Public Health Commons^™

A Cross-Sectional Survey Of Potential Factors, Motivations, And Barriers Influencing Research Participation And Retention Among People Who Use Drugs In The Rural Usa, Angela T. Hetrick, April M. Young, Miriam R. Elman, Sarann Bielavitz, Rhonda L. Alexander, Morgan Brown, Elizabeth Needham Waddell, P. Todd Korthuis, Kathryn E. Lancaster

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background:

Despite high morbidity and mortality among people who use drugs (PWUD) in rural America, most research is conducted within urban areas. Our objective was to describe influencing factors, motivations, and barriers to research participation and retention among rural PWUD. Methods: We recruited 255 eligible participants from community outreach and community-based, epidemiologic research cohorts from April to July 2019 to participate in a cross-sectional survey. Eligible participants reported opioid or injection drug use to get high within 30 days and resided in high-needs rural counties in Oregon, Kentucky, and Ohio. We aggregated response rankings to identify salient influences, motivations, and …

Antipsychotic Medication Administration In Oregon Assisted Living/Residential Care Settings: Analyzing An Action Situation, Sarah Dys

Dissertations and Theses

Antipsychotic medication use (APU) in assisted living and residential care (AL/RC) settings is an under-studied and controversial health policy issue. APU in older adults with dementia is associated with an increased risk of falls, hospitalizations, and early mortality. I operationalize the Institutional Analysis and Development Framework using a situational analysis approach, an extension of grounded theory methods, to explore the APU in Oregon AL/RC settings. Regulatory deficiency citations, Oregon AL/RC population data, and semi-structured interviews suggest that staff role clarity, organizational characteristics, and perceived agency influence decision-making around APU. AL/RC providers and caregivers are forced to simultaneously balance and prioritize …

Centering Equity In Sustainable Food Systems Education, Eleanor J. Sterling, Erin Betley, Selena Ahmed, Sharon Akabas, Daniel J. Clegg, Shauna Downs, Betty T. Izumi, Pamela Koch, Sara M. Kross, Karen Spiller, Lemir Teron, Will Valley

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sustainable food systems education (SFSE) is rapidly advancing to meet the need for developing future professionals who are capable of effective decision-making regarding agriculture, food, nutrition, consumption, and waste in a complex world. Equity, particularly racial equity and its intersectional links with other inequities, should play a central role in efforts to advance SFSE given the harmful social and environmental externalities of food systems and ongoing oppression and systemic inequities such as lack of food access faced by racialized and/or marginalized populations. However, few institutional and intra-disciplinary resources exist on how to engage students in discussion about equity and related …

The Longitudinal Effects Of A Family And Sleep Supportive Intervention On Service Member Anger And Resilience, Shalene Joyce Allen

Dissertations and Theses

The vast majority of workplace intervention research on employee anger and resilience primarily focuses on individual-level strategies for mitigating employee anger and resilience outcomes in the workplace, with no studies having examined these outcomes with tangible occupational health interventions utilizing organizational-level techniques. Thus, the current study extends the literature on how to provide improvements in employee anger and resilience using higher system and organizational change mechanisms by providing evidence-based support for the effectiveness of a Total Worker Health® intervention, referred to as the Family and Sleep Supportive Intervention Training (FaSST). This approach employs both health protection and health promotion strategies …

Addressing And Supporting Mental Health Today: Society-Wide And In Hospital Emergency Departments, Kira La Sage

University Honors Theses

Mental health has become one of the most pressing public health issues of the 21st Century. Westernized societies offer much of their attention to childhood obesity, to COVID-19, to undiagnosed and diagnosed Americans living with diabetes. America even sees extended U.S. Senate hearings focusing on opioid use and abuse. Each of these concerns legitimately commands public health official attention, but what the world does not see is any level of sustainable attention given to emotional and mental health crises affecting tens of millions in Westernized countries. Suicide, the most serious of mental health crises, has become the second leading cause …

Effects Of Hormone Replacement Therapy (Hrt) On Gene Expression In The Amyloid Processing Pathway Of Ovariectomized Rhesus Macaque Females Under An Obesogenic Diet, Megan Ball

University Honors Theses

Estrogens rapidly decline at the onset of menopause, putting women at higher risk of osteoporosis, obesity, and neurodegenerative diseases, including Alzheimer’s disease (AD). Estradiol hormone therapies (HT) have been suggested to limit these negative effects on women, with controversial findings as to their effectiveness. A study at OHSU recently found differentially expressed genes (DEGs) using RNAseq between ovariectomized/hysterectomized (OvH) old (range = 19.4–23.2 years) female rhesus macaques on HT and those on a placebo on chronic western style diet (WSD). The DEGs identified in the amyloid processing pathway of the amygdala were selected for validation using RT-qPCR because β-amyloid peptide …

Understanding The Role Of Family-Specific Resources For Immigrant Workers, Faviola Robles-Saenz, Rebecca M. Brossoit, Tori L. Crain, Leslie Hammer, Jacqueline R. Wong

