Public Health Commons^™

Applying The Ecological Model Of Medical Encounters To Understand Patient-Centered Communication For Older Korean Migrants In The U.S., Seulgi Park

Electronic Theses & Dissertations (2024 - present)

Patient-Centered Communication (PCC) is defined as an approach that places patients at the center of communication with healthcare providers. PCC has been recognized as a strategy to address disparities experienced by minority populations. However, despite its associations with positive health outcomes and ethical significance, there has been a paucity of research on PCC in minority populations such as older Korean migrants in the U.S. Understanding PCC within this group may contribute to improving healthcare communication tailored to their needs. This dissertation aimed to (1) explore the expectations of PCC in primary care settings among older Korean migrants in the U.S., …

Formation, Operation, And Maintenance Of A Community Advisory Board For Research With Lgbtq+ Parents, Aubrey Jones, Olivia S. Yinger, Rachel H. Farr, Keisa Fallin-Bennett, Sabrina Beiring, Cassi Crouse, Carolyn Greenstrom

Transforming Communities

Community-engaged research is becoming increasingly popular to promote health equity. Objective: The purpose of this paper is to describe the formation, operation, and maintenance of a community advisory board (CAB) of LGBTQ+ parents and healthcare providers who work with LGBTQ+ parents. Method: Using Newman and colleagues outline, we describe the formation, operation, and maintenance phases of our CAB process. Inclusion criteria for CAB members is as follows, CAB members must be 18 years of age or older, live in the U.S., and (a) self-identify as LGBTQ+ and have had a child in the NICU more than five years prior to …

The Camden Study - A Pregnancy Cohort Study Of Pregnancy Complications And Birth Outcomes In Camden, New Jersey, Usa., Stephanie Shiau, Xinhua Chen, Ayana April-Sanders, Ellen C Francis, Shristi Rawal, Megan Hansel, Kehinde Adeyemi, Zorimar Rivera-Núñez, Emily S Barrett

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Pregnancy is a unique stage of the life course characterized by trade-offs between the nutritional, immune, and metabolic needs of the mother and fetus. The Camden Study was originally initiated to examine nutritional status, growth, and birth outcomes in adolescent pregnancies and expanded to study dietary and molecular predictors of pregnancy complications and birth outcomes in young women.

METHODS: From 1985-2006, 4765 pregnant participants aged 12 years and older were recruited from Camden, NJ, one of the poorest cities in the US. The cohort reflects a population under-represented in perinatal cohort studies (45% Hispanic, 38% non-Hispanic Black, 17% White …

¿Qué Futuro Les Espera A Los Trabajadores Latinos? El Calor Extremo, Las Promesas Vacías Y La Incertidumbre Política, Yunior Rivas Garcia

Capstones

Este artículo explora las condiciones mortales que enfrentan los trabajadores latinos en Estados Unidos debido al estrés por calor, un riesgo creciente en sectores esenciales como la construcción, la agricultura y el almacenamiento. A pesar de representar una proporción significativa de las muertes laborales, las protecciones contra el calor son insuficientes, y la falta de regulación federal agrava la vulnerabilidad de estos trabajadores, muchos de los cuales son indocumentados. A través de casos específicos, como la muerte de Esvin Cruz Mateo, y un análisis de las políticas laborales actuales, el texto examina las fallas estructurales que perpetúan la inseguridad laboral …

Disparities In The Pregnancy Experience: A Multi-Case Analysis, Tiffany C. Thomas, Lindsay Gietzen

Pacific Journal of Health

Racial disparities in maternal healthcare continue to be a significant issue, with Black women experiencing worse outcomes compared to White women. Despite improvements in healthcare, Black women are still 2.5 times more likely to die from pregnancy-related causes, and they face higher rates of preterm births, low birth weight, and insufficient prenatal care. This paper examines the experiences of three African American women from high socioeconomic backgrounds, focusing on where these negative experiences are most common throughout pregnancy, childbirth, and postnatal care. The study uses the Pregnancy and Maternity Care Patients' Experiences Questionnaire (PreMaPEQ) to explore different stages of care, …

Covid For One: Identifying Obstacles To Self-Management Of Covid-19 For Single Adults, Linda A. Treiber, Christie Emerson, Jenna Shackleford

