Public Health Commons^™

Dissemination And Implementation Approach To Increasing Access To Local Pre-Exposure Prophylaxis (Prep) Resources With Black Cisgender Women: Intervention Study With Vlogs Shared On Social Media, Mandy J Hill, Laurenia Mangum, Sandra J Coker, Tristen Sutton, Diane M Santa Maria

Faculty, Staff and Student Publications

Background: Black cisgender women account for only 2% of pre-exposure prophylaxis (PrEP)-eligible people in the United States who use PrEP to prevent HIV. Owing to the low PrEP use, Black cisgender women continue to contract HIV more frequently than women from every other racial group. Intervention efforts that can bridge the link between knowing that PrEP prevents HIV and support with access to PrEP are necessary for Black cisgender women.

Objective: The purposes of the vlogs through the campaign were to share information about ways to prevent HIV using PrEP and fact-based education and provide access to PrEP resources with …

Breast Cancer Diagnoses Are Increasing Among Racial And Ethnic Minority Women In The U.S., Esther Oshaji

Population Health Research Brief Series

Breast cancer is the second most common cancer and a leading cause of cancer deaths among women in the United States. This data slice uses data from the Surveillance, Epidemiology and End Results Program (SEER) Incidence Database to examine trends in breast cancer incidence rates among women by race and ethnicity in the U.S. from 2000 to 2021. The author finds that, while incidence rates remain highest among non-Hispanic White women, the largest increases in diagnoses have been among American Indian/Alaska Native Asian/Pacific Islander women.

Spatial And Seasonal Dynamics Of Mosquito Species In Harris County, Texas, Highlight Risk Of Arbovirus Introduction And Transmission, Morgan Jibowu, Maximea Vigilant, Andre Luis Costa-Da-Silva, Alisa Nelson, Heather T Essigmann, Eric L Brown, Sarah M Gunter

Faculty, Staff and Student Publications

Mosquito-borne diseases pose a significant public health threat, particularly in densely populated urban areas. Climate change, urbanization, and global connectivity have fueled the expansion of mosquitoes and their associated pathogens, increasing the disease burden. Harris County, Texas, is among the most vulnerable regions in the United States for mosquito-borne disease outbreaks, underscoring the critical need for localized insights into mosquito population dynamics to inform vector surveillance and control strategies. This study provides a comprehensive analysis of the population dynamics of mosquito species in Harris County by exploring their species composition, spatial distribution, and seasonal patterns. Our findings reveal the extensive …

Exploring The Causes Of Plwha Non-Adherence With Antiretroviral Therapy: Implications For Practice In The Post-Covid-19 Era, A Phenomenological Study, Adriani Suwito, Evi Hasnita, Nurhayati -. Nurhayati, Oktavianis -. Oktavianis

The Qualitative Report

One of the goals of HIV/AIDS health services is to combat patients’ non-adherence with medication. This is the key to providing effective care for these patients. If a patient is rebellious or undisciplined in following his treatment regimen, the consequences can include decreased production, increased morbidity, and even death. However, in the post-COVID-19 period, where health protocol adherence remains strong, there are concerns regarding the potential spread of HIV/AIDS. The purpose of this qualitative phenomenon study is to investigate the factors that contribute to non-adherence to medicine in HIV/AIDS patients during the post-COVID-19 condition to remove barriers to patient treatment. …

Value-Based Healthcare Reimagined: A Mixed-Methods Study On Behavioral Health Clinicians' Perspectives, Amanda L. Strickland

Electronic Theses and Dissertations

This study explores how behavioral health clinicians perceive Value-Based Healthcare (VBHC), a model designed by Porter and Teisberg (2006) to improve outcomes relative to costs. While widely promoted in healthcare reform, VBHC poses unique challenges when applied to behavioral health settings. Using an explanatory mixed-methods design, this study first assessed clinicians’ awareness of VBHC through a survey of 23 licensed clinicians at a Community Mental Health Center (CMHC) in Colorado. Quantitative findings revealed that one-third of participants were aware of VBHC with awareness differing by role prompting further exploration in a qualitative phase. Semi-structured interviews with eight clinicians provided deeper …