Psychology Faculty Publications and Presentations

Very few studies to date have examined immigrant workers’ (i.e., workers who were not born in the United States) experiences of the work-family interface. In a sample of healthcare workers across two time points, the present study evaluates the role of different family-specific resources for immigrant workers compared to native-born workers (i.e., workers born in the U.S.). The results suggest that family-specific support from coworkers is especially beneficial for reducing immigrant workers’ experiences of family-to-work conflict. For both native-born and immigrant workers, those who experience more family-specific support from supervisors and coworkers, and those who work in an organization that …

“It’S Like 1998 Again”: Why Parents Still Refuse And Delay Vaccines, Jiana L. Ugale, Heather Spielvogle, Christine Spina, Cathryn Perreira, Ben Katz, Barbara Pahud, Phd Amanda F. Dempsey Md, Jeffrey D. Robinson Phd, Kathleen Garrett Ma, Mph Sean T. O’Leary Md, Mph Douglas J. Opel Md

Communication Faculty Publications and Presentations

We conducted a qualitative study from 2018 to 2019 to update the reasons why US parents’ refuse or delay vaccines. Four focus groups and 4 semi-structured interviews involving 33 primary care pediatric providers were conducted in Washington and Colorado. A thematic analysis was conducted to identify themes related to reasons for parental refusal or delay. Five predominant themes were identified: (1) vaccine safety, (2) relative influence of information sources, decision-makers, and timing, (3) low perceived risk of contracting vaccine-preventable disease, (4) lack of trust, and (5) religious objection. Vaccine safety was the theme mentioned most frequently by providers (N = …

The Social Determinants Of Human Milk Banking: Impacts Of Demographic And Geographical Factors On Human Milk Donor Behavior, Zayba Z. Afshar, Claire Wheeler

McNair Symposium

Human milk banking is a vital source of milk for infants for a multitude of reasons. Many of which go to medically fragile infants in Newborn Intensive Care Units (NICUs). The purpose of this study is to learn about how the social determinants of health and graphical factors affect human milk donor behavior through GIS (Geographic Information System) mapping to provide recommendations on how to improve overall donor participation. This research was conducted through a partnership with a local human milk bank accredited by HMBANA called Northwest Mothers Milk Bank (NWMMB) located in Tigard, OR. Demographic and geographic data was …

Using Blood Biomarkers To Predict Traumatic Brain Injury, Rosol Hatim Mikail, Martin Schreiber

McNair Symposium

Traumatic brain injury (TBI) is a serious medical condition that needs a diagnosis to be treated. The neurological exam used for diagnosis is not able to detect all TBIs. Without a TBI diagnosis, a patient is not able to get the necessary medical care in time which could potentially lead to long-term brain damage and mortality. Some blood biomarkers have been investigated and found to have a correlation with TBI. Testing the blood is more accessible to diagnose TBI; this could connect the patient with further medical treatment when a TBI is suspected through the test. In this experiment, the …

Exploring The Impact Of Interpersonal Trust On Health Outcomes In Rapidly Gentrifying Neighborhoods In Portland, Oregon, Julie Ha, Yves Labissiere

McNair Symposium

Social determinants have been recognized to be significant factors contributing to the overall health outcomes of individuals. However, there is limited research on how these factors have directly impacted the mental and physical wellness of people in neighborhoods who are experiencing rapid gentrification. The objective of this study is to determine whether the level of interpersonal trust present between individuals in neighborhoods is associated with the mental and physical health outcomes among its residents. This quantitative study uses the Albina-Rockwood Neighborhood Promise Survey, which uses data from a random sample of families living in two rapidly gentrified neighborhoods in Portland, …

Affecting Absenteeism Through School-Based Health Services Delivery: A Configurational Comparative Methods Study Of Oregon's Public Secondary Schools, Kelly Elizabeth Coates

Dissertations and Theses

A student's ability to attend school regularly can be profoundly affected by poor health-related behaviors, illnesses, and chronic diseases that are left unaddressed and unattended. The delivery of health services in the school environment is uniquely positioned to interrupt the effects these health barriers to learning (HBLs) can have on subsequent diminished educational and health outcomes. The literature widely acknowledges the intersectionality between health and education, but no comprehensive overview exists of how different structures and processes within a school work (or do not work) together to lead to higher or lower student absenteeism. This research sought to fill that …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

Impacts Of Covid-19 On Rural Medical Business Models, Kendra L. Stefan

Anthós

This paper is concerned with the question of how COVID-19 impacts the medical delivery system in a rural community. It presents findings from interviews of medical professionals participating in an isolated rural community and public health officials that coordinate preparedness planning. This paper reviews barriers of access to healthcare in an already constricted system. Then looks at the implications of COVID-19 as an additional strain. Interviews of professionals will survey preparedness, regulatory impacts, repercussions to the business model, impact on service capacity, and opportunities for improvement. Interested parties would include patient advocates, patients, healthcare workers, politicians, and employers.

