Public Health Commons^™

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.

Study Protocol For A Randomized Controlled Trial Of Realconsent2.0: A Web‑Based Intervention To Promote Prosocial Alcohol‑Involved Bystander Behavior In Young Men, Laura F. Salazar, Dominic J. Parrott, David Dilillo, Sarah J. Gervais, Anne Marie Schipani‑Mclaughlin, Ruschelle Leone, Kevin Swartout, Lauren Simpson, Renita Moore, Tiffany Wilson, Nyla Flowers, Haley Church, Amanda Baildon

Department of Psychology: Faculty Publications

Background Sexual violence (SV) is a significant, global public health problem, particularly among young adults. Promising interventions exist, including prosocial bystander intervention programs that train bystanders to intervene in situations at-risk for SV. However, these programs suffer from critical weaknesses: (1) they do not address the proximal effect of alcohol use on bystander decision-making and (2) they rely on self-report measures to evaluate outcomes. To overcome these limitations, we integrate new content specific to alcohol use within the context of prosocial bystander intervention into an existing, evidence-based program, RealConsent1.0. The resulting program, RealConsent2.0, aims to facilitate bystander behavior …

Learning From Women Veterans Who Navigate Invisible Injuries, Caregiving, And Reintegration Challenges, Nicholas A. Rattray, Diana Natividad, Katrina Spontak, Marina Kukla, Ai Nghia L. Do, Leah Danson, Richard M. Frankel, Gala True

School of Medicine Faculty Publications

Background: As women comprise a greater proportion of military service members, there is growing recognition of how their experiences in the early phase of military to civilian transitions have an important influence on their health and reintegration outcomes. Qualitative accounts of women veterans can inform programs that support transitioning service members. Objectives: We examined narratives of civilian reintegration among women veterans to understand their experiences of adjusting to community life while coping with mental health challenges. Methods/Participants: We interviewed 16 post-911 era women who were within 5 years of separating from military service and developed a case study based on …

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

The Impact Of The Covid-19 Pandemic On The Well-Being Of People Incarcerated In United States Prisons, Kimberly Rivera

Department of Sociology: Dissertations, Theses, and Student Research

The COVID-19 pandemic has negatively impacted the population as a whole. However, the incarcerated population (which also experiences a variety of health disparities) has been disproportionately affected by the pandemic. Due to overcrowding, poor ventilation, and lack of resources, the incarcerated population already is at a heightened risk for negative health outcomes, made worse by the recent pandemic. To adapt to the rapidly changing conditions during the pandemic in 2020 and into 2022, new safety measures were implemented, but the unintended consequences associated with the implementation of these procedures have yet to be examined empirically. I conducted a qualitative content …

From Vapor To Vice: Unraveling The Links Between Vaping And Traditional Substance Abuse Among Youth, Ayana Powell

Capstone Experience: Master of Public Health

ABSTRACT:

Objective: To evaluate whether vaping or using e-cigarettes is associated with the use of traditional substances, such as cigarettes, alcohol, and marijuana.

Methods: Using data from the Monitoring the Future surveys, a multivariable logistic regression model was performed, and prevalent odds ratio were calculated to evaluate the association between vaping and traditional substances.

Results: Vaping use among U.S. adolescents and teenagers was found to be an associated with use of traditional substances (cigarette use [OR]= 6.36 [CI]= 4.84, 8.38; alcohol use [OR]=5.80 [CI]= 5.28, 6.38; and marijuana use [OR]= 7.77 [CI]= 6.95, 8.70).

Conclusion: This study will assist …

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

A Policy Evaluation For California’S Care Act And The Application Of The Social Determinants Of Health, Adelina Mercedes Lang

Capstone Experience: Master of Public Health

In 2022, California passed a legislative bill, SB 1338: the Community Assistance, Recovery, and Empowerment (CARE) Act, which created a new statewide procedure for treating mentally ill homeless adults diagnosed with psychotic disorders through a court-ordered CARE plan. SB 1338 intends to alleviate the mental health and homeless crisis. This capstone project provides an early assessment of SB 1338 using a modified formative policy evaluation methodology, including a scoping literature review and applying a policy assessment using the CDC's Policy Evaluation Framework. A stakeholder survey was also applied to gather stakeholders' perspectives on SB 1338. The literature review supported the …

