Public Health Commons^™

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. …

Challenging Aggressive Behaviors Experienced By Personal Support Workers In Comparison To Home Care Workers: Relationships Between Caregiver Experiences And Psychological Health, Kelsey N. Womack, Teala W. Alvord, Caitlyn F. Trullinger-Dwyer, Sean P.M. Rice, Ryan Olson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Personal support workers (PSW) are caregivers for children and adults with intellectual and developmental disabilities (IDDs) or adults experiencing mental illness or other behavioral health conditions. The work can be very meaningful, but many PSWs must prepare for, monitor, and manage challenging behaviors, including aggression. This study was designed to estimate the prevalence of aggression experienced by PSWs in Oregon, and compare it to a previous sample of Oregon home care workers (HCWs). This comparison included an analysis of relationships between exposures to aggression and psychological health factors. PSWs in Oregon (N = 240) were surveyed electronically at a single …

Menthol In Electronic Cigarettes: A Contributor To Respiratory Disease?, Vijayalekshmi Nair, Malcolm Tran, Rachel Z. Behar, Song Zhai, Xinping Cui, Rattapol Phandthong, Yuhuan Wang, Songqin Pan, Wentai Luo, James F. Pankow, David C. Volz, Prue Talbot

Civil and Environmental Engineering Faculty Publications and Presentations

Menthol is widely used in tobacco products. This study compared the effects of menthol on human bronchial epithelium using submerged cultures, a VITROCELL® cloud chamber that provides air liquid interface (ALI) exposure without solvents or heating, and a Cultex ALI system that delivers aerosol equivalent to that inhaled during vaping. In submerged culture, menthol significantly increased calcium influx and mitochondrial reactive oxygen species (ROS) via the TRPM8 receptor, responses that were inhibited by a TRPM8 antagonist. VITROCELL® cloud chamber exposure of BEAS-2B monolayers increased mitochondrial protein oxidation, expression of the antioxidant enzyme SOD2, activation of NF-κB, and secretion of inflammatory …

Improving Smoking Cessation Outcomes Through Tailored-Risk Patient Messages At A University Hospital Tobacco Cessation Service, David Gonzales, Wendy G. Bjornson, Catherine J. Markin, Trisha M. Coleman, Frances Favela, Noal Clemons, Caroline Koudelka, Jodi Lapidus

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Postdischarge follow-up is a critical step for increasing effectiveness of hospital smoking cessation treatment. A quality improvement project was undertaken at an academic medical center tobacco cessation consult service to evaluate whether a tailored message (TM) linking immediate risks of continued smoking—particularly carbon monoxide exposure— to hospital recovery would stimulate more patient interest in the hospital’s cessation treatment, including agreement to postdischarge follow-up, compared to patients receiving the usual treatment protocol with a standard message (SM) regarding more general health benefits of abstinence. Methods: Data from 697 smokers ordered/referred for smoking cessation treatment in 2013 who received either the …

Trajectories Of Hiv-Related Internalized Stigma And Disclosure Concerns Among Art Initiators And Non-Initiators In South Africa, Brian T. Chan, Brendan G. Maughan-Brown, Laura M. Bogart, Valerie A. Earnshaw, Gugulethu Tshabalala, Ingrid Courtney, Janan J. Dietrich, Catherine Orrell, Glenda Gray, David R. Bangsberg, Alexander C. Tsai, Ingrid T. Katz

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV-related stigma among people living with HIV (PLHIV) is associated with worse health outcomes. We used longitudinal data from a multisite cohort in South Africa to assess changes over time in stigma after HIV diagnosis and determine whether antiretroviral therapy (ART) initiation is associated with stigma reduction. We administered the Internalized AIDS-Related Stigma Scale (IARSS, a six-item dichotomous scale questionnaire) at baseline, 3 months, and 6 months to newly diagnosed ART-eligible participants between 2014 and 2015. A confirmatory factor analysis indicated that the IARSS contained a four-item internalized stigma factor (α = .80) and a two-item disclosure concerns factor (α …

A Sexual Health Promotion App For Transgender Women (Trans Women Connected): Development And Usability Study, Christina J. Sun, Kirsten M. Anderson, Tamara Kuhn, Liat Tzvia Mayer, Charles H. Klein

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, we designed a prototype mobile app to promote HIV prevention among transgender women.

Objective: This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.

