Public Health Commons^™

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …

Assessing U.S. Fatal & Nonfatal Injury Trends By Worker Age, Alexander Mcdaniel

All-Inclusive List of Electronic Theses and Dissertations

Occupational injuries and fatalities in the United States have declined over time; however, meaningful differences by worker age remain a concern for employers and safety professionals. Younger workers often experience higher non-fatal injury rates due to limited experience and developing hazard-recognition skills, while older workers face increased risk of severe and fatal outcomes related to age-associated physical changes. The purpose of this study was to analyze long-term injury and fatality trends by age group and determine whether differences exist over time. National injury data from the Census of Fatal Occupational Injuries (1992–2023) and the Survey of Occupational Injuries and Illnesses …

Diabetes And Hypertension Frequencies And Trends In The Health Districts Of Sololá, Alejandro Cerón, Sophie Perfetto, Ana Textor, Sidona Alemayehu, Emilia Alvear Escobar, Adele Beard, Sarah Berson, Rachel Bryant, Jennifer Calzontzi, Rylee Castro, Eva Cress Palencia, Jake Czarnecki, Jordyn Epstein, Nikki Harris, Patience Hinojos, Max Hippisley, Erin House, Jackson Hullett, Nathan Johnson, Amelie King, Saule Lankelyte, Juan Loya, Ashley Mackenzie, Ilana Mighdoll, Molly Morrill, Maria De Jesus Ramos Jimenez, Lilly Teklemedhin, Joseph Trujillo, Lauren Verachtert, Nathan Verachtert, Violet Vreeland, Alex Welch, Jada Wright

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students, Graduate Teaching Assistants, and instructor of “The Social Determination of Health” class taught in the fall of 2025 at the University of Denver. The report was prepared for Dr. Luis Pablo Méndez, of the Vice Ministry of Health Regulation, Surveillance and Control, of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: How can available data about service production can be used to inform the planning process for the implementation of the Global Hearts Initiative’s HEARTS technical package in the Distrito de Redes Integradas de …

Assessing Neurocognitive Functioning Among Adults Ageing With And Without Hiv At The Kenyan Coast: Measurement Issues And Correlates, Patrick Nzivo Mwangala, Carophine Nasambu, Ryan Wagner, Mihaela Duta, Gaia Scerif, Charles Newton, Amina Abubakar

Institute for Human Development, East Africa

Background: Cognitive impairment is one of the most prevalent complications of HIV infection, with significant medical and functional impacts. However, valid, and reliable assessment tools are lacking for the newly emergent ageing population of people living with HIV (PLWH) in many parts of sub-Saharan Africa (SSA), including Kenya. Without these tools, critical intervention opportunities, e.g., psychoeducation, treatment and additional support, are missed. To bridge this gap in Kenya, we adapted the Oxford Cognitive Screen Plus (OCSPlus), a tablet-based cognitive assessment tool designed for low-literacy settings, with adults ageing with HIV ≥ 50 years and their uninfected peers. This study examines …

Identifying Alcohol Intervention-Relevant Constructs For Greek Life: Examining Across Greek Membership And Gender Among College Students, Emily Susan Renzoni

Psychology Theses & Dissertations

Among college populations, students who are members of social Greek life organizations (i.e., social fraternities and sororities) drink more and experience higher rates of negative alcohol-related consequences than their non-affiliated peers. Although there has been success of alcohol interventions in general college populations, research has shown that college drinking interventions that are delivered to students in Greek life are not efficacious in reducing alcohol consumption or related consequences. It is meaningful to investigate if the content commonly addressed in these interventions, although well-documented as being linked to drinking in the general college population, has the same associations for students who …

Burden Of Neurodevelopmental Disorders In Kenyan Children, Symon Kariuki, Patricia Kipkemoi, Martha Kombe, Mary Bitta, Jacqueline Phillips Owen, Amina Abubakar, Charles Newton

Institute for Human Development, East Africa

Importance: Neurodevelopmental disorders (NDDs) such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability contribute to one-tenth of the global burden of mental and neurologic disorders. The burden of NDDs is not well documented in Africa.