Factors Associated With Caregiver Responsive And Non-Responsive Feeding Styles In Clark County, Nevada, Amanda Castelo Saragosa

UNLV Theses, Dissertations, Professional Papers, and Capstones

Early childhood obesity has increased significantly over the last few decades, reaching epidemic levels in the United States. Many interventions exist to alleviate early childhood obesity; however, little focus is on preventing obesity-related risks for children under two. High-quality child-caregiver interactions are deemed critical for preventing early childhood obesity development, but there is little information on the socio-ecological factors that influence a caregivers' feeding styles. This study examined socio-ecological factors associated with caregivers' feeding styles (responsive vs. non-responsive) for infants under two in Clark County, Nevada. This cross-sectional study utilized a survey targeted to caregivers (18 and older) with infants …

Associations Between Avocado Intake And Measures Of Glucose And Insulin Homeostasis In Hispanic Individuals With And Without Type 2 Diabetes: Results From The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Mackenzie K Senn, Mark O Goodarzi, Gautam Ramesh, Matthew A Allison, Mariaelisa Graff, Kristin L Young, Gregory A Talavera, Amanda C Mcclain, Tanya P Garcia, Jerome I Rotter, Alexis C Wood

Faculty, Staff and Students Publications

BACKGROUND AND AIMS: To investigate associations between avocado intake and glycemia in adults with Hispanic/Latino ancestry.

METHODS AND RESULTS: The associations of avocado intake with measures of insulin and glucose homeostasis were evaluated in a cross-sectional analysis of up to 14,591 Hispanic/Latino adults, using measures of: average glucose levels (hemoglobin A1c; HbA1c), fasting glucose and insulin, glucose and insulin levels after an oral glucose tolerance test (OGTT), and calculated measures of insulin resistance (HOMA-IR, and HOMA-%β), and insulinogenic index. Associations were assessed using multivariable linear regression models, which controlled for sociodemographic factors and health behaviors, and which were stratified by …

The Associations Of Parental Smoking, Quitting And Habitus With Teenager E-Cigarette, Smoking, Alcohol And Other Drug Use In Gui Cohort ’98, Salome Sunday, Luke Clancy, Joan Hanafin

Articles

We analyse parental smoking and cessation (quitting) associations with teenager e-cigarette, alcohol, tobacco smoking and other drug use, and explore parental smoking as a mechanism for social reproduction. We use data from Waves 1–3 of Growing Up in Ireland (Cohort ’98). Our analytic sample consisted of n = 6,039 participants reporting in all 3 Waves. Data were collected in Waves 1 and 2 when the children were 9 and 13 years old and in Wave 3 at age 17/18 years. Generalized Estimating Equations (GEE) models were used to analyse teenage substance use at Wave 3. Parental smoking was associated with …

Association Between Lack Of Access To A Neighborhood Park And High Blood Pressure In The Philadelphia Metropolitan Area, Stephanie Kjelstrom, Richard W. Hass, Russell K. Mcintire

College of Population Health Faculty Papers

INTRODUCTION: Studies have shown a lower risk of high blood pressure (HBP) among people who live near parks; however, little information exists on how feeling safe and comfortable visiting the park affects blood pressure. We identified associations between neighborhood park access, comfort visiting a park, and HBP to understand how these factors may contribute to disparities in HBP prevalence.

METHODS: The 2018 Southeastern Pennsylvania Household Health Survey of 3,600 residents in the Philadelphia metropolitan area asked if respondents had ever been told they had HBP and whether they had a neighborhood park or outdoor space that they were comfortable visiting …

Mosaic Chromosomal Alterations In Blood Across Ancestries Using Whole-Genome Sequencing, Yasminka A Jakubek, Ying Zhou, Adrienne Stilp, Jason Bacon, Justin W Wong, Zuhal Ozcan, Donna Arnett, Kathleen Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Jiawen Chen, Michael Cho, Matthew P Conomos, Nancy Cox, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Sharon L R Kardia, Joshua P Lewis, Ruth J F Loos, Xiaolong Ma, Mitchell J Machiela, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Josyf C Mychaleckyj, Kari North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce Psaty, Laura M Raffield, Ramachandran S Vasan, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Jennifer A Smith, Aaron P Smith, Margaret Taub, Kent D Taylor, Jeong Yun, Yun Li, Pinkal Desai, Alexander G Bick, Alexander P Reiner, Paul Scheet, Paul L Auer

