Public Health Commons^™

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Leptin Produced By Obesity-Altered Adipose Stem Cells Promotes Metastasis But Not Tumorigenesis Of Triple-Negative Breast Cancer In Orthotopic Xenograft And Patient-Derived Xenograft Models, Rachel A. Sabol, Annie C. Bowles, Alex Côté, Rachel Wise, Benjamen O'Donnell, Margarite D. Matossian, Fokhrul M. Hossain, Hope E. Burks, Luis Del Valle, Lucio Miele, Bridgette M. Collins-Burow, Matthew E. Burow, Bruce A. Bunnell

School of Medicine Faculty Publications

BACKGROUND: Breast cancer is the second leading cause of cancer deaths in the USA. Triple-negative breast cancer (TNBC) is a clinically aggressive subtype of breast cancer with high rates of metastasis, tumor recurrence, and resistance to therapeutics. Obesity, defined by a high body mass index (BMI), is an established risk factor for breast cancer. Women with a high BMI have increased incidence and mortality of breast cancer; however, the mechanisms(s) by which obesity promotes tumor progression are not well understood. METHODS: In this study, obesity-altered adipose stem cells (obASCs) were used to evaluate obesity-mediated effects of TNBC. Both in vitro …

Increasing Long Acting Reversible Contraception Use In Primary Care: Removing The Barriers, Jessamyn Phillips

Doctor of Nursing Practice (DNP) Projects

Problem: Unintended pregnancy is a serious public health concern. About half of all pregnancies in the United States are unintended (Guttmacher Institute, 2016). This project lead by a Doctor of Nursing Practice (DNP) student at the University of San Francisco, will showcase the development, implementation, and evaluation of a LARC training program aimed at improving confidence in counseling, competence in insertion, and evaluation increased rates of LARC usage in primary care, directed at reducing unintended pregnancy rates. This program expands upon the Healthy People 2020 goals dedicated to family planning and emphasis on increased utilization of the most effective forms …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

Orthorexia Nervosa Among Collegiate Female Student-Athletes, Maryse Bard-Martel

Graduate Theses/Dissertations

Orthorexia nervosa (ON) is a specific style of disordered eating defined as an unhealthy obsession with eating healthy food, or going to extremes in the pursuit of a diet that is supposed to be good for you. The purpose of this study was to explore the prevalence of orthorexia nervosa tendencies in college female soccer players in the NCAA Division 1. Purposive sampling was used, and participants were current student-athletes from the Missouri State women’s soccer team (n=18). Survey research was utilized to assess athletes’ attitudes and behaviors related to various aspects of diet and training, and the control it …

Impacts Of Contraception On Women’S Decision-Making Agency In Indonesia, Michaela J. Fogarty

Undergraduate Economic Review

Increasing access to contraception has the potential to empower women and improve the economic standing of families across the globe. Many researchers have explored the impacts of contraception on families and the determinants of women’s level of empowerment, but little scholarship exists on their direct relationship. This paper explores the impacts of contraceptive use on women’s empowerment, measured by a sum of women’s household decision-making agency. Panel data from three rounds of the Indonesian Family Life Survey is used to run multiple regressions with household fixed effects. Results suggest that women who use contraception have input on two additional types …

“I Don’T Know If I Have The Courage”: Reproductive Choices In Times Of Zika, Ana Rosa Linde Arias, Elisa Tristan-Cheever, Grace Furtado, Eduardo Siqueira

Gastón Institute Publications

Neste estudo transnacional, pretendemos fornecer informações sobre as opiniões e atitudes das mulheres em relação aos seus direitos reprodutivos durante a epidemia do Zika. Mulheres de diferentes nacionalidades e etnias foram recrutadas em vários locais do Brasil, Porto Rico e Estados Unidos. Foram realizadas entrevistas semiestruturadas que sugerem que as decisões reprodutivas dos participantes estavam intimamente relacionadas às convicções pessoais e crenças culturais, e suas ações e pensamentos foram incorporados em suas normas socioculturais. A maioria das mulheres entrevistadas comunicou que é preciso coragem para tomar a decisão extrema, emocional e esmagadora de fazer um aborto. Os achados deste estudo …