Faculty Articles

Given the complexities of healthcare provision, it is imperative to understand how single adults experience their interactions with medical professionals and health care organizations, manage care and treatment, and navigate the barriers encountered. This study’s purpose is to understand physical and mental health experiences in consideration of social determinants of health, barriers, and coping strategies for single adults diagnosed with COVID-19. An interpretive phenomenology study design was used with 12 individuals who were single and living alone during the COVID-19 pandemic. Semi-structured, open-ended interviews revealed important aspects of the COVID-19 illness experience. Interviews were transcribed for coding and thematic analysis. …

Delinquency And Inadvertent Neglect As Byproducts Of Work-Addicted Parents, Shelley Sasser

Bridges: A Journal of Student Research

Over the past decade, discussions of work addiction throughout academic literature have increased substantially. However, the relationship between childhood outcomes and parental work addiction has yet to be explored. In this study, I set out to identify functions of parent-child relationships and comparisons of situational outcomes stemming from work addiction in relation to social determinants such as income, ethnicity, and gender, along with resulting stratification. The degree to which children benefit from features of lifestyles typically associated with high household incomes, such as financial security, health care benefits, access to educational resources, and neighborhood socioeconomic advantage, wherein parental work-addiction might …

Challenging Myths & Addressing Intimate Partner Sexual Violence In Lgbtq+ Relationships, Nora K. Whitten

SPARK Symposium Presentations

Intimate partner violence (IPV), including intimate partner sexual violence (IPSV), is a public health crisis that disproportionately affects members of the LGBTQ+ community. This paper draws upon related, though limited, research to identify the five prevalent myths surrounding IPSV in LGBTQ+ relationships, addressing the following misconceptions: 1) IPSV can only occur in heterosexual relationships, 2) IPSV in LGBTQ+ relationships is not as severe, 3) Women cannot commit acts of sexual violence, 4) The more “masculine” partner is always the perpetrator, and 5) IPSV is a “mutual fight” among partners of the same sex. These myths perpetuate victim-blaming, minimize the severity …

Exposing The Disaster Disparities And Experiences On College Campuses, Deleanor Kirkpatrick Murray

All-Inclusive List of Electronic Theses and Dissertations

Challenges in higher education continue to arise, providing administrators with insights into how prepared—or unprepared—their institutions may be for future crises. The purpose of the study is to examine how mid-level leadership, staff, and students perceived the disaster response to Hurricane Ida during the 2021–2022 academic year. Using the theoretical frameworks of the Four-Frame Model (Bolman & Deal, 2021), Critical Race Theory (Delgado & Stefancic, 2017), and Institutional Theory (Manning, 2018), this case study employed interviews with 8 participants. Data analysis resulted in the emergence of 7 major themes and 11 sub-themes. The findings from the study suggest that participants …

Obesity: Influencing Behavioral Consumption Through Meal Kit Distribution, Alejandro Hernandez

Capstone Projects and Master's Theses

Founded in 2002, Everyone’s Harvest is a grassroots nonprofit dedicated to providing access to healthy, affordable fruits and vegetables through certified farmers markets and community food programs. Its key initiatives—Fresh Rx, Market Match, Edible Education and Farms Together —focus on alleviating nutrition insecurity and combating diet-related health conditions by providing vulnerable populations the resources to purchase, or receive, fresh produce and gain nutritional knowledge. This study explores a new intervention: the distribution of farmers' market meal kits as a complementary strategy to the current Edible Education program. These meal kits, which feature seasonally available produce and pre-measured ingredients, aim to …

Understanding The Association Between Neighborhoods And Adolescent Sleep: Evidence From Add Health, Sam J Neally, Breanna J P Rogers, Yangyang Deng, Mohammad Moniruzzaman, Qian Xiao, Kosuke Tamura

Faculty, Staff and Student Publications

INTRODUCTION: Research suggests that perceived neighborhood social environments (PNSE) may contribute to gender and race/ethnicity-based sleep disparities. Our study aimed to examine associations between PNSE factors and adolescents' sleep patterns. As a secondary aim, we examined how gender and race/ethnic groups might moderate these associations.

METHOD: Data came from the National Longitudinal Study of Adolescent to Adult Health (n=5158; mean age=15.34 years). Four self-reported sleep outcomes were created: 1) sleep duration (hours/night), 2) short sleep (≥8 hours [reference] vs <8 >hours), 3) parental set bedtime (10:00 PM/earlier [reference] among girls vs by 11:00PM vs by/after 12:00AM), and 4) sleep satisfaction (enough …

Economic Disadvantage During Childhood, Obesity, And Diabetes Across Three Birth Cohorts Of Older Mexicans, Jesús-Daniel Zazueta-Borboa, Rafael Samper-Ternent, Rebeca Wong, Neil Mehta

Faculty, Staff and Student Publications

OBJECTIVES: Diabetes prevalence has increased markedly in Mexico. We examined the individual and joint contributions of economic disadvantage during childhood (EDDC) and elevated body weight on diabetes prevalence in 3 cohorts of Mexican adults.

