Public Health Commons^™

From Theory To Practice: What Global Health Practitioners Need To Know About Social Norms And Narrative Interventions, Amy Henderson Riley, Kriss Barker, Rebecka Lundgren

College of Population Health Faculty Papers

There has been a marked increase in the literature in recent years about social norms, what they are, and how to measure them. New theoretical connections indicate specific significance for those working with global health programs that use narrative interventions, such as mass, print, and community media. The literature is dense, however. Different terms describe similar constructs, and the sheer number of new articles and emerging academic frameworks can be overwhelming. In this letter, we briefly summarize current social norms and narrative theorizing and provide examples of global programs that have effectively applied these theories. In so doing, we hope …

Racial Disparities In Post-Acute Home Health Care Referral And Utilization Among Older Adults With Diabetes, Jamie Smith, Olga Jarrín, Haiqun Lin, Tina Dharamdasani, Jennifer Tsui, Charlotte Thomas-Hawkins

College of Nursing Faculty Papers & Presentations

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and outcomes including disabling and life-threatening complications among patients with diabetes. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordination, and psychosocial support for patients and their caregivers. The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The study was limited to patients who were continuously enrolled in Medicare for at …

Will The Covid-19 Pandemic Finally Fuel Drug Repurposing Efforts?, Anna Chen, Shivangi Patel, Matthew Alcusky, Vittorio Maio

College of Population Health Faculty Papers

No abstract provided.

A Brazilian National Preparedness Survey Of Anesthesiologists During The Coronavirus Pandemic, Vinícius Caldeira Quintão, Claudia Marquez Simões, Gibran Elias Harcha Munoz, Paul Barach, Maria José Carvalho Carmona, Brazilian Network For Research On Complications In Anesthesia Branca

College of Population Health Faculty Papers

No abstract provided.

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Vaccine Hesitancy In The Era Of Covid, Nicole Parkerson, Md, Faap, Amy Leader, Drph, Mph

Population Health Leadership Series: PopTalk Webinars

In 2019, the World Health Organization named vaccine hesitancy a top 10 threat to global public health. Vaccine hesitancy threatens to reverse progress made in tackling vaccine-preventable diseases and could compromise our ability to curb a raging global pandemic. Learn about the underlying causes of vaccine hesitancy, what health care professionals can do to lessen vaccine hesitancy among patients, and how research is uncovering the most effective ways to message vaccines to the public.

Pandemic Makes Chronic Disease Prevention A Priority., Karen S. Kmetik, Alexis Skoufalos, David B. Nash

College of Population Health Faculty Papers

This article is the authors' final version prior to publication in Population Health Management, Volume 24, Issue 1, February 2021, Pages 1-2

Final publication is available from Mary Ann Liebert, Inc., publishers https://doi.org/10.1089/pop.2020.0126

Assessing Food Quality And Regulations At Homeless Shelters In Philadelphia, Emily Casaletto, Rickie Brawer, Phd, Mph, Mches

Phase 1

Introduction: Nutritional diseases such as hypertension, diabetes, and cholesterol disorders are particularly high among individuals experiencing homelessness in comparison to the general United States population, leading the propagation of chronic health conditions and overuse of expensive healthcare resources. In addition, the food served in homeless shelters is the main source of nutrition for those living in these shelters, most notably when there is no option for food storage available. Despite the disproportionate prevalence of nutrition-related diseases among the homeless population, there is limited research on the quality of the food provided in homeless shelters and there are few policies to …

Patient Characteristics Of A Primary Care-Based Medication-Assisted Treatment Program For Opioid Use Disorder In Philadelphia, Zoe Wong, Lara Weinstein, Md

Phase 1

Introduction: The opioid crisis is a persistent national public health concern, with Philadelphia at its epicenter. Medication-assisted treatment (MAT) programs for opioid use disorder in primary care settings afford greater access to marginalized groups and integration of healthcare services. This study describes patient characteristics of a low-threshold, primary care-based MAT program in Philadelphia.

Methods: 134 patient interviews between February 12, 2019 and March 14, 2020 were retrospectively analyzed. Key characteristic measures included drug and alcohol use history, co-occurring health conditions, history of violence or trauma, and quality of life. The results from the two program locations, Stephen Klein Wellness Center …

The Wic Program: Background, Trends And Factors Associated With Participation Among Wic Eligible Families, Peace Nosa-Omorogiuwa, Cheryl Bettigole

Phase 1

Introduction

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides access to supplemental foods, nutrition education etc. to low-income pregnant women, infants and children under 5. Despite being a safety net for nutritionally at-risk individuals, the coverage rates for WIC eligible individuals are far lower than the eligibility rates. This study seeks to understand the history of the WIC program, analyze current trends and discuss factors affecting participation in the WIC program.

