Public Health Commons^™

Clinician Perspectives On Fistula Mental Health, Victoria K. Leonard

Doctoral Dissertations

Background – Obstetric fistula is a childbirth injury caused by prolonged labor that leads to stillbirth and incontinence, spurring social exclusion and isolation. These layers of trauma put women with fistula at great risk for psychological suffering, which has profound negative socioeconomic impacts on them, their families, and communities. This study captured treatment as usual at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula care.

Method – Improving holistic fistula treatment requires engaging the clinicians who care for women with fistula. This study aimed to investigate the training, beliefs, and treatment approaches of nurses and …

Effect Of Insufficient Sleep On Activity Limitation: Results From The Brfss 2022 Survey, Jonathan Meyer

Capstone Experience

Objective: To determine whether insufficient sleep (less than 7 hours per night) is associated with activity limitation (14 days or more of poor mental or physical health interfering with everyday activities) in Behavioral Risk Factor Surveillance System (BRFSS) survey data from 2022. Methods: BRFSS is a nationally representative cross-sectional survey of non-incarcerated US adults. The exposure of interest was insufficient sleep, and the outcome of interest was activity limitation. Other demographic variables used in a final weighted adjusted analysis include age >65 years, race/ethnicity, gender, marital status, income, and total physical inactivity. Results: The weighted prevalence of insufficient sleep for …

The Health Risks Of Deportation: Impacts Of Family Separation On Relationships And Wellbeing In Latinx Communities, Shantay Rocha

University Honors Theses

Anti-immigration policy and deportation practices create multifaceted implications for Latinx communities in the United States. A comprehensive literature review drawing from public health and immigration studies was used to examine the direct and indirect implications of separation of families due to deportation. This thesis synthesizes existing research to illuminate the health threats pertaining to Latinx wellbeing in the context of being undocumented and fearing being separated from their family. Addressing the dimensions of deportation-related health risks, policy makers, health care professionals, and community organizations can work towards promoting Latinx health and well-being in the U.S. to mitigate the health consequences …

Restoring, Protecting, And Expanding Abortion Access In The United States: Seeking Consensus Through The Delphi Method, Sarah Pickering

Dissertations and Theses

Background: The Dobbs v. Jackson Women’s Health Organization Supreme Court decision exacerbated inequitable access to abortion in the US. Agreement is needed on which strategies should be prioritized to restore, protect, and expand abortion access.

Methods: We convened a multidisciplinary, geographically diverse Delphi panel of clinical, research, policy, legal, and advocacy experts to reach consensus (i.e., agreement >67%) on recommended actions. Using feedback from three rounds of surveys, and input from a select expert advisory group (N=10), we iteratively refined the statements and recommendations.

Results: The panel (N=85) developed 25 consensus statements and 32 recommendations for action by advocates, funders, …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Guilty Pleasure: Women's Perception Of Health, Body Image, And Femininity, Irene *Yi-Han Chung

Masters Theses

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Early Detection Of Alcohol Related Dementia Across The Lifespan: An Integrative Literature Review For Primary Care Providers, Kaylee A. Chapman

University Honors Theses

Introduction: Alcohol related dementia (ARD) is a long-term, heterogeneous cognitive impairment that can develop in the course of excessive and prolonged use of alcohol. This integrative literature review evaluated the relevant research, preventative measures, and early detection of brain changes leading to memory impairment as a result of the chronic consumption of alcohol.. Widespread prevention and detection of ARD can be achieved through the support of healthcare professionals in understanding, observing, and catching behavioral patterns ahead of time to properly direct treatment. The risk factors associated with an early diagnosis of dementia include, but are not limited to, abnormal brain …

Artistic Expression Of Medical Experiences Of Mothers Of Color: Perspectives Using Art Therapy, Lauren Barrett

Expressive Therapies Dissertations

The purpose of this study was to qualitatively examine perspectives of mothers of color living in the US and their experiences in the healthcare system through art therapy. The study aimed to further identify personal narrative experiences of mothers of color navigating the healthcare system, promote individual voices, and acknowledge disparities impacting those within marginalized communities. The participants in this study included a total of eight identified mothers of color (non-White) living in the US. Participants took part in four weeks of consecutive art therapy sessions either in 60-minute group or individual virtual meetings. One art therapy directive was provided …

Impact Of Temperature On Children’S Nutrition: A Comparative Study Of Three Ecological Regions Of Nepal, Prakriti Shakya

