Public Health Commons^™

Reducing Tobacco-Related Health Disparities : Exploring The Barriers And Facilitators To Smoking Cessation Among Individuals Experiencing Homelessness., Bernadette Guzman Antoon

Electronic Theses and Dissertations

Although the prevalence of smoking has declined in the U.S., vulnerable populations continue to suffer from tobacco-related health disparities. An estimated 68.0-80.0% of homeless adults are current cigarette smokers compared to 15.1% in the general population. The large gap in smoking rates suggests that current tobacco cessation programs designed to reduce smoking have little impact among individuals experiencing homelessness. The purpose of this study was to explore the barriers and facilitators to smoking cessation among the homeless. The second aim of this study was to explore if the barriers and facilitators to tobacco cessation differed among male smokers experiencing homelessness …

A Guide For Assessing Older Adults’ Needs On Maine Islands, Beatrice Byrne

Muskie School Capstones and Dissertations

This template may help Maine island communities identify older adults’ needs and island resources, in order to allow older adults to age in the island communities.

Three interviews with island health leaders, one community conversation with older islanders, and one pilot test provided information about what to include in the template.

The template includes a demographic survey, guides for conducting semi-structured interviews and group conversations with older adults and caregivers, a guide and worksheet for analyzing the data, a guide for assessing community resources, a guide for dissemination, and a list of additional resources.

Social Support For Physical Activity For High Schoolers In Rural Appalachia, Pooja M. Shah

Undergraduate Honors Theses

The purpose of the present study is to conduct a secondary qualitative analysis to examine parent, teacher, and high school adolescents’ perceptions of social support for physical activity (PA) for high schoolers in Southern Appalachia. Social support for PA is linked to higher rates of PA participation in adolescents. Parents, siblings, and peers provide key sources of support. Social support for PA may be even more important in under-resourced communities such as Appalachia, where geographic, economic, and environmental barriers negatively impact PA engagement. During 2013-2014, focus groups and semi-structured interviews were conducted with parents of adolescents (n=39), high school teachers …

Meaning Of Pregnancy Terms Among African-American Women, Stephanie Solomon, Sandra G. Suther, Ivette Lopez, Alicestine Ashford, Linda C. Amankwaa, Gareth Dutton

The Qualitative Report

The concept of pregnancy intendedness is complex and may not bear the same meaning to all women. Moreover, researcher definition and women’s meaning were thought to be different. Some researchers have indicated that it is unclear how well women understand and relate to questions used by the National Survey of Family Growth (NSFG) and how the classifications relate to women’s lives. The purpose of this study was to explore the meaning of terms such as planned and/or intended pregnancy among African-American women of childbearing age using a qualitative exploratory descriptive method. Although African-American women want children, they are three times …

Interdisciplinary Team Based Pastoral Care: A Potentially Adaptable Model For Estonian Healthcare, Liidia Meel, Tõnu Lehtsaar

Occasional Papers on Religion in Eastern Europe

This article aims to build a potentially adaptable model of clinical pastoral care for Estonia’s healthcare institutions. To help the development of spiritual support provision in Estonian healthcare institutions, we are currently working on creating a model of clinical pastoral care that would be in accordance with the local circumstances. Preparatory research in the matter has addressed the socio-cultural and institutional context that shows the great need for interdisciplinary teamwork. The current article offers concrete proposals in the following main points: a) presentation of the pastoral caregiver; b) main actors; c) forms of cooperation; and c) education and internal trainings. …

Can Global Health Governance Contend With Transnational Corporate Activities? A Case Study On The Chinese Tobacco Industry, Xing Gao

Geography Honors Projects

In the past two decades, China’s state-owned tobacco enterprise (CNTC) has expanded its operation and influence abroad under the “going global” strategy. These globalization activities directly and indirectly impact the Framework Convention on Tobacco Control (FCTC), the first international treaty signed under the WHO auspices. In this project, I explore how certain CNTC expansionary strategies undermine FCTC articles, as well as the ways in which FCTC articles have failed to curb the tobacco industry’s transnational growth. Using international political economy as an overarching framework for the analysis of global health governance, I argue that the FCTC fails to halt the …