The Importance Of Recruitment Of Low-Income Pregnant Persons In Interdisciplinary Research To Understand The Impact Of Social And Environmental Determinants: Lessons Learned About Implementation And Recruitment, Erika R. Marquez, Amanda Haboush-Deloye, Elizabeth M. Lawrence, Selam Ayele, Courtney Coughenour, Nora Doyle, Wynona Dizon, Lizbeth Perez Rodriguez, Chloe Bombara

Environmental & Global Health Faculty Research

Background: Prior research indicates that enrolling underrepresented populations in clinical research is challenging. Although research has identified some barriers to participation and strategies to overcome them, studies have made little progress in being inclusive and representative. There remains a great need for including racial/ethnic minorities, low-income families, and pregnant women in research. The purpose of this article is to describe the implementation of enrollment strategies used in our study to understand the feasibility of building a maternal cohort and better understand the relationship between environmental and social impacts on maternal exposure and child outcomes.

Methods: Working across multiple academic units, …

Older Women In The U.S. Were Lonelier Than Men During The Covid-19 Pandemic, Qiyu Deng

Population Health Research Brief Series

Loneliness damages health and quality of life. The COVID-19 pandemic increased social isolation and loneliness among some groups in the U.S. This data slice uses data from the 2020 Health and Retirement Study to examine gender and age differences in loneliness among older adults (50+) in the U.S. during the first year of the pandemic. The author finds that loneliness was more prevalent among women than among men, with the highest rate among women ages 80 and older.

Heart Failure In Black Populations: Epidemiology, Pathophysiology, And Treatment Disparities, Kazi N. Islam, Rahib K. Islam, Ivan Nguyen, Yasmeen Magherahabed, Humza Pirzadah, M. Bazlur Rashid

School of Medicine Faculty Publications

Heart failure (HF) remains a significant health challenge globally, placing a heavy burden on individuals, families, and healthcare systems. The prevalence of HF continues to rise, posing substantial public health concerns. This burden is particularly pronounced among the Black Population, who face higher prevalence, earlier onset, and greater severity of HF compared to other racial and ethnic groups. This review explores the multifaceted landscape of HF in Black individuals by examining epidemiological patterns, pathophysiological mechanisms, clinical presentations, treatment disparities, and clinical outcomes. Black individuals exhibit distinct pathophysiological characteristics, such as genetic variations contributing to heightened susceptibility and severity of HF. …

Outcomes Of Double Free Flap Reconstruction For Advanced Head And Neck Tumors In A Safety-Net Hospital Population, Yossef Alsabawi, John M. Gaddis, Angela D. Haskins, Jonathan Shum, David J. Hernandez

Research Symposium

Background: Double-free flap reconstruction has emerged as a viable option for addressing more complicated defects after oncologic resection. We aim to report the feasibility of this approach at a single-institutional safety net hospital.

Methods: A retrospective chart review was performed between November 2020 and October 2023 for adult patients who underwent multiple, simultaneous free tissue transfers for head and neck defects following tumor resection. This study occurs at Ben Taub Hospital, a safety net hospital in Houston, Texas. Data collected included demographics, risk factors, oncologic and operative details, complications, and functional and disease outcomes. Socioeconomic status was assessed …

Overcoming Vaccine Hesitancy: Evidence From Italy During The Covid-19 Pandemic, Alessandro Del Ponte, Audrey De Dominicis, Paolo Canofari

Political Science Faculty Articles and Research

Objectives

Study design

Associations Among Shopping Methods, Diet Adherence, And Nutrition Knowledge Of Employed Primary Grocery Shoppers In Households With Children, Baylee Schneider

Master's Theses

Obesity is a prominent risk factor for chronic disease, which is the leading cause of death in the United States. Obesity and chronic disease rates continue to rise, requiring a need for prevention and intervention efforts. The future role of dietetics is to provide treatment and prevention through holistic approaches, by understanding individuals’ habits that contribute to the onset of disease, specifically their food choices, grocery shopping methods, and influences that waver these selections. The purpose of this study is to evaluate the relationship between grocery shopping methods (online or in-store), Mediterranean diet adherence, nutrition knowledge, and food purchase patterns …