METHODS: Data on those 60-69 years old from the 1930-1939, 1940-1949, and 1950-1959 birth cohorts in Waves 1 (2001), 3 (2012), and 5 (2018) of the Mexican Health and Aging Study were used. EDDC was defined as the absence of a toilet in the household before age 10. Body mass status was defined using self-reported perceived body image at age 50. Diabetes was based on respondent …

Mortalidad Por Cirrosis En Guatemala 2018: Patrones E Inequidades, Cristian Ramírez, Luis Pablo Méndez-Alburez, María Fernanda Piedrasanta, Alejandro Cerón

Anthropology: Faculty Scholarship

El presente estudio busca analizar la mortalidad por cirrosis en Guatemala. El propósito es identificar posibles criterios epidemiológicos que orienten la priorización de acciones de salud pública. El riesgo de morir por cirrosis en Guatemala muestra marcadas desigualdades por departamento, las cuales son mayores al comparar por municipio. El riesgo de morir es también más alto en hombres, en personas mestizas o ladinas, en niveles educativos bajos, y en personas que se dedican a ocupaciones elementales. Las medidas de salud pública orientadas a los municipios y grupos en mayor riesgo son de suma importancia para la prevención de muerte por …

The Meatpacking Industry Needs Stronger Worker Protections And Enhanced Oversight, India Luxton, Laura-Anne Minkoff-Zern

Center for Policy Research

Meatpacking plants are hazardous workplaces with high injury rates and poor working conditions, negatively impacting the health of the industry’s predominately immigrant and refugee workforce. The COVID-19 pandemic illuminated ongoing concerns in the industry, including the problems associated with consolidation and concentration, worker safety, and poor public health outcomes. This brief summarizes findings from a study that used data from 39 interviews with local, state, and federal officials and bureaucrats, worker advocates, and workers to analyze meatpacking policymaking and oversight during COVID-19. The authors find that a lack of industry oversight and decreased regulation contribute to unsafe environments, and injustices …

Lengthening Atlantic Hurricane Seasons With Earlier Storm Formation Dates Including Implications From 2020, Barry D. Keim, L. C. Hamilton, V. M. Brown, P. J. Klotzbach, A. B. Lewis, D. T. Thompson

School of Public Health Faculty Publications

This paper analyzes the formation dates of the nth storm in a sequence for all named North Atlantic tropical cyclones (TCs) and assesses whether the intraseasonal length of the Atlantic hurricane season has changed temporally. The record-breaking 2020 season, with 30 named storms, set records for the earliest third TC formation (Cristobal) and from the sixth TC (Fay) onward. Analysis of season length from 1851 to 2022 identifies only one statistically significant breakpoint detected in the early 1970s, roughly coinciding with the introduction of satellite observations. Since 1970, we also find a trend toward longer North Atlantic hurricane seasons. The …

Impacting Community Well-Being Through Effective Engagement Using The Seed Method, Carlin Rafie, Emily B. Zimmerman, Angelina Hargrove, Theodora Biney Amissah, Samantha Lee

Journal of Extension

Cooperative Extension can make a significant impact on health in the United States through effective community engagement that focuses on the complex socio-ecological factors that impact health. The Stakeholder Engagement in Question Development Method (SEED Method) employs community based participatory research principles to engage communities in research, problem-solving, and action planning. Projects employing the SEED Method engage community members from diverse backgrounds, create community capacity, result in tangible outcomes, and foment inter-organizational trust and networking. A SEED Toolkit is available on the Extension Foundation Campus site and provides implementation instructions, tools and timelines, and potential applications within Extension.