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 …

Estimation Of Excess Mortality Rates Among Us Assisted Living Residents During The Covid-19 Pandemic., Kali S. Thomas, Wenhan Zhang, David M. Dosa, Paula Carder, Philip Sloane, Sheryl Zimmerman

Institute on Aging Publications

The devastating effects of COVID-19 among older adults residing in long-term care settings have been well documented.1 Although much attention has been paid to COVID-19–associated mortality in nursing homes,2 less is understood about its effects on assisted living residents. Most assisted living residents are aged 80 years or older and many have multiple chronic illnesses, making them highly susceptible to poor outcomes of COVID-19.3 This study examines the excess mortality among a US cohort of assisted living residents during the COVID-19 pandemic.

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 …

Men And Oral Health: A Review Of Sex And Gender Differences, Martin S. Lipsky, Sharon Su, Carlos J. Crespo, Man Hung

OHSU-PSU School of Public Health Faculty Publications and Presentations

Sex and gender related health disparities in oral health remain an underappreciated and often over looked aspect of well-being. The goal of this narrative review is to identify sex and gender related oral health disparities by summarizing the current literature related to differences in oral health between men and women. The review identified that men are more likely to: ignore their oral health, have poorer oral hygiene habits, and experience higher rates of periodontal disease, oral cancer, and dental trauma. Men also visit dentists less frequently and compared to women seek oral treatment more often for an acute problem and …

Cra To Inform Health Related Research In Rural Oregon, Christina Jäderholm

OHSU-PSU School of Public Health Annual Conference

Background

To assess five rural Oregon counties’ readiness to take action towards conducting health-related research within their communities, we conducted a Community Readiness Assessment as a process towards reconciling research aims with community priorities and shared resources.

Results were used to guide OHSU’s clinical researchers with plans to implement an exercise-based pilot program for cancer survivors and their partners in Oregon’s rural counties.

Method

The Community Readiness Assessment (CRA) is a validated interviews-based tool for measuring attitudes, knowledge, beliefs and shared resources within communities; Here, as it relates to health-related research. The 36 open-ended questions were administered to 15 community …

An Intervention To Increase Detection Of Developmental Delays In Wic Programs, Mohadeseh Solgi, Julie A. Reeder, Sherri Alderman, Katharine E. Zuckerman

OHSU-PSU School of Public Health Annual Conference

Background: Low-income children are at risk for under-detection of developmental disabilities DD. WIC clinics see low-income children regularly in early childhood and could be an important source of referrals to developmental services.

Objectives: To increase the number of referrals to EI/ECSE from non-primary care settings such as WIC.

Methods: This was a site-randomized trial of an intervention to train WIC staff in early identification of DD’s, using CDC’s LTSAE developmental monitoring materials. 7 county WIC agencies in Oregon enrolled; 4 intervention agencies and 3 control agencies. The intervention consisted of an on-site, half-day training regarding signs of developmental delays, use …

Primary Preeclampsia In A Second Pregnancy: Comparing Outcomes To Illuminate Preeclampsia Etiology, Rebecca Parmenter, Abigail Newby-Kew, Anna Sandstrom, Jonathan Snowden

OHSU-PSU School of Public Health Annual Conference

Previous preeclampsia is a strong predictor of subsequent preeclampsia. There is a noted evidence gap regarding primary preeclampsia among parous women. We will use the Swedish Medical Birth Register to explore risk factors that may contribute to primary preeclampsia in parous women

Urbanization And Mental Health: The Power Of Green Space, Emma Rosenthal

OHSU-PSU School of Public Health Annual Conference

In this presentation, I will review the negative impacts of urbanization on mental health and the positive role of green space on mental well-being. Moreover, I will provide examples of projects being conducted to increase the amount of green space in urban communities.

Examining The Link Between Acculturation And Reproductive Autonomy Among Oregon Latinas: Work In Progress, Sara M. Diaz-Anaya

OHSU-PSU School of Public Health Annual Conference

Authors: Sara Diaz-Anaya, Edlyn Lopez, & Blair Darney PhD, MPH.

Title

Examining the Link Between Acculturation and Reproductive Autonomy Among Oregon Latinas: Work in progress

Background

Reproductive autonomy is defined as the power a woman has over matters such as pregnancy, childbearing, and contraceptive use and is essential to human rights. Acculturation, or how much of the values, practices, and norms of a host culture an immigrant has adopted, may influence reproductive autonomy. The purpose of this study is to test whether acculturation is associated with reproductive autonomy among Oregon Latinas. We hypothesize that highly acculturated women will report …

Covid-19 Impact Survey For Filipinos In Oregon, Maria Theresa D. Dizon, Anthony Ponticello

OHSU-PSU School of Public Health Annual Conference

COVID-19 Impact Survey for Filipinos in Oregon

Data about Filipino populations tend to be obscured when aggregated into the Asian and/or Asian and Pacific Islander category. Filipinos are hit hard by the COVID-19 pandemic and yet there is little information about them. As a result, COVID-19 Impact Survey was developed for Filipinos in Oregon to better understand their needs arising from the COVID-19 crisis. It is modeled after the Massachusetts Department of Public Health’s COVID-19 Community Impact Survey. It has been translated into both English and Tagalog. After finalization of the survey, it has been piloted by National Alliance for …

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …