Public Health Commons^™

Association Between E-Cigarette Use Behaviors And Anxiety/Depression Among Black/African American Adults Based On Sexual Identity, David Adzrago, Melissa B Harrell, Kayo Fujimoto, Antwan Jones, J Michael Wilkerson

Faculty, Staff and Student Publications

Limited studies have examined disparities in e-cigarette use among Black/African American adults by sexual identity and whether the relationship between symptoms of anxiety/depression and e-cigarette use varies by sexual identity. We examined the association between e-cigarette use behaviors (never, former, and current use) and anxiety/depression among a nationally representative sample of Black/African American adults who identified as a sexual minority (lesbian/gay, bisexual, and others) or heterosexual individuals. We combined cross-sectional data from the 2011 to 2020 Health Information National Trends Survey (n = 6267), which is a nationally representative data set. We computed weighted e-cigarette use prevalence and multinomial logistic …

Factors In Primary Care Use Among Young Adult Refugees From Burma And Bhutan In Early Resettlement: Findings From Colorado, Sarah Brewer, Jini Puma

Journal of Refugee & Global Health

Background: Young adult refugees have suboptimal primary care use in early resettlement—domains of integration influence primary care engagement during this time.

Methods: Adjusted logistic regression models were used to estimate odds of (1) having a primary care exam and (2) identification of a primary care provider (PCP) as predicted by domains of integration among young adult refugees (n=154) from Burma and Bhutan across four years following resettlement.

Results: Overall integration and predisposing factors, such as language and cultural knowledge, were lower odds of having a primary care provider. Enabling factors such as having insurance and knowing how to make an …

"Women Are Again Unsafe": Preventing Violence And Poor Maternal Outcomes During Current Floods In Pakistan, Sarmad Muhammad Soomar, Abir Arefin, Salman Muhammad Soomar

School of Nursing & Midwifery

No abstract provided.

Community Facing Athletic Trainer, Eric Post

2022 Fall Reports (Marshall, IL)

In an initial planning meeting with Marshall Mayor John Hasten, the mayor identified the potential need for an athletic trainer to serve as a community-facing health professional within the Marshall community in order to provide access to highquality injury prevention, evaluation, and care. The agreed-upon objectives for this project were to: ● Perform a needs assessment to determine the potential costs and resources necessary to provide a community-facing athletic trainer within the Marshall community. ● Share perspectives on how athletic trainers can provide services to serve the health needs in the Marshall community. ● Determine the best strategies for providing …

Unraveling Controversies Over Civic Honesty Measurement: An Extended Field Replication In China, Qian Yang, Weiwei Zhang, Shiyong Liu, Wenjin Gong, Youli Han, Jun Lu, Donghong Jiang, Jingchun Nie, Xiaokang Lyu, Rugang Liu, Mingli Jiao, Chen Qu, Mingji Zhang, Yacheng Sun, Xinyue Zhou, Qi Zhang

Community & Environmental Health Faculty Publications

Cohn et al. (2019) conducted a wallet drop experiment in 40 countries to measure "civic honesty around the globe," which has received worldwide attention but also sparked controversies over using the email response rate as the sole metric of civic honesty. Relying on the lone measurement may overlook cultural differences in behaviors that demonstrate civic honesty. To investigate this issue, we conducted an extended replication study in China, utilizing email response and wallet recovery to assess civic honesty. We found a significantly higher level of civic honesty in China, as measured by the wallet recovery rate, than reported in the …

"I Haven’T Really Made Those Connections That Maybe Most Would Their First Year": A Qualitative Study Of The Covid-19 Pandemic And Student Social Capital Among 3 Cohorts Of First-Year Engineering Majors, Patricia Wonch Hill, Lance C. Pérez, Sohrab Asgarpoor, David Jones, Zachary George Short, Jennifer N. Rutt

UNL Office of Research and Innovation, Social/Behavioral Sciences Research Consortium