Objective:To assess the prevalence, risk factors, and comorbidities of NDDs in young Kenyan children.

Design, setting and participants: This cross-sectional study was conducted among children aged 6 to 9 years residing in the Kilifi Health and Demographic Surveillance System in Kenya. In stage I of the study, children were screened for NDDs from March 16, 2015, to September 14, 2016; those …

Bridging The Language Gap: The Impact Of In-Person Versus Remote Interpreter Services On Medication Adherence And Patient Safety In Adult Spanish-Speaking Patients, Ashley E. Alarcon Martinez, Jocelyn N. Lopez Maradiaga

Nursing | Student Research Posters

Background: Significant health inequities are caused by language barriers between patients and health care staff, resulting in miscommunication among adult Hispanic patients with low English proficiency, reducing medication adherence, impairing patient safety, and raising the possibility of medical errors. To address this issue, interpreter services, both in-person and remote translation, have been introduced in healthcare settings to enhance communication. Objective: The purpose of this study is to investigate the differences in patient safety and medication adherence between in-person and remote translation services for adult Hispanic individuals with limited English proficiency in healthcare settings. Methods: The proposed research involves five local …

Enhancing End-Of-Life Quality In Hospice Care, Gerson Orellana Prudencio

Capstone Projects and Master's Theses

The‍‌‍‍‌ increasing demand for hospice care in Monterey County is a clear indicator of the rapid growth in the need for end-of-life services driven by the aging population. The project was developed at the Department of Hospice of the Central Coast, which is under the Montage Health Foundation, a non-profit organization. The community served consists of elderly people receiving hospice and end-of-life care, as well as volunteers who provide administrative and indirect support. The Volunteer Handbook aims to create a comprehensive procedural manual for hospice volunteers to improve administrative efficiency and ensure the quality of care. Interviews were conducted with …

Environmental Sanitation In Long-Term Care Facilities: A Focus On Regulations And Implementations, Ruwan Dissanayake Dissanayake Mudiyanselage

All Theses

Environmental sanitation is a fundamental component of infection prevention in long-term care facilities (LTCFs), where residents are at increased risk due to advanced age, underlying health conditions, and communal living arrangements. Despite its critical role, significant gaps remain in implementing environmental sanitation procedures and the regulatory frameworks that guide them.

This study combines two components: (1) an across-state regulatory review of environmental sanitation in LTCF regulations and (2) a cross-sectional survey assessing environmental sanitation characteristics of nursing homes (NHs) and assisted living facilities (ALFs) and Rural and Urban LTCF observation study in South Carolina (SC) . For the regulatory review …

A Quantitative Exploration Of Risk And Protective Factors Affecting The Mental Health Of Chitimacha Tribal Youth, Daphnie Vilcan-Tanner

LSU New Orleans Theses and Dissertations

This study examines the relationships between demographics, risk factors, and protective factors with mental distress among Chitimacha Tribal adolescents aged 12 to 18. Using a Positive Youth Development framework, the research aimed to identify the prevalence of mental distress, trauma, discrimination, and protective factors, as well as their collective and individual impacts on mental health. Data were collected through online surveys completed by 73 participants residing on or near the Chitimacha Tribal Reservation. Descriptive statistics and multiple linear regression analyses were conducted to analyze the data. Results revealed that while trauma and discrimination collectively predicted mental distress, family and community …

Drought, Worry, And Preparing For The Future: The Ethnopsychology Of Climate Distress In Kilifi County, Kenya, Edna Bosire, Syed Wahid, Linda Khakali, Benjamin Oestericher, Felix Agoi, Anthony Ngugi, Rosebella Iseme, Jasmit Shah, Zul Merali, Lukoye Atwoli

