Public Health Commons^™

Align Appalachia’S Opioid-Settlement Spending With Evidence And Emerging Threats, Bradley Firchow

Journal of Appalachian Health

State and local governments across Appalachia are allocating opioid-settlement dollars over the coming years. This funding opportunity can support lasting public health infrastructure or be spent on short-term programs anchored in the opioid crisis of the past. Evidence indicates that emerging synthetic drugs such as nitazenes and xylazine are altering overdose risk patterns in ways that require urgent policy attention.

Medical Students’ Perspectives On Dobbs V Jackson Women’S Health Organization, Victoria Lazarov, Cecilia Mastrogiacomo, Mikaela Koch, Kirsten Wohlars, Tova Ablove, Student Perspectives On Reproductive Rights Research Group

Cooper Rowan Medical Journal

Background: In June 2022, the Dobbs v Jackson Women’s Health Organization ruling overturned the previously upheld constitutional right to abortion. The resulting impact on medical training and student decision-making remains uncertain. This study aims to assess the nationwide impact of the Dobbs decision on medical students’ geographic residency preferences, specialty selection, and level of concern regarding civil and criminal charges for physicians providing abortion and fertility care.

Methods: An anonymous IRB-approved REDCap survey was distributed to American accredited medical schools across the United States and Israel between December 2022 and May 2023. Participants indicated specialty interests and geographic preferences for …

P.L.A.Y. For All Pilot: Effects Of A Community-Based, Inclusive After-School Program On Physical Activity And Motor-Skill Outcomes, Allison R. Tsuchida, Karl-Richard Hennebach, Erin E. Centeio

International Journal of Physical Activity and Health

After-school programs for physical activity (PA) can contribute to helping children and youth achieve the suggested 60 minutes a day of PA. Previous research also suggests that developing motor competency can positively impact long-term PA participation. Additionally, parent and peer support can help children and youth overcome barriers to PA participation. The primary purpose of this pilot research study was to determine the effects of an inclusive after-school program on PA levels and motor-skill outcomes for children with and without disabilities. A secondary purpose was to examine parental support for physical activity and children’s physical activity and motor skills. 38 …

Neonatal Striatal Volume Is Associated With Infant Anhedonia, Melissa Nevarez-Brewster, Catherine H. Demers, Jessica L. Irwin, Laura M. Glynn, Martin A. Styner, Mercedes Hoeflich Haase, M. Camille Hoffman, Diego A. Pizzagalli, Benjamin L. Hankin, Elysia Poggi Davis

Psychology Faculty Articles and Research

Anhedonia is increasingly recognized as a transdiagnostic risk factor for psychopathology. New evidence demonstrates that anhedonia is present in infancy and early childhood. Structural variability in striatal regions involved in reward processing and pleasure seeking is concurrently linked to anhedonia, yet few studies have examined whether striatal differences presage anhedonia, and none have examined prospective associations before middle childhood. The present study examined whether neuroanatomical markers that confer risk for anhedonia can be detected as early as the neonatal period. Specifically, we tested whether the volume of striatal regions in neonates predicted the emergence of infant anhedonic behaviors at six …

Towards Accessibility In Healthcare For Individuals With And Without Hearing Loss: Evaluation Of Usability, Fit, And Communicative Effectiveness Of A Transparent N95 Mask Prototype, Samuel R. Atcherson, Brooklyn Schultes, Jeanne Hahne, Barbara Debaun, Chris Showell

JADARA

The COVID-19 pandemic has underscored the necessity of effective face masks in both public and healthcare settings for mitigating the spread of disease. However, traditional face masks impede communication, posing significant challenges for approximately 13% of the general population and 10% of healthcare and social assistance workers who have hearing loss and who rely on lipreading and other non-verbal cues. Traditional surgical masks and N95 respirator masks serve important roles in healthcare, but they differ in levels of protection. Currently, a transparent surgical mask is available, but not an N95 version. Thus, this study aimed to evaluate the usability, fit, …

