Public Health Commons^™

Exploring Connections Between Food Sovereignty, Cultural Food Access And Urban Health Promotion: A Systematic Review Of The Literature, Stephanie L. Kenyon

University Honors Theses

Marginalized urban communities face disproportionate rates of food insecurity related health outcomes and are more likely to lose important connections to traditional and cultural foods. Food sovereignty approaches, including policy changes, decolonized methods and community created perspectives to research and interventions have the potential to impact access to traditional and cultural foods, improving food security and supporting a healthier diet. The evidence in support of a food sovereignty approach to public health research and practice is limited and much of what is known is primarily based on studies at the global level or on rural communities. This systematic literature review …

Disaster And The Built Environment: How The Prephub Has The Potential To Impact Preparedness And Create Resilience During Natural Disasters., Sequoia Bellanca

University Honors Theses

Around the world, natural disasters pose a common threat to most communities. In 2015, Thecho, Nepal, suffered a magnitude 7.8 earthquake, killing 9,000 people and injuring nearly 22,000 (Reid, 2018). In the Pacific Northwest, the coast awaits a catastrophic earthquake, known as "The Really Big One" (Schulz, 2020), scientifically predicted to cause mass destruction. Although communities continue to experience and anticipate these disasters, the preparedness rate amongst individuals is shockingly low. Using this information, researchers developed a structure, rooted in interdisciplinary design, that will aid in the passive education of disaster preparedness amongst individuals and communities. Through unobtrusive qualitative research, …

Relationships Between Coping Mechanisms And Perceived Stress Of Portland State University Community Members Amidst Covid-19, Julie Goldman

University Honors Theses

Purpose: The purpose of this study was to assess the coping mechanisms used by the Portland State University (PSU) community and their relationships to perceived stress.

Methods: A virtual survey composed of demographic questions, the Perceived Stress Scale (PSS10), the Brief COPE, and two open-ended questions was distributed to the community. Data were collected from 231 respondents, mostly PSU students. Statistical Package for the Social Sciences (SPSS) was used to compute mean PSS score, adaptive coping score, and avoidant coping score. Pearson correlations and t-tests were run to explore the relationship between perceived stress and coping data.

Results: Perceived stress …

Treatment Satisfaction And Self-Efficacy In Hispanic Diabetes Patients At A Free Clinic Setting, Lhanze Tum

University Honors Theses

Diabetes continues to be one of the leading causes of death within the United States, with the Hispanic population having an especially high risk of developing diabetes. Understanding the different factors that may affect adherence to diabetes self-care, such as self-efficacy, duration of diabetes, and patient treatment satisfaction is important to reduce diabetes-related health complications. The aim of this study is to examine the relationship between patient self-efficacy for diabetes management and satisfaction with treatment, as well as whether the duration of diabetes is associated with self-efficacy for disease management. Baseline data was collected on 16 Hispanic patients with diabetes …

A Hidden Crisis During Covid-19: How Have Intimate Partner Violence Screening Guidelines For Pregnant Patients Changed Since The Start Of The Global Covid-19 Pandemic?, Zayba Afshar

University Honors Theses

Introduction: Due to the risks of pregnancy outcomes in relation to IPV and the increased rates of IPV as a result of COVID-19 precautions, health care screening for IPV in the prenatal process is even more imperative for preventing negative healthcare outcomes for both the pregnant patient and children.

Background: Intimate partner violence (IPV) is a significant public health issue that puts both baby and pregnant patients at risk for severe negative healthcare outcomes. Healthcare screening is a tool to find a condition or to learn more about a patient before symptoms become severe.