Brain and Mind Institute

The impacts of climate change in sub-Saharan Africa (SSA) presents a chronic and intensifying disaster, with drought, flooding, and extreme heat, presenting unique challenges and profound disruptions. Growing evidence links such events to ecological grief, ecological anxiety, and solastalgia – negative affective states that reflects responses to climate change related destruction of nature, species, culturally significant or sacred spaces, and other ways of life. While this literature is expanding in the Global North, little is known about how communities in SSA perceive and respond to deteriorating or depleting natural ecosystems. This article explores the ethnopsychology of distress precipitated by environmental …

Community Perspectives On Factors Contributing To Resilience For Healthy Aging In Kenya, Linda Khakali, Everline Onchari, Maureen Ondire, Catherine Onyancha, Chinedu Momoh, Edna Bosire

Brain and Mind Institute

Background: The global elderly population is increasing and expected to double in thenext decade. Aging increases the likelihood of adversities, with resilience becomingan important aspect of healthy aging. Understanding how individuals conceptualizeresilience offers an opportunity to create contextually relevant interventions forpromoting healthy aging. This study aimed to explore adults’ perspectives on factorsinfluencing resilience in Kenya.

Method: Using qualitative methods, 36 adults aged 35 years and above werepurposively recruited from various communities in Nairobi County to participate ininterviews. We asked questions about their understanding of aging, adversity andresiliency. We also provided them with case scenarios of two individuals respondingdifferently to the …

Reassessing Dementia Risk: Expanding The 2024 Lancet Commission Report For A More Accurate Global Understanding, Cyprian Mostert

Brain and Mind Institute

Background: The 2024 Lancet Commission Report analyzes 14 risk factors thataccount for 45 percent of global dementia cases. However, it overlooks four criticalrisk factors: poverty, wealth shocks, income inequality, and viral infections. This isparticularly concerning given that 57 percent of the identified risk factors in theLancet report are more prevalent in men, even though dementia predominantly affectswomen worldwide.

Method: In this policy paper, we used the recent global review studies and argue that itis essential to recalibrate and expand the 2024 Lancet Commission’s list of risk factorsto include poverty, wealth shocks, income inequality, and viral infections. Our analysissuggests that these …

Understanding And Willingness To Participate In Dementia Clinical Trials In Kenya: An Ethnographic Study, Edna Bosire, Lucy Kamau, Chinedu Momoh, Jasmit Shah, Karen Blackmon, Caroline Kiio, Irene Meier, Vaibhav Narayan, Olivera Nesic Taylor,, Zul Merali

Brain and Mind Institute

Background: Advancements in dementia research are in part contingent on participation in clinical research. Clinical trials can help researchers determine if new drugs, devices, or diagnostic procedures for dementia are safe and effective. However, little is known about clinical trials for dementia in resource constrained settings such as Kenya. The aim of our research was to explore people’s understanding of dementia clinical trials, their attitudes and perceptions towards dementia clinical trials and what can be done to enhance enrollments on such clinical trials.

Method: This was an ethnographic study involving 8 focused group discussions (FGDs; age and gender stratified; n=81) …

Cultural Adaptation Of An Innovative Reproductive Health Assessment Tool For Dementia Research In Africa: Insights From The Fember-Africa Study, Alice Moraa Ondieki, Anne Njogu, Cynthia I Sabel Smith, Edna Bosire, Karen Blackmon, Harrison Kaleli, Jasmit Shah, Rachel Maina, Sheila Waa, Chinedu Momoh

Brain and Mind Institute

Background: Dementia research accounts for only 0.1% of all research in Africa,making it the lowest among all low- and middle-income country (LMIC) regions. Thedevelopment and adaptation of biological and psychosocial measures in ethnicallyand culturally diverse populations remain limited but are essential for culturallyinformed research. This is particularly critical for examining sex- and gender-basedvulnerabilities to Alzheimer’s disease and related dementias (ADRD), including factorssuch as reproductive health and fertility.