From Past To Present: Tracing Africa’S Path To Universal Health Coverage, Evaline Chepchirchir Langat, Paul Russell Ward, Hailay Abrha Gesesew, Lillian Mwanri

Centre of Excellence in Women and Child Health

At the 58th World Health Assembly in 2005, the international community charted a course for universal health coverage (UHC), aiming to ensure access to health care for all in need, of sufficient quality, and without causing financial hardship. At the time, barriers to accessing health care were overwhelming, particularly in low-and middle-income countries like Africa. Currently, 50 of Africa’s 54 countries are in various phases of UHC implementation. Some are developing national UHC agendas, while others have made significant progress but still face gaps in meeting UHC targets. This mini review comprehensively examines the literature to understand the temporal and …

Risk Factors And Public Health Interventions Associated With Adolescent Pregnancy Prevention Among Females Aged 10–19 Years In Kenya: A Scoping Review Protocol, Kimbley Asaso Omwodo, Abdu Mohiddin, Danielle Denwood, Augustine N. Gitonga

Centre of Excellence in Women and Child Health

Background ; Adolescent pregnancy is associated with multifaceted challenges that impact countries’ health, education and economic stability. Despite ongoing interventions, in developing countries such as Kenya, adolescent pregnancy rates continue to be high. There is a need for more synthesised evidence on regional-specific risk factors to support tailored prevention strategies.

Objective; This scoping review aims to explore what is known about the risk factors and intervention strategies focused on adolescent pregnancy prevention in Kenya.

Methods and analysis; Using the Arksey and O’Malley framework combined with a three-step search strategy as recommended by the Joanna Briggs Institute, relevant articles will be …

Violence Against Healthcare Workers In Kenya: A Cross-Sectional Sub-Analysis Of The Global Vishwas Study, Reena Shah, Jasmit Shah, Rakhtan K. Qasba, Ruman K. Qasba, Annastacia Mbithi, Eric Njenga, Akshat Banga, Rahul Kashyap, Salim Surani

Institute for Educational Development, East Africa

Background: Global concern exists for workplace violence against healthcare workers (HCWs), especially in low and middle-income nations. This violence includes physical, verbal, or sexual abuse and has a significant impact despite initiatives like Occupational Safety and Health Administration (OSHA) guidelines. We conducted a study in Kenya to address this issue.

Methods: We did a cross-sectional survey that collected responses during June 6th to August 9th, 2022, focused on healthcare professionals in Kenya within the global ViSHWaS study. Violence against healthcare professionals in multiple Kenyan counties was analysed, The study reached participants through social media, emails, and other channels using a …

The Swahili Version Of The Cd-Risc 10 Resilience Scale: Psychometric Properties And Factors Associated With Resilience Among Healthcare Workers In Tanzania, Kevinson Mwangi, Sabina Odero, Gideon Mbithi, Rachel Odhiambo, Rosemary Stephen, Tumbwene Mwansisya, Eunice Pallangyo, Eunice Ndirangu, Amina Abubakar

Institute for Human Development, East Africa

Background: Despite the central role of resilience in promoting mental well-being, little is known about the resilience process among healthcare workers in East Africa, partly due to the lack of adequately standardised and psychometrically sound assessment tools for our context. This study provides the first psychometric evaluation of the Swahili version of the Connor-Davidson Resilience Scale 10 (CD-RISC 10) among nurses/midwives and community health volunteers (CHVs) in Tanzania, potentially informing the accuracy of measuring resilience in this setting. Additionally, we examine factors associated with self-reported resilience as measured by the CD-RISC 10 scale.

Methods We used cross-sectional data on nurses/midwives …

Substance Use Among Healthcare Professionals: A Cross-Sectional Study In Kenya, Jasmit Shah, Cynthia Smith, Cyprian Mostert, Linda Khakali, Zul Merali, Sayed Karar

Brain and Mind Institute

Substance use among healthcare professionals, including alcohol, tobacco, marijuana, benzodiazepines etc., is a rising concern. The immensity of substance use is not yet clear, though recently, studies conducted on medical students and physician trainees show that 10% to 15% of all healthcare professionals misuse drugs at some point in their career, and that 6% to 8% of physicians have a substance use disorder. Substance use has a direct impact on relationships, physical health, and job performance, and is associated with depression, burnout, and decreased career satisfaction. The aim of this study was to shed light on the prevalence of substance …