Methods: Screening for …

The Digital Divide And Health: Examining Digital Access As A Social Determinant Of Health, Elizabeth Melissa Withers

Dissertations and Theses

This dissertation is comprised of three papers that consider ways in which one's level of digital access may impact self-rated health. Data are from multiple years of three separate nationally representative cross-sectional surveys: National Health Interview Survey, General Social Survey, and Health Information National Trends Survey to address the primary overarching research question: Is there an association between digital access and health? The examination of the relationship between digital access and health is situated within a social determinants of health perspective and draws on van Dijk's (2005) causal and sequential model of digital access. Education, income, race and ethnicity, work …

Identifying The Cost Of Preventable Chronic Disease In Prison: Can Illness Prevention Of Adults In Custody Save Money?, Molly Bineham

Dissertations and Theses

This study investigates the cost of preventable health problems and ailments when compared to other costs of incarceration. The purpose of this study is to examine the impact of imprisonment on the costliest chronic illness. The health of adults in custody related to the general population and the overall fiscal cost of the deadliest chronic illness among incarcerated adults is discussed. Linear regression is used to analyze the occurrence of heart disease and diabetes among adults in custody while controlling for other factors. The results of this analysis provide insight that chronic diseases like heart disease and diabetes should be …

Nhanes Iii Mortality Follow Up: Social Determinants Creating Disparity Within The Health Outcomes Of Persons With Diabetes, Claire B. Adams

University Honors Theses

Given the recent research into the social determinants affecting health outcomes, the goal of this thesis is to examine whether a non-urban setting, among other social determinants of health, increases the risk of mortality among the United States diabetic population. We examined the relationship of urban and non-urban diabetes rates among those aged 40-74 years using a national sample of diabetic and nondiabetic Americans. The data was pulled from the Third National Health and Nutrition Examination Survey (NHANES III) which was conducted from 1988 to 1994. After excluding pregnant women, those who did not complete a fasting AM glucose, and …

Get Your Model Out There: Advancing Methods For Developing And Using Causal-Loop Diagrams, Erin Suzanne Kenzie

Dissertations and Theses

As simple visual diagrams of key dynamics in complex systems, causal-loop diagrams could meet known needs in settings such as theory-based program evaluation and qualitative research. Methods for developing and using causal-loop diagrams, however, are underdeveloped. This dissertation comprises three articles that advance these methods. The first paper describes a systematic review of evaluation studies utilizing causal-loop diagramming to illustrate program theory. The second paper pilots an improved method for systematically generating causal-loop diagrams from qualitative data. The third paper presents a protocol for an interview-based approach to mapping mental models. Together, this research contributes to recognizing the modeler as …

Decolonizing Healthcare: A Black Feminist Analysis Of Sisters Informing Sisters On Topics Of Aids (Sista), Joy Mutare Fashu Kanu

Dissertations and Theses

This mixed methods project combines the conceptual insights offered by institutional ethnography, the deductive and inductive attributes of content analysis, semi structured interviews, and quantitative data analysis to study Sisters Informing Sisters on Topics of AIDS (SISTA), a social skills training program designed for sexually active, heterosexual African American women. This progressive program serves as a site to examine the complex relationship the U.S. state has had, and continues to have, with marginalized populations, particularly African Americans. The program reveals how the state, through the public health service, partners with scholars, researchers, and community-based organizations to produce, reproduce and perpetuate …

Dual Panics: A Media Analysis Of Narratives On The Role Of Unauthorized Migration In America's Overdose Crisis, Morgan Godvin

University Honors Theses

Background: The realms of drug policy and immigration policy have long been fueled by misinformation, where sensationalism and panics help shore up political support. Most recently, the "border crisis" has been invoked to explain the "overdose crisis" in mass media narratives. Although the increase in migration is being blamed for illicit drug flows, drug importation occurs primarily through legal points-of-entry. The extent and excess visibility of false narratives linking overdose to migration in mainstream media is unknown.

Methods: We used the Media Cloud ecosystem to compile and characterize mainstream media content published between June 2021 and July 2021 regarding the …

Aligning Food Environments With Institutional Values: A Mixed Methods Study Of Oregon Health Care Organizations, Elizaveta Walker

Dissertations and Theses

A major driver of the obesity epidemic is obesogenic food environments, characterized by nutrient-poor and energy-dense foods that saturate the collective physical, economic and sociocultural conditions that influence nutritional status. Food environments in organizations such as hospitals and public health agencies warrant special consideration given their health-focused mission. Improving food environments within health care settings has been highlighted by the Centers for Disease Control and Prevention (CDC) as one of seven key strategies to prevent obesity. However, most of the refereed literature examining healthy food environment policies (HFEPs) within hospitals focuses on the inpatient dietary environment, leaving a paucity of …