Assessing The Psychological Wellbeing And Resilience Of Frontline Health Workers In Uganda: A Cross-Sectional Study, Ahmed Sarki, Joseph Atukwatse, Gideon Mbithi, Sabina Odero, Mary Namuguzi, Bernard Mutwiri, Lestine Bitakwitse, Peninah Wachira, Kevinson Mwangi, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Health workers in the frontline are the major drivers of health systems in low- and middle-income countries. However, these health workers face both chronic and acute shocks and stressors that expose them to mental health problems which are often overlooked. We examined the prevalence of mental health problems, correlates of psychological functioning, and resilience of frontline health workers in Uganda.

Methods: We conducted a cross-sectional study comprising 1800 frontline health workers across all regions of Uganda from August through October 2023. We used tools such as the PC-PTSD-5, PHQ9, PSS, GAD-7, Oldenburg Burnout Inventory, and CD-RISC-10 to assess PTSD, …

The Blacker The Berry: Food Environments And Intake Associated With Perinatal Depression And Secondary Breastfeeding Outcomes Among Black Americans In The St. Louis Metropolitan Area, Najjuwah S. Walden

Brown School Graduate Student Theses and Dissertations

The relationship between the food environment, intake, and health is complex. The purpose of this study was to evaluate if food environments in proximity to Black pregnant women in the St. Louis Metropolitan Area were associated with prenatal eating habits and if these eating habits were associated with the risk of developing depressive symptoms in pregnancy and postpartum. The study also aimed to understand if there was a relationship between prenatal eating habits and the decision to breastfeed and if the onset of postpartum depressive symptoms has any effect on this relationship. Due to the importance of nutrient-dense, anti-inflammatory foods …

Strategies And Considerations For Forming And Managing Community Advisory Boards From Health Research With Transgender And Nonbinary Communities, Mannat Malik, Anushka Aqil, Jennifer L. Glick, Jean Michel Brevelle, Anthony Black, Kellan Baker, Arjee Restar, Molly Gribbin, Colin Flynn, Danielle German

School of Public Health Faculty Publications

Purpose: There is limited research on the use of community advisory boards (CABs) in health research with transgender and nonbinary communities. Transgender communities are navigating challenging histories of health researcher exploitation and research distrust alongside exponential research growth. We explored strategies for forming and managing CABs when conducting transgender community-informed health research. Methods: We used purposive and snowball sampling to identify key informants (KIs): research leaders, implementing staff, and community partners engaging in transgender health research. Between October 2018 and December 2020, we conducted 30 semi-structured in-depth interviews. We used coding followed byiterative thematic analysis and memoing to identify themes. …

Outcomes Of Bio-Psycho-Social-Spiritual Communitybased Drug Rehabilitation Program For Voluntary Vs. Court-Mandated Clients In The Philippines, Maria Regina M. Hechanova, Trixie Anne Co, Fessa R. Egusquiza

Psychology Department Faculty Publications

This study sought to evaluate the outcomes of a community- based rehabilitation program for voluntary and court-mandated drug users in the Philippines. Participants went through a bio-psycho-social-spiritual group-based program that aimed to develop their recovery skills and life skills. The program also included family modules to enhance their knowledge of drug use, its effects, and the role of family in recovery. A cohort design was used with pre- and posttest surveys administered before and immediately after the program. The sample consisted of 105 voluntary clients and 118 court-mandated clients who underwent screening or drug dependency evaluation and were recommended for …

Old Frames On New Media: Health Misinformation In Black Digital Communities, Merriah Croston