Methods

The target population are populations that are eligible for the WIC program. A narrative review of journal articles was conducted. Databases searched were EBSCO …

Exploring Political Awareness And Civic Engagement Among Women Utilizing Mater Services, Cathy Lu, Meghan Gannon, Phd, Msph

Phase 1

Introduction: High levels of civic engagement by United States citizens sustains the integrity of the democratic system. Health organizations, such as The Maternal Addiction Treatment Education and Research (MATER) program, are in a position to help marginalized voting-eligible individuals overcome barriers to voting.

Methods: The target population was women utilizing MATER services. The study design consisted of a survey collecting data including demographic information, political engagement, perceived barriers, and interest in future advocacy. Following the survey, participants were offered more voting resources.

Results: One hundred percent of participants reported utilizing public assistance. Forty-eight percent reported a social network as their …

Strategic Design Development For Malawian Public Health Center Labor & Delivery Suites, Kayla Holston, Mph, Meghan Gannon, Phd, Msph, Christopher Harnish, March, Zayithwa Fabiano, Mbbs, Luis Gadama, Mbbs, Mmed

Phase 1

Introduction: Maternity ward pre-, peri-, and postnatal room sharing creates concerns regarding maternal privacy (particularly confidentiality and dignity), paternal involvement in birthing process, and staff workflow efficiency. This study aimed to understand the current state of the aforementioned concerns and their impact on maternal child bonding and maternal mental health at Queen Elizabeth Central Hospital (QECH).

Methods: At discharge, mothers of birth (MOBs) were surveyed on pre-, peri-, and postnatal experience with regard to privacy and paternal involvement in the birthing process, and then assessed using the Mother to Infant Bonding Scale and Edinburg Depression Scale. Father of births (FOBs) …

Effectiveness Of Enrichment Programs Such As Step Up In Increasing The Matriculation Of Urim Students To Medical Schools, Jessica Amoako, Traci Trice, Md

Phase 1

Introduction: Diversity in healthcare can improve access to healthcare for racial/ethnic minorities. However, barriers such as lack of educational opportunities have hindered URiM (underrepresented in medicine) students from matriculation to medical school. Enrichment programs such as STEP UP Medicine seek to break down these barriers. It provides its participants with MCAT preparation, advising, medical skills sessions, clinical shadowing experiences, and networking opportunities. Thus, the goal of this project is to assess if this program is effective in improving the medical school matriculation rates of URiM students.

Methods: Data was collected through a self-administered online survey using Google forms. The link …

Retrospective Chart Review Of Metastatic Solid Tumor Discharges To Subacute Rehab, Sarah Svetec, Molly Hanson, Crnp, Brooke Worster, Md

Phase 1

Introduction: Regaining strength through rehabilitation as a mechanism to return cancer patients to therapy is poorly understood and therefore realistic advice cannot be given to patients when cancer-directed therapy must be stopped. This research examines what cancer patients are able to accomplish following referral to subacute rehabilitation (SAR). It was hypothesized that the majority of patients would not return to cancer-directed therapy following SAR and that a high functional status at discharge would be the best predictor of this return.

Methods: A retrospective chart review was completed for 112 metastatic solid tumor patients discharged to SAR (2018-2020). The primary outcome …

Training Toolkit For Caregivers At Residential Care Centers In Peru, Elizabeth Stratton, Stephen Didonato, Wayne Centrone

Phase 1

Introduction:

Health Bridges International (HBI) is developing a training toolkit for caregivers working with marginalized youth in residential care centers (RCCs) in Peru. The toolkit represents an amalgamation of best practices, evidence informed research, and the results of our QI survey tool. We predicted that current Peruvian caregivers will identify topics of interest that differ from current literature.

Methods:

Surveys were distributed to over 150 RCCs throughout Peru using email and WhatsApp messages in a snowball format, starting at the administration level. The survey required 20-30 minutes to complete and was completely voluntary. All preliminary data was de-identified and imputed …

Patient Evaluation Of Medication-Assisted Treatment For Opioid Dependency, Francesca Ciocco, Lara Weinstein, Md

Phase 1

Introduction: Although primary care settings are a promising setting for expansion of medication-assisted treatment (MAT) for opioid use disorder (OUD), currently there is not an established primary care model for MAT. While creating a primary care MAT model, traditional treatment success measures (TSMs), like abstinence, may not be effective for vulnerable populations. This study aims to identify patient-important TSMs and compare their relative importance to traditional TSMs.

Methods: Traditional TSMs for MAT programs were identified with a literature review, while potential patient-important TSMs were identified from qualitative analysis of intake interviews for a MAT program in Philadelphia. Traditional and …

Pattern Of Sexual Partner Violence And Health In Young Adult College Students Ages 18-24, Alice Renaud, Allison Casola, Phd

Phase 1

No abstract provided.