More Than 95 Percent Of U.S. Children Had Health Insurance In 2015, Michael J. Staley

Carsey Publications

In this brief, author Michael Staley examines rates of children’s health insurance across the United States, by region and by place type, breaking down rates by private and public coverage. He reports that over 95 percent of all U.S. children under age 18 were covered by some form of health insurance in 2015—the highest share since the American Community Survey began measuring insurance rates in 2008. Rates of coverage increased between 2014 and 2015 in all four U.S. regions, and the greatest growth occurred in the South and West. Growth in public insurance—Medicaid and the Children’s Health Insurance Program— remained …

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside …

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …

Experiences Of Communication Barriers Between Physicians And Immigrant Patients: A Systematic Review And Thematic Synthesis, Salim Ahmed, Sonya Lee, Nusrat Shommu, Nahid Rumana, Tanvir Turin

Patient Experience Journal

Frequent immigration of peoples from outside often challenges various systems of any country; healthcare sector is the most confronted one. One of the most prominent reasons for this confrontation is communication gap between physicians and immigrant patients. In this systematic narrative review, we studied existing literature on physician-immigrant patient communication. We systematically searched the repositories of literature and followed some criteria to select literature. We selected 32 literatures for information extraction. Three themes emerged from the synthesis: Physicians’ viewpoint about communication barrier with their immigrant patients, Immigrant patients’ viewpoint about the communication barrier with their physicians, and Interpreter as a …

Patient Experiences Of Cancer Care: Scoping Review, Future Directions, And Introduction Of A New Data Resource: Surveillance Epidemiology And End Results-Consumer Assessment Of Healthcare Providers And Systems (Seer-Cahps), Michelle A. Mollica, Lisa M. Lines, Michael T. Halpern, Edgardo Ramirez, Nicola Schussler, Matthew Urato, Ashley Wilder Smith, Erin E. Kent

Patient Experience Journal

The shift towards providing high value cancer care has placed increasing importance on patient experiences. This scoping review summarizes patient experience literature, highlights research gaps, and provides future research directions. We then introduce a new resource that links the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program with the Centers for Medicare and Medicaid Services Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and longitudinal medical claims data. We conducted a scoping review to identify relevant research within the Medicare CAHPS domain that examine factors associated with patient-reported experiences with their cancer care. Gaps indicate a need …

Leadership Development Practices And Patient Satisfaction: An Exploratory Study Of Select U.S. Academic Medical Centers, Chien-Ching Li, Peter Barth, Andrew N. Garman, Matthew M. Anderson, Peter W. Butler

Patient Experience Journal

Interest has been growing among academic medical centers (AMCs) in organization-wide strategies that may improve patient satisfaction. Although leadership development programs have been cited as a potentially useful approach, thus far almost all evidence has come from single-organization case studies. The present study sought to examine potential relationships between leadership development and patient experience across organizations. Data for leadership development practices were obtained from a survey conducted by the National Center for Healthcare Leadership. Patient experience data were obtained from the U.S. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Multivariate analyses (general linear regressions) were performed to examine …

“Quiet At Night”: Reduced Overnight Vital Sign Monitoring Linked To Both Safety And Improvements In Patients’ Perception Of Hospital Sleep Quality, Kevin Stiver, Nandini Sharma, Kayla Geller, Lisa Smith, Julie Stephens, Emile Daoud, Susan Moffatt-Bruce, Ernest Mazzaferri

Patient Experience Journal

Obtaining middle of the night vital signs is disruptive to sleep and not founded on evidence-based medicine. We sought to investigate the perception of quality of sleep and overall satisfaction during a hospital stay between an intervention group where overnight night vital signs were not obtained and a standard of care group where overnight vital signs were obtained every four hours. We also monitored for adverse events in the intervention and standard group. Low-risk observational stay patients with a planned cardiac procedure were eligible for this study. After consent, patients were randomized to the intervention or standard group. Participants were …