Smoking Behaviors In Patients Offered Lung Cancer Screening, Sara Elizabeth Golden

Dissertations and Theses

In the United States, smoking causes preventable diseases, including lung cancer, which is the leading cause of cancer deaths. Improving smoking cessation rates is important to decrease lung cancer deaths. Health care visits with a discussion about lung cancer screening (LCS) may help in increasing prevalence of smoking cessation. Importantly, insurers now require clinicians to have a shared decision-making discussion with patients that includes discussion of smoking abstinence before they can receive an LCS scan (i.e., a low-dose computed tomography scan). This discussion may represent a unique opportunity to encourage smoking cessation since it may prompt positive smoking behavior change. …

Exploratory Study Of Obesogenic Commercial School Food Environments In The Portland Metropolitan Area, Sruthi Eapen

University Honors Theses

Objective

The purpose of this exploratory research was to study commercial food environments around high schools in the Portland metropolitan area to explore the question: How do the economic, geographic, and racial demographics of public high schools in the Portland metropolitan area affect the prevalence and make-up of obesogenic commercial food environments surrounding these schools?

Methods

Commercial food environments within a 1 km radius of 35 public high schools in the Portland metropolitan area were surveyed. The “healthiness” of the environment was calculated by establishing a “Food Environment Score.” This score was correlated with economic, geographic, and racial demographics obtained …

How Does The Effect Of Hurricane Katrina Influence Healthcare Infrastructure And Resilience?, Sean Y. Wei

University Honors Theses

In August 2005, Hurricane Katrina brought upon the city of New Orleans, LA one of the costliest natural disasters in U.S. history. This paper looks at how hospitals were prepared before Katrina, responded to, and grappled with the aftermath of this natural disaster. In the aftermath of Katrina, careful investigation of the healthcare system along with its hospitals, physicians, patients, and residents allow us to take innovative measures and provide guidance to create recommendations to better monitor and care for individuals in the future. Frameworks of resilience theories, studies, and recommendations display how and why disaster planning is essential. The …

Differential Effects Of Buprenorphine/Naloxone Vs. Methadone On Quality Of Life Over Time: A Subset Of The Bravo Study (Buprenorphine To Improve Hiv Care Engagement And Outcomes: A Randomized Trial), Ali Mirzazadeh Javaheri

University Honors Theses

Health-related Quality of Life (QoL) is generally poorer in individuals with opioid use disorder (OUD) in comparison with those suffering from other chronic diseases. Little is known about the difference each buprenorphine/naloxone (BUP/NX) or methadone maintenance therapy (MMT) may make in the QoL for the HIV-infected people with OUD who are new to HIV care. The objective of this study is to evaluate the difference in the impact that BUP/NX and MMT treatment delivery models make on the QoL of the HIV-infected participants with OUD in Vietnam.

This study was a subset of the BRAVO study, buprenorphine to improve HIV …

The Role Of Strategic Governance In Reducing Infant Mortality Under Crisis Conditions, Lynn Christine Finley

Dissertations and Theses

The infant mortality rate (IMR) in some developing countries has decreased faster than the global average even though these countries lack strong economic growth, good governance, and democracy (often acknowledged precursors to improved health outcomes). What accounts for the improvement of the IMR in the absence of these traditional pathways to health gains? Some scholars suggest that the concept of "strategic governance" might help direct attention to intermediary factors that reduce neonatal deaths in countries that experience crisis conditions. The main objective of this dissertation is to investigate the set of governance practices that have reduced IMR in two such …

Factors Affecting Clinical Research Enrollment Among Individuals With Alzheimer's Disease And Related Dementias, Nicole Grace Bouranis

Dissertations and Theses

The need to increase ADRD research participation has become more pressing as the prevalence of ADRD increases. Nearly 70,000 Oregonians and 7 million people in the United States live with ADRD, and this number is expected to increase by 200% by 2050 without identification of an intervention to halt its increase. Developing mechanisms for effective care and treatment depends on implementing research with numerous participants. Historically, ADRD research programs have had difficulty recruiting and enrolling individuals into studies for a variety of reasons. Given low recruitment rates, the interest in researching and evaluating effective strategies to recruit specifically for ADRD …