Methods: We engaged in a 3-phase prototype development process. After conducting formative research about the health needs of this population, we outlined a theory-based app framework …

Tracking Multimorbidity Changes In Diverse Racial/Ethnic Populations Over Time: Issues And Considerations, Ana R. Quiñones, Heather G. Allore, Anda Botoseneanu, Jason T. Newsom, Corey L. Nagel, David A. Dorr

OHSU-PSU School of Public Health Faculty Publications and Presentations

Multimorbidity is widely recognized as having adverse effects on health and wellbeing and may threaten the ability of older adults to live independently. Much of what is known about multimorbidity rests on research that has largely focused on one point in time, or from a static perspective. Given that there remains a lack of agreement in the field on how to standardize multimorbidity definitions and measurement, it is not surprising that analyzing and predicting multimorbidity development, progression over time, and its impact are still largely unaddressed. As a result, there are important gaps and challenges to measuring and studying multimorbidity …

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 …

Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Preventing unintended pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals. Family planning services should support WLWH at risk of repeat unintended pregnancies. We examined the relationship between unintended pregnancy and subsequent contraception use among WLWH in Uganda.

Study design: This was a retrospective analysis of data from a longitudinal cohort of individuals initiating antiretroviral therapy (ART), restricted to women with pregnancy (confirmed via urine β-hcg testing) between 2011–2013. The exposure of interest was intended vs unintended pregnancy, and the outcome was self-report of modern contraceptive use (hormonal methods, intrauterine device, sterilization, and/or …

Towards A People’S Social Epidemiology: Envisioning A More Inclusive And Equitable Future For Social Epi Research And Practice In The 21st Century, Ryan J. Petteway, Mahasin Mujahid, Rachel Morello-Frosch, Amani Allen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise—reimagining what “social” could, or even should, mean for the future of the field. …

Air Pollution, Neighborhood Deprivation, And Autism Spectrum Disorder In The Study To Explore Early Development, Laura A. Mcguinn, Gayle C. Windham, Lynne C. Messer, Di Qian, Joel Schwartz, Lisa A. Croen, Eric J. Moody, Ana G. Rappold, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To examine whether neighborhood deprivation modifies the association between early life air pollution exposure and autism spectrum disorder (ASD), we used resources from a multisite case–control study, the Study to Explore Early Development.

Methods: Cases were 674 children with confirmed ASD born in 2003–2006; controls were 855 randomly sampled children born during the same time period and residents of the same geographic areas as cases. Air pollution was assessed by roadway proximity and particulate matter

Results: Neighborhood deprivation modified (P_{for interaction} = 0.08) the association between PM2.5 exposure during the first year of life …

World Health Organization Cardiovascular Disease Risk Charts: Revised Models To Estimate Risk In 21 Global Regions, Stephen Kaptoge, Lisa Pennells, Dirk De Bacquer, Marie Therese Cooney, Maryam Kavousi, Gretchen Stevens, Leanne Margaret Riley, Stefan Savin, Taskeen Khan, Servet Altay, Carlos J. Crespo, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions.

Methods: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history …

Correlates Of Same-Sex Behavior Disclosure To Health Care Providers Among Black Msm In The United States: Implications For Hiv Prevention, Christina J. Sun, Karin Tobin, Pilgrim Spikes, Carl Latkin

OHSU-PSU School of Public Health Faculty Publications and Presentations

Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006–2009 identified individual and social network characteristics of Black MSM (n = 226) that are associated with disclosure that may be leveraged to increase disclosure. Over two-thirds (68.1%) of the sample had ever disclosed to HCPs. Part-time employment (AOR = 0.32, 95% CI = 0.11–0.95), bisexual identity (AOR = …

Clinical Practice Variation Among Adult Infectious Disease Physicians In The Management Of Staphylococcus Aureus Bacteremia, Catherine Liu, Luke Strnad, Susan E. Beekmann, Philip M. Polgreen, Henry F. Chambers

OHSU-PSU School of Public Health Faculty Publications and Presentations

Infectious disease management of Staphylococcus aureus bacteremia (SAB) was surveyed through the Emerging Infections Network. While there were areas of consensus, we found substantial practice variation in diagnostic evaluation and management of adult patients with SAB. These findings highlight opportunities for further research and guidance to define best practices.

Divergent Trends In Life Expectancy Across The Rural-Urban Gradient And Association With Specific Racial Proportions In The Contiguous Usa 2000-2005, Yun Jian, Lucas Neas, Lynne C. Messer, Christine L. Gray, Jyotsna S. Jagai, Kristen M. Rappazzo, Danelle T. Lobdell

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives: To estimate county-level adult life expectancy for Whites, Black/African Americans (Black), American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (Asian) populations and assess the difference across racial groups in the relationship among life expectancy, rurality and specific race proportion.

Methods: We used individual-level death data to estimate county-level life expectancy at age 25 (e25) for Whites, Black, AIAN and Asian in the contiguous USA for 2000–2005. Race–sex-stratified models were used to examine the associations among e25, rurality and specific race proportion, adjusted for socioeconomic variables.

