productivity and effectiveness by increasing resilience. The concept of resilience has been widely suggested as safety management due to its ability to support organizations to continue operating even when facing unexpected demands or scale disruptions by improving their day-to-day performance. This study used a systematic literature review to explore the implementation of safety resilience in various industries. The results showed that 50% of articles used the Resilience Assessment Grid instrument to measure safety resilience in the workplace. In brief, …

Individual Longitudinal Changes In Dna-Methylome Identify Signatures Of Early-Life Adversity And Correlate With Later Outcome, Annabel K. Short, Ryan Weber, Noriko Kamei, Christina Wilcox Thai, Hina Arora, Ali Mortazavi, Hal S. Stern, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Adverse early-life experiences (ELA) affect a majority of the world's children. Whereas the enduring impact of ELA on cognitive and emotional health is established, there are no tools to predict vulnerability to ELA consequences in an individual child. Epigenetic markers including peripheral-cell DNA-methylation profiles may encode ELA and provide predictive outcome markers, yet the interindividual variance of the human genome and rapid changes in DNA methylation in childhood pose significant challenges. Hoping to mitigate these challenges we examined the relation of several ELA dimensions to DNA methylation changes and outcome using a within-subject longitudinal design and a high methylation-change threshold. …

A Qualitative Exploration Of Well-Being In Cancer Survivorship: Implications For Counselors, Hallie M. Sylvestro, Lindsey K. Umstead, Heather Delgado, Christopher Lawrence, Keith Mobley, Kelly L. Wester, Andrew Wood

Adultspan Journal

Adult cancer survivors represent an important–and growing–population that could benefit from counseling services. This study employed consensual qualitative research to examine the well-being experiences of eight cancer survivors. Findings suggest a broad range of changes to individual well-being following cancer diagnosis and treatment, and indicate counseling can provide an ideal setting for processing such changes. Recommendations for counseling practice and future research are provided.

Management Overview Of The Lung Tuberculosis Control Program At The Dki Jakarta Provincial Health Office In 2023, Mutiara Kiranti, Helen Andriani

Journal of Indonesian Health Policy and Administration

Tuberculosis is one of the infectious diseases that is fatal if not cured immediately. In 2022, the success rate of tuberculosis treatment in DKI Jakarta Province is 81%, while the national target is 90%. In the field, the number of cadres to carry out contact investigations is still insufficient, so that in 2022 the coverage of contact investigations in DKI Jakarta Province will only reach 25%, while the national target is 90%. To increase the scope of successful treatment, the government should try to overcome tuberculosis, which is needed. Proper program management is required to run effectively and efficiently for …

Island Health Crisis: Bridging Gaps In Indonesia's Healthcare Deserts, Joyce Mangoma, Wahyu Sulistiadi

Journal of Indonesian Health Policy and Administration

This narrative literature review examines critical healthcare challenges in Indonesia's island communities, focusing on workforce shortages, inadequate health infrastructure, and the profound impact of geographical and socioeconomic factors. Drawing from eight studies published between January 2000 and December 2023, the discussion highlights both the strengths and weaknesses of existing research. The studies were selected based on their relevance to healthcare issues in island communities, rigorous methodological approaches, and significant insights into healthcare challenges and solutions. This time frame was chosen to encompass a comprehensive evolution of healthcare challenges and responses, particularly considering the effects of the COVID-19 pandemic. Grounded in …

Policy Implementation Analysis Of Antenatal Care Services At Puskesmas Negara Ratu And Puskesmas Cempaka Kabupaten Lampung Utara, Willyana Syafriyanti, Anhari Achadi

Journal of Indonesian Health Policy and Administration

The Ministry of Health has issued Minister of Health Regulation Number 21 of 2021 to strengthen maternal health services, which regulates health services during pregnancy (antenatal). The Minister of Health's regulation states that antenatal care is carried out at least six times, 2 (two) of which are examinations with a doctor using an Ultra Sonography (USG) device. Community health centers as primary services are expected to be able to provide antenatal services according to standards. The North Lampung Health Service has distributed ultrasound equipment to community health centers in the North Lampung Regency to support the implementation of antenatal services. …

Balancing Community And Individual Health Efforts By Utilizing Sub-Primary Health Care At Regions: Analysis For Policy, Rocky Setya Budi, Wiku Bakti Bawono Adisasmito, Adang Bachtiar, Elvi Rosanti

Journal of Indonesian Health Policy and Administration

Public Health Centers (PHCs) are responsible for organizing public health efforts and individual health efforts. PHCs also serve as FKTP, UPTD, sub-district supervisors, and implementers of policies and programs from the Ministry of Health. The workload of PHCs is increasing because people visit PHCs primarily for treatment, rather than seeking preventive measures to stay healthy. The PHCs have Sub-PHCs to lighten the workload of the PHCs, but there is no policy regulating Sub-PHCs to be used as FKTP. This research aims to analyze the policy of Balancing Community and Individual Health Efforts by utilizing Sub-PHCs such as FKTP. The research …