The Cross-Sectional Association Between Lifestyle Behaviors And Breast And Cervical Cancer Screening Among Hispanic Women Along The Texas-Mexico Border, Paul Gerardo Yeh, Audrey C Choh, Susan P Fisher-Hoch, Joseph B Mccormick, David R Lairson, Belinda M Reininger

Faculty, Staff and Student Publications

Objective: Lifestyle behaviors may influence timely cancer screening, but their relationship is unknown among Hispanic women who have low cancer screening rates.

Methods: We used Cameron County Hispanic Cohort data from 2014 to 2022 to evaluate the relationship between lifestyle and compliance with mammography and Papanicolaou (Pap) screening guidelines ("up-to-date") among Hispanic women along the Texas-Mexico border. The 2018 World Cancer Research Fund scoring system characterized cancer-preventive lifestyle adherence. Multivariable logistic regression assessed the association between lifestyle behaviors and mammography and, separately, Pap screening.

Results: Among 385 age-eligible women for mammography and 412 age-eligible women for Pap test screening, up-to-date …

"Our Vision Is That Black Mothers And Birthing People, Fathers, And Partners Are Safe, Honored, And Respected Throughout Pregnancy And Parenthood": Black Birth Workers' Agenda For Black Maternal Health In Oregon, Sarah Marguerite Applin

University Honors Theses

Black women and Birthing People (BWBP) face disproportionate rates of mortality within the United States healthcare system. BWBP are three times more likely to suffer a pregnancy-related death than White women. Therefore, addressing and consulting with BWBP about the birthing experience that BWBP sustains when they are bearing children is imperative. The inclusion and application of this key knowledge and understanding should be emphasized and at the root of further development toward reproductive justice. This participatory story was led by Dr. Roberta Hunte. Interviews and focus groups with Black birth workers, birthing people, and public health professionals were conducted in …

Framework, Design, And Baseline Data Of A Collective Impact Initiative To Strengthen The Community Health Worker Workforce Ecosystem In Texas, Shreela V Sharma, Heidi Hagen Mcpherson, Jemima John, Rosalia Guerrero, Sisan B Tennyson, Deborah Banerjee, Nadia Siddiqui, Sheila Savannah, Peter Durand, Amanda Gao, Sean A Haley, Elisa Garcia, Jennifer Cofer, Adrick Harris

Faculty, Staff and Student Publications

BACKGROUND: The Health Equity Collective (HEC), a multi-sector systems-level collective impact coalition in the Greater Houston region, partnered with the City of Houston Health Department (HHD) to launch a 2-year effort to implement a comprehensive approach towards strengthening the regional Community Health Workers (CHW) workforce infrastructure as a pathway to advancing health equity. Our paper presents the logic model, methods, and baseline qualitative and quantitative data from this initiative.

METHODS: In the fall of 2022, the Health Equity Collective brought together a Network of CHW-employing or training organizations in the Greater Houston region. This Network was the working group of …

Investigating Mental Health Disparities In Rural Sexual And Gender Minority Adults: Protocol For The Rural Exploration And Approaches To Lgbtq + Mental Health (Realm) Prospective Cohort Study, Shoshanna L. Fine, Kalai Willis, Iaah L. Lucas, Kirsten F. Siebach, Jennifer L. Glick, Mariah Valentine-Graves, Savannah Winter, Michael Smith, Thomas Waltz, Gina Bailey Herring, Marissa Hannah, Holly C. Wilcox, Travis Sanchez, Stefan D. Baral, Sarah M. Murray

School of Public Health Faculty Publications

BACKGROUND: Sexual and gender minority (SGM) persons experience substantial mental health disparities throughout the life course, including increased vulnerability to depression and suicide. Few existing studies, however, have explored how pervasive experiences of SGM-related stigma, discrimination, and trauma (i.e., minority stress) contribute to adverse mental health outcomes among diverse sub-populations of SGM adults living in rural areas of the United States. This paper describes the protocol for a prospective cohort study, "Rural Exploration and Approaches for LGBTQ + Mental Health (REALM)," that will explore minority stress in relation to mental health conditions and suicidal behaviors among rural SGM adults. METHODS: …

