Is The Phq-9 A Unidimensional Measure Of Depression? A 58,272-Participant Study, Renzo Bianchi, Jay Verkuilen, Sharon Toker, Irvin Sam Schonfeld, Markus Gerber, Elmar Brähler, Kurt Kroenke

Publications and Research

The PHQ-9 has become a measure of reference in depression research and clinical practice. However, the issue of the PHQ-9’s unidimensionality has not been fully elucidated, and the usability of the PHQ-9’s total score requires clarification. In this study, we examined the dimensionality, scalability, and monotonicity properties of the PHQ-9 as well as the scale’s total-score reliability. We did so based on exploratory structural equation modeling (ESEM) bifactor analysis and Mokken scale analysis (MSA). We relied on a total of 58,272 participants (63% female; Mage = 43, SDage = 13) from 29 samples involving seven different countries (e.g., Germany, the …

The Global Implementation Of Dolutegravir For Hiv Treatment, Matthew L. Romo

Dissertations and Theses

Background
Dolutegravir, an integrase strand transfer inhibitor, is now recommended by international guidelines as part of preferred antiretroviral therapy (ART) regimens for people living with HIV. In low- and middle-income countries (LMICs), HIV treatment programs are transitioning from non-nucleoside reverse transcriptase inhibitors (NNRTIs) to dolutegravir because of its superior efficacy and tolerability, and high genetic barrier to HIV drug resistance. Along with the optimism surrounding widespread dolutegravir use, key questions regarding its implementation have emerged. In this dissertation, I sought to achieve the following specific aims: Aim 1: Characterize dolutegravir uptake in LMICs and identify potential disparities related to sex …

Assessing Psychosocial Factors That Influence Water, Sanitation, And Hygiene Behavior In The Amhara Region Of Ethiopia, Kimberly Kamara

Dissertations and Theses

Background: The absence of potable drinking water from an improved source combined with inadequate sanitation and hygiene contributed to an estimated 1.9% of the global burden of disease in 2016. The estimated number of diarrheal deaths in 2016 was 1.4 million, of which 829,000 could have been prevented through improved drinking water and sanitation services, and hand-washing with soap. Despite the clear link between poor water and sanitation access and hygiene practices, 785 million people do not have access to water and two million do not have access to basic sanitation services. However, access does not automatically result in increased …

Episode Based Payment Models And The Hospital Safety-Net: An Evaluation Of The Center For Medicare And Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program, John A. Gravina

Dissertations and Theses

Episode Based Payment Models and the Hospital Safety-net: An Evaluation of the Center for Medicare and Medicaid Services’ Comprehensive Joint Replacement Bundled Payment Program

By John Anthony Gravina

Advisor: Alexis Pozen, Ph.D.

Introduction: Payments for Healthcare services are increasingly being tied to clinical quality, patient experience, health outcomes, and efficiency through value-based payment arrangements (VBP). VBP presents a potential opportunity to reduce healthcare expenditures by requiring providers to take on financial risk associated with the cost and quality of care, therefore aligning payment incentives with the goals of providing higher quality and efficient care. As of 2020, 80 percent of …

Exploring Social Identity Threat And Safety Cues For Lesbian, Gay, Bisexual, Pansexual, And Queer Cisgender Women In Ob/Gyn Care, Rachel Fikslin

Dissertations, Theses, and Capstone Projects

Lesbian, gay, bisexual, pansexual and queer (LGBPQ) cisgender women (CW) experience a number of health inequities compared to heterosexual cisgender women related to sexual and reproductive health. Heterosexist health care cultures may signal social identity threat for LGBPQ-CW that may undermine their health care engagement and outcomes. In three online studies, I examined the effects of two heterosexist cultures (i.e., gender essentialism and pronatalism) as well as two potentially identity-safe alternatives (i.e., gender diversity and reproductive/sexual autonomy) on the identity threat and health care engagement experiences of LGBPQ-CW in OB/GYN care.

In Study 1 (n = 213), I used …

Gobernar Es Prever: Health Management Self-Efficacy Among A National Sample Of Latinx Adults, Giselle Gerardi

Dissertations, Theses, and Capstone Projects

Background: Minority populations, such as Latinx people, are more likely to develop chronic diseases and increased complications related to disease severity when compared to Non Latinx Whites (NLW). Furthermore, Latinx people are less likely to engage and maintain health promoting behaviors (HPB) to prevent disease development. HPB are effective in preventing or delaying chronic disease. Despite interventions and resources aimed at supporting Latinx populations, often, there are low participation and high attrition rates.