State Capacity And Covid-19 Responses: Comparing The Us States, Kiran Auerbach, Joshua Y. Lerner, Hannah M. Ridge

Political Science Faculty Articles and Research

This article addresses the interstate differences in outcomes from the coronavirus disease COVID-19 pandemic by focusing on state capacity. State capacity refers to states’ ability to create and implement policy. We posit that states want to limit death and destruction within their borders. COVID-19 created an instance in which states had a shared, preferred outcome but had very different levels of success. Using a novel measure of state capacity that allows for subnational comparisons – and is independent of ideological political will – we show that states with greater capacity experienced fewer excess deaths during 2020 and more successfully distributed …

Examining Adolescence And Agency In The Midst Of International Crisis: Pandemics, Pandemonium, And Zombie Young Adult Literature, T. Hunter Strickland

Dialogue: The Interdisciplinary Journal of Popular Culture and Pedagogy

The COVID-19 pandemic of 2020-22 brought an abundance of changes to secondary education as students transitioned across the country to virtual and hybrid learning contexts. Teachers flexed quickly and frequently to support the learning that students acquired in these new, digital spaces even as school, district, and state demands on teaching increased. The English/Language Arts classroom pivoted along with others as teachers sought out digital reading and writing resources for students to engage in. In the midst of a national crisis, a metaphorical monster that sought to destroy, much like Beowulf ’s dragon did, adolescent readers, despite the discourses of …

Understanding The Impact Of Covid-19 On Yoga Instruction: Examining Teaching Methodology, Class Components, And Injury Patterns In The Northeastern Us, Sojung Kim, June Solow, Donald H Lein, Harshvardhan Singh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVES: This study aimed to examine the impact of COVID-19 on the perspectives of yoga instructors (YIs) regarding teaching methodology, class components, and yoga-related injuries among their clients DESIGN: A cross-sectional design in this study.

SETTING: A total of 407 YIs from Northeastern United States completed a customized, web-based survey.

MAIN OUTCOME MEASURES: Chi-square tests were carried out to determine changes in yoga teaching format before and during the pandemic, as well as the counts of yoga related injuries between face-to-face (FtoF) and online teaching format. Independent t tests were used to compare the characteristics of yoga teaching elements.

RESULTS: …

Health Outcomes Reported By Healthcare Providers And Clients Of A Community-Based Medically Tailored Meal Program, Jessica M Sautter, Jule Anne Henstenburg, Adrian Glass Crafford, Ian Rowe-Nicholls, Victor S Diaz, Kaitlyn Ann Bartholomew, Julia S Evans, Maria R Johnson, Jeffrey Zhou, Deeksha Ajeya

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Medically tailored meal (MTM) programs provide home-delivered meals to people living with serious illness and poor nutritional status. Client outcome studies have found evidence of decreased healthcare utilization and cost savings associated with MTM program participation, and inconclusive evidence of change in health measures. The purpose of this study was to use a novel observational framework to describe the client profile and change in health outcomes using routinely collected health and program data from a community-based MTM program at MANNA (Philadelphia, PA).

METHODS: Clients reported their self-rated health and experiences of food insecurity and malnutrition. Healthcare providers reported clients' …

Protein Consumption And Risk Of Cvd Among Us Adults: The Multi-Ethnic Study Of Atherosclerosis (Mesa), Ji Yun Tark, Ruosha Li, Bing Yu, Alexis C Wood, Nikhil S Padhye, Marcia C De Oliveira Otto

Faculty, Staff and Students Publications

BACKGROUND: Although some randomized trials have reported beneficial effects of protein intake on cardiometabolic risk factors, evidence from prospective studies have not supported a strong link between protein intake and cardiovascular disease (CVD) risk. It is also unclear whether diversity in protein intake plays a role in CVD risk.

OBJECTIVE: We investigated prospective associations of (1) protein intake, overall and by food source and (2) diversity of protein sources with risk of CVD, coronary heart disease (CHD), and stroke.

METHODS: In a multi-ethnic cohort of 5879 U.S. adults (45-84 years), who were free of CVD at baseline, protein intake was …

Sexual Behavior Among Emerging Adults In Africa: A Systematic Review And Meta-Analysis, Stevenson Chea, Vincent A. Kagonya, Osman Abdullahi, Amina Abubakar, Souheila Abbeddou, Kristien Michielsen, Amin Hassan

Institute for Human Development, East Africa

Background: Estimates on sexual behavior (SB) among emerging adults (EmA) is varied in literature, which presents a challenge when designing targeted interventions. We aimed to summarize literature on prevalence and risk factors of SB among EmA in Africa.

Methods: A search for studies published in PubMed, Embase, and Psych Info by March 2023 was done. Studies involving EmA (18–25 years), conducted in Africa, and reporting 1 or more of 7 SBs were reviewed. Pooled prevalence estimates were summarized using forest plots. Heterogeneity in SB was explored. Risk factors were synthesized using a modified socioecological model.

Results: Overall, …

A Fluid Frontier: Cholera Throughout Latin American History, Sarah Auletta

Sociology Between the Gaps: Forgotten and Neglected Topics

No abstract provided.