Brown School Graduate Student Theses and Dissertations

Growing evidence suggests that health misinformation has the potential to proliferate on social media. However, our understanding of the problem’s magnitude continues to evolve. Despite several studies on health misinformation and Black communities in the United States (U.S.), few of these studies characterize misinformation within digital settings. This dissertation seeks to address this gap by: 1) synthesizing the literature on health misinformation and Black communities to identify prevalent misinformation topics and claims, characteristics of exposure to and belief in these topics and claims, and successful intervention strategies; 2) quantifying and characterizing the volume of COVID-19 misinformation on Black Twitter during …

Public Support For And Reactive Behavior Toward Technological Risk Interventions: An Extension Of Secondary Risk Theory, Hye Kyung Kim, Rui Gu, Fiona Goh, Sonny Rosenthal, Shirley S. Ho

Research Collection College of Integrative Studies

Project Wolbachia is a dengue control initiative in Singapore. Guided by Secondary Risk Theory, this study examined how primary (dengue) and secondary (Wolbachia) threat and coping appraisals shape public support and reactive behavior toward the project. A nationally representative survey of 1,000 Singaporeans showed that support was positively linked to the perceived primary risk, the efficacy of the project and the government, while negatively related to the perceived secondary risk. Reactive behavior was positively associated with perceptions of both primary and secondary risk. Media attention and trust in the government indirectly influenced support and behavior moderated by knowledge.

Policy Evaluation With Nonlinear Trended Outcomes: Covid-19 Vaccination Rates In The United States, Lynn Bergeland Morgan, Peter C. B. Phillips, Donggyu Sul

Research Collection School Of Economics

This paper discusses pitfalls in two way fixed effects (TWFE) regressions when the outcome variables contain nonlinear and possibly stochastic trend components. If a policy change shifts trend paths of outcome variables, TWFE estimation can distort results and invalidate inference, especially in a context of evolving policy decisions. A robust solution is proposed by allowing for dynamic club membership empirically using a relative convergence test procedure. The determinants of respective club memberships are assessed by panel ordered logit regressions. The approach allows for policy evolution and shifts in outcomes according to a convergence cluster framework with transitions over time and …

Accordance And Conflict Between Religious And Scientific Precautions Against Covid-19 In 27 Societies, T. Samore, D.M.T. Fessler, A.M. Sparks, C. Holbrook, L. Aarøe, C.G. Baeza, M.T. Barbato, P. Barclay, R. Berniūnas, J. Contreras-Garduño, B. Costa-Neves, M.P. Grazioso, P. Elmas, P. Fedor, Li, Norman P., R. Fernández-Morales, L. Garcia-Marques, P. Giraldo-Perez, P. Gul, F. Habacht

Research Collection School of Social Sciences

Meaning-making systems underlie perceptions of the efficacy of threat-mitigating behaviors. Religion and science both offer threat mitigation, yet these meaning-making systems are often considered incompatible. Do such epistemological conflicts swamp the desire to employ diverse precautions against threats? Or do individuals—particularly individuals who are highly reactive to threats—hedge their bets by using multiple threat-mitigating practices despite their potential epistemological incompatibility? Complicating this question, perceptions of conflict between religion and science likely vary across cultures; likewise, pragmatic features of precautions prescribed by some religions make them incompatible with some scientifically-based precautions. The COVID-19 pandemic elicited diverse precautions thus providing an opportunity …

Nursing Students’ Sociodemographic Characteristics And Consumer Preferences’ Prediction Level Of Perceived Food Literacy, Sinan Duru

Makara Journal of Health Research

Background: Food literacy, which is a critical competency for nursing students, plays a pivotal role in promoting evidence-based nutrition behaviors and contributes effectively to public health. This study aimed to determine the level of perceived food literacy among nursing students.

Methods: This cross-sectional study involved 488 nursing students from two universities in the south of Turkey. The research data were collected face to face via the Personal Information Form, the Consumer Preferences Form, and Self Perceived Food Literacy. The data was analyzed using the Independent Sample t Test, One Way ANOVA, and multiple linear regression.