Methods: This research explores the relative impact of aspects of health, built environment and key demographic domains on HMSE of a national sample of Latinx adults through …

Lactating Justice: Constructing A Society Economically Focused On Optimizing Health Through Human Lactation, Shadley Hobour

Dissertations, Theses, and Capstone Projects

This paper uses a qualitative research method to answer if a Universal Base Income would be a good economic policy to adopt to optimize Black chestfeeding. The key idea this thesis aims to clarify is how anti Blackness is killing Black people and how one economic policy could improve health. In this essay, I will break down the significance and importance of human lactation for lifelong better health, and investment in a UBI would especially work as a preventative measure for several health issues Black people experiences.

The Arv Treatment Adherence Model: A Qualitative Study On Antiretroviral (Arv) Treatment Adherence For People Living With Hiv, Danielle Strauss

Dissertations, Theses, and Capstone Projects

Adherence to antiretroviral (ARV) treatment improves life expectancy and other health outcomes for people living with HIV (PLWH). It also minimizes their risk of transmitting HIV through sexual contact and is therefore a form of HIV prevention. However, many PLWH, specifically low-income PLWH of color who have been disproportionately impacted by the virus, face a multitude of barriers to ARV treatment adherence, making it much harder for them to take their medication as prescribed and remain engaged in care. This qualitative study based on Constructivist Grounded Theory explored the process by which 14 virally suppressed, low-income PLWH of color overcame …

The Associations Between Diabetes, Cardiovascular Disease And Occupational Hearing Loss In A Cross-Sectional Analysis Of Department Of Energy Nuclear Workers, With A Mendelian Randomization Of Publicly Available Data To Enhance Observational Findings, Jonathan Corbin

Dissertations and Theses

Title: The Associations between Diabetes, Cardiovascular Disease and Occupational Hearing Loss in a Cross-sectional analysis of Department of Energy Nuclear Workers, with a Mendelian Randomization of Publicly Available Data to Enhance Observational Findings

Author: Jonathan Corbin

Advisor: Ghada Soliman, MD, PhD, R.D., CDN

Introduction: Occupational Hearing Loss (OHL) is the most common workplace health condition, and the overall impact of hearing loss (HL) on health is underappreciated. Diabetes and cardiovascular disease (CVD) are two of the most common causes of death and are largely preventable and treatable. Previous research has evaluated associations between OHL and …

A Novel Approach Toward Concussion Testing, Jorge K. Mercado, Ari Schacter, Danielle Euzent

Student Theses

A concussion is a violent jarring or shaking of the head caused by whiplash or direct impact that results in a disturbance of brain function. Concussions can be mild and brief, as a person may be dazed momentarily or can be more serious, resulting in a loss of consciousness. Underreporting of concussions is prevalent because they are a symptom-based diagnosis, lacking a clinical test. In this study, we investigated the use of VNG testing as a clinical diagnosis of concussions. Looking at the VNG test battery, the previous research cohort found that saccades, gaze, and positional testing are the most …

Using Geospatial Analysis To Evaluate Relationships Between Cancer Incidence And Social Factors In Brooklyn, Ny, Sheena Philogene

Theses and Dissertations

This study explored the spatial distribution of cancer incidence in Brooklyn, NY. Using publicly available data, the relationships between cancer incidence and factors linked to cancer were investigated. Furthermore, the study explored the value of using large amounts of data with GIS techniques to quickly analyze geographic trends for cancer.

Covid-19 Vaccine Mandate, Mikhail Kun, Tatiana Ryzhakova

Publications and Research

The COVID-19 pandemic has wreaked havoc on the planet and killed millions of people. Health care workers and radiology technicians who come into direct contact with COVID-19 patients have indeed been the most affected by the virus. Since the pandemic began, the COVID-19 cases among health care workers have surged and quadrupled. COVID-19 vaccine mandate is the need of the time. Mandates have a history and are in effect for other diseases such as smallpox, measles, or mumps. But since the vaccines have come out for COVID-19, there is a public impetus to condemn these vaccines, based on the false …

Parenthood Orientation Among Young Women: Is It Associated With Pregnancy Intention And Unprotected Intercourse?, Nakeisha Blades

Theses and Dissertations

This study explored relationships between parenthood orientation, pregnancy intention, and unprotected intercourse. Nulligravid, sexually active women aged 18-29 (N = 252) were surveyed on these topics in May 2019. There were significant differences in parenthood orientation by past and current pregnancy intention. Higher scores on parenthood orientation were associated with increased odds of past unprotected intercourse and expecting future unprotected intercourse. Only education and contraceptive self-efficacy retained significance in adjusted models. Study results are consistent with prior work on parenthood orientation and pregnancy intention and point to other factors as stronger correlates of contraceptive use.