Iron-Deficiency Anaemia (Ida): Socio-Cultural Misconceptions Intersect The Health Of Vulnerable Populations In Developing Countries, Samantha G. Alarcon Basurto

University Honors Theses

Iron is a mineral that the human body uses to make hemoglobin, a protein that red blood cells need to carry oxygen from the lungs to all parts of the body. The lack of adequate iron in the blood is known as iron deficiency, which if experienced in greater proportions, can lead to anaemia. Iron-deficiency anaemia is generally understood as a nutritional deficiency that can be treated by diets of food rich in iron content or the ingestion of iron supplements; yet lack of information, restricted access to bioavailable iron-rich foods, minimal awareness of anaemia’s detrimental effects on children’s cognitive …

Emergence In The Strengths And Love Of My People To Counter Invisibility For Liberation In The White Academy, Emily D. Carrillo-Casares

University Honors Theses

Through a literature review and personal reflection, my thesis will focus on the strengths and love of my people to counter invisibility for liberation in the white academy. More importantly, my aim in this paper is to illustrate the strengths, courage, and will-power I came across to dismantle the concealed barriers in a system that misperceived my values. I will speak from the first person to express my feelings and experiences. When I use the words, my people, I mean people who identify themselves as Hispanic/Latino or non-white. The goal of this paper is to explicate how I remained strong …

A Public Health Recommendation Countering The Online Anti-Vaccination Movement, Grace M. Neumann

University Honors Theses

The anti-vaccination movement had posed a threat to the health of communities, since the inception of the smallpox inoculation practice. As the anti-vaxx movement continues to grow in strength and reach, public health officials must be prepared to combat the flow of misinformation, with sound scientific data in a way that connects with individuals from all communities. Online platforms such as blogs and social media, allow newfound access to vaccine opinions and information, posing an even greater risk of vaccine misinformation being spread to the public. Different communities hold different reasons for vaccine hesitancy and avoidance. An effective public health …

Sudden Cardiac Death In Young Adults With Long-Chain 3-Hydroxyacyl Coa Dehydrogenase Deficiency (Lchadd), Ajesh Saini

University Honors Theses

Long-chain 3-Hydroxyacyl CoA Dehydrogenase Deficiency (LCHADD) is an autosomal recessive defect in fatty acid oxidation that presents with hypoketotic hypoglycemia and/or hypertrophic cardiomyopathy in infancy, and recurrent rhabdomyolysis in adolescence, however, sudden cardiac death has not been a previously reported complication of LCHADD. We have conducted a case review study comparing young adult LCHADD patients who have experienced sudden cardiac arrest events (n=5) to similar patients who have not (n=5) for the purpose of evaluating associated cardiac risk factors. We reviewed medical records from ECG tests, hospitalization reports, acylcarnitine, and complete metabolic panels, clinic notes, and autopsy reports. Retrospective chart …

Frequency Of Limited English Proficient (Lep) Patient Visits And Language Resources: An Assessment Of Rural Oregon's Health Centers And Working With Lep Communities, Gabriel I. Lehrburger

University Honors Theses

Persons with limited English proficiency (LEP) can face barriers when seeking health care. Rural communities often have reduced access to some health resources. However, little is known about how rural communities meet the language needs of their LEP populations. A cross-sectional survey and interview were designed and sent to managerial staff in rural health centers around the state of Oregon. During the months of January – March 2020, survey and interview data were collected to assess the relationship between frequency of LEP patient visits and available language resources in rural Oregon. The study also investigated staff perceptions when working with …

Organizational Risk In Multi-Sector Health Partnerships: A Case Study Of Oregon's Accountable Health Communities, Shauna Jean Nicole Petchel

Dissertations and Theses

The literature on collective action has documented that the perception of organizational risk -- both the uncertainty of potential outcomes and the meaning attached to them -- is an important factor in whether and how organizations engage in cross-sector collaborations. Yet there are few examples to date that document how health and social service leaders perceive organizational risks in cross-sector health partnerships focused on social determinants of health, or how their perceptions influence organizational commitment and willingness to engage in these partnerships over time.