Results: Lower e25 was found in the central USA for AIANs and …

Racial/Ethnic Differences In Multimorbidity Development And Chronic Disease Accumulation For Middle-Aged Adults, Ana R. Quiñones, Anda Botoseneanu, Sheila Markwardt, Corey L. Nagel, Jason T. Newsom, David A. Dorr, Heather G. Allore

Psychology Faculty Publications and Presentations

Multimorbidity–having two or more coexisting chronic conditions–is highly prevalent, costly, and disabling to older adults. Questions remain regarding chronic diseases accumulation over time and whether this differs by racial and ethnic background. Answering this knowledge gap, this study identifies differences in rates of chronic disease accumulation and multimorbidity development among non-Hispanic white, non-Hispanic black, and Hispanic study participants starting in middle-age and followed up to 16 years.

We analyzed data from the Health and Retirement Study (HRS), a biennial, ongoing, publicly- available, longitudinal nationally-representative study of middle-aged and older adults in the United States. We assessed the change in chronic …

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 …

Prescription Opioid Use Patterns, Use Disorder Diagnoses, And Addiction Treatment Receipt After The 2014 Medicaid Expansion In Oregon, Rachel Springer, Miguel Marino, Steffani R. Bailey, Heather Angier, Jean O'Malley, Megan Hoopes, Stephan Lindner, Jennifer E. Devoe, Nathalie Huguet

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background/Aims: Evidence suggests Medicaid beneficiaries in the USA are prescribed opioids more frequently than are people who are privately‐insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid‐use‐disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014, or returned to Medicaid coverage after expansion.

Design: Cross‐sectional study using inverse‐propensity weights to adjust for …

It's Not Easy - Impacts Of Suicide Prevention Research On Study Staff, Jason I. Chen, Ginnifer L. Mastarone, Lauren M. Denneson

Communication Faculty Publications and Presentations

Suicide prevention researchers who work with individuals at high risk of suicide or are exposed to details of suicide attempts and deaths may experience negative impacts on their own well-being. This is not unlike the experiences of mental health providers, where repeated exposure to clients' difficult experiences gas long been identified as an occupational risk (Molnar et al., 2017). however, there have been few studies evaluating how exposure to details of suicide-related behavior impacts researcher well-being. This gap in the literature is worrisome, as researcher' mental health and well-being might be negatively impacted by repeated exposure to graphic details of …

Does Ownership Make A Difference In Primary Care Practice?, Stephan Lindner, Leif I. Solberg, William L. Miller, Bijal A. Balasubramanian, Miguel Marino, K. John Mcconnell, Samuel T. Edwards, Kurt C. Stange, Rachel J. Springer, Deborah J. Cohen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices.

Methods: This cross-sectional analysis used electronic health record and survey data collected between September 2015 and April 2017 as part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by the Agency for Health Care Research and Quality. We compared physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHC) by using 15 survey-based practice characteristic measures, 9 survey-based quality improvement process measures, and 4 …

Dohad And The Latina Paradox, Chelsea Peterson, Kellie Pertl, Lulu Gonzalez, Molly Sax

OHSU-PSU School of Public Health Annual Conference

The Latina Paradox is the observation that Latina mothers in the United States have better than expected birth outcomes despite lower socioeconomic status and higher prevalence of risk factors. The Latina Paradox is particularly prominent among women born in Mexico that immigrate to the U.S. prior to having children. Mexican-born women who give birth in the U. S. experience fewer incidences of low birth weight than White women born in the U. S. Various factors are responsible for the Latina Paradox, including social and cultural support in maternity, traditional diet, and immigration of healthier than average women to the U.S. …

Quantifying The Invisible: A Literature Review And History Of Research On The Health Effects Of Wildfire Smoke, Lily A. Cook Ma

OHSU-PSU School of Public Health Annual Conference

The objective of this scoping review is to provide an overview of issues affecting the results of studies on the health effects of non-occupational wildfire exposure. Although it is well established that wildfire smoke is harmful to people with chronic respiratory conditions, research on other health impacts have often found inconsistent results or small effect sizes. These results are often misinterpreted to mean that wildfire smoke has a negligible effect on non-respiratory outcomes such as cardiovascular health or mortality. However, what these results actually reflect is the complexity of determining public exposure to wildfire smoke, as well as variations in …

A Data Collection Program For Reducing Ipv In Lgbtq+ Communities, Alexandra Michel, Nicholas Cheke, Lourdes Gonzalez, Rachel Greim

