Public Health Commons^™

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 …

Hospital-Based Services For Opioid Use Disorder: A Study Of Supply-Side Attributes, Kelsey Caroline Priest

Dissertations and Theses

The United States (U.S.) is in the midst of an opioid overdose epidemic. In the U.S., overdose deaths related to opioid exposure are the leading cause of accidental death, yet life-saving treatments, such as methadone or buprenorphine (opioid agonist therapy [OAT]), are underused. OAT underused is due, in part, to complex regulatory and health services delivery environments. Public health officials and policymakers have focused on expanding OAT access in the community (e.g. office-based buprenorphine treatment, and opioid treatment programs); however, an often-overlooked component of the treatment pathway is the acute care delivery setting, in particular hospitals.

Opioid use disorder (OUD)-related …

Racial Disparities In A State Based Workers' Compensation System, Caroline Kristine Smith

Dissertations and Theses

Racial, ethnic, and linguistic minority workers suffer higher rates of work-related injuries and illnesses in the United States compared to their White counterparts. Explanations for these higher rates include potential socioeconomic causes (education, income, and wealth) and occupational segregation into more dangerous occupations. What is less studied are the post-injury sequelae for minority workers, which is their experiences in the workers' compensation system, as well as their health and return to paid employment. What is known comes primarily from qualitative literature, which includes themes of racial discrimination (from employers, health care providers, and workers' compensation employees), a lack of information …

Age-Based Differences In The Usefulness Of Resources: A Multi-Study Investigation Of Work And Well-Being Outcomes, Lale Muazzez Yaldiz

Dissertations and Theses

The labor force is aging globally. It is projected that the number of older workers will increase in the workforce in the near future. At the same time, it is estimated that workplaces will grow more age-diverse, where younger and older workers will work side-by-side more often than they used to. These demographic shifts in the workforce necessitate a further understanding of the differences between the values, needs and motivation, and work outcomes of employees of different ages. To this end, few studies to date have investigated whether job-related resources are differentially useful for the work and non-work outcomes of …

Quantifying Spatial Potential Access Equity In An Agent Based Simulation Model Of Buprenorphine Treatment Policy In The United States, Alexandra Elizabeth Nielsen

Dissertations and Theses

Opioid dependence and opioid related deaths are a public health problem which the United States Centers of Disease Control have declared an epidemic. While opioid agonist therapy for opioid addiction has been accepted as the most effective treatment for opioid dependence among academics, and office based buprenorphine treatment has been available in the Unites States for over 10 years, OB buprenorphine faces many barriers to widespread adoption. Empirical data on the geographic distribution of physicians able to prescribe buprenorphine and the prescribing patterns of those physicians show considerable unevenness in access and utilization of treatment services.

Federal-level policies have recently …

Enhancing Value-Based Healthcare With Reconstructability Analysis: Predicting Risk For Hip And Knee Replacements, Cecily Corrine Froemke

Dissertations and Theses

Legislative reforms aimed at slowing growth of US healthcare costs are focused on achieving greater value, defined specifically as health outcomes achieved per dollar spent. To increase value while payments are diminishing and tied to individual outcomes, healthcare must improve at predicting risks and outcomes.

One way to improve predictions is through better modeling methods. Current models are predominantly based on logistic regression (LR). This project applied Reconstructability Analysis (RA) to data on hip and knee replacement surgery, and considered whether RA could create useful models of outcomes, and whether these models could produce predictions complimentary to or even stronger …

Socioeconomic Determinants Of Health Disparities By Race And Ethnicity: The Mediating Role Of Social, Psychological And Behavioral Factors, Amanuel Zimam Melekin

Dissertations and Theses

Socioeconomic status (SES) is inversely related to health status. Disparities in health status among races and ethnic groups are partly attributable to differences in SES, but the indirect pathways by which SES may influence health status are not widely studied.

Using the Health and Retirement Study (HRS) data, this dissertation examined the pathways by which SES, via social, psychological, and behavioral factors predicted physical impairment and overnight hospitalization, and asked whether these indirect relationships differed by race/ethnicity. The HRS is a nationally representative multistage area probability sample administered biennially to respondents over the age of 51 and their spouses. Data …

Foundational Knowledge And Other Predictors Of Commitment To Trauma-Informed Care, Stephanie Anne Sundborg

Dissertations and Theses

Trauma-informed care (TIC) is an approach to service delivery based on the understanding of the prevalence of psychological trauma among service users, knowledge about the impact trauma has on engagement to services, and recognition that service settings can be re-traumatizing. For more than a decade, momentum has been building on this topic. Practitioners are pursuing the knowledge and skills needed to implement trauma-informed service delivery, while organizations are building infrastructure and processes aimed at supporting this approach. Disciplines across many human service sectors are eager to incorporate TIC into policy and practice. Despite this enthusiasm, implementation efforts are slow. Acquiring …

The Effects Of Frequency Of Social Interaction, Social Cohesion, Age, And The Built Environment On Walking, Gretchen Allison Luhr