Identifying Health Topics For Elementary-Aged Children In Delaware, Kayla Morrell, Denise Hughes

Phase 1

Introduction: Health literacy involves understanding health-related information to make educated decisions regarding an individual’s needs. Low health literacy is associated with poorer health outcomes, which can be minimized by early introduction to accurate health information. Currently, elementary schools in Delaware have no health curriculum, leaving students at risk for low health literacy.

Methods: Interviews were conducted with Delaware elementary school teachers to identify a series of topics that would allow students to learn health information via incorporation into existing curriculum. Teachers were divided into focus groups by school and grade level. The resulting discussions were qualitatively analyzed by two independent …

Assessing The Role Of Virtual Social Networks In The Treatment Progress Of Mothers Recovering From Opiate Addiction, Marisa Wu, Meghan Gannon, Phd Msph, Diane Abatemarco, Phd, Msw

Phase 1

Introduction: Social engagement is a significant contributor to the treatment success of individuals with prior substance use. This project aims to determine if social engagement improves the progression through and experience of treatment of mothers with prior opioid use at an inpatient recovery facility. We hypothesize that increased social engagement will improve treatment progress and experience.

Methods: The project is centered on mothers seeking treatment for opioid use at an urban inpatient treatment facility. The study obtains qualitative and quantitative data through interviews and therapy sessions. The data informs the extent and quality of social engagement and individual perspectives of …

Maternal Stress And Breastfeeding Intention In Pregnant Women With Opioid Use Disorder, Yassamin Jamshidian, Vanessa Short, Phd, Mph, Diane J. Abatemarco

Phase 1

Introduction: Breastfeeding rates are low among women in treatment for opioid use disorder (OUD). Information on determinants of breastfeeding intention can help inform the design of breastfeeding promotion interventions for this population. The objective of the study was to examine associations between maternal characteristics, including stress, and breastfeeding intention among pregnant women in treatment for OUD.

Methods: Fifty-six pregnant women who were receiving treatment for OUD at Thomas Jefferson University’s Maternal Addiction Treatment Education & Research (MATER) program completed a survey, which included questions on demographics, psychosocial characteristics, breastfeeding history, and breastfeeding intention. Maternal stress was measured using the Perceived …

Immigrant Health Literacy Initiative, Yuliya Goykhman, Kelsey Salazar, Mph

Phase 1

Introduction: Low health literacy in immigrant and refugee patients contributes to reduced health access and overall poorer quality of life in these patient populations. Community-Based Organizations (CBOs) provide necessary health navigation services for immigrant populations, but their role is often overlooked by large healthcare institutions. This project aims to illustrate the unique needs of both immigrant and refugee clients in navigating the healthcare system and CBO staff in assisting them with navigation, and to demonstrate to hospital partners how their services are crucial to adequate care of these communities.

Methods: As part of the Pennsylvania Health Literacy Coalition (PAHLC), four …

Nutritional Intervention In Concussion Treatment And Analysis Using Mri And Eeg, Jideofor Okafor, Namdi Nwasike, Andrew Newberg, Md

Phase 1

Traumatic brain injuries (TBI) occur in over one million Americans annually, leading to thousands of deaths, hospitalizations, and individuals with long term disability. The most common causes of TBI which result in hospitalization primarily affect middle-aged to older adults and contribute to the annual economic burden of billions of dollars. The goal of this study is to determine if baseline EEG scans predict responsiveness to supplemental treatment in TBI patients experiencing chronic symptoms, which could improve their care.

Subjects recruited from the greater Philadelphia area were randomly separated into 3 groups—Control, N-acetylcysteine (NAC), or Nutrition—and either received standard treatment for …

Menstrual Management In Adolescent Transgender Males, Julia Eisenberg, Sarah Felleman, Benjamin Bear, Mph, Arielle Effron, Md, Anne Kazak, Phd, Abpp, Anthony Alioto, Phd, Evan Graber, Do, Vanessa Short, Phd, Mph, Meghan Gannon, Phd, Msph, Beth Schwartz, Md

Phase 1

Introduction: Gender dysphoria is associated with increased rates of anxiety, depression, and suicidal ideation in adolescents. There is anecdotal evidence that menstruation increases the occurrence of gender dysphoria in adolescent transgender males. We hypothesize that menses are distressing to transgender males and this population would benefit from menstrual management.

Methods: We conducted a retrospective chart review of all transgender male patients seen in the Nemours Gender Wellness Program (GWP) and limited our population to those who have reached menarche. Data was extracted from the encounters at the GWP clinic and recorded in REDCap. We compared self-reported symptoms of gender dysphoria …

Diabetes Distress, Daily Functioning, And Hemoglobin A1c In Older Black Individuals With Diabetes And Mild Cognitive Impairment, Navajyoti R. Barman, Robin J. Casten, Phd, Barry W. Rovner, Md

Phase 1

Objective: The purpose of the cross-sectional study was to identify associations between diabetes distress, physical functioning, and cognition with hemoglobin A1c in older Black individuals with diabetes and mild cognitive impairment.