When One Is Sick And Two Need Help: Caregivers’ Perspectives On The Negative Consequences Of Caring, Ilja Ormel, Susan Law, Courtney Abbott, Mark Yaffe, Marc Saint-Cyr, Kerry Kuluski, Debbie Josephson, Ann C. Macaulay

Patient Experience Journal

Informal or family caregivers contribute significantly to individual care, and to the Canadian healthcare system, yet receive limited support from governments, institutions, and healthcare professionals in recognition of their role, or in response to their health and social care needs – often due to the negative consequences of caregiving. Learning about the diversity of others’ experiences can positively influence personal decision-making, reduce feelings of isolation, as well as promote adjustment to a personal situation. For caregivers, however, few resources exist that provide reliable information on others’ experiences. We collected the narratives of caregivers’ experiences of caring for someone with a …

Engaging Rural Residents In Patient-Centered Health Care Research, Michelle Levy, Cheryl Holmes, Amy Mendenhall, Whitney Grube

Patient Experience Journal

Patient engagement is increasingly recognized as a critical component in improving health care. Yet, there remains a gap in our understanding of the intricacies of rural patient engagement in health-related research. This article describes the process of engaging rural patients, caregivers and broader stakeholders to actively participate in an exploratory effort to understand rural perspectives around the patient-centered medical home model. Highlights of the project’s engagement activities demonstrate how giving voice to rural residents can have a significant impact. Lessons learned point to the importance of six factors for successful engagement of rural residents as partners in health care research: …

Evaluating Variables Of Patient Experience And The Correlation With Design, Dyutima Jha, Amy Keller Frye, Jennifer Schlimgen

Patient Experience Journal

The objective of this paper was to understand the variables of patient experience by analyzing recent and relevant evidence and to identify design solutions within the hospital environment that positively impact those variables. A systematic review of literature published from 2008-present was conducted to identify variables that contribute to patient experience benefits. Identified variables were documented and categorized into a design, organizational, and outcome variable matrix. Interviews were conducted with professionals from healthcare institutions, architecture firms and organizations committed to improving the patient experience. Data from healthcare facilities, with high patient experience scores, was also examined to derive effective design …

Patient Experience: The Field And Future, Geoffrey A. Silvera, Courtney N. Haun Mph, Jason A. Wolf Phd

Patient Experience Journal

In an effort to understand the progress and evolution of the field, a self-examination study has been administered to assess contributions to the core knowledge base in the field and to assess the degree to which articles published in Patient Experience Journal (PXJ) addressed the core elements of patient experience outlined in the definition of patient experience as offered by The Beryl Institute. The purpose of this examination is to understand PXJ’s position as a central voice for patient experience scholarship, practice, and knowledge exchange. The findings suggest that the operating definition of the field continues to be suitable and …

Learning And Leading In The Experience Age, Jane Cummings

Patient Experience Journal

A focus on experiences of care helps health systems realize the very transformations they look to achieve. This is because patient experience allows patients, families and carers to define value, enabling healthcare organizations to focus on what matters to them and not simply what is the matter with them. This is what we mean by an ‘experience age’, one in which clear connections are made between the things patients value and the clinical outcomes we look to achieve: where links are drawn between experience, clinical effectiveness, safety and cost in order to provide the very best care for all patients. …

Patient Experience: A Return To Purpose, Jason A. Wolf Phd

Patient Experience Journal

As an opening reflection to Volume 4 of Patient Experience Journal (PXJ), this editorial reviews the progress of the journal and the implications seen both in the evolving healthcare marketplace globally as well as reviews the data on the developing field of patient experience. It reinforces the need for an integrated view of experience as supported by data in the most recent State of Patient Experience research – one encompassing quality, safety, service, cost and population health implications and one driven on an engine of both patient and family engagement and employee/staff engagement. The article offers that healthcare is as …

Mexicans In The U.S And Hiv: Reviewing Social And Cultural Factors, Eduardo Alvarez