The Correlation Between Undergraduate Students Who Attend The University Recreation Center And Students Exhibiting Symptoms Of An Eating Disorder, Olivia Daniels

Senior Honors Projects, 2010-2019

Background: The prevalence of eating disorders on college campuses indicates an important issue in contemporary society. As students experience a heightened level of freedom, they have the option to explore multiple forms of weight- management, including compulsive exercise.

Methodology: An online survey was distributed to female undergraduate students(n=206) at James Madison University.

Results: A significant relationship was found between eating disorder symptomology and where participants decided to spend their time at the University Recreation Center (UREC), as well as what type of physical activity they chose to perform. A significant inverse relationship between increasing muscle mass and burning calories was …

Impact Of The Affordable Care Act On The Cooper Women’S Care Center, Amanda Malik, Natali Franzblau

Cooper Rowan Medical Journal

Background: The Affordable Care Act (ACA) increased access to women’s health care by expanding Medicaid eligibility and requiring that insurance plans cover many gynecologic preventive services at no cost to patients. Before implementation of the ACA, pregnant women with low incomes qualified for Medicaid but childless adults of the same income did not, and though prenatal obstetrical visits were covered by plans at no or low cost to patients, most gynecologic services required out of pocket payments.

Objective: This study aimed to identify changes in the types of visits (gynecologic or obstetric) and patient demographics (including age, race, …

Pre-Operative Risk Of Medical Complications Varies By Health Insurance Carrier In Moderately Obese Women: Medicaid V Medicare V Private V Self-Pay, Paul Osterdahl, Melissa Gott, Amanda Sundling, Gus J. Slotman

Rowan-Virtua Research Day

Introduction: Clinical variation by health insurance status in mixed sex bariatric surgery populations is reported, but such variation among moderately obese women is unknown.

Objective: to identify pre-operative variation by health insurance in female surgical patients.

Conclusions: Pre-operative characteristics of moderately obese women vary by insurance. Medicare’s highest risk for cardiopulmonary problems and diabetes, and Medicaid’s highest asthma, abdominal-hepatobiliary, and psychological/behavioral complications should be considered in managing moderately obese women subscribing to these carriers.

Maternal Morbidity Outcomes In Idiopathic Moyamoya Syndrome In New York State, Hajere J. Gatollari, Amelia K. Boehme, E. Sander Connolly, Alexander M. Friedman, Mitchell S.V. Elkind, Joshua Z. Willey, Eliza C. Miller

Rowan-Virtua Research Day

Background: Pregnancy is associated with an increased risk of stroke in young women. Idiopathic moyamoya syndrome (IMMS) is a rare condition characterized by progressive narrowing of large cerebral arteries resulting in flimsy collaterals prone to rupture or thrombosis. Data are limited on pregnancy outcomes in women with IMMS. We hypothesized that IMMS would be associated with increased pregnancy morbidity, including stroke.

Conclusion: Pregnancies within 1 year prior or any time after IMMS diagnosis did not have increased maternal morbidity compared to unexposed pregnancies after adjusting for age and clustering of women with multiple pregnancies. Prospective studies are needed to better …

“Flowing Along The Wall”: Anarcha-Feminist Bioethics And Resistance In Octavia E. Butler’S Dawn 2019., Theresa Mendez

Master's Theses

Science fiction (sf) texts conversant with the temporal play between past, present, and future push readers to imagine the extremes of human and environmental existence, interaction, and potential. Simultaneously, despite the sf genre’s tendency to traffic in extremes, these texts provoke readers to consider the ways in which these imagined worlds are grounded in history as well as in the contemporary social moment. As Donna Haraway has argued, “the boundary between science fiction and social reality is an optical illusion” (306). This illusory boundary must continue to be traversed in order to consider how sf literatures, particularly those which imagine …