Results: The …

Towards A New Health Politics In Kenya: Labor Organizing And Strikes By Health Workers In The Public Health Sector, Michael Scanlon

Graduate Doctoral Dissertations

There has been insufficient attention by global health scholars to labor organizing by health workers, including when and why organizing occurs, what forms and strategies it takes and its implications for governance and policy. These questions are critical but largely absent in research on what has been called the “global health workforce crisis.” Kenya represents an important case study. A new constitution in 2010 expanded institutional spaces for labor organizing and decentralized governance of the health system. Both reforms had significant implications for the health workforce and strikes by health workers have been pervasive. In 2017, nationwide strikes by public …

Barriers To Implementing Comprehensive Sexuality Education As A Strategy To Prevent Adolescent Pregnancy In Indramayu District, Indonesia, Een Kurnaesih, Chahya Kharin Herbawani, Nelly Febriani

Kesmas

The implementation of comprehensive sexuality education (CSE) is not optimal. This qualitative study aimed to identify and contextualize barriers to CSE implementation, specifically in Indramayu District, Indonesia. Conventional content analysis procedures were used. Seven participants, consisting of relevant authorities, were interviewed. A purposive sampling technique was employed to select participants. Data were collected through in-depth, semi-structured interviews. All interviews were recorded and transcribed verbatim. Data were analyzed using conventional qualitative content analysis. The barriers to CSE implementation in Indramayu District were identified across five themes: advocacy, technical considerations, coordination and collaboration, integration with other sexual and reproductive health projects, and …

Experiences Of Elderly Living With Noncommunicable Diseases In Utilizing Health Services In Myanmar During The Covid-19 Pandemic, Nway Eint Chei, Kwanjai Amnatsatsue, Natkamol Chansatitporn, Ariya Bunngamchairat

Kesmas

The COVID-19 pandemic and armed conflicts in Myanmar have intensified the challenges in accessing and utilizing health services, particularly for noncommunicable diseases (NCDs) among older adults. This qualitative study explored the experiences of the elderly with NCDs regarding health service accessibility and utilization in secure areas with fully operational health facilities by conducting in-depth interviews with 20 eligible older adults in Myanmar; data were analyzed using content analysis. Four key themes emerged: NCD service utilization patterns; unmet needs; preferences and hesitancy toward NCD services; and disparities, barriers, and opportunities. The findings revealed widespread underutilization of NCD services due to several …

Government Health Spending And Life Expectancy: Evidence From Cities And Districts In Indonesia, Kurnia Sari, Budi Hidayat, Amal Chalik Sjaaf, Mardiati Nadjib

Kesmas

Life expectancy is widely recognized as a fundamental indicator of population health, and its improvement is often linked to government health spending, particularly in decentralized health systems. This study aimed to investigate the relationship between local government health expenditures and life expectancy in decentralized Indonesia. Data from 492 cities and districts, spanning from 2015 to 2019, were analyzed using a two-way fixed effects regression model to control for time-invariant district characteristics and common temporal shocks. The findings indicated that a 10% increase per capita in government health expenditure was associated with a 0.01% increase in life expectancy. This association was …

Has Regional Hospital Autonomy Achieved Its Goals? Lessons Learned From Indonesia: A Systematic Review, Masyitoh Basabih, Indriaswari Widhakuswara

Kesmas

This study examined the impact of hospital autonomy implementation on the performance of regional public hospitals in Indonesia, particularly in terms of efficiency, effectiveness, and governance. A systematic review of 32 peer-reviewed studies published between June 12 and September 6, 2023, was conducted using Garba Rujukan Digital and Google Scholar, following PRISMA guidelines. Studies addressing financial performance, service outcomes, and challenges related to implementing autonomy were included. The findings indicated that while autonomy led to improvements in infrastructure, service types, visit volumes, and hospital revenues, it had only a marginal impact on improving key health performance outcomes, such as service …

Predicting Cardiovascular Mortality In Hampton Roads Using Social Determinants Of Health, Mohan D. Pant, Aditya Chakraborty, Prachi P. Chavan, George Mcleod, Brett J. Sierra, Glenn A. Yap, Brian C. Martin, Ebbie Kalan, Gregory T. Scott

Cardiovascular Research Symposium

Background: In Virginia’s Hampton Roads (HR) region, minority populations experience notably higher mortality rates than white populations. Despite abundant research on the association between social determinants of health (SDOH) and cardiovascular mortality rates at the state and national levels, there is a lack of research examining this association in the HR region.