Annual Undergraduate Conference on Health and Society

Mexican immigrants in the United States continue to struggle with disproportionate incidences of HIV infection. Behaviors that contributed to the development of AIDS among Mexican immigrants were the lack of condom use, engaging in risky sexual behavior, and not having HIV testing (Martínez Donate, et al., 2015). While these risk factors are preventable, religious and social stigmatization present within the Mexican community generate shame and embarrassment. This discourages Mexican immigrants from seeking health services, such as HIV testing. An estimated 20% of HIV positive Mexican immigrants are unaware of their condition, and contribute to the spread of the virus (Hall …

Discovery And Fine-Mapping Of Adiposity Loci Using High Density Imputation Of Genome-Wide Association Studies In Individuals Of African Ancestry: African Ancestry Anthropometry Genetics Consortium, Maggie C. Y. Ng, Mariaelisa Graff, Yingchang Lu, Anne E. Justice, Poorva Mudgal, Ching-Ti Liu, Kristin Young, Lisa R. Yanek, Mary F. Feitosa, Mary K. Wojczynski, Kristin Rand, Jennifer A. Brody, Brian E. Cade, Latchezar Dimitrov, Qing Duan, Xiuqing Guo, Leslie A. Lange, Michael A. Nalls, Hayrettin Okut, Salman M. Tajuddin, Bamidele O. Tayo, Sailaja Vedantam, Jonathan P. Bradfield, Guanjie Chen, Wei-Min Chen, Alessandra Chesi, Marguerite R. Irvin, Badri Padhukasahasram, Jennifer A. Smith, Wei Zheng, Donna K. Arnett

Epidemiology and Environmental Health Faculty Publications

Genome-wide association studies (GWAS) have identified > 300 loci associated with measures of adiposity including body mass index (BMI) and waist-to-hip ratio (adjusted for BMI, WHR_adjBMI), but few have been identified through screening of the African ancestry genomes. We performed large scale meta-analyses and replications in up to 52,895 individuals for BMI and up to 23,095 individuals for WHR_adjBMI from the African Ancestry Anthropometry Genetics Consortium (AAAGC) using 1000 Genomes phase 1 imputed GWAS to improve coverage of both common and low frequency variants in the low linkage disequilibrium African ancestry genomes. In the sex-combined analyses, we identified …

Rape Crisis Center Professionals' Perception Of Sexual Violence Policy: A Qualitative Analysis, Stephanie Manieri

Scholarly and Creative Works Conference (2015 - 2021)

The purpose of this study is to collect information about the perceptions of rape crisis center professionals regarding the current policies surrounding sexual violence crimes that victimize people over the age of 18. This research aims to gather information about effective and ineffective policies from professionals who are first- responders to sexual assaults.

Priority Hypertension Management Strategies For At-Risk African Americans As Perceived By Medical Clinicians And Academic Scholars, Shirley M. Timmons, Lu Shi, Amin Khademi

Journal of Health Disparities Research and Practice

African American adults, in the United States (US), bear the greatest burden of high blood pressure (HBP)--a primary risk factor for cardiovascular disease and premature death. Current research does not adequately inform the design of multi-level interventions that work to control HBP in this at-risk population. The purpose of this study was to uncover information about priority strategies recommended for HBP control in African American adults. Research questions are 1) what are factors that reduce or manage HBP in at-risk African Americans and 2) what factors are important to the design and implementation of successful HBP interventions in at-risk African …

Identifying Corners Stores As The Future Of Healthy Food Access In African American Communities, Victor Romano, Jennifer Lee, Elliott Royal, Katherine Metzo, William Ruth, Theodore Hartsook

Journal of Health Disparities Research and Practice

For many people, the corner store remains the main grocer, or the only source of sustenance in minority communities. This study examined the distribution of corner stores as a future reference point to provide healthy food access to predominantly African American communities that lack full service grocery stores. Business data was obtained from respective county by use of Standard Industrial Codes. Each corner store was then categorized by either being Full Service (Stores that sell fresh produce, fresh meat, fresh dairy, and processed foods) or Non-Full Service (stores that do not sell all four categories of foods included in the …

Exploring The Life Course Perspective In Maternal And Child Health Through Community-Based Participatory Focus Groups: Social Risks Assessment, Abraham Salinas-Miranda, Lindsey M. King, Hamisu M. Salihu, Estrellita "Lo" Berry, Deborah Austin, Susan Nash, Kenneth Scarborough, Evangeline Best, Lillian Cox, Georgette King, Carrie Hepburn, Conchita Burpee, Eugene Richardson, Marlo Ducket, Richard Briscoe, Julie Baldwin

Journal of Health Disparities Research and Practice

Little is known about the patterns of risk factors experienced by communities of color and how diverse community contexts shape the health trajectory of women from the early childhood period to the time of their pregnancies. Thus, we conducted a focus group study to identify social risks over the life course that contribute to maternal and child health from the perspective of community members residing in low income urban areas.