An Analysis Of Providers’ Perceived Barriers To Contraceptive Access And Reproductive Healthcare, Ashley Weadick

Senior Honors Projects

The field of Reproductive Healthcare covers nearly every aspect of women’s health. Even during non-reproductive years, Reproductive Healthcare is important for women because it provides medical care often essential to their lives before and after child-bearing years. Contraception is needed by many women before they wish to have children, and after they have any children they choose to have, they may again wish to use contraception or they may require help with postpartum care. One of many reasons why Reproductive Healthcare is so important is because it explains the wide array of options available when it comes to methods of …

Addressing Barriers To Preventative Health Care For Transgender Populations: A Systems Approach To Improving Access To Gynecological Care, Meghan N. Flynn

Master's Theses

The current study addresses the lack of research exploring the individual and systemic barriers to accessing gynecological care for transgender populations. An integrated mixed-methods needs assessment was designed to explore the individual and systemic barriers to gynecological health care for transgender and gender diverse populations. Participants of the study included established community providers known to serve the transgender community through advocacy or research efforts, as well as clinical psychologists and medical professionals working in gynecological settings. The study includes a brief quantitative survey, which measured “Perceptions of Inclusivity Importance” among key stakeholders. Following the survey, participants were invited to engage …

A Qualitative Analysis Of Men’S Intended Bystander Behaviors In Response To A Sexual Assault Vignette, Evelyn Day

Health, Human Performance and Recreation Undergraduate Honors Theses

Sexual assault is a pervasive problem; there are myriad negative consequences associated with sexual assault victimization. Given the commonality and consequences associated with victimization, preventing sexual assault is paramount. One mechanism thought to reduce rates of sexual assault is bystander intervention, in which third parties are encouraged to intervene when witnessing sexual assault risk factors and to challenge cultural norms regarding rape and assault. Despite the benefits of bystanding, not everyone intervenes. Previous research indicates that compared with women, men are less likely to intervene. Although some men intervene, researchers’ understanding of how men bystand is limited. The goal of …

The Association Between Advanced Maternal Age And Short Interpregnancy Intervals On Preterm Labor, Hannah N. Burns, Kristi L. Duchanois

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background: Preterm birth is the leading cause of neonatal and infant mortality and has become a major health concern due to the increasing rates of infant deaths in the United States (WHO, 2017). Studying maternal risk factors for preterm labor provides insight to this obscure condition and can assist in the identification of high risk women, as well as facilitate appropriate pregnancy planning. Purpose: Although research can be found on interpregnancy intervals and maternal age as independent risk factors for premature labor, gaps exist within the relation of these variables. This study was done to investigate whether there is …

Pro-Anorexia Website Harm, Jane C. Silva Ramirez

Journal of Critical Issues in Educational Practice

This paper explores the nature of websites that glorify eating disorders, or EDs. These websites are often referred to as “pro-ED” (pro-eating disorder), “pro-ana” (pro-anorexia), or “pro-mia” (pro-bulimia). For the purpose of this paper, only pro-ED, pro-ana, and pro-recovery website research were the focus. Scholarly articles found in California State University San Bernardino’s database were used to distinguish the different ways that these websites help and cause harm to individuals. Articles about pro-ED and pro-ana websites helped prove harmful to individuals, claiming the disorder as a “lifestyle”. It also showed the support these communities feel when interacting through blogs, comments, …

Shifting Abortion Attitudes Using An Empathy-Based Media Intervention: A Randomized Controlled Study, Mary Ellen Hunt

Graduate Theses and Dissertations

U.S. abortion restrictions diminish access and perpetuate a culture of hostility toward abortion seekers. Support for restrictions is high—potentially, because restriction knowledge is low and attitudes are complex. The current study focused on knowledge and support of restrictions and empathy for abortions seekers among Arkansans. The purpose was to evaluate the effectiveness of a video intervention intended to increase awareness of Arkansas abortion restrictions and induce empathy for abortion seekers.