Objective: The main objective of this study is to train and validate a geospatial-temporal predictive model to examine the association between SDOH and cardiovascular mortality, in the HR region.

Methods: Utilizing a longitudinal dataset (2010–2021) from the Virginia Department of Health and the U.S. Census Bureau, we trained …

Time Ticks Slowly For Kidney Transplant Reform: Eskd Patient Challenges And Opportunities, Gregory P. Hess

College of Population Health Faculty Papers

No abstract provided.

Enhancing Cataract Surgery Outcomes: Optimal Use Of Pre- And Post-Operative Eye Drops, Keith Skolnick M.D., Anu Valiaveedu

Mako: NSU Undergraduate Student Journal

Many preoperative and postoperative cataract patients struggle with comprehending the use of prescription medication as directed. Language barriers and low health literacy levels are major factors contributing to improper use of prescriptions. To increase patients comprehension, the Fort Lauderdale Eye Institute employed an educational intervention consisting of a live presentation and an instructional video. Results found that 44% of patients were hesitant to ask questions to clinical staff, 32% felt overwhelmed, and nearly 70% lacked confidence in using their prescribed eye drops. Following the intervention, 91% of patients reported increased confidence in their medications, and most indicated that the video …

A Religious Etiology Of Genito-Pelvic Pain And Pain With Penetration, Emily L. Carlson

Theses and Graduate Projects

Pelvic pain during penetration (PPDP) has been described using various diagnostic terms, including vaginismus, dyspareunia, and vulvodynia. The most recent and comprehensive classification is Genito-pelvic pain/penetration disorder (GPPPD) which is characterized by psychological distress associated with pain during or in anticipation of vaginal penetration (DSM-5-TR; American Psychiatric Association [APA], 2022). The etiology of PPDP is multifactorial, involving a complex interplay of biological, psychological, and relational factors. Religious and cultural influences may play a significant role in shaping individuals’ experiences of sexual pain. This study investigated the etiology of PPDP in relation to the religious influences among women raised in Judeo-Christian …

Is Health Insurance Related To Breastfeeding Duration?, Anna De La Paz

Population Health Research Brief Series

Breastfeeding duration, which plays an important role in shaping maternal and infant health, can be influenced by insurance type. This data slice uses data from the 2022-2023 National Survey of Family Growth (NSFG) to described differences in breastfeeding duration by insurance type among females ages 15-49 in the United States. Findings show that mothers with private insurance breastfeed longer than mothers with public insurance, such as Medicaid, net of controls for maternal age, race, education, and income.

Promising Practices To Address Healthcare Needs Voiced By Local Native Americans, Noelle Taylor, Mykin R. Higbee, Raiden Gaul

Transforming Communities

Purpose

To examine barriers and facilitators to nursing education among Native Americans and identify evidence-based strategies to increase the number of Native American nurses working in their local communities to address health disparities.

Background

Native Americans experience significantly higher rates of chronic illnesses such as diabetes and heart disease, and lower life expectancies. Only 4% of registered nurses identify as Native American, with no growth despite increased funding for diversity in nursing education. This underrepresentation contributes to culturally insensitive care and persistent healthcare inequities stemming from historical marginalization and trauma.