Ten community-based participatory focus groups were conducted with residents from selected communities in Tampa, Florida, from September to November 2013. We used the life course perspective to illuminate and explain …

Knowledge And Beliefs About Cancer In African American Population, Rabindra P. Gautam Dhs, Deven Shah Phd, Eric Matthews Phd

Journal of Health Disparities Research and Practice

Cancer is the second most common cause of death in the United States, taking the lives of one in four Americans each year (American Cancer Society [ACS], 2015). A total of 1,658,370 new cancer cases and 589,430 deaths from cancer were projected to occur in the United States in 2015 (ACS, 2015). In 2013, approximately 176,630 new cancer cases and 64,880 deaths from cancer were projected to occur in African American communities. The majority of diagnoses were cancers of the prostate, lung, colon, rectum, breast, and colorectal region (ACS, 2013). For most cancers, African Americans have the highest death rate, …

No Puffs: Penguins Go Smoke-Free, Monica Sciamanna

Scholarly and Creative Works Conference (2015 - 2021)

In partnership with the Department of Student Life, this project examines campus smoking behaviors among students, faculty, and staff. It will gather information regarding awareness and perceptions of current smoking policies at Dominican. Data may be used in the development of a new campus smoking policy.

Culturally Competent Health Education In African-Americans’ Faith-Based Communities For Better Health Outcomes: A Literature Review, Kougang Anne Mbe

McNair Research Journal SJSU

Obesity is a compelling health issue among African-Americans, who have the highest prevalence of excess weight among all ethnic and racial groups in the United States. This soaring obesity rate contributes to poor health outcomes and significantly inflates the risks for many chronic diseases, including cardiovascular diseases, diabetes, and certain forms of cancer. The literature provides evidence for the success of health programs aimed at promoting healthy behavior and lifestyles in African-American faith-based organizations, as the influential role of churches in African-American communities is well documented. However, few studies have investigated the criteria essential for improved efficiency of health interventions …

Prescribed Fire And Deer Ticks: A Management Method For The Primary Vector Of Lyme Disease In The Eastern United States, Shane M. Tripp

Graduate Dissertations and Theses

The United States is currently amid a public health crisis caused by the bacteria, Borrelia burgdorferi, that is responsible for Lyme disease. A deer tick, Ixodes scapularis, is the primary vector for these bacteria in the Eastern United States and its explosive population increase and range expansion in the past several decades is responsible for the rapid spread of the disease. Understanding the cause of this growth is dependent on the habitat characteristics that determine the deer tick’s abilities to survive, reproduce, and disperse into new areas and the changes that may have released it from historic limits. Fire suppression …

Geographic Variation Within The Military Health System, Linda G. Kimsey, Samuel Olaiya, Chad Smith, Andrew Hoburg, Stuart R. Lipsitz, Tracey Koehlmoos, Louis L. Nguyen, Joel S. Weissman

Health Policy & Management: Faculty Publications (2006-2018)

Background: This study seeks to quantify variation in healthcare utilization and per capita costs using system-defined geographic regions based on enrollee residence within the Military Health System (MHS).

Methods: Data for fiscal years 2007 – 2010 were obtained from the Military Health System under a data sharing agreement with the Defense Health Agency (DHA). DHA manages all aspects of the Department of Defense Military Health System, including TRICARE. Adjusted rates were calculated for per capita costs and for two procedures with high interest to the MHS- back surgery and Cesarean sections for TRICARE Prime and Plus enrollees. Coefficients of variation …