Method: We conducted a thorough review of our clinical and health questionnaires forcultural relevance and sensitivity through a series (n = 3) of focus groups discussions.These focus groups included a diverse range of …

Vitality Tracking In Kenyan Adults Using Wearable Devices And Ecological Momentary Assessments, Karen Blackmon, Benard Alaka, Catherine Onyancha, Litha Musili, Raechel Kamau, Cyprian Mostert, Mansoor Saleh, Zul Merali, Chinedu Momoh, Thomas Thesen

Brain and Mind Institute

Background: Vitality is essential to healthy aging but is elusive to define and measure.Dynamic capture of fluctuations in vitality can uncover abnormal trajectories thatcould be a harbinger of frailty in older adults. Yet, these fluctuations are missed bystatic and/or sparse sampling strategies. To address the need for dynamic and high-density capture of vitality in older adults, we developed a passive sensing and activeprobing digital platform using wearable devices and smartphones. We deployed thisparadigm in older Kenyan adults and evaluated its potential for use in research on thedynamics of accelerated aging.

Method: Cognitively unimpaired (CU) Kenyan adults ≥ 35 years of …

Predicting Accelerated And Delayed Aging In Global Settings: Biobehavioral Age Gaps And The Role Of Global Exposomes, Hernan Hernandez, Hernando Santamaria-Garcia, Sebastian Moguilne, Agustina Legaz, Pavel Prado, Jhosmary Cuadros, Liset Gonzalez, Cyprian Mostert, Chinedu Momoh, Zul Merali

Brain and Mind Institute

Background: Global health challenges like aging and dementia are shaped bysocioeconomic disparities, environmental factors, and social determinants of health.We developed a behavioral age gap (BAG), measuring the difference between expectedbehavioral age and chronological age

Method: We utilized a cross-sectional sample (n = 161,981) comprising countriesfrom Latin America, Europe, Asia, and Africa. Behavioral age was estimated usinga Gradient Boosting Regressor with 10-fold cross-validation, incorporating multiplerisk factors (hypertension, diabetes, heart disease, female sex, visual impairment andhearing impairment) and protective factors (cognition, functional ability, education)associated with healthy aging. BAG was calculated as the difference between predictedand chronological age, and adjusted gaps were derived …

Preparing For “Disease X”: Lessons From Tax And Non-Tax Policy Responses To The Covid-19 Pandemic In Singapore And Australia, Vincent Ooi

Research Collection Yong Pung How School Of Law

During the Covid-19 pandemic, a lack of pre-pandemic planning resulted in sub-optimal policy outcomes. Crucial lessons can be drawn from the experience of Singapore and Australia in the pandemic in implementing various tax and non-tax economic measures; lessons that can help in preparing for the next pandemic (“Disease X”). This article analyses and critically evaluates three main categories of economic measures: direct payments, tax measures and non-tax “other” measures. It finds that direct payment measures such as jobs support had a very significant impact on preserving jobs and supporting the economy. However, eligibility conditions have to be carefully designed for …

Updated Prevalence Estimates Of Obesity Among Adults In The United States, 2005–2018, Ashley W. Kranjac, Dinko Kranjac

Sociology Faculty Articles and Research

Introduction

Body mass index is an imperfect measure of excess adiposity but is ingrained in both research and clinical practice to define and diagnose adult obesity. The addition of waist circumference measure is recommended to fully capture obesity-related health risks at a population level. The latest reframing of obesity by the Lancet Commission relies on body mass index and waist circumference, as well as organ dysfunction and functional limitations, to differentiate between preclinical and clinical obesity.