Ask The Experts: Community Engagement Studios To Inform Research On Cannabis Use In Cancer Symptom Management, Brittney Greene, Grace Mckenzie, Keenan Gibbons, Salimah Meghani, Brooke Worster, Rebecca Ashare

Institute of Emerging Health Professions Faculty Papers

AIM: Despite one-third of patients with cancer using cannabis for symptom management, little is known about their access to and usage of cannabis. Community Engagement (CE) studios involving community experts with chronic health conditions were used to inform a qualitative study on access to and use of cannabis products among patients with cancer.

METHOD: We conducted two 2-hour CE studios with residents from Western NY (WNY) (N = 18). Our sample primarily included White and Black residents (56% vs. 39%). After a researcher-led 10-minute presentation, a community facilitator led the discussion, which focused on questions about challenges to cannabis …

Investigating Suicide Risk Factors Among Appalachian West Virginian Adults, Erin D. Caswell, Angela M. Dyer, Summer D. Hartley, Caroline P. Groth, Mary Christensen, Sahiti K. Tulabandu, Bryce K. Weaver, Ruchi Bhandari

Journal of Appalachian Health

Introduction: Suicide rates in the United States have increased over the past two decades, with rural areas, particularly the Appalachian Region, facing unique challenges that elevate suicide risk. These include economic hardships, social isolation, and limited access to mental health services.

Purpose: This study addresses critical gaps in understanding lifetime suicide risk in West Virginia (WV), a predominantly rural state entirely within the Appalachian Region. By identifying the factors driving urban-rural differences in suicide risk, this research seeks to inform interventions tailored to the state's distinct needs and provide insights applicable to the broader Appalachian Region

Methods: Using 2021 Mountain …

Current Attitudes And Barriers Among Appalachian Patients Towards Orthopaedic Surgery, Dylan Smith Md, Justin B. West Ms, Wade Smith Md, Micah Macaskill Md, Jonathan Lash, Matthew W. Bullock Do, Mpt

Journal of Appalachian Health

Introduction: This study explores the challenges faced by residents of rural West Virginia in accessing orthopaedic care due to geographic and socioeconomic barriers.

Purpose: This study seeks to survey rural West Virginia residents about their attitudes and experiences regarding access to orthopaedic care in southern West Virginia.

Methods: A total of 132 electronic surveys were collected from rural West Virginia residents during an appointment with their primary care provider located at an affiliated outreach clinic. The survey was designed to investigate various factors influencing their access to orthopaedic care.

Results: Delays in seeking orthpaedic care are common in rural West …

The Journal Of Appalachian Health: A Year Of Growth And Impact, Noah Wren, Bradley Firchow, Emily Wilson, Randy Wykoff

Journal of Appalachian Health

The Journal of Appalachian Health continues to grow in strength and reach, serving as a critical platform for research and discussion on the unique health challenges and opportunities in Appalachia, as well as how the challenges and opportunities Appalachia faces are local manifestations of broader regional and global phenomena. Over the past year, we have witnessed a remarkable expansion in our readership, reflecting the increasing demand for evidence-based insights into the health of our region.

The Quic-Sp: A Spanish Language Tool Assessing Unpredictability In Early Life Is Linked To Physical And Mental Health, Sabrina R. Liu, Natasha A. Bailey, Sara Romero-González, Amy Moors, Belinda Campos, Elysia P. Davis, Laura M. Glynn

Psychology Faculty Articles and Research

Accumulating evidence indicates that unpredictable signals in early life represent a unique form of adverse childhood experiences (ACEs) associated with disrupted neurodevelopmental trajectories in children and adolescents. The Questionnaire of Unpredictability in Childhood (QUIC) was developed to assess early life unpredictability, encompassing social, emotional, and physical unpredictability in a child’s environment, and has been validated in three independent cohorts. However, the importance of identifying ACEs in diverse populations, including non-English speaking groups, necessitates translation of the QUIC. The current study aims to translate and validate a Spanish language version of the QUIC (QUIC-SP) and assess its associations with mental and …