Master's Theses

Nutrition obtained during the growth period of childhood significantly influences long-term well-being and overall productivity, ultimately contributing to the economy of a society. However, weather shocks can wreak havoc by damaging crops, changing yields of important crops and disrupting market access, which directly impacts the food intake of both adults and children. When these adverse events occur during childhood, short term and long term inadequacy in nutrition as well as disease incidence can cause malnutrition leading to stunted growth and cognitive impairment that may persist into adulthood, affecting the labor market and increasing health expenditure. To address this issue, we …

Lyme Disease In The Northeast: The Unintended Consequence Of Suburban Development, Hayden Neubert

Student Theses 2015-Present

This paper addresses the role of suburban development in the suburbs of the Northeastern United States in increasing human Lyme disease infection. Over the past 50 years, Lyme disease has become the most common vector-borne disease in the United States. In 2021, the two states with the most Lyme disease cases were New York and New Jersey, with a collective 6,524 cases, with Connecticut still representing 541 total cases. It is not a coincidence that case numbers are concentrated in suburban areas with high forest fragmentation. Chapter 1 of this essay analyzes how human land development disrupts bioregulatory ecosystem actors …

What Is The Effect Of Telehealth And The Internet Of Medical Things (Iomt) On Outcomes When Used In At-Risk Pregnancies: A Scoping Review Of The Components Of Remote Maternal Monitoring For Hypertensive Disorders That Can Successfully Be Done Via Digital Technology?, Leighton Pitter

MUSC Theses and Dissertations

IoMT (Internet of Medical Things) is an emerging technology that facilitates individualized remote e-health services to improve patient's quality of life and satisfaction while decreasing healthcare expenditures. The objective of this scoping review is to explore the usage of IoMT and remote patient monitoring (RPM) in at-risk pregnancies for hypertensive disorders to mitigate pregnancy-related complications. IoMT and other devices in an intelligent health system can meaningfully ameliorate maternal care management in the United States (U.S.). Wearables and nearables, subcategories of IoMT, can be utilized to facilitate patient-centered care and promote excellence in health maintenance/management through a holistic continuum of care …

The Impact Of Female Political Leadership On Intimate Partner Violence In India, Khushboo Patel

Master's Theses

Abstract:

This study employs an instrumental variable approach to examine the impact of female political leadership on women’s experiences of Intimate Partner Violence (IPV). It finds that in rural areas with more female leaders, incidents of sexual and psychological IPV increase. The analysis investigates the drivers behind this impact, revealing that entrenched gender norms and expectations, such as a husband’s preference for more sons, may exacerbate IPV. Additionally, despite the increase in female leaders, attitudes toward violence remain largely unchanged. These findings highlight the need for research and policy initiatives that not only encourage female political participation but also specifically …

Matrilineal Ethnic Affiliation And Female Empowerment: Investigating Attitudes Towards Female Autonomy And Health In Ivorian Households, Martine Hind Stølan

Master's Theses

Kinship structure is a fundamental aspect of anthropology, however, there is still a gap in literature on its impact on economic research, particularly regarding female autonomy and health. This study aims to address this gap by examining the influence of matrilineal ethnic affiliation on attitudes towards female autonomy and health within Ivorian households. Using data from the 2011 IPUMS Demographic and Health Survey for the Ivory Coast, using female responses, this study investigates the complex dynamics shaping attitudes towards female autonomy and access to health care. Analysis on these aspects is done using ordinary least squares (OLS) and logistic estimations. …

Implementation Of Lymphedema Education Toolkit For Nurse Coordinators, Heather Gee

Master's Projects and Capstones

Problem: Lymphedema is a chronic condition that develops secondary to cancer treatments such as chemotherapy, radiation, and surgical removal of affected lymph nodes. This swelling in patient’s limbs can cause discomfort and limit mobility, however lymphedema is often not detected until later stages, delaying treatment and patient education.

Context: This quality improvement project was conducted at Hospital S Women’s Cancer Center, an outpatient center specializing in advanced treatments for breast and gynecological cancers. This center has a multidisciplinary team focusing on both the medical and surgical aspects of oncology treatment.