Methods

Using data from the National Health and Nutrition Examination Survey (2005–2018), we adhere to the proposed redefinition to examine obesity trends in the …

The Road To Regulation: A Literature Review Of The Influences On The Updated Silica Standards, Skye M. Medcraft

Capstone Experience: Master of Public Health

Silica is a hazardous compound that poses a risk to human health resulting from dust creating activities across various industries. Several agencies, including OSHA (Occupational Health and Safety Administration) and MSHA (Mine Safety and Health Administration) have adopted regulatory oversight of silica exposure in the workplace. As more research has been conducted on silica exposure, the health effects are becoming better described, which has led to the creation and updating of exposure regulations to protect worker health. The objective of this literature study is to review the data presented to the Department of Labor and discuss how the factors that …

Acceptability Of Corticosteroid Use In The Treatment Of Infant Bronchiolitis: Utilizing The Theoretical Framework Of Acceptability To Design Research Instruments, Caroline R. Smetanka

Capstone Experience: Master of Public Health

Bronchiolitis is the leading cause of hospitalization among infants under six months, yet treatment remains largely supportive due to clinical guidelines that discourage pharmacologic intervention. Recent research suggests that bronchiolitis is not a uniform condition, and a subgroup of infants (those classified within “Profile A”) may benefit from targeted corticosteroid therapy. However, these treatments remain outside current clinical guidelines, and their successful adoption depends on stakeholder acceptability. This Capstone project developed and refined four data collection instruments- two questionnaires and two interview guides- designed to assess how healthcare providers and caregivers perceive the acceptability of corticosteroid treatment for Profile A …

Infectious Disease Crisis Communication After The Covid-19 Pandemic, Macy Lloyd

Capstone Experience: Master of Public Health

Since the COVID-19 pandemic, the United States has experienced a proliferation of mis- and disinformation, an increasing politicization of health and science, and growing distrust in government, science, and institutions. While these trends present challenges for normal public health communications, during a public health emergency, such as an infectious disease outbreak, these challenges are even more acute. To address challenges at the local level, health departments need plans, products, and tools that adapt health crisis communications to the current media environment and meet community members where they are across the trust continuum. To develop an infectious disease incident communication plan, …

Public Views Towards Lifespan, Healthspan, And Healthy Longevity Medicine In Singapore: A Qualitative Study From The Healthy Longevity (Helo) Initiatives, Belinda Wang, Anna Szucs, Elena Sandalova, Zhi Meng Lim, E. J. Horberg, Paul A. O’Keefe, Louis Island, Sonny Rosenthal, Andrea B. Maier

Research Collection College of Integrative Studies

Introduction: Healthy Longevity Medicine (HLM) offers a strategy to reduce the healthspan-lifespan gap, yet public perspectives remain unclear. This study refines the Healthy Longevity (HELO) framework through a qualitative exploration of public views towards lifespan, healthspan, and HLM.Methods: Individuals living in Singapore participated in semi-structured group or individual discussions to explore (a) their understanding of lifespan and healthspan, (b) motivational factors for health behaviours, and (c) their awareness of HLM. Sampling maximised variation across age, sex, and ethnicity. Data obtained through 13 discussions were analysed with a mixed, inductive-deductive approach employing the HELO framework.Results: Thirty-six participants (mean age = 49.4 …

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Young Adults And Early-Onset Psychosis: A Grounded Theory Study Of Experiences Of Identity Development, Katherine Hayden-Lewis, Deborah Rubel

The Qualitative Report

While identity development is a crucial task for young individuals ages 15-25, current research inadequately centralizes identity development in the context of first-time psychosis related to schizophrenia spectrum disorders. This study addresses the knowledge gap by exploring the grand research question, “How does a young person experience their identity development after the first episode of psychosis?”. Constructivist grounded theory methods influenced by critical frameworks were used to collect and analyze data with seven young adults engaged in first episode psychosis programs. Participants were young adults, between the ages of 19-24, that at the time of the study were enrolled in …

Workplace Policy And Associated Factors Of Minimum Acceptable Diet Practices: An Online Survey Among Working Mothers In Indonesia, Fadhila Iswi Deandra, Judhiastuty Februhartanty, Muchtaruddin Mansyur

Kesmas

Working mothers in Indonesia may influence complementary feeding practices, particularly their ability to ensure that their infants properly meet the minimum acceptable diet (MAD). In this cross-sectional study, an online survey was distributed through various online platforms where participants were recruited using convenience sampling. The questionnaire covered sociodemographic factors, workplace policies, and infant and young child feeding (IYCF) practices. Descriptive and logistic regression analyses were conducted. A total of 394 working mothers participated, of which over 90% of the respondents reported meeting minimum dietary diversity, minimum milk frequency, minimum milk feeding frequency, and MAD indicators as assessed with a standardized …

General Practitioners' Perspectives On Identifying Early Symptoms For Breast Cancer Detection In The Primary Care Facilities: A Case Study, Bob Andinata

Kesmas

In primary care settings, general practitioners (GPs) frequently face challenges in identifying the early symptoms of breast cancer. This study aimed to explore, in depth, the perspectives of GPs regarding the identification and interpretation of early-stage breast cancer symptoms during the early detection process in primary care facilities. This study used a qualitative approach based on a case study. Data were collected through in-depth interviews with GPs at primary health care and private clinics in Depok City, Indonesia, complemented by observations and documentation. The data was analyzed using the Miles and Huberman method. The questionnaire assessment and focus group discussion …

Gender Differences In Healthy Eating Index As Informed By The Awareness Of Diagnosis Of Metabolic Dysfunction-Associated Steatotic Liver Disease, Wei Ting Lin, Madeline Novack, Suthat Liangpunsakul, Chiung Kuei Huang, Hui Yi Lin, Po Hung Chen, Tung Sung Tseng, Peng Sheng Ting

School of Public Health Faculty Publications

Background/Objectives: Dietary quality is a driver of metabolic dysfunction-associated steatotic liver disease (MASLD). Men and women often have different levels of adherence to medical advice, but the effect of gender on adherence to dietary advice as a function of awareness of MASLD is understudied. We aim to investigate the differences in diet quality between men and women who are aware of their diagnosis of MASLD compared to their undiagnosed counterparts. Methods: We utilized the National Health and Nutrition Examination Survey 2017–2020 to identify a nationally representative sample of subjects with MASLD, 127 of whom reported a diagnosis of MASLD (diagnosed …

Post-Release Health Insurance Utilization Among Ex-Prisoners: A Scoping Review, Icha Khaerunnisa, Megah Andriany, Luky Dwiantoro

Kesmas

The lack of health insurance coverage after prison release significantly reduces access to essential healthcare services, hindering the continuity of care during community reintegration. The evidence on studies of health insurance use following prison release is limited. This scoping review aimed to summarize research on health insurance utilization after release from prison. Literature searches were conducted across databases including ScienceDirect, PubMed, and Scopus. Relevant articles were selected through a two-stage screening process. Data were extracted from the included studies and presented in tabular and descriptive formats. The keywords used were "health insurance AND post-release" and "inmates OR prisoners." This scoping …

High Prevalence And Atypical Genotype Distribution Of Oral Human Papillomavirus In An East African Hiv Cohort: A Cross-Sectional Study, Ian G. Munabi, Adriane Kamulegeya, Dunstan Kalanzi, David P. Kateete, Fred Collins Semitala, Catherine-Lutalo Mwesigwa, Samuel Kalungi, Jennifer E. Cameron, Kimon Divaris, William Buwembo

School of Medicine Faculty Publications

BACKGROUND: Globally, Human Papillomavirus type 16 (HPV-16) is the predominant genotype associated with oropharyngeal cancers. However, little is known about the prevalence and type distribution of Oral Human Papillomavirus (OHPV) in people living with HIV (PLWHIV) in the East African region. The objective of this study was to document the prevalence and circulating genotypes of OHPV infection in a large cohort of PLWHIV attending an urban HIV clinic in Eastern Africa METHODS: This was a cross-sectional study among 1,715 participants of the Makerere University Joint AIDS Program clinic, located in Kampala, Uganda, in East Africa. A salivary sample was collected …