OHSU-PSU School of Public Health Annual Conference

Sexual and gender minority populations are not currently being accurately tracked or counted in most domestic violence (DV) and intimate partner violence (IPV) surveillance programs in Oregon. However, research indicates that LGBTQ+ populations experience IPV at rates comparable or even higher than heterosexual populations. Additionally, distrust of law enforcement and services designed around heterosexual experiences of IPV further reduce the ability of LGBTQ+ populations, particularly transgender women, to access IPV services. We propose that through the use of a PRECEED-PROCEED model, a program could be developed to more accurately collect sexual orientation and gender identity data by IPV service providers …

Take Control: A Proposed Mental Health Treatment Program To Be Implemented In Youth Correctional Facilities Around Oregon Based On The Evidence-Based Target Program, Zoey S. Rochefort

OHSU-PSU School of Public Health Annual Conference

70% of youth in state and local juvenile justice systems exhibit symptoms of one or more mental health disorders and are not receiving adequate treatment. Currently, in Oregon, there is no mental health-screening requirement for youth admitted into detention centers or correctional facilities. Though this doesn’t mean kids never get diagnosed, it does mean there is a large delay in time before treatment begins where they could be receiving care. The Take Control program is working to mitigate wasted time and improve mental health treatment for youth inmates through a seven-step treatment program that provides youth with steps and strategies …

Validity Of An Atopic Dermatitis Outcome Measure For Real-World Clinical Practice, Christina Topham, Dylan Haynes, Molly Brazil, Eric Simpson

OHSU-PSU School of Public Health Annual Conference

Introduction: Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the United States. AD is associated with reduced quality of life and substantial financial costs, making it burdensome at an individual and population level. Disease severity outcome measures are validated tools to assess severity and therapeutic response. Recent consensus statements have identified gold-standard outcome measures for AD in clinical trials, but further work is needed evaluating outcome measures feasible for clinical practice.

Objective: To investigate the validity and feasibility of the product of investigator global assessment and body surface area (IGA x BSA) as an outcome measure …

Study Of Physical Literacy And Physical Fitness In School Children, Natalie T. Pexton

OHSU-PSU School of Public Health Annual Conference

Background: Currently there is no standard physical education (P.E.) assessment for tracking students’ progress across the state. As a result, there is little data on the physical literacy and physical fitness of school children which are essential to lifelong physical activity.

Physical Literacy is the confidence, knowledge, and ability to execute fundamental movement skills like hopping, throwing, and kicking.

Cardiorespiratory fitness is a measure of the stamina and capacity to perform aerobic exercise.

Objective: To test the “PlayFun” physical literacy and “Pacer” cardiorespiratory fitness tests with Portland Public School students.

Methods:

Setting: Two Portland Public School district elementary …

Preventing Infectious Hematopoietic Necrosis In Salmonid Fish Along The Columbia River Basin, Whitney L. Wright

OHSU-PSU School of Public Health Annual Conference

Infectious hematopoietic necrosis virus (IHNV) is a member of the Rhabdoviridae family and causes infectious hematopoietic necrosis (IHN) disease in many salmonid species during the juvenile or “fry” stage of life. IHNV is endemic to Western North America and occurs in the Columbia River Basin, where Steelhead and Chinook salmon are the most abundant IHNV-vulnerable species. IHNV can cause an epidemic in wild or farmed stocks, killing 90-95 percent of the fish it infects. Transmission is currently understood to occur by direct exposure through the gills, and the virus is shed typically from asymptomatic or clinically ill carrier adults at …

Theorizing Indigenous Student Resistance, Radical Resurgence, And Reclaiming Spiritual Teachings About Tma’Áakni (Respect), Michelle M. Jacob, Kelly L. Gonzales, Chris Finley, Stephany Runninghawk Johnson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Indigenous dispossession and environmental devastation are intertwined outcomes of settler colonialism’s cycle of violence. However, indigenous people continue to draw from cultural and spiritual teachings to resist such forms of violence, and engage in what Leanne Simpson calls “radical resurgence.” Our paper analyzes the Yakama elders’ teachings about Tma’áakni (Respect), to examine principles and forms of indigenous resistance and resurgence, demonstrated by indigenous students in support of the NoDAPL(No Dakota Access PipeLine) movement. Elders’ teachings, which are rooted in spiritual traditions held by indigenous peoples since time immemorial, are useful for understanding and articulating the importance of the contemporary indigenous …

Growing Healthy Together: Protocol For A Randomized Clinical Trial Using Parent Mentors For Early Childhood Obesity Intervention In A Latino Community, Byron A. Foster, Kelsey Weinstein, Jackilen Shannon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation.

Methods/design: This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2–5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a …