Interventions: An evidence-based lymphedema education toolkit was created for nurse …

Burnout Syndrome Among Minority Women Leading Community Health Centers: A Phenomenological Study, Thelma Christine Sardin

Ed.D. Dissertations

Community health center leaders have potential burnout exposure due to occupational and personal stressors. The transcendental phenomenological study delved into the experiences of minority female community health center leaders, examining how the COVID-19 pandemic, diversity, equity, and inclusion issues influenced their burnout syndrome compared to their peers. The focus of the study was on 17 community health leaders in the Midwestern U.S., including minority and non-minority leaders. Data was collected through semi-structured interviews, demographic screening, and field notes. Three themes emerged: Leader characteristics with training and experience, Stressors that impact burnout, and Diversity, equity, and inclusion issues impacting burnout. The …

Beyond The Surface: Understanding The “Blurred Lines” Of Sexual Dynamics And Consent In Trinity College's Hookup Scene, Zoe Kon

Senior Theses and Projects

This thesis explores the complex interplay of sexual behaviors, consent, and campus culture at Trinity College through qualitative ethnographic research. Delving into the nuances of hookup culture, a prevalent social phenomenon, the research examines how it often blurs the boundaries between consensual and non-consensual sexual interactions. Thirty in-depth interviews with Trinity College students reveal the intricate dynamics of consent communication and understanding within this context. The findings highlight significant gaps in students' communication about boundaries and consent, driven by the pressures of social capital and the normalization of alcohol-fueled encounters. The theme of blurred lines emerges as a central issue, …

Humanizing Affordable Housing: A Public Health Centered Approach To Affordable Housing, Eiman Mohamed

Graduate School of Architecture & Urban Design Theses & Dissertations

This thesis focuses on exploring housing as a determinant of health; thus, the aim is to investigate the historical and current influence of housing design and city planning on occupant health and population health in metropolitan cities. The thesis will primarily examine how housing affects the health of low-income individuals. Historically and presently, this demographic has been disproportionately affected by health issues stemming from overcrowding, substandard housing design, declining neighborhood conditions, and environmental inequities. The goal is to discern the dimensions and standards for healthy housing against which designers and planners can define health outcomes. By acknowledging the factors that …

Improving Quality Of Life In Menopausal Women Through A Best Practice Protocol: The Use Of Hormone Therapy, Mindfulness-Based Module And Exercise, Claire Czerwonka

Evidence-Based Practice Project Reports

Menopause is a normal process of aging, but many of the symptoms negatively impact women’s day-to-day quality of life (QOL), as well as activities of daily living, physical and mental health (ACOG, 2014). Generally, systemic estrogen hormone therapy is indicated for menopause-related vasomotor symptoms, but there is no research further addressing QOL issues or lifestyle management in addition to hormone therapy. The purpose of this evidence-base practice (EBP) project was to implement a menopause protocol to address QOL issues in menopausal women with the use of hormone replacement therapy, education through an online mindfulness module, and the use of exercise. …

Improving Early Identification And Management Of Depression Symptomology Through Implementation Of Universal Depression Screening In A University Student Health Center, Jessica M. Monjaras

Evidence-Based Practice Project Reports

Depression is the leading cause of disability in the United States for individuals aged 15 to 44 (Anxiety and Depression Association of America, 2023). The purpose of this evidence-based practice (EBP) project was to increase early identification of depression through implementation of universal depression screening, and to implement management strategies to decrease symptoms of depression. A two-tiered approach to universal depression screening was utilized through use of the PHQ-2 and PHQ-9 screening tools. Ten young adult patients, between the ages of 18 to 25, from a university student health center clinic in Northwest Indiana participated in this project. Participants underwent …

A Multi-Modal Intervention To Decrease Hpv Vaccine Hesitancy And Increase Uptake In Young Adult Women, Rylee Cartales

Evidence-Based Practice Project Reports

Human Papillomavirus (HPV) is the leading cause of cervical cancer worldwide and the most common sexually transmitted disease, yet hesitancy towards the HPV vaccine remains high and uptake of the HPV vaccine remains remarkably low (CDC, 2021b). The purpose of this evidence-based practice (EBP) project was to determine if the implementation of a multimodal intervention including a motivational interview, strong provider recommendation, and educational materials will decrease HPV vaccine hesitancy and consequentially increase uptake of the vaccine. Eleven young adult women ages 18-26 from a rural outpatient Obstetrics and Gynecology (OBGYN) clinic in Indiana participated in this project. After agreeing …