Policy Content Analysis In Minister Of Health Regulation Number 15 Of 2016 About Hajj Health Istithaah, Salman Mauluddin Idris, Atik Nurwahyuni

Journal of Indonesian Health Policy and Administration

Indonesia has the world's largest Muslim population and sends the most pilgrims to Saudi Arabia. The Hajj Health Istithaah Policy in Minister of Health Regulation Number 15 of 2016 is the government's effort to carry out health screening for pilgrims before leaving so that they can perform the Hajj in a healthy and independent condition. This research was conducted using a qualitative approach by collecting data through in-depth interviews and document reviews. In this study, Walt and Gilson's Policy Triangle Model was used as a reference for reviewing the Hajj health istithaah policy, especially in the content section of the …

Entertainment-Education And Climate Change: Program Examples, Evidence, And Best Practices From Around The World, Suruchi Sood, Amy Henderson Riley, Lyena Birkenstock

College of Population Health Faculty Papers

Entertainment-education is a global theory-driven and evidence-based storytelling strategy that promotes social and behavioral change. A formal review of the peer-reviewed and grey literature, alongside consultations with program and industry experts, revealed several contemporary examples of entertainment-education and climate change. Late-night comedy, with the inclusion of climate change storylines within popular entertainment, is common in the Global North. In the Global South, climate adaptation and mitigation narratives are situated in formats portraying audiences’ lived experiences. Crosscutting trends relate to documentary storytelling, children’s programming, and future efforts. Recommendations include re-examining theories across the social-ecological model; placing entertainment front and center; including …

Social/Emotional Health, Mental Health And Quality Of Life Among Adults With Comorbid Diabetes And Hypertension: A Population-Based Cross-Sectional Study, Ranjita Misra, Sara Nayeem

Journal of Appalachian Health

Introduction: West Virginia has a disproportionately large population of rural adults with diabetes and hypertension, two common chronic, comorbid conditions that represent a national economic, social, and public health burden. Anxiety, depression, and severe mental illness are associated with poor motivation to engage in coping/self-care behaviors and related increased morbidity/mortality.

Purpose: This study examines the relationship between self-reported mental health, selected social and emotional health factors, health-related quality of life (HRQoL), and clinical outcomes among adults with comorbid diabetes and hypertension.

Methods: This cross-sectional study consisted of 75 participants who participated in a diabetes and hypertension self-management program (DHSMP) in …

Describing Trends In Virginia's Dentist And Dental Hygienist Workforce: Challenges And Opportunities, Shillpa Naavaal, Yetty Shobo, Barbara Hodgdon

Virginia Journal of Public Health

Purpose: Regular assessment of the dental workforce is essential to improve the population's oral health. This analysis aimed to understand the trends in the distribution of dentists and dental hygienists (DHs) in Virginia.

Methods: Annual survey data (2013-2022) of dentists and DHs from the Virginia Department of Health Professions Healthcare Workforce Data Center was used to examine the trends in provider distribution by age, gender, race/ethnicity, and geography across Virginia.

Results: In 2022, there were 5,720 dentists and 5,290 DH licensees in Virginia. In the dentist workforce, there was a high representation of those aged ≥60 years (23%), males (58%), …

Determinants Of Implementation For Group Medical Visits For Patients With Chronic Pain: A Systematic Review, Isabel Roth, Malik Tiedt, Carrie Brintz, Ariana Thompson-Lastad, Gayla Ferguson, Erum Agha, Jennifer Holcomb, Paula Gardiner, Jennifer Leeman

Faculty, Staff and Student Publications

BACKGROUND: Despite the critical need for comprehensive and effective chronic pain care, delivery of such care remains challenging. Group medical visits (GMVs) offer an innovative and efficient model for providing comprehensive care for patients with chronic pain. The purpose of this systematic review was to identify barriers and facilitators (determinants) to implementing GMVs for adult patients with chronic pain.