Dissertations and Theses

The purpose of this dissertation was to explore, through a social ecological framework, the multifaceted effects of the neighborhood environment by investigating how dimensions of both the built environment and the neighborhood social context may interact to influence walking. Aesthetics, land use mix, crime, and pedestrian infrastructure were considered with respect to built environment walkability, and the neighborhood social context was conceptualized using measures of both social cohesion and social interaction with neighbors. This research used data from an Environmental Protection Agency (EPA)-funded study of 748 adults (18 years of age and older) residing in the Lents neighborhood in Portland, …

Immediate And Short-Term Effects Of Kinesio® Taping On Lower Trunk Range Of Motion In Division I Athletes, Hoshito Mizutani

Dissertations and Theses

Low back pain (LBP) is a common health problem that contributes to the high cost of health care. Improvement in trunk range of motion has been considered to be an important factor in ameliorating the symptoms of LBP. Kinesio® taping is a prominent therapeutic modality commonly used in the variety of populations for treating musculoskeletal conditions. However, previous research on the efficacy of Kinesio® taping for LBP is limited. The purpose of this study was to investigate the immediate and short-term effects of Kinesio® taping with the muscle inhibition technique on active trunk flexion range of motion. Twenty-five subjects with …

Exploring The Impact Of An Ld Diagnosis On The Self-Determination Of Women In Poverty, Cynthia Jakes Stadel

Dissertations and Theses

This collective case study explored the impact of a later-in-life learning disability (LD) diagnosis on women in poverty. The study focused on the perspectives of four women who were not identified with LD as children but accessed assessment services as adults receiving Oregon's Temporary Assistance for Needy Families (TANF). All four reported painful awareness of learning differences as youths; as adults they voluntarily engaged in a "labeling event," furthering a process toward personal transformation and enhanced well-being initiated by their own awareness and curiosity. The women described critical social and emotional support systems and relationships that helped them integrate understanding …

Thinking About Work At Home: Implications For Safety At Work, Frankie Guros

Dissertations and Theses

Safety at work is of the utmost importance to employees and the organizations they work for, and as such, it is a central issue for occupational health psychology. Although dramatic decreases in the number of worker injuries and fatalities have been observed over the last several decades, safety remains a principal concern for organizations. This is especially true in occupations in which employees face serious threats to their personal safety, such as correctional officers (COs). While a number of studies have identified workplace factors that contribute to worker safety, few have attempted to draw a link between employee nonwork experiences …

Non-Steroidal Anti-Inflammatory Drug Use In Collegiate Athletes, Brian Robert Davis

Dissertations and Theses

Non-steroidal anti-inflammatory drugs (NSAID) are a class of medications used in the treatment of pain, inflammation, and illness. These medications are common, affordable, and easy to access. For these reasons, NSAIDs are commonly used by athletes of all backgrounds for treating injuries and as ergogenic aids. However, despite these behaviors, NSAIDs have well-documented side effects and the efficacious nature of these medications has been brought into question. Despite this, many athletes continue to use these medications frequently and indiscriminately. It is not known why athletes use these medications in light of their questionable effectiveness and cited adverse effects. Therefore, this …

Analytic Thinking Predicts Vaccine Endorsement: Linking Cognitive Style And Affective Orientation Toward Childhood Vaccination, Daniel A. Anderson

University Honors Theses

Though popular opinion in the US is favorable toward vaccination, a growing hesitancy to vaccinate children threatens rates of uptake and coverage. In response, researchers now study psychological factors thought to influence vaccine-decisions, as having this information might be useful in addressing vaccine hesitancy in the clinic and beyond. The present thesis reviews evidence from this body of work, and shares results of a new study on the influence of analytic and intuitive thinking styles upon endorsement of childhood vaccines. In a national sample (N = 543), analytic thinking predicted endorsement alone and in the presence of covariates in …

Trauma-Informed Research And Planning: Understanding Government And Urban Native Community Partnerships To Addressing Substance-Exposed Pregnancies In Portland, Or, Amanda Mercier

Dissertations and Theses

In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given …

Participation, Information, Values, And Community Interests Within Health Impact Assessments, Nicole Iroz-Elardo

Dissertations and Theses

Health impact assessment (HIA) has emerged in the U.S. as one promising process to increase social and environmental justice through addressing health equity issues within planning. HIA practice is guided by values such as democracy and equity and grounded in broad social determinants of health. The most readily applied definition of democracy is problematic because it implies an element of direct, participatory engagement with the public. This is at odds with HIA practice that largely relies on stakeholder engagement strategies.

This dissertation critically examines the engagement strategies of three transportation planning HIA cases to more fully understand how the HIA …

Factors Influencing Youth Self-Perceptions Of Overweight And Obesity, Caitlin Helen Sommers

Dissertations and Theses

This study sought to examine whether participation in physical activity affects the ability to correctly classify body size, based on body mass index classifications. Secondarily, this study determined whether adolescents who incorrectly classified their body size overestimated or underestimated their size. Self-report data from the Youth Risk Behavior Surveillance Survey collected by the Centers for Disease Control and Prevention were analyzed. Logistic regression was performed to examine relationships between self-perception of body size and physical activity, television viewing time, computer/video game use, physical education class time, and extracurricular sports activities. Significance was set to p<0.05. Physical activity was the only statistically significant independent variable (p=0.058, OR = 1.060). Although physical activity was shown to be statistically significant, it did not appear to meaningfully increase the ability of youth to correctly classify body size. Secondary analysis showed that adolescents who incorrectly classified their body size were more likely to underestimate their body size. Females more frequently underestimated their body size (females=673; males=384).