Promoting Healthy Eating In Latin American Restaurants: A Qualitative Survey Of Views Held By Owners And Staff, Fuster, Melissa, Rosa Abreu, Margaret A. Handley, Donald Rose, Michelle A. Rodriguez, Emily G. Dimond, Brian Elbel, Terry T. K. Huang

Publications and Research

Background

Restaurants, particularly independently-owned ones that serve immigrant communities, are important community institutions in the promotion of dietary health. Yet, these restaurants remain under-researched, preventing meaningful collaborations with the public health sector for healthier community food environments. This research aimed to examine levels of acceptability of healthy eating promotion strategies (HEPS) in independently-owned Latin American restaurants (LARs) and identify resource needs for implementing HEPS in LARs.

Methods

We completed semi-structured, online discussions with LAR owners and staff (n = 20), predominantly from New York City (NYC), to examine current engagement, acceptability, potential barriers, and resource needs for the implementation …

Feasibility Of Using Electronic Health Records For Cascade Monitoring And Cost Estimates In Implementation Science Studies In The Adolescent Trials Network For Hiv/Aids Interventions, Tyra Dark, Kit N. Simpson, Sitaji Gurung, Amy L. Pennar, Marshall Chew, Sylvie Naar

Publications and Research

Background:One of the most difficult areas in the fight against HIV/AIDS is reaching out to youth aged 13 to 24 years. The proportion of youth living with HIV/AIDS on antiretroviral therapy (ART) and who are virally undetectable is low, highlighting significant challenges for reaching the Joint United Nations Program on HIV targets.

Objective:This study aimed to assess the feasibility of obtaining key clinical indicators and monitoring treatment, viral suppression, and retention components of the youth HIV treatment cascade in Adolescent Trials Network for HIV/AIDS Interventions clinics using electronic health record (EHR) downloads and to provide baseline characteristics for the study …

Occupational Depression In A Spanish-Speaking Sample: Associations With Cognitive Performance And Work-Life Characteristics, Bianchi Renzo, Guadalupe Manzano García, Maria Pilar Montanes, Emily A. Schonfeld, Irvin Sam Schonfeld

Publications and Research

This 386-participant study investigated the structural and psychometric properties of the Spanish version of the Occupational Depression Inventory (ODI). Exploratory structural equation modeling bifactor analysis revealed that the ODI meets the requirements for essential unidimensionality. Measurement invariance held across our sample and the English- and French-speaking samples used in the ODI’s initial validation study. Mokken scale analysis indicated that (a) the scalability of the instrument was strong, (b) no violations of monotonicity or local independence were present, and (c) invariant item ordering was sufficiently accurate. The ODI’s reliability was optimal. The ODI exhibited both convergent validity and discriminant validity vis-à-vis …

Lessons To Build An Educational Model For Higher Education Institutions Defined As Anchor Institutions To Tackle Public Health Crises: A Pilot Study On Covid-19 Vaccine Hesitancy Among Faculty And Students In Herbert L. College In The Bronx, Ny, Maria-Isabel Roldos, Katherine Burt, Jacob Eubank

Publications and Research

Coronavirus disease 2019 exacerbated health inequities in Bronx Communities. This study explored vaccine hesitancy among a random sample of faculty and students from Herbert Lehman College. Findings suggest faculty are largely vaccinated (87%), while 59% of students are unvaccinated. Significant gaps in information were found related to safety and complications. This suggests universities need to adopt an educational model with a multipronged social support strategy to gain students’ trust and a greater sense of belonging.

Monitoring Sars-Cov-2 In Wastewater During New York City's Second Wave Of Covid-19: Sewershed-Level Trends And Relationships To Publicly Available Clinical Testing Data, Catherine Hoar, Francoise Chauvin, Alexander Clare, Hope Mcgibbon, Esmeraldo Castro, Samantha Patinella, Dimitrios Katehis, John J. Dennehy, Monica Trujillo, Davida S. Smyth, Andrea I. Silverman

Publications and Research

New York City's wastewater monitoring program tracked trends in sewershed-level SARS-CoV-2 loads starting in the fall of 2020, just before the start of the city's second wave of the COVID-19 outbreak. During a five-month study period, from November 8, 2020 to April 11, 2021, viral loads in influent wastewater from each of New York City's 14 wastewater treatment plants were measured and compared to new laboratory-confirmed COVID-19 cases for the populations in each corresponding sewershed, estimated from publicly available clinical testing data. We found significant positive correlations between viral loads in wastewater and new COVID-19 cases. The strength of the …