The COVID-19 pandemic disrupted the education of students of all ages and challenged teachers and academic support services to make major adaptations to continue to support student learning while also limiting the spread of the virus. Our team received an NSF grant in the Fall of 2018 to broaden participation in engineering by recruiting and retaining students who have been historically marginalized in engineering. We focused our research on first-year students who participated in pathway programs which provided peer and formal mentoring, success coaching, shared classes, and social activities, that would provide a sense of community and shared engineering identity …

Reproductive Justice And Feminism: A Comparative Legal Analysis Of The Policies And Healthcare Systems In The United States And Colombia, Samantha Cooke

Modern Languages, Philosophy and Classics Theses

This thesis seeks to offer a comparative legal analysis of the state of the laws regarding abortion and reproductive autonomy in the United States of America and Colombia. This thesis will first address a brief history of feminism and its origins in the United States and Colombia. It will also analyze the policies held by each respective nation; starting with old legislation and moving to current policies regarding abortion. It will also include a comparison between both the U.S. and Colombia; offering suggestions for the future with regards to potential policy changes. The purpose of this thesis is to demonstrate …

Emoting In Context: Lived Narratives Of Filipino Health-Care Frontliners During The Early Days Of The Covid-19 Pandemic, John Martin Bernard Gappy

Sociology & Anthropology Department Faculty Publications

The current SARS-CoV-2 pandemic has placed the entire world in a liminal position whereby our well-rehearsed and predictive practices have been deeply shaken. Within this context of liminality, studies point to potential distress among healthcare workers who are taking care of COVID-19 patients. Most studies focus on emotional distress of frontline healthcare workers as fixed entities. The current approach perceives emotion as a type of connection with social worlds. This article focuses on contextual acts of emoting and is organized around personal, situational, and cultural features of nine frontline medical doctors affiliated with ten hospitals in Metro-Manila who were taking …

“My Ob/Gyn Has The Worst Bedside Manner…” A Qualitative Analysis Of Patient-Provider Communication And Mental Health Outcomes Of Women In Rural Georgia, Tobi F. Oloyede

College of Graduate Studies: Theses & Dissertations

Despite technological advances in medicine and public health innovations, maternal mortality in the United States remains significantly higher than in other developed countries. Specifically, Georgia ranks as the second worst place to give birth in the country. Maternal mental health conditions are common, manageable complications that can happen at any point during pregnancy, childbirth, or in the first year following delivery, with 1 in 5 women affected. Unfortunately, 75% of women who experience MMH symptoms are left untreated.

This study focuses on patient-provider communication through the birthing experiences of women who have been pregnant in Georgia to examine how their …

The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen

Walden Dissertations and Doctoral Studies

Women have severe health risks associated with drinking alcohol long-term and excessively. The purpose of this qualitative study was to explore the lived experience of women in healthcare positions regarding alcohol use during the COVID-19 pandemic. The study was informed by the theory of planned behavior. Semistructured interviews were used to gather information from participants based on their firsthand experiences with alcohol usage. Understanding women’s attitudes toward alcohol use during the COVID-19 pandemic can improve intervention. Data were analyzed using an inductive, thematic procedure. Participants associated their own use of alcohol with socialization, and all participants reported that they regarded …

The Digital Divide: The Path Towards Digital Inclusivity, Angelica Gonzalez Almanza

Social Justice | Senior Theses

The gap between those Americans who use or have access to ICTs and those who do not is referred to as the digital divide (PACEs, 2002). The pandemic has increased dependence on technology and exacerbated the digital divide, which perpetuates existing systems of racism and poverty (Early et al., 2021). In this study, a mixed-method approach was conducted to understand what digital literacy skills parents need to overcome the digital divide and support their child's education. Specifically, the study explored how the program Impact Technology training has affected parents' involvement with their child's education. There were 175 Latinx parents that …

Health Behavior And Outlooks In An Altered Microbial Diversity: Changes In Parental Attitudes On ‘Building Immunity’ Throughout The Covid-19 Pandemic, Jennifer Vidal