Mental Health Among Collegiate Athletes, Stella Elise Fairbanks

Honors Thesis

Mental health has become increasingly more linked with athletics, especially collegiate athletics. There has been an increase in public acknowledgment of the presence of mental health in sports, specifically, more athletes are speaking about their mental health struggles as well as more research is being conducted in order to gain a greater understanding of the relationship between mental health and athletics. This literature review discusses athletes’ personal experiences of their mental health struggles, the presence of stigma associated with mental health and athletics, and the results of the recent NCAA, National Collegiate Athletic Association, research. This thesis aims to uncover …

The Relationship Between Sun Protective Behavior, Health Beliefs, Attitudes, And Norms Of Sun Exposure Among College Athletes, Avery B. Snyder

Honors Theses

The purpose of this study was to access the relationship between sun protective behavior, health beliefs, attitudes, and norms of sun exposure among college athletes. An electronic survey was provided to student athletes for about two weeks in October of 2023. Prior to student participation the Institutional Review Board approved the protocol and data collection. The survey was sent to the students by the athletic director through an app called Teamworks that connects to all the athletes at Coastal Carolina. The majority of students who took the survey reported they did not wear sunscreen in past games/practices. Of those who …

A Literature Review Of Societal Obesity And Its Impact On United States Military Recruitment, Megan Thibodeaux

Capstone

In recent decades, obesity rates have increased in the United States, raising significant health and societal concerns, especially in terms of military readiness. The ever-rising rates of weight-related health obstacles present a critical national security issue as it impacts the effectiveness of recruitment. This literature review aims to analyze how obesity impacts military recruitment and readiness to serve while utilizing the socio-ecological model to help determine gaps in evidence. Data was drawn from Embase, PubMed, and PsychInfo. Inclusion criteria consisted of academic journals and reports from government and non-profit organizations written in English. They focused only on the United States …

Building Trust To Extinguish Burnout: A Qualitative Study Of Hospital, State, And Federal Policies That Impact Pediatric Nurse Burnout In Connecticut, Cecelia Angelica Morello

Senior Theses and Projects

This thesis explores how federal and state governments, as well as individual hospitals, respond or fail to respond to pediatric nurse burnout. The problem of nurse burnout is not new, and can cause nurses to make mistakes on shift, experience increased anxiety and depression, and increase risk of patient death or injury. Solutions to burnout in healthcare workers have been organized at the hospital, state, and federal government level. However, this thesis examines a lack of research on pediatric nurse burnout more specifically. After reviewing the national landscape of hospital-based solutions, short-term policy solutions, and long-term policy solutions, I examine …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …

Factors Affecting The Use Of Food Pantries By California State University Students, Beyza Aktepe

Electronic Theses, Projects, and Dissertations

Food insecurity is one of the major public health issues world-wide including the United States. A significant proportion of students within the California State University (CSU) system, approximately 41.6%, experience food insecurity. The purposes of this study was 1) to determine the factors and barriers that affect the use of campus food pantries by university students on seven CSU campuses, 2) to determine the improvements that can be implemented in the on-campus food pantries, 3) to evaluate the effectiveness of the management of food pantries, and 4) to evaluate the effectiveness and utilization of nutrition education services provided in conjunction …

Does Appearance Matter? The Relationship Of Perceived Body Size And Physical Appearance On Students' Attraction To Physical Activity At Recess, Danielle Belcher

Master's Theses

Drastic declines in recess physical activity (PA) have been observed within recent years (Center for Disease Control (CDC), 2017). Due to recess’ discretionary nature, psychosocial variables associated with PA are predictors of students’ PA levels. Recess is also a time of heightened bullying occurrences (Vaillancourt et al., 2010). Appearance-based bullying is the most common type of victimization that occurs in schools, transpiring more often in children with larger body max indexes (BMI), and possibly altering students’ physical self-perceptions. Physical self-perceptions have been shown to impact PA motivation, however, it is still unknown the extent to which appearance-based bullying, body size, …

Effect Of Progesterone On Cognition Among College Aged Women, Katelyn Helberg

Biological Sciences Undergraduate Honors Theses

Women who have a reoccurring menstrual cycle and do not take hormonal birth control naturally experience changes in the amount of sex hormones that their body produces. These sex hormones help promote sexual development, fertility, and mood regulation, but can be hard to study due to their conflicting effects on each other. One such hormone, progesterone, is produced in different concentrations throughout the menstrual cycle to prepare the uterus for a potential pregnancy. However, it also may have secondhand effects on how well women can complete everyday tasks involving memory, attention, processing speed, and more which is what we measured …