This research aimed to fill this gap through a mixed methods case study of health and …

Meta-Analysis Of Tobacco Control Policies For Reducing Tobacco Consumption, Arya Kevin Naghdi

University Honors Theses

The harmful effects of tobacco consumption and smoking have been well documented, and the literature is conclusive on their negative effects. However, there is still a great deal of discussion to be had on which policies and strategies can be employed to decrease smoking rates. Tobacco control policies used in the past included tobacco taxes, smoke free zones, anti-smoking media, sale to minors bans, and advertising restrictions on tobacco companies. Yet, it is still unclear which policies are most effective and least effective when it comes to reducing smoking rates. A meta-analysis of 11 articles analyzing the effects of each …

Examining Integration And Sense Of Belonging Among Undergraduate Students Participating In Stem Support Programs, Mackenzie J. Gray

University Honors Theses

National calls have been made to strengthen our nation’s Science, Technology, Engineering, and Mathematics (STEM) workforce by improving student preparation and increasing retention rates. A sense of belonging in STEM fields is thought to be key for persistence in STEM, but many students face academic, social, and financial barriers that can impede this sense of belonging. These barriers can be more pronounced for students underrepresented in STEM. In response, many federal and non-governmental agencies have invested in the future STEM workforce by funding STEM support programs. Such programs aim to support student persistence by providing academic, social, and financial resources …

Life Satisfaction In Division Iaa And Division Iii Football Players, Krista Haunani Francisco

Dissertations and Theses

Level of life satisfaction is not something of which many sit down and take appraisal. However, levels of life satisfaction, especially low levels of life satisfaction, can have a direct effect on health. Low levels of life satisfaction cause an increase in self-reported stress. Inversely, high levels of stress cause a decrease in life satisfaction. This decrease in life satisfaction is associated with poor mental and physical health outcomes. A majority of student-athlete healthcare is centered around the physical aspects of health, with mental health just recently becoming a concern. It was apparent through the research for this study that …

Migrant Health Policies In The European Union: A Comparative Policy Analysis, Jessica Joanne Currier

Dissertations and Theses

There is an undeniable relationship between migration and health. Despite the fact that the concept of health as a fundamental human right has been enshrined in numerous international and supranational policy instruments, health disparities between migrants and host nation populations persist. Inequities in health are perpetuated by several factors that include, but are not limited to, immigration status, lack of knowledge of health system access points, appropriateness of health care services, language barriers, and unique health profiles of migrants. The literature firmly positions migrants as a vulnerable population due to their collective risk of poor health outcomes in multiple areas. …

How Urban Land Use Contributes To Inequitable Health Outcomes: An Interdisciplinary Review & Analysis, Bliss Storm Croton

University Honors Theses

Using existing literature as a basis for initial review, this paper seeks to explore the relationship between urban land use and socioeconomic status as both pertain to the prevalence of psychological health diagnoses among neighborhood residents. The purpose of this analysis is to investigate the combined literature from multiple areas of research in order to gain a more holistic, up-to-date scope of knowledge regarding how discriminatory neighborhood land use may result in poorer psychological health outcomes for urban populations. By utilizing an interdisciplinary approach, some of the locally relevant, long-term impacts of uneven development and environmental injustice are examined based …

Medicaid Patients' Use Of Dental Benefits, Merit Roshdy

University Honors Theses

Oregon Health Plan patients experienced reduction to their dental coverage in 2003. This study explores Medicaid patients’ use of those dental services that are still offered to them and the effect of their use on self-assessment of their oral health. A phone survey was conducted in 2017 and collected a sample of 293 Medicaid patients in Oregon. Only two thirds of participants reported that they have a regular dentist. Participants were more likely to rate their overall health as Excellent/Good when also rating their gum health as Excellent/Good. Low English Proficiency (LEP) patients were NOT less likely to visit their …