Pitzer Senior Theses

The Covid-19 Pandemic in a short amount of time put into action disease control measures. Current literature has sought to address the long-term effects of sanitization efforts and social isolation on the diversity of the microbiome and the future of infectious diseases. Microbes – microorganisms such as bacteria, protozoa, algae, fungi, and viruses – inhabit the natural environment and human microbiome with our immune system, playing an essential role in immune regulation. The interplay between humans and microbes forms early immune development that has impacted parents’ attitudes toward microbes shown through their participation in Covid-19 preventative health practices. Using the …

Reply To Tannenbaum Et Al.: Constructive Dialogue Advancing Research On Civic Honesty, Weiwei Zhang, Yacheng Sun, Shiyong Liu, Xinyue Zhou, Qian Yang, Qi Zhang

Community & Environmental Health Faculty Publications

No abstract provided.

Integrating Feminist Approaches In Counseling Work With Adult Women, Kristen M. Toole

Adultspan Journal

The scope of ‘women’s issues’ in counseling is an ever-evolving landscape. Recent events such as the reversal of Roe v. Wade and the disproportionate impact of COVID-19 on women serve as powerful reminders of the necessity of this focus while underscoring a deep-rooted history of oppressive patriarchal structures. Therefore, counselors must remain informed of the unique considerations surrounding adult women in counseling and acquire proficiency in versatile techniques to meet this population’s nuanced needs. This article examines the complexity of contemporary womanhood and explores the fundamentals of Feminist Counseling Theory (FCT), a holistic, multiculturally conscious, social justice theory in counseling. …

Crime, Illness, & Abolition: An Exploration Through The Connective Tissue Within The Pic/Mic Matrix, Laila Kent

Scripps Senior Theses

This two part zine illuminates the shared mechanisms that construct and respond to ‘crime’, also define and treat illness in the US. Part 1 uncovers the status quo of our prison and health care system via the emergence of the The Prison-Industrial Complex (PIC), and The Medical-Industrial Complex (MIC). Through an exploration of the respective and overlapping histories, logics, and realities underlying the function of these systems, the mechanisms of individualism, objectification, and profiteering become strikingly clear. Part 2 breaks free of the status quo outlined in Part 1 by introducing abolition as the vision and strategy to heal from …

Deep Community Partnerships: The Future Of Community-Based Senior Care In A Value-Driven Era, Diana Wilcox

DSW Capstone Projects

This capstone reviews three scholarly products that examine how chronically ill older adults interact with healthcare systems and senior service delivery systems in the United States. The systematic literature review examines how community-based senior programs that are funded by the Older Americans Act (OAA) positively impact health outcomes and promote health and wellness among the older adult population. The conceptual paper examines how Accountable Care Organizations (ACOs), Managed Care Organizations (MCOs), Area Agencies on Aging (AAA) interact with the patient and with one another using the lens of Systems Theory. The practice application paper examines best practices regarding care coordination …

Disparities In Mental Health Technology Among African Americans: Breaking Cultural Inclusion Barriers, Nyoki Cosey-Brown

DSW Capstone Projects

Mental health technology is a healthcare delivery model of the future. The engagement in virtual healthcare was intensified when traditional healthcare methods were inaccessible during the federal restrictions implemented due to the COVID-19 pandemic. Utilizing digital apparatuses for healthcare improved the convenience, efficiency, and accessibility of various mental health services that were inoperable in past healthcare models. However, the historical constructs of stigma, discrimination, inequity, exclusion, and structural racism in mental healthcare were prevalent problems that remained present in virtual mental health platforms concerning the experiences of African-American patients and professionals who utilized the spaces.