Methods

A comprehensive literature review was conducted using CINAHL, PubMed, …

A Feasibility Study To Mitigate Arsenic Exposure In Well Water In Oregon, Christine Lucas-Woodruff, Veronic L. Irvin, Laura Nielsen, Meghan Megowan, Lilly Anderson, Julia Pavlosek, Molly Kile

Journal of Extension

Approximately 13 million households in the United States rely on private wells for their drinking water. It is the homeowner’s responsibility to manage the quality of water in their private wells. There are many toxic contaminants that can be present private wells that can negatively impact health. Extension Agents are well positioned to assist homeowners in understanding how to manage toxics in private wells. This study demonstrated the feasibility that motivational education provided by an Extension Agent’ trained in motivational interviewing techniques is able to help homeowners with private wells mitigate their exposure to arsenic by adopting appropriate water treatment.

Analyzing Food Access: An Investigation Of Food Insecurity Amongst Latinos In Rural Nebraska, Natalia Santos

Theses & Dissertations

Background: Food insecurity is a public health issue in the United States, with disproportionately higher rates among Latino/Hispanic households. Rural communities face unique geographical, socioeconomic, and systemic barriers that often exacerbate food access disparities. Despite the growing Latino population in rural areas, particularly in Midwestern states like Nebraska, there remains a critical gap in comprehensive research that integrates both objective and subjective understandings of their food environments. Understanding these multifaceted influences is crucial for developing effective, culturally sensitive interventions.

Problem Statement: This dissertation aims to answer the central question: How does food access and food insecurity manifest amongst Latinos in …

More Than A Feeling: A Mixed-Methods Examination Of Transgender Community Connectedness And Associations With Suicidality, Erin Rook

UNLV Theses, Dissertations, Professional Papers, and Capstones

Transgender adults experience significantly higher rates of suicidal ideation than the general population. A sense of transgender community connectedness (STCC) may reduce this risk, but predictors of STCC and its association with suicidal ideation are understudied. This cross-sectional mixed methods study examined STCC and past-year suicidal ideation in relation to dimensions of transgender community connectedness (TCC) at each level of the Social Ecological Model using data from a U.S. survey of transgender adults (n = 126). About half (52.4%) felt connected to the transgender community, and 27.0% reported past-year suicidal ideation. Hierarchical logistic regression models for both outcomes showed good …

A Qualitative Analysis Of The Lived Experience Of Active-Duty Servicewomen Receiving Perinatal Care Within The Military Health System., Caitlin Russell, Emily Balog, Anne Teitelman, Rosemary Polomano

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: We explored the lived experiences of active-duty servicewomen (ADSW) accessing and receiving care during the perinatal period (from discovery of pregnancy to 1 year postpartum) within the Military Health System.

STUDY DESIGN: Using qualitative methods, we conducted semi-structured interviews between September 2022 and February 2023 with 23 ADSW participants who were pregnant or within their first year postpartum. Data were analyzed using inductive coding and thematic analysis techniques.

RESULTS: Participants reported bureaucratic hurdles and long wait times for accessing care, too little choice in providers, and inadequate coordination between civilian and military care providers. Those who experienced perinatal complications …

Increasing Implementation Of The Comfortable Cafeteria Program To Promote School-Age Children’S Mental Health And Well-Being, Reinecka Mondesir, Angela Labrie Blackwell Phd, Otr

Summer 2025 OTD Capstone Symposium

Every Moment Counts (EMC) is a positive mental health promotion initiative that offers several initiatives to create inclusive environments that support student participation and emotional well-being throughout the school day. Comfortable Cafeteria, part of EMC, fosters positive mealtime experiences supporting peer interaction, emotional regulation, and inclusion. Many SBOT practitioners lack the resources to implement Comfortable Cafeteria, despite its benefits. This capstone project addresses the need for practical tools to help school-based occupational therapy (SBOT) practitioners integrate the Comfortable Cafeteria program into daily practice. Using the Multi-Tiered System of Supports (MTSS) framework, the project developed and disseminated an interactive, evidence-based video …