METHODS: The review included peer-reviewed studies reporting findings on implementation of GMVs for chronic pain, inclusive of all study designs. Pubmed, EMBASE, Web of Science, and Cochrane Library were searched. Studies of individual appointments or group therapy were excluded. The Mixed …

Prediction Of Disease-Free Survival For Precision Medicine Using Cooperative Learning On Multi-Omic Data, Georg Hahn, Dmitry Prokopenko, Julian Hecker, Sharon M Lutz, Kristina Mullin, Leinal Sejour, Winston Hide, Ioannis Vlachos, Stacia Desantis, Rudolph E Tanzi, Christoph Lange

Faculty, Staff and Student Publications

In precision medicine, both predicting the disease susceptibility of an individual and forecasting its disease-free survival are areas of key research. Besides the classical epidemiological predictor variables, data from multiple (omic) platforms are increasingly available. To integrate this wealth of information, we propose new methodology to combine both cooperative learning, a recent approach to leverage the predictive power of several datasets, and polygenic hazard score models. Polygenic hazard score models provide a practitioner with a more differentiated view of the predicted disease-free survival than the one given by merely a point estimate, for instance computed with a polygenic risk score. …

Assessing Health Needs In A Dominican Republic Community During An Interprofessional Service-Learning Trip, Gabriela Andonie, Hanna Rotundo, Ashanti Jones, Logan Dugas, Shylon Francis

Journal of Interprofessional Practice and Collaboration

Purpose: International medical missions may increase access to medicines and care, but international teams must understand local needs to implement appropriate services. In 2023, a multidisciplinary team from our institution partnered with a nonprofit organization in the barrio of Cienfuegos, Dominican Republic with the goal of strengthening local health services. The primary objective of this study was to identify health-related needs in Cienfuegos from the perspective of community members and local health care workers.

Methods: A qualitative study was conducted as part of a service-learning initiative. After obtaining informed consent, the investigators conducted individual semi-structured interviews facilitated by multi-lingual interpreters. …

Disasters And Impacts In Appalachian Kentucky: A Behavioral Health Analysis, Walter David Mathews Phd, Joseph M. Clark, Amy S. Potts

Journal of Appalachian Health

Introduction: Major disasters continue to occur in Appalachian Kentucky with devastating consequences. A major disaster, defined by the Federal Emergency Management Agency (FEMA) as an event too large for a community to manage without outside help, involves emergency responders from the local, state, and federal disaster agencies, plus national volunteers.

Purpose: This paper reports on recent disasters in eight southeast Kentucky counties, the changing nature of these disasters, and the behavioral health impact on the people affected.

Methods: In this large-scale disaster survey in the Appalachian counties in Southeast Kentucky, over 3,500 people were asked about their recent disaster experiences …

Community Needs Assessment Collaboration Following The July 2022 Flooding In Eastern Kentucky, Melissa Slone Dsw, Frances Feltner Dnp, William M. Baker Rn, Anthony S. Lockard Msw, Csw, Angela Raleigh Rd

Journal of Appalachian Health

Rapidly rising waters due to flash floods and thunderstorms on the night of July 27, 2022, resulted in hundreds of water rescues throughout 14 rural Appalachian Kentucky counties. Lives were lost, thousands were injured, homes and property were damaged or destroyed, and many roadways were unpassable. Community partners serving these counties collaborated to design and conduct an assessment to gain a better understanding of the needs of individuals residing in certain remote sections within the communities. The assessment, conducted three months after the flood, collected information regarding flooding impact on housing, physical and behavioral health, transportation, work, and finances.

A Microcosting Approach For Planning And Implementing Community-Based Mental Health Prevention Program: What Does It Cost?, Sharmily Roy, Henry Shelton Brown, Lisa Sanger Blinn, Sarah Carter Narendorf, Jane E Hamilton

Faculty, Staff and Student Publications

BACKGROUND: Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds Healthy Communities (HMHC), a mental health promotion and prevention multi-level intervention initiative. This Program is among the first to use the Community Initiated Care (CIC) model in the US and is aimed at building community resilience and the capacity for communities to provide mental health support, particularly among those disproportionately impacted by COVID-19. Our objective is to share our methods for costing a program targeting 10 zip codes that …

Impact Of The Department Of Defense Maternity Leave Policy Change On Retention And Postpartum Depression And The Air Force Postpartum Physical Fitness Policy Change On Physical Readiness Outcomes, Minette S. R. Herrick

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Understanding the implications of health policy is paramount to support continued execution and further wide-spread distribution. The Department of Defense has made many recent family friendly policy changes in effort to improve the health and morale of the force. Two such policies were analyzed in this study. The first was the change in maternity leave, in 2016, from allotting women six weeks time off to twelve weeks time off in the postpartum period. The second was executed by the Air Force to permit postpartum women a longer duration for their required physical fitness assessment (an increase from six months to …

Artistic Expression Of Medical Experiences Of Mothers Of Color: Perspectives Using Art Therapy, Lauren Barrett

Expressive Therapies Dissertations

The purpose of this study was to qualitatively examine perspectives of mothers of color living in the US and their experiences in the healthcare system through art therapy. The study aimed to further identify personal narrative experiences of mothers of color navigating the healthcare system, promote individual voices, and acknowledge disparities impacting those within marginalized communities. The participants in this study included a total of eight identified mothers of color (non-White) living in the US. Participants took part in four weeks of consecutive art therapy sessions either in 60-minute group or individual virtual meetings. One art therapy directive was provided …