This research explored mental health …

Expanding Medicaid To Reduce Human Immunodeficiency Virus Transmission In Houston, Texas: Insights From A Modeling Study, Francis Lee, Aditya S Khanna, Camden J Hallmark, Richa Lavingia, Marlene Mcneese, Jing Zhao, Melanie L Mcneese, Salma Khuwaja, Babak M Ardestani, Nicholson Collier, Jonathan Ozik, Anna L Hotton, Nina T Harawa, John A Schneider, Kayo Fujimoto

Faculty, Staff and Student Publications

CONTEXT: Medicaid expansion has been nationally shown to improve engagement in the human immunodeficiency virus (HIV) treatment and prevention continua, which are vital steps to stopping the HIV epidemic. New HIV infections in the United States are disproportionately concentrated among young Black men who have sex with men (YBMSM). Houston, TX, is the most populous city in the Southern United States with a racially/ethnically diverse population that is located in 1 of 11 US states that have not yet expanded Medicaid coverage as of 2021.

METHODS: An agent-based model that incorporated the sexual networks of YBMSM was used to simulate …

A Coalition-Driven Examination Of Organization Capacity To Address Food Insecurity In Greater Houston: A Qualitative Research Study, Jemima C John, Jennifer Gonzalez, Sara-Grace Chan, Heidi Mcpherson, Jennifer N Aiyer, Esperanza Galvan, Nicole Browning, Shreela V Sharma

Faculty, Staff and Student Publications

BACKGROUND: Economic and social hardships have worsened food insecurity, particularly among low income and racial-ethnic minority groups. Given the core goal of the 150+ member Houston Health Equity Collective (HEC) to reduce food insecurity by 5% in 2025, we explored member organizations' capacity and challenges faced in screening and responding to food insecurity through care coordination efforts.

METHODS: A twice-administered Qualtrics XM survey (Provo, Utah) with 76 organizations, followed by five focus groups with 22 of these organizations, explored reach and response efforts to food insecurity. Qualitative assessments lasted between 0.5 to 1.5 h, were audio-recorded, cleaned, coded, and thematically …

Using Implementation Mapping To Increase Uptake And Use Of Salud En Mis Manos: A Breast And Cervical Cancer Screening And Hpv Vaccination Intervention For Latinas, Lara S Savas, Preena Loomba, Ross Shegog, Angelita Alaniz, Crystal Costa, Emily Adlparvar, Marlyn A Allicock, Roshanda Chenier, Margaret Goetz, Christine M Markham, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Despite CDC recommendations for breast and cervical cancer screening and HPV vaccination, cancer control behaviors are underutilized among low-income Latinas.

METHODS: We used Implementation Mapping to create SEMM-Dissemination and Implementation Assistance (SEMM-DIA), a set of implementation strategies designed to support implementation and maintenance of SEMM in clinic settings. Specifically, we used Implementation Mapping's five iterative tasks to guide the use of theories and frameworks, evidence, new data, and stakeholder input to develop strategies to accelerate and improve implementation fidelity, reach, and maintenance of the SEMM intervention. The resulting implementation mapping logic model also guides the SEMM-DIA evaluation plan to …

Health-Related Quality Of Life And Recovery Capital Among Recovery Residents Taking Medication For Opioid Use Disorder In Texas, Elizabeth O Obekpa, Sheryl A Mccurdy, Vanessa Schick, Christine M Markham, Kathryn R Gallardo, Johnny Michael Wilkerson

Faculty, Staff and Student Publications

BACKGROUND: Recovery from opioid use disorder (OUD) includes improvements in health-related quality of life (HRQOL) and is supported by recovery capital (RC). Little is known about RC and HRQOL among recovery residents taking medication for OUD. We described HRQOL and RC and identified predictors of HRQOL.