Faculty, Staff and Student Publications

Megabase-scale mosaic chromosomal alterations (mCAs) in blood are prognostic markers for a host of human diseases. Here, to gain a better understanding of mCA rates in genetically diverse populations, we analyzed whole-genome sequencing data from 67,390 individuals from the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine program. We observed higher sensitivity with whole-genome sequencing data, compared with array-based data, in uncovering mCAs at low mutant cell fractions and found that individuals of European ancestry have the highest rates of autosomal mCAs and the lowest rates of chromosome X mCAs, compared with individuals of African or Hispanic ancestry. …

Mountain West State Health System Rankings, 2023, Julia Salangsang, Ivan Sun, Caitlin J. Saladino, William E. Brown Jr.

Health

This fact sheet presents data from the “2023 Scorecard on State Health System Performance” published by The Commonwealth Fund. The original report includes data from all 50 states and measures health system performance based on health care access, quality, use of services, costs, health disparities, reproductive care and women’s health, and health outcomes.

Association Of Social Vulnerability And Covid-19 Mortality Rates In Texas Between 15 March 2020, And 21 July 2022: An Ecological Analysis, Dennis Ogeto Nyachoti, Nalini Ranjit, Ryan Ramphul, Leah D Whigham, Andrew E Springer

Faculty, Staff and Student Publications

BACKGROUND: Despite the key role of social vulnerability such as economic disadvantage in health outcomes, research is limited on the impact of social vulnerabilities on COVID-19-related deaths, especially at the state and county level in the USA.

METHODS: We conducted a cross-sectional ecologic analysis of COVID-19 mortality by the county-level Minority Health Social Vulnerability Index (MH SVI) and each of its components in Texas. Negative binomial regression (NBR) analyses were used to estimate the association between the composite MH SVI (and its components) and COVID-19 mortality.

RESULTS: A 0.1-unit increase in the overall MH SVI (IRR, 1.27; 95% CI, 1.04-1.55; …

The Parenting Education Needs Of Aboriginal Women Experiencing Incarceration, Belinda J. Lovell, Mary Steen, Angela Brown, Karen Glover, Adrian Esterman

Journal of the Australian Indigenous HealthInfoNet

The aim of this study was to listen to the voices of women experiencing incarceration and understand their parenting education needs. This paper reports on data from focus group interviews with 13 Aboriginal women in prison. The data were analysed using reflexive thematic analysis, creating five themes: (1) working towards a positive self; (2) communication (3) parenting from a distance; (4) jumping through hoops to get connected; and (5) connecting with Aboriginal cultures. The women were seeking guidance and clarity about the Child Protection system and how to regain child custody. Many women were wanting to invest in self-care and …

Us Adolescent Rest-Activity Patterns: Insights From Functional Principal Component Analysis (Nhanes 2011-2014), Chris Ho Ching Yeung, Jiachen Lu, Erica G Soltero, Cici Bauer, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND: Suboptimal rest-activity patterns in adolescence are associated with worse health outcomes in adulthood. Understanding sociodemographic factors associated with rest-activity rhythms may help identify subgroups who may benefit from interventions. This study aimed to investigate the association of rest-activity rhythm with demographic and socioeconomic characteristics in adolescents.

METHODS: Using cross-sectional data from the nationally representative National Health and Nutrition Examination Survey (NHANES) 2011-2014 adolescents (N = 1814), this study derived rest-activity profiles from 7-day 24-hour accelerometer data using functional principal component analysis. Multiple linear regression was used to assess the association between participant characteristics and rest-activity profiles. Weekday and weekend …

Tuberculosis Presentation And Outcomes In Older Hispanic Adults From Tamaulipas, Mexico, Belinda A Medrano, Miryoung Lee, Gretchen Gemeinhardt, Javier E Rodríguez-Herrera, Moncerrato García-Viveros, Blanca I Restrepo