Aromatase, Testosterone, Tmprss2: Determinants Of Covid-19 Severity, Eric C Mohan, Jude P J Savarraj, Gabriela D Colpo, Diego Morales, Carson E Finger, Alexis Mcalister, Hilda Ahnstedt, Huimahn Choi, Louise D Mccullough, Bharti Manwani

Faculty, Staff and Student Publications

Background: Male sex has been identified as a risk factor for worse COVID-19 outcomes. This sex difference has been mostly attributed to the complex role of sex hormones. Cell surface entry of SARS-CoV-2 is mediated by the transmembrane protease serine 2 (TMPRSS2) which is under transcriptional regulation by androgens. P450 aromatase enzyme converts androgens to estrogens. This study measured concentrations of aromatase enzyme, testosterone, estradiol, and TMPRSS-2 in plasma of hospitalized COVID-19 patients to elucidate the dynamics of sex-linked disparity in COVID-19 and correlate them with disease severity and mortality.

Methods: In this prospective cohort study, a total of 265 …

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

Open Access In The Age Of Ai: The Journal Of Appalachian Health And Hurricane Helene Recovery, Noah Wren, Bradley Firchow

Journal of Appalachian Health

The recent destruction brought upon the Appalachian region by Hurricane Helene has emphasized the importance of the Journal of Appalachian Health. As an open-access peer-reviewed source of information, the Journal plays a critical role in not only facilitating public health research about Hurricane Helene, but also combating misinformation regarding the event. In the days following Hurricane Helene, misinformation about the federal government’s response, along AI generated images, have left many in the region confused and misled about what had happened. Going forward, the Journal will play an necessary part in making sure accurate information is shared to understand how …

Credentialing Care: Covid-19 And The Bureaucratization Of Doulas, Ellen Block, Julie Johnson Searcy, Angela N. Castañeda

Sociology Faculty Publications

Doulas in the United States offer embodied, informational, and continuous one-on-one care to birthing people. Doulas have historically sought certification to gain knowledge through training and to gain legitimacy for healthcare providers and clients. During the COVID-19 pandemic, hospitals required doulas to provide proof of certification. The COVID-19 pandemic, and the proliferation of state-sponsored doula programs, has sparked a shift in how doulas are viewed and regulated, enabling new forms of bureaucratic oversight and control. Based on participant observation, surveys, and semi-structured interviews, we examine the connection between certification and care including motivations doulas have for certification, the perceived value …

Reviewer Acknowledgements, Randy Wykoff, Emily Wilson

Journal of Appalachian Health

We at the Journal of Appalachian Health would like to thank the multitude of reviewers who have volunteered their time, talents, and attention to the journal. Reviewers help us consider the rigor and quality of the submissions we receive, and their willingness to read material ahead of publication ensures we can bring timely research to our readers in Appalachia and further afield.

Impacts Of The Covid-19 Pandemic On Intimate Partner Violence And Child Maltreatment Services In Rural Northwest North Carolina, Elisabeth G. Galphin, Adam Hege, Amy Dellinger Page

Journal of Appalachian Health

The current study examined the impact of the COVID-19 pandemic on IPV and child maltreatment services in rural northwestern North Carolina. Qualitative interviews were conducted with eight professionals representing six service organizations across four counties. The findings highlighted challenges these agencies faced throughout the pandemic, new risks for the clients served, and positive outcomes. In addition, it has been a useful learning experience as public health and social service agencies learn to serve their communities more effectively moving forward. This is especially relevant for rural communities, as it has put public health preparedness at the forefront.

The Impact Of Primary Care Physician Capacity On Preventable Hospitalizations: Identifying Bright Spots In The Appalachian & Mississippi Delta Regions, Michael Topmiller, Peter J. Mallow, Hoon Byun, Mark Carrozza, Yalda Jabbarpour

Journal of Appalachian Health

Introduction: Several studies have documented that higher rates of primary care physicians are associated with lower rates of preventable hospitalizations. Counties with higher rates of preventable hospitalizations are found in the Appalachian and Mississippi (MS) Delta Regions.

Purpose: (1) To determine if the association of primary care capacity with preventable hospitalizations is different in the Appalachian and MS Delta regions compared to the rest of the U.S., and (2) to explore primary care capacity in counties with lower-than-expected preventable hospitalization rates.

Methods: This study modeled preventable hospitalizations with primary care physicians (PCP) per 100,000 (PCP capacity) while controlling for several …