METHODS: Project HOMES is an ongoing longitudinal study implemented in 14 recovery homes in Texas. This is a cross-sectional analysis of data from 358 participants' on HRQOL (five EQ-5D-5L dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and RC (Assessment of Recovery Capital scores) collected from April 2021 to June 2023. Statistical analyses were conducted …

Understanding The Implications Of Under-Reporting, Vaccine Efficiency And Social Behavior On The Post-Pandemic Spread Using Physics Informed Neural Networks: A Case Study Of China, Samiran Ghosh, Alonso Ogueda-Oliva, Aditi Ghosh, Malay Banerjee, Padmanabhan Seshaiyer

Faculty, Staff and Student Publications

In late 2019, the emergence of COVID-19 in Wuhan, China, led to the implementation of stringent measures forming the zero-COVID policy aimed at eliminating transmission. Zero-COVID policy basically aimed at completely eliminating the transmission of COVID-19. However, the relaxation of this policy in late 2022 reportedly resulted in a rapid surge of COVID-19 cases. The aim of this work is to investigate the factors contributing to this outbreak using a new SEIR-type epidemic model with time-dependent level of immunity. Our model incorporates a time-dependent level of immunity considering vaccine doses administered and time-post-vaccination dependent vaccine efficacy. We find that vaccine …

Age And Sex-Specific Stroke Epidemiology In Covid-19, Youngran Kim, Maria A Parekh, Xiaojin Li, Yan Huang, Guo-Qiang Zhang, Bharti Manwani

Faculty, Staff and Student Publications

BACKGROUND: COVID-19 has emerged as an independent risk factor for stroke. We aimed to determine age and sex-specific stroke incidence and risk factors with COVID-19 in the US using a large electronic health record (EHR) that included both inpatients and outpatients.

METHODS: A retrospective cohort study was conducted using individual-level data from Optum

RESULTS: Of 387,330 COVID-19 patients, 2,752 patients (0.71%, 95% CI 0.68-0.74) developed stroke during the 180-day follow-up, AIS in 0.65% (95% CI 0.62-0.67), and ICH in 0.11% (95% CI 0.10-0.12). Of strokes among COVID-19 patients, 57% occurred within 3 days. Advanced age was associated with a substantially …

Association Of The Gut Microbiome With Kidney Function And Damage In The Hispanic Community Health Study/Study Of Latinos (Hchs/Sol), Brandilyn A Peters, Qibin Qi, Mykhaylo Usyk, Martha L Daviglus, Jianwen Cai, Nora Franceschini, James P Lash, Marc D Gellman, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan

Faculty, Staff and Student Publications

BACKGROUND: The gut microbiome is altered in chronic kidney disease (CKD), potentially contributing to CKD progression and co-morbidities, but population-based studies of the gut microbiome across a wide range of kidney function and damage are lacking.

METHODS: In the Hispanic Community Health Study/Study of Latinos, gut microbiome was assessed by shotgun sequencing of stool (

RESULTS: Higher eGFR was associated with overall gut microbiome composition, greater abundance of species from Prevotella, Faecalibacterium, Roseburia, and Eubacterium, and microbial functions related to synthesis of long-chain fatty acids and carbamoyl-phosphate. Higher UAC ratio and CKD were related to lower gut microbiome diversity and …

Assessing Pandemic Preparedness, Response, And Lessons Learned From The Covid-19 Pandemic In Four South American Countries: Agenda For The Future, Andrea Ramírez Varela, Michael Touchton, J Jaime Miranda, Juliana Mejía Grueso, Rachid Laajaj, Gabriel Carrasquilla, Martha Vives Florez, Ana María Vesga Gaviria, Ana María Ortiz Hoyos, Esteban Orlando Vanegas Duarte, Alejandra Velásquez Morales, Nubia Velasco, Silvia Restrepo Restrepo

Faculty, Staff and Student Publications

INTRODUCTION: The COVID-19 pandemic emerged in a context that lacked adequate prevention, preparedness, and response (PPR) activities, and global, regional, and national leadership. South American countries were among world's hardest hit by the pandemic, accounting for 10.1% of total cases and 20.1% of global deaths.