Faculty, Staff and Student Publications

Older people are at high risk of developing and dying from pulmonary infections like tuberculosis (TB), but there are few studies among them, particularly in Hispanics. To address these gaps, we sought to identify host factors associated with TB and adverse treatment outcomes in older Hispanics by conducting a cross-sectional study of TB surveillance data from Tamaulipas, Mexico (2006-2013; n = 8381). Multivariable logistic regressions were assessed for older adults (OA ≥65 years) when compared to young (YA, 18-39 years) and middle-aged adults (40-64 years). We found that the OA had features associated with a less complicated TB (e.g., lower …

Association Of Parental Status And Gender With Burden Of Multidisciplinary Tumor Boards Among Oncology Physicians, Brittney L Chau, Jonnby S Laguardia, Sungjin Kim, Samuel C Zhang, Eric Pletcher, Nina N Sanford, Ann C Raldow, Lisa Singer, Jun Gong, Sukhmani K Padda, Mitchell Kamrava, Tara Cohen, Devarati Mitra, Katelyn M Atkins

Faculty, Staff and Student Publications

IMPORTANCE: Tumor boards are integral to the care of patients with cancer. However, data investigating the burden of tumor boards on physicians are limited.

OBJECTIVE: To investigate what physician-related and tumor board-related factors are associated with higher tumor board burden among oncology physicians.

DESIGN, SETTING, AND PARTICIPANTS: Tumor board burden was assessed by a cross-sectional convenience survey posted on social media and by email to Cedars-Sinai Medical Center cancer physicians between March 3 and April 3, 2022. Tumor board start times were independently collected by email from 22 top cancer centers.

MAIN OUTCOMES AND MEASURES: Tumor board burden was measured …

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

Centros De Inclusión Social Bajo Gestión Asociada Y La Salud Mental De Las Personas En Situación De Calle, Kien Phan

Independent Study Project (ISP) Collection

Esta investigación se enfoca en analizar las acciones del gobierno de la Ciudad Autónoma de Buenos Aires (CABA) para abordar la salud mental de las personas en situación de calle en 2023. Se examina el estado actual de esta población, identificando factores clave y evaluando las medidas gubernamentales. El marco teórico aborda determinantes sociales y derechos humanos, subrayando la importancia de cambios legislativos para abordar la falta de vivienda. La metodología combina análisis de datos gubernamentales, estudios previos y entrevistas con profesionales de Centros de Inclusión Social. Las organizaciones de la sociedad civil, como Cáritas y la Asociación Civil Isauro …

Surveillance Systems In Western Kenya: Methods, Perceptions, And Effectiveness, Marissa Duffy

Independent Study Project (ISP) Collection

Surveillance is an important tool in monitoring and evaluating infectious disease patterns and trends. Surveillance is vital because it aids public health officials and medical professionals in creating better prevention methods and efficiently managing outbreaks. Kenya is home to many noncommunicable diseases making it an important location to conduct disease surveillance. Within Kenya, each county has its own surveillance unit which tracks and controls outbreaks. In addition, government run surveillance systems were established to determine disease burden, incidence, and patterns in specific at-risk communities around Kenya. One of these major surveillance systems is Population-Based Infectious Disease Surveillance (PBIDS) which has …

No Woman Left Behind: Women’S Lived Experiences, Purposes, And Perceptions On Female Genital Mutilation (Fgm) Of Maasai And Datoga Communities In Arusha, Tanzania, Audrey Tirrill

Independent Study Project (ISP) Collection

Female genital mutilation (FGM) has been practiced for centuries around the world, currently FGM occurs in Africa, Asia and the Middle East. Even though many counties like Tanzania has outlawed FGM and stating it is a violation of human rights, many people continue the procedure without adequate education on FGM. While believing the decline in number of FGM incidences and there is still a lack of local women perspectives and their respective lived experiences on the matter. This is particularly true in some Tanzanian rural and male dominated tribes where most women are educated with limited freedom of speech such …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Parent-Reported Provider Recommendation Of Hpv Vaccination Among Minority Adolescents Before And During The Covid-19 Pandemic: Findings From The National Immunization Survey-Teen, 2019-2021, Chinenye Lynette Ejezie, Paula Cuccaro, Casey Durand, Lara Savas, Ross Shegog