Sleep And Economic Status Are Linked To Daily Life Stress In African-Born Blacks Living In America., Zoe C. Waldman, Blayne R. Schenk, Marie Grace Duhuze Karera, Arielle C. Patterson, Thomas Hormenu, Lilian S. Mabundo, Christopher W. Dubose, Ram Jagannathan, Peter L. Whitesell, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22-65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS < 16. Poor sleep quality required PSQI > 5. Low income was defined as groups, PSS were: 21 ± 4 versus …

Factors Associated With Hepatitis B Medication Adherence And Persistence Among Underserved Chinese And Vietnamese Americans, Aisha Bhimla, Lin Zhu, Wenyue Lu, Sarit Golub, Chibuzo Enemchukwu, Elizabeth Handorf, Yin Tan, Ming-Chin Yeh, Minhhuyen T. Nguyen, Min Qi Wang, Grace X. Ma

Publications and Research

Background: Hepatitis B virus (HBV) infection disproportionately affects Asian Amer- icans in the United States, while this population faces low adherence to HBV treatment. Using the information–motivation–behavioral skills model (IMB), the study aims to examine medication adherence and persistence among Chinese and Vietnamese people with HBV. Methodology: Study participants were recruited between March 2019 and March 2020 and were enrolled through multiple recruitment approaches in the Greater Philadelphia Area and New York City. The study is an assess- ment of the baseline data on medication adherence, HBV-related knowledge, motivation of HBV med- ication treatment, self-efficacy about HBV medication treatment, and …

Four Corners: A Values Clarification Exercise, Montsine Nshom

Open Educational Resources

Four Corners is a values clarification activity that asks participants to stand/show whether they strongly agree to strongly disagree with a specific statement, and reflect on their position during and after the activity. This four corners activity is designed to help students think about and discuss topics that are pertinent to urban community health and public health.

No prior reading or coursework is required; it is a good option for the first day of class to introduce key themes that will be covered during the course as well as practice ground rules and class discussion norms.

From Abortion Rights To Reproductive Justice: A Call To Action, Erica Goldblatt Hyatt, Judith L.M. Mccoyd, Mery Diaz

Publications and Research

As aggressive cultural and legislative attacks on abortion rights and access continue, we call upon social workers to pursue the liberatory aims of the reproductive justice (RJ) movement. We argue that the RJ framework, rooted in feminist theory, aligns with social work’s social justice ethos and goals, appropriately guiding advocacy and intervention. After outlining the central aims and tenets of the RJ movement, we consider policies that impair RJ and those that could promote RJ, focusing on enhancing body sovereignty, childbearing, and parenting. We conclude with concrete recommendations for how social workers can pursue RJ professionally and personally.

Maternal Choline Supplementation And High-Fat Feeding Interact To Influence Dna Methylation In Offspring In A Time-Specific Manner, Hunter W. Korsmo, Bhoomi Dave, Steven E. Trasino, Anjana Saxena, Jia Liu, Jorge Matias Caviglia, Kaydine Edwards, Moshe Dembitzer, Shameera Sheeraz, Sarah Khaldi, Xinyin Jiang

Advanced Science Research Center

Maternal methyl donor supplementation during pregnancy has demonstrated lasting influence on offspring DNA methylation. However, it is unknown whether an adverse postnatal environment, such as high-fat (HF) feeding, overrides the influence of prenatal methyl donor supplementation on offspring epigenome. In this study, we examined whether maternal supplementation of choline (CS), a methyl donor, interacts with prenatal and postnatal HF feeding to alter global and site-specific DNA methylation in offspring. We fed wild-type C57BL/6J mouse dams a HF diet with or without CS throughout gestation. After weaning, the offspring were exposed to HF feeding for 6 weeks resembling a continued obesogenic …

Factors Associated With Racial And Ethnic Disparities In Cesarean Delivery Among Women With Low-Risk Pregnancies At New York City Hospitals, 2012-2017, Ellen Brazier

Dissertations and Theses

BACKGROUND: While Cesarean delivery is a life-saving procedure when certain complications arise, it is associated with increased risks of maternal mortality and morbidity, as well as neonatal and childhood morbidities, and increased risks for women during subsequent pregnancies. Stark and persistent racial/ethnic disparities in Cesarean delivery that are not explained by clinical risks raise concerns about overuse of the procedure, as well as the contribution of potentially avoidable Cesareans to disparities in maternal mortality and morbidity. Understanding the extent to which disparities in Cesarean delivery may be attributable to differences in care during labor is critical for addressing these disparities. …