Exploring The Effects Of Multi-Level Protective And Risk Factors On Child And Parenting Outcomes In Families Participating In Healthy Start/Healthy Families Oregon (Hs/Hfo), Peggy Nygren

Dissertations and Theses

While many studies focus on the links between multiple risk factors and negative outcomes such as child maltreatment, less is known about the influence of protective factors in the face of risks. The theoretical base of this study was a social ecological model of interactive influences including individual parent, family, and neighborhood level factors to predict outcomes. Protective Factor Index (PFI) and Risk Factor Index (RFI) predictors were developed to explore potential multi-level protective factor buffering effects on key child development and parenting outcomes. Participants were first time mothers enrolled in a randomized controlled study of the Healthy Start/ Healthy …

Work Stress Reactivity And Health Outcomes: A Study Of Nurses, Laurie Marie Jacobs

Dissertations and Theses

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health.

Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on …

Batterer Intervention Programs' Response To State Standards, Ashley Lynn Boal

Dissertations and Theses

The study of policy implementation has recently garnered research and federal attention highlighting the importance of implementation in achieving desired policy and program outcomes (Durlak & DuPre, 2008; Meyers, Durlak & Wandersman, 2012; National Institutes of Health, 2013). Psychology is one discipline that is well poised to guide the study of policy implementation as it can inform the creation, development, and outcomes associated with the introduction of a policy (Esses & Dovidio, 2011; Fischhoff, 1990). Given that batterer intervention programs (BIPs) have been developed to prevent future intimate partner violence (IPV) and improve victim safety, ensuring these programs have successfully …

The Historical, Political, Social, And Individual Factors That Have Influenced The Development Of Aging And Disability Resource Centers And Options Counseling, Sheryl Dejoy Elliott

Dissertations and Theses

This thesis reports on the perspectives and experiences of policymakers, advocates, agency supervisors, and experts in the field of gerontology, about the development of Aging and Disability Resource Centers (ADRC) programs and Options Counseling (OC). By examining the foundations upon which ADRCs and OC are built, this study sought to inform future research about the effectiveness of existing practice, increase understanding of best practices, and clarify whether these emerging services are accomplishing original goals.

ADRCs and OC intend to address long-term care issues and healthcare needs by providing a single entry point to the social service system. ADRCs offer information, …

International And Domestic Student Health-Information Seeking And Satisfaction, Stacy Theodora Austin

Dissertations and Theses

This study examines two groups -international and domestic students at Portland State University (PSU) - in terms of their motivations to seek university-health services, and their satisfaction with university-health services. The Theory of Motivated Information Management (W. A. Afifi & Weiner, 2004) served as the foundation for this study to examine the preferences of students in terms of the ways they seek information about their health concerns. Differences in international and domestic students' anxiety, efficacy, and satisfaction with physicians were supported. International students reported more anxiety than domestic students. Domestic students reported being more efficacious than international students when talking …

Exploring Four Barriers Experienced By African Americans In Healthcare: Perceived Discrimination, Medical Mistrust, Race Discordance, And Poor Communication, Adolfo Gabriel Cuevas

Dissertations and Theses

For many health conditions, African Americans bear a disproportionate burden of disease, injury, death, and disability compared to European Americans. African Americans also use health services less frequently than do European Americans and this underuse of services contributes to health disparities in the United States. Studies have shown that some disparities are present not as a result of poor access to care, but, to a certain extent, as a result of the experiences patients have at their doctors' offices. It is, therefore, essential to understand African American patients' perspectives and experiences with healthcare providers. Past studies have shown that four …

The Institutional Context That Supports Team-Based Care For Older Adults, Anna Foucek Tresidder

Dissertations and Theses

The aging population in the U.S. is dramatically increasing; it is predicted that not only will individuals live longer but also that they will live with multiple chronic diseases that could require high levels of medical and social resources. While the aging population increases, the number of health care providers choosing to specialize in caring for the elderly is decreasing just as dramatically. Teams are believed to be a possible response to more efficiently use the providers available, take advantage of alternative provider types, and integrate a range of health and social services to meet patient needs more effectively. Interdisciplinary …

Community-Based Approaches To Mental Health And Conflict Resolution In Post-Conflict Libya, Amanda Lubit

Anthropology Theses

Post-conflict Libya faces the challenges of establishing a national health system that is capable of addressing mental health needs for a population traumatized by decades of repression and a recent war. In order to recover, traumatized populations require feelings of safety, calm, empowerment, connectedness, and hope. To help achieve this outcome, programs must focus on medical and social aspects at both the individual and community level.

As part of an internship experience, I worked with Dr. Omar Reda, a Libyan psychiatrist at Oregon Health and Science University (OHSU) who helps communities, organizations and mental health professionals throughout Libya to address …