What Factors Influenced Covid-19 Vaccine Hesitancy? Evidence From Social Media, Huseyin Zeyd Koytak

Population Health Research Brief Series

Vaccine hesitancy is one of the most significant threats to global public health efforts. Despite the rapid development and deployment of effective vaccines, resistance to vaccination has persisted in many communities, undermining collective immunity and prolonging health crises, including most recently the COVID-19 pandemic. This brief summarizes findings from a study that used data from over 50 million tweets (later rebranded as X) from 2020 to 2022 to investigate the patterns, justifications, and socioeconomic roots of vaccine hesitancy in the United States. The authors find that Twitter users in states with lower levels of education, higher poverty and unemployment rates, …

Genome-Wide Association Study Reveals Shared And Distinct Genetic Architecture Of Fatty Acids And Oxylipins In The Hispanic Community Health Study/Study Of Latinos, Carolina G Downie, Heather M Highland, Mona Alotaibi, Barrett M Welch, Annie Green Howard, Susan Cheng, Nick Miller, Mohit Jain, Robert C Kaplan, Adam G Lilly, Tao Long, Tamar Sofer, Bharat Thyagarajan, Bing Yu, Kari E North, Christy L Avery

Faculty, Staff and Student Publications

Bioactive fatty acid-derived oxylipin molecules play key roles mediating inflammation and oxidative stress. Circulating levels of fatty acids and oxylipins are influenced by environmental and genetic factors; characterizing the genetic architecture of bioactive lipids could yield new insights into underlying biology. We performed a genome-wide association study (GWAS) of 81 fatty acids and oxylipins in 11,584 Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants with genetic and lipidomic data measured at study baseline (58.6% female, mean age = 46.1 years (standard deviation 13.8)). Additionally, given the effects of central obesity on inflammation, we examined interactions with waist circumference using two-degree-of-freedom …

Covid-19 Vaccine Hesitancy Among Black Women In The Us, Brittany C Slatton, Farrah G Cambrice, Serwaa S Omowale

Faculty, Staff and Student Publications

IMPORTANCE: COVID-19 vaccine hesitancy among Black women is a critical public health concern, potentially exacerbating existing health disparities and impacting community-wide vaccination efforts.

OBJECTIVE: To explore the factors associated with COVID-19 vaccine hesitancy among Black women in the US and identify the specific concerns and experiences shaping hesitant attitudes toward vaccination.

DESIGN, SETTING, AND PARTICIPANTS: Qualitative study using in-depth, semistructured interviews conducted virtually between June and November 2021. Thematic analysis was used to identify key themes from the interview data. Participants were recruited through social media platforms and word-of-mouth referrals from various regions of the US. Interviews were conducted remotely …

Suicide Exposure In The Army National Guard: A Three Manuscript Dissertation, Rebecca Willis-Nichols

Theses and Dissertations--Social Work

Between 2000-2022, the U.S. suicide rate increased 36% with one death now occurring every 11 minutes (CDC, 2024). Despite the Department of Defense making a concerted effort to curb the suicide increases in their ranks, the rates have continued to rise. Active-duty component rates have slowly increased since 2011 while reserve and guard components have held steady (U.S. Department of Defense, 2023). After adjusting for age, the suicide rate in the veteran population was 57% greater than the civilian population in 2020 (CDC, 2024). There is a need for a better understanding of the impact of these deaths and the …

Developing A Culturally Sensitive Nursing Framework For Muslim Patients Practicing Ramadan: Focusing On Fasting Benefits And Islamic Dietary Recommendations, Amreen M. Munshi

Nursing | Senior Theses

Background: Muslims practice Ramadan, a month-long period of fasting from dawn to dusk, yet many healthcare providers lack knowledge of its principles and practices. Hospitals lack formal education on caring for fasting Muslim patients, leading to a knowledge deficit in cultural competence and sensitivity of Islamic practices. Purpose: This paper proposes a research design for a nurse education program on Ramadan fasting to promote cultural competence and sensitivity in nursing care. The proposed research aims to educate nurses on Islamic practices, particularly Ramadan, to bridge the cultural competency gap. The literature review also explores the health benefits of …