METHODS: This study explores how pandemic PPR were affected by political, socioeconomic, and health system contexts as well as how PPR may have shaped pandemic outcomes in Argentina, Brazil, Colombia, and Peru. We then identify lessons learned and advance an agenda for improving PPR capacity at regional and national levels. We do this through a …

Genetic Associations Between Sleep Traits And Cognitive Ageing Outcomes In The Hispanic Community Health Study/Study Of Latinos, Yuan Zhang, Michael Elgart, Einat Granot-Hershkovitz, Heming Wang, Wassim Tarraf, Alberto R Ramos, Ariana M Stickel, Donglin Zeng, Tanya P Garcia, Fernando D Testai, Sylvia Wassertheil-Smoller, Carmen R Isasi, Martha L Daviglus, Robert Kaplan, Myriam Fornage, Charles Decarli, Susan Redline, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: Sleep phenotypes have been reported to be associated with cognitive ageing outcomes. However, there is limited research using genetic variants as proxies for sleep traits to study their associations. We estimated associations between Polygenic Risk Scores (PRSs) for sleep duration, insomnia, daytime sleepiness, and obstructive sleep apnoea (OSA) and measures of cogntive ageing in Hispanic/Latino adults.

METHODS: We used summary statistics from published genome-wide association studies to construct PRSs representing the genetic basis of each sleep trait, then we studied the association of the PRSs of the sleep phenotypes with cognitive outcomes in the Hispanic Community Healthy Study/Study of …

Pregnancy-Related Covid Worry, Depressive Symptom Severity, And Mediation Through Sleep Disturbance In A Low-Income, Primarily Latinx Population In California’S Central Valley, Jennifer N Felder, Patience A Afulani, Kimberly Coleman-Phox, Serwaa S Omowale, Charles E Mcculloch, Lauren Lessard, Miriam Kuppermann

Faculty, Staff and Student Publications

Purpose: This study (1) assessed the psychometric properties of a pregnancy-related COVID worry scale, (2) explored variations in pregnancy-related COVID worry over the course of the pandemic, and (3) examined associations between pregnancy-related COVID worry and depressive symptom severity, and evaluated sleep disturbance as a mediator.

Methods: Data were drawn from an ongoing randomized trial comparing the effectiveness of two enhanced forms of prenatal care. The current analysis includes baseline pre-randomization data collected from participants who enrolled November 2020-November 2021 (n = 201). Participants were pregnant individuals with low income and primarily Latinx.

Results: Our 7-item scale was valid and …

The Experiences Of Women In The Healthcare Profession With Alcohol Use During The Covid-19 Pandemic, Amber Olsen

Walden Dissertations and Doctoral Studies

Women have severe health risks associated with drinking alcohol long-term and excessively. The purpose of this qualitative study was to explore the lived experience of women in healthcare positions regarding alcohol use during the COVID-19 pandemic. The study was informed by the theory of planned behavior. Semistructured interviews were used to gather information from participants based on their firsthand experiences with alcohol usage. Understanding women’s attitudes toward alcohol use during the COVID-19 pandemic can improve intervention. Data were analyzed using an inductive, thematic procedure. Participants associated their own use of alcohol with socialization, and all participants reported that they regarded …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

College of Graduate Studies: Theses & Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

“So Many Extra Safety Layers:” Virtual Service Provision And Implementing Social Distancing In Interpersonal Violence Service Agencies During Covid-19, Rachel J Voth Schrag, Sarah Leat, Bethany Backes, Saltanat Childress, Leila Wood

Faculty, Staff and Student Publications

The coronavirus pandemic necessitated rapid shifts in approach for service providers working with survivors of interpersonal violence. To reduce the spread of the virus, providers and agencies implemented a rapid and unplanned expansion of virtual services while also developing new protocols to support safe and socially distant in-person services. To understand how these shifts have impacted victim service professionals and the survivors they serve, to provide guidance for on-going efforts, and to inform planning for future public health emergencies, this study asks the question: What approaches did the interpersonal violence workforce use to address social distancing needs during COVID-19? Semi-structured …