Methods: The investigators analyzed previously collected data from 101 older Black individuals with diabetes and mild cognitive impairment. Participants were administered surveys at baseline to assess diabetes distress, physical functioning, and cognitive functioning, and had hemoglobin A1c testing.

Results: Participants with higher hemoglobin A1c showed worse self-reported daily function (r = -0.279, p < .01). Three of four diabetes distress factors were positively correlated with hemoglobin A1c – emotional (r = .276, p < .01), regimen-related (r = .330, p < .01), and interpersonal distress (r = 0.266, p <.01). In a multivariate regression with hemoglobin A1c as the dependent variable, only regimen-related diabetes distress (beta = .282, p = .012) and self-reported daily function (beta = -0.294, p = .027) were significant.

Conclusion: The main finding of this study is that regimen-related diabetes distress and self-reported daily …

Racial Discrepancies In Interpregnancy Intervals And Postpartum Contraception Receipt In Centering Pregnancy Prenatal Care, Amulya Raju, Ms, Dennis Hand, Phd

Phase 1

Non-Hispanic black women are disproportionately affected by higher rates of shorter interpregnancy intervals. The purpose of this study is to identify whether the Centering Pregnancy model of group prenatal care (GPC) can reduce this health disparity by increasing postpartum contraception receipt.

This retrospective chart analysis measures consistency in contraception intent versus actual postpartum receipt in populations of women who received either individual or GPC. The main predictors were: race, insurance type (public or private), marital status, and type of prenatal care. The main outcomes were: type of contraception received, consistency with contraception intent, and presence of a short interpregnancy interval. …

The Number And Types Of Procedures Performed At Jeffhope Clinics, Jeremy Heard, James Plumb

Phase 1

Introduction: Procedures performed as part of the urgent care medical services provided at JeffHOPE Clinics (JHCs) are common in daily operations, but the number and types of procedures performed at each JHC have not yet been reported. The goal of this research was to provide JHCs the data needed to ensure clinic-specific evidence-based training for incoming procedures committee members, and thus ensure the highest quality patient care. The inquiry question was what are the number and types of procedures performed at each JHC?

Methods: An IRB waiver of authorization was obtained. A chart review of patients 18 years or older …

Net Therapy Effect On Chronic Pain Patients: An Fmri/Pet Imaging Study, Layla Annous, Andrew Newberg

Phase 1

Chronic pain is pain that lasts longer than 3 months or lasts longer than tissue healing should naturally take, which can limit patients’ daily activities. Chronic pain impacts 20% of people worldwide, preferentially affecting vulnerable and marginalized populations. We aimed to use fMRI/PET imaging of the brain to determine the efficacy and therapeutic use of Neuro-emotional Technique (NET) therapy for chronic pain patients. We anticipated that NET Therapy would result in decreased activity in areas of the brain associated with pain and decreased perception of pain. Patients who have been suffering chronic pain conditions were used as the experimental group …

Racial Disparities In Occupational Risks And Lung Cancer Incidence: Analysis Of The National Lung Screening Trial., Hee-Soon Juon, Alicia Hong, Marcella Pimpinelli, Madhuwani Rojulpote, Russell Mcintire, Julie A. Barta

College of Population Health Faculty Papers

The relationship between racial disparities in occupational risk and lung cancer diagnosis is not well defined. We examined occupational exposure to asbestos, silica, and other workplace chemicals, fumes, or dusts as reported in the National Lung Screening Trial (NLST). Descriptive analyses and multivariate logistic regression models were performed. Among the NLST study cohort, 3.9% were diagnosed with lung cancer. African-Americans had a higher rate of lung cancer diagnosis than White individuals (4.3% vs. 3.9%). About 28% reported at least one occupational exposure, including 6.5% exposed to silica and 4.7% to asbestos. African-Americans reported occupational exposure more frequently than White participants, …

Disparities In Sars-Cov-2 Positivity Rates: Associations With Race And Ethnicity, Harvey W Kaufman, Justin K Niles, David B. Nash

College of Population Health Faculty Papers

Numerous reports indicate that African Americans and Latinos are being affected disproportionately by coronavirus disease 2019 (COVID-19). Positivity rates have not been analyzed on scale because only 4 states report race/ethnicity as part of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. Previous studies also have had little ability to control for many known risk factors to better identify the effects of COVID-19 on racial and ethnic communities. Using test results from a large national reference laboratory database that included patients from all 50 states and the District of Columbia, this study compared positivity rates for SARS-CoV-2 nucleic acid amplification …

The Quest For Conquering Covid-19: Updates From The Laboratory, David B. Nash

College of Population Health Faculty Papers

No abstract provided.