Using a randomized controlled trial with pre-, post-, and follow-up design, a sample of Arkansans (N = 369) were randomly assigned to one of five video conditions--either a control or …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

Fertility Awareness Based Methods (Fabms): Evaluating And Promoting Female Interest For Purposes Of Health Monitoring And Family Planning, Amylynn Smith

Graduate Theses and Dissertations

Natural or fertility awareness-based methods (FABMs) help users monitor, interpret, and systematically chart female biological markers. FABMs are used as family planning methods and sometimes as reproductive health monitoring methods. The American College of Obstetricians and Gynecologists (ACOG) encourages medical professionals to use female reproductive cycle patterns, ‘the female fifth-vital sign’, as a means of improving the diagnosis and treatment of reproductive health diseases, disorders, and conditions. Patients need to have accurate knowledge of healthy and unhealthy cycle patterns. The general public does not have a sufficient level of fertility health knowledge. This study examined whether females that are interested …

Pain Management For Intrauterine Device Insertion And Endometrial Biopsy, Michelle Lipton-Carroll

Evidence-Based Practice Project Reports

Intrauterine device (IUD) insertions and endometrial biopsies (EMB) can be painful in office gynecological procedures. In the clinical setting used for this evidence-based project (EBP) it was noted there was no consistent pain management being used for these procedures. For this EBP project a protocol for pain management during IUD insertions and EMBs was developed and implemented into this clinical setting. The protocol was created from an exhaustive literature search, which yielded six pieces of high-level evidence of good quality. The evidence supported the use of a 1% lidocaine paracervical block prior to IUD insertion and a 2% lidocaine intrauterine …

Preventive Health Service Use Among Rural Women, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Jaclyn Janis Bsn, Rn

Access / Insurance

Preventive health services and screenings are an important component in the continuum of care provided to individuals across all ages. Yet, research has shown that rural residents generally use fewer preventive health services and screenings. This study used the National Health Interview Survey to examine receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and receipt of the HPV vaccine) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services, and that some of the differences may be …

Parameterizing And Validating Existing Algorithms For Identifying Out-Of-Bed Time Using Hip-Worn Accelerometer Data From Older Women, John Belletierre, Yiliang Zhang, Vincent Berardi, Kelsie M. Full, Jacqueline Kerr, Michael J. Lamonte, Kelly R. Evenson, Melbourne Hovell, Andrea Z. Lacroix, Chongzhi Di

Psychology Faculty Articles and Research

Objective: To parameterize and validate two existing algorithms for identifying out-of-bed time using 24-hour hip-worn accelerometer data from older women. Approach: Overall, 628 women (80±6 years old) wore ActiGraph GT3X+ accelerometers 24 hours/day for up to 7 days and concurrently completed sleep-logs. Trained staff used a validated visual analysis protocol to measure in-bed periods on accelerometer tracings (criterion). The Tracy and McVeigh algorithms were adapted for optimal use in older adults. A training set of 314 women was used to choose two key thresholds by maximizing the sum of sensitivity and specificity for each algorithm and data (vertical axis, VA, …

Contraception Utilization Among Women, Ages 18-45, Receiving Medication Assisted Therapy For Opioid Use Disorder In Middle Tennessee, Kerry J. Ternes

DNP Projects

The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey …

Religious Coping And Christ-Centered Recovery For Women With Substance Use Disorders, Mary Beth Bever

DNP Projects

Women have unique risk factors for the development of substance use disorder (SUD), barriers to SUD treatment, and risk factors for SUD relapse that require holistic care models and provide trauma-informed care approaches that address effective coping strategies. The use of religion and spirituality has been commonplace in many SUD programs to inspire the use of positive religious coping; however, negative religious coping may also be drawn on which poses a potential harm for women with SUD. The aim of this project was to assess for a correlation in positive and negative religious coping scores and program completion rates in …