Covid-19 Challenges And Firm Responses: Analysis Of A City-Wide Census In A Developing Country, Bryan S. Weber, Toan Luu Duc Huynh

Publications and Research

We use the unique data set of 16,300 firms' responses for the large‐scale census survey in an urban area at Ho Chi Minh City (Vietnam) to study how firms perceived their problems and responded to during the COVID‐19 pandemic. We provide estimates of 65 cross‐associations between a firm's challenges during the pandemic and their responses. We find several firm characteristics that suggest increased likelihood of pandemic response, including some, such as state ownership, which are typically associated with being slow to respond to market conditions. A theoretical model is posited that matches with the rapidly declared survey response.

Assessing The Association Among Hospital Ownership Penalties Assessed Under The Hospital Readmissions Reduction Program And 30-Day Risk Standardized Mortality Rates For Selected Conditions, 2016-2018, Jennifer Carmona

Dissertations and Theses

Background: The Hospital Readmissions Reduction Program (HRRP) is an aspect of Patient Protection and Affordable Care Act (ACA) of 2010. HRRP requires Medicare to reduce payments to hospitals with relatively high readmission rates. While the implementation of the program has been accompanied by reductions in readmission rates, some have expressed concerns about unintended consequences, including harm to patient care and even death. Under HRRP, hospitals serving a high proportion of socioeconomically disadvantaged patients, like public hospitals, have been more likely to receive financial penalties, potentially impeding their ability to invest resources in improving patient outcomes. There is previous research …

Contraceptive Use And Sterilization Among People With Disabilities, Gabrielle Y. Defiebre

Dissertations and Theses

Background

Approximately 20% of individuals in the United States (US) have a disability, with 1 in 4 adult women above the age of 18 having a disability. People with disabilities include individuals who may experience difficulties with mobility, cognition, independent living, vision, hearing, and/or self-care. Disabled people face physical/environmental barriers, provider-level barriers, and system-level barriers in accessing health care, including sexual and reproductive health care, and are more likely than people without disabilities to have unmet medical needs. Four recent studies have indicated that those with disabilities are more likely to have received female sterilization as a family planning service …

Association Between Childhood Obesity, Family Meals, And Dietary Quality Among Us Children Aged 6 To 17 Years Residing In Snap-Eligible Households, Noemi Rodriguez

Dissertations and Theses

Background:

Between 20 and 21% of US children 6-19 have obesity. Children residing in households eligible for the Supplemental Nutrition Assistance Program (SNAP) are exposed to vulnerable socioeconomic conditions, often living in low-resourced households and communities. These children are at a high risk for obesity, and thus to obesity-related comorbidities as well as adulthood obesity. The US Department of Agriculture (USDA) recommends family meals as well as diets meeting the American Dietary Guidelines as an obesity prevention strategy. These are connected; the dominantly theorized pathway by which family meals protect against childhood obesity is through the diet quality of the …

Beyond The Covid-19 Pandemic: The Importance Of Social Determinants Of Health In Educating Healthcare Leaders, Tashuna Albritton, Miguel Muñoz-Laboy, Umadevi Yokeeswaran, Marlene Camacho-Rivera

Publications and Research

As scholars of color and educators in the health professions, we are compelled to advocate for the inclusion of the study of health disparities and social determinants of health (SDOH) throughout higher education to understand, analyze, and effectively respond to healthcare access disparities, including COVID-19 disparities, in Black and Latinx communities across the United States. In addition to our identities and lived experiences, healthcare access disparities and their root causes are woven throughout the courses that we teach in the departments of social medicine, social work, and social and behavioral sciences.

Humidity Reduces Rapid And Distant Airborne Dispersal Of Viable Viral Particles In Classroom Settings, Antun Skanata, Fabrizio Spagnolo, Molly Metz, Davida S. Smyth, John J. Dennehy

Publications and Research

The transmission of airborne pathogens is considered to be the main route through which a number of known and emerging respiratory diseases infect their hosts. While physical distancing and mask wearing may help mitigate short-range transmission, the extent of long-range transmission in closed spaces where a pathogen remains suspended in the air remains unknown. We have developed a method to detect viable virus particles by using an aerosolized bacteriophage Phi6 in combination with its host Pseudomonas phaseolicola, which when seeded on agar plates acts as a virus detector that can be placed at a range of distances away from an …