Faculty, Staff and Student Publications

Provider recommendation of human papillomavirus (HPV) vaccination among adolescents has steadily improved over the years, however, limited research has been conducted to examine if the COVID-19 pandemic disrupted this positive trend in parent-reported provider recommendation among minority adolescents. Therefore, we conducted the present study to determine if there is an association between the pandemic and parent-reported provider recommendation of HPV vaccine among non-Hispanic black and Hispanic adolescents. We also examined whether any changes in parent-reported provider recommendation in the years 2019, 2020, and 2021 differed by race or ethnicity. Using a cross-sectional design to examine data from the National Immunization …

Hidden Hurdles: Evaluating Informal Barriers To Primary Healthcare Access Among Undocumented Migrants In Switzerland, Arantxa Bonifaz Rosas

Independent Study Project (ISP) Collection

Undocumented migrants face heightened difficulties in accessing healthcare due to a combination of legal, financial, and social challenges. Informal barriers to accessing healthcare further exacerbate poor health outcomes among undocumented migrants. In Switzerland, where undocumented migrants have the right to health insurance, barriers to receiving healthcare continue to restrict their access to essential services, such as primary healthcare (PHC). Employing a meta-analysis approach, this qualitative study aimed to broaden existing research on informal barriers hindering access to PHC for undocumented migrants, with a particular focus on the Swiss context. The identified informal barriers centered around health insurance, fear of deportation, …

Analyzing African American College Student Willingness To Participate In Clinical Trials, Caitlin B. Ulmer

Senior Theses

Previous studies regarding African American participation in clinical trials have found that African Americans participate at a significantly lower rate than other ethnic/racial groups. Scholars argue that this lack of participation in clinical trials is a direct result of historical trauma linked to unethical experiments and African American distrust in the healthcare system. However, there is a gap in the literature because these studies focus on African American individuals above the age of 30. This study aimed to fill the gap by examining clinical trial participation among African American college students within the ages 18 to 23. This study also …

Expanding Health Professional Education In The Rio Grande Valley During The Covid-19 Pandemic, Sabrina R. Orta, Samantha G. Alvarado, Shuchita Jhaveri

Research Symposium

Purpose: The COVID-19 Pandemic has prompted innovation in health professional education, such that learners are able to recognize and mitigate healthcare disparities in the outcomes of vulnerable populations. The objective of our project was to increase education on preventing, preparing for, and responding to COVID-19 and other locally prevalent infectious diseases that disproportionately affect RGV communities.

Description: This project had 3 goals: (1) provide learners with virtual patient-interaction simulations (2) provide interactive training modules on the identification, prevention, and treatment of infectious diseases affecting South TX and strategies to increase child vaccinations, and (3) provide learners an opportunity to coordinate …

The Impact Of Virtual Learning On Health Literacy: Lessons From A Virtual Townhall Held By The Lamar University Recovery And Resilience Academy, Margot Gage Witvliet, Chiung-Fang Chang

Research Symposium

Background: The COVID-19 pandemic shut down the entire world. This caused universities and addiction recovery programs to get creative on how to reach community needs. Many professors found themselves teaching online for the first time. Apps for mental health and addiction recovery programs grew exponentially. Information on how adequate virtual programs perform are mixed. We investigate the extent to which a virtual program can increase health literacy. To accomplish this, the professors of the sociology program launched the Recovery and Resilience Academy (RnR Academy). The aim of RnR Academy is to serve as an outreach and educational center for the …

Characterization Of Prostate Cancer In Transgender Women, Simita Gaglani, Rajveer Purohit, Ashutosh Tewari, Dara Lundon, Natasha Kyprianou

Research Symposium

Background: The risk of developing prostate cancer (PC) in transgender women is unknown. Many patients are unaware that the prostate is not removed during male-to-female surgical transition. It is unclear what the exposure of estrogens and androgen blockers in these transgender patients has on the prostate. Our aim was to examine and characterize the different presentations of PC in published cases and augment this with an additional case series from one institute.

Methods: A retrospective review of prospectively maintained medical records was performed identifying features of PC diagnoses in transgender women. These included age, duration of feminizing hormone therapy, PSA …