Why Doula Services Should Become An Essential Health Benefit In New York State, Jalisha Hanshaw, Amy White

Publications and Research

Doulas are birth workers who assist expecting mothers through pregnancy, birth and postpartum using holistic techniques. Techniques include: prenatal yoga, birth affirmations and induction acupuncture. Doulas are underrated healthcare providers who deserve the same respect as clinical and non-clinical providers. Doulas are well-rounded alternative care providers who focus on mental, emotional, and physical well being of mothers. Also, they know special alternative medical techniques that prevent mothers from maternal mortality among other negative health outcomes. The amount of time and effort doulas perform with expecting mothers are equal or more than the average medical healthcare provider and should be a …

Nutrient And Food Group Intakes Of Low-Income Pregnant Women By Race/Ethnicity, Alla M. Hill, Danielle L. Nunnery Phd, Rdn, Ldn, Alice Ammerman Drph, Jigna M. Dharod Phd

Journal of Health Disparities Research and Practice

In an exploratory study, a convenience sample of 148 pregnant women was recruited from a WIC clinic in the southeast region of the U.S. to: 1) Examine and compare daily nutrient and food group intakes of WIC pregnant women to national guidelines, and; 2) Determine racial/ethnic differences in nutrient and food group intakes among WIC pregnant women. Women were selected for the study if they were: ≥ 18 y, in 2^nd trimester of pregnancy, and if they spoke English or Spanish as a first language. Upon recruitment, participants were interviewed to collect information on their socio-demographics, including race/ethnicity. Additionally, …

G.I. Jane Fem Etran Goes Corporate: An Exploration Of Post-9/11 Female Combat Veterans Transitioning To A Civilian Career, Tumona Austin

Dissertations

Purpose: The purpose of this multiple-case study was to explore the experiences of post- 9/11 female combat veterans transitioning from military service to civilian careers, using the Schlossberg transition model factors of situation, self, social support, and strategies.

Methodology: This multiple-case study identified and interviewed post-9/11 female combat veterans transitioning from active-duty to civilian career. Respondents were purposively chosen based on specific criteria and expert panel recommendations.

Findings: Examination of case-study interview data and artifacts from the 3 post-9/11 female combat veterans indicated nine major findings:

1. The factor of situation clearly outweighed the other Schlossberg factors in impact.

2. …

The Effect Of Exercise On Menopausal Women, Audry Holman, Barbara Mcclaskey

Posters

The purpose of this research is to identify if the negative physical and physiological symptoms of menopause are decreased in menopausal women who exercise compared to menopausal women who do not exercise. There are many negative symptoms of menopause including an increase in waist circumference, hot flashes, and weight gain. Exercise is a non-pharmacological way to decrease some of these symptoms that women experience when going through menopause. Multiple studies show that exercise decreases the risk of osteoporosis, body fat, waist circumference, triglyceride levels, and depressive symptoms in menopausal women. The studies also show that exercise increases quality of life, …

Effects Of Evidence-Based Materials And Access To Local Resources On Physical Activity During Pregnancy, Kolbi Edens

Masters Theses & Specialist Projects

Physical activity (PA) during pregnancy has been shown to be safe and effective for improving maternal and infant health; however, only 23% of pregnant women exercise in accordance with guidelines. PURPOSE: To determine if the distribution of evidence-based educational resources as well as access to community resources will increase PA levels as well as knowledge/beliefs about PA during pregnancy. METHODS: Participants (8-12 weeks) completed assessments concerning their activity levels, as well as knowledge/beliefs regarding PA, during pregnancy. Next, participants were randomly assigned to either an intervention (IG) or control group (CG). The IG received educational